IntroductionInfertile males experience considerable psychological distress, with feelings of inadequacy, marginalization, guilt and loss ofself-esteem.ObjectivesOur study aims to investigate the impact of male infertility on men’s self-esteem and to study risk factorsfor low self-esteem.MethodsWe conducted a cross sectional, descriptive and analytical study, including 108 infertile men who presented to the laboratory of reproductive biology and the unit of assisted medical procreation of Military Hospital of Tunis between June and September 2019. For each patient, we collected sociodemographic and clinical data. We used Rosenberg scale to assess self-esteem.ResultsThe average age of participants was 36.8 years. Eleven patients had a history of varicocele (10.18%) and six of them sufferedfrom associated erectile dysfunction (5.55%). Infertility was primary in most of patients (77.8%) with an average duration of 3.32 years. 25% of patients had at least one previous failed assisted reproductive attempt. Spermogram abnormalities were found in 78.7% of patients. The mean score of Rosenberg scale was 30.68±4.35. Low self-esteem was associated with older age (p=0.006), lower educational level (p=0.019) and longer duration of infertility (p=0.022). Men who had children had better self-esteem (p=0.022). No associations were found between self-esteem and erectile dysfunction or previous failed assisted reproductive technique attempt.ConclusionsOur results show that infertility reduces men’s self-esteem, especially of patients with lower educational level and longer duration of infertility. Physician dealing with infertility should be aware of these psychosocial aspects and offer help when needed.
Objective:
To study the clinical characteristics and imaging features of breast tuberculosis (TB) and to describe treatment.
Material and Methods:
A retrospective study including all patients hospitalized in the infectious diseases department for breast TB between 1997 and 2018.
Results:
Twenty-two women, with a mean age of 39±12 years, were identified. In total, 18 patients were multiparous (81.8%). Both lump and mastalgia were the presenting symptoms in 19 cases (86.3%). Ipsilateral axillary lymphadenopathy was noted in 14 cases (63.6%). The most common finding on ultrasound was a well or poorly defined mass lesion, noted in 17 cases (77.2%), followed by fistulous tracts in seven cases (31.8%). Mammography showed focal, asymmetric breast density in 17 cases (89.5%) and diffuse in two cases (10.5%). The diagnosis was confirmed based on the presence of epithelioid cell granulomas and caseous necrosis in 13 cases (59.1%). Patients received antitubercular therapy for a mean duration of 11±5 months. The disease evolution was favorable in 20 cases (91%). There were two relapsing cases (9%).
Conclusion:
Breast TB should be considered in the differential diagnosis of young patients presenting with palpable lump with axillary lymphadenopathy, especially in endemic regions. The diagnosis confirmation usually requires an excision biopsy providing histological or bacteriological evidence.
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