No abstract

Highlights Rarity of this presentation. Controversies on treatment. Controversies about diagnosis.

There is a paucity of osteometric standards for sex estimation from unknown skeletal remains in Jordan and the sexual dimorphism of the sternum has not yet been investigated. The aim of this study was to evaluate the sexual dimorphism in sternal measurements using 3D multidetector computed tomography (MDCT), and to assess their reliability for sex estimation in a Jordanian population. A total of 600 MDCT scans (300 males and 300 females) were used and a total of 8 sternal measurements were studied (manubrium length, sternal body length, combined length of manubrium and body, corpus sterni width at 1st and 3rd sternebrae, sternal index and area). Sexual dimorphism was evaluated by means of discriminant function analyses. Significant sexual dimorphism was found mainly in middle-aged and older adults. Including all subjects, multivariate, and stepwise functions gave an overall accuracy of 83.0% and 84.0%, respectively. Additionally, multivariate and stepwise analyses were conducted separately for each age group. The accuracy of sex estimation in multivariate analysis (all variables) varied from 63.2% in the young, and 83.7% in the middle adults to 84.9% for older adults. In stepwise analysis, the highest accuracy rates were provided by only sternal area in young adults (81.6%), and sternal area combined with sternal body length in middle-aged and older adults (84.2% and 85.3%, respectively). The best sex discriminator using univariate analysis (single variable) was sternal area followed by sternal body length (84.0% and 80.8% respectively). Notably, univariate analyses for most variables gave relatively higher classification accuracies in females but were poor at predicting males in the sample (sex bias ranged between −6.4% and −20%). Our data suggest that dimorphism in the human sternum increases with advancing age and separate discriminant functions are needed for each age group in Jordanians. In addition, multivariate and stepwise analyses using sternum gave higher classification accuracies with comparatively lower sex biases compared to univariate analyses.

Background and objective: Psoriasis is a chronic inflammatory skin condition characterized by thick silvery plaques, commonly involving the elbow, knees, lower back, and scalp. Psoriasis also affects the reproductive systems of patients. Males with untreated psoriasis are at risk of impaired fertility due to chronic systemic inflammation, which might affect the hormonal profile and sexual accessory glands. In females, having psoriasis does not affect the chances of getting pregnant. This study aims to assess the effect of psoriasis, as a chronic inflammatory condition, on sex hormone profiles and seminal fluid parameters. Methods: 87 male patients aged 18−50 with psoriasis who fulfilled the inclusion criteria were included in the study and matched with healthy controls. Demographic and clinical data, including age, severity, duration, and body mass index (BMI) were recorded. All patients underwent a complete physical exam, including a skin and andrological exam, in addition to ultrasound scrotum and seminal fluid analysis. Blood sample tests were conducted for a complete hormonal profile, including luteinizing hormone (LH), follicular stimulating hormone (FSH), testosterone, and estradiol. Results: The mean age of the case group was 39.5 ± 5.6 years, and the mean BMI was 24.0 ± 2.2. The mean duration of psoriasis was 6.5 ± 3.5 years. The mean levels of testosterone and LH of cases were lower than those of controls, whereas FSH and estradiol were abnormally higher among case groups. Sperm concentration, normal sperm motility, and normal sperm morphology were also found to be lower than in the case group. Age, psoriasis area, and severity index (PASI) scores were significant predictors of sperm concentration (P = 0.000). The BMI was negatively correlated with sperm concentration (−0.249, P = 0.01), motility (−0.198, P = 0.05), and morphology (−0.205, P = 0.05). A negative correlation was found between the PASI score and sperm concentration (−0.519, P = 0.01). Conclusion: The evaluation of seminal fluid analysis and hormone profiles among psoriasis patients showed marked variability. However, it was evident that the levels of sex hormones and seminal parameters were lower among patients with psoriasis than the healthy controls; this may indicate the possibility of developing sexual dysfunction and infertility among patients with untreated psoriasis. The level of estradiol was found to be abnormally high among psoriasis cases, which may account for a possible compensatory mechanism in ongoing sexual dysfunction among psoriasis patients.

Introduction Septic knee arthritis after elective arthroscopic procedures is a rare surgical emergency, with Pseudomonas aeruginosa even more rarely causing the infection. The treatment by arthroscopic debridement and lavage with diluted Povidone-Iodine has potential benefits that may be useful in improving the prognosis for patients. This case report discusses the potential benefits of using antiseptics like Povidone-Iodine in the washout of the affected joint. Presentation of case We present a patient with post arthroscopic septic knee arthritis caused by P . aeruginosa treated successfully by arthroscopic synovectomy and washout with normal saline and diluted povidone‑iodine, and prolonged antimicrobial therapy. Discussion Preceding reports of P . aeruginosa suggest intraoperative factors, postoperative factors, and host factors that may lead to this uncommon infection. There is controversy over the optimal management regarding arthroscopic versus open debridement, and the choice of the irrigating fluid. Conclusion The use of antiseptics like Povidone-Iodine in the washout procedure may lead to improved outcomes if used for a short controlled period of time and followed by copious irrigation with saline. Further studies must be done to determine the efficacy and risk-to-benefit ratio of this method.