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Sulfur mustard (SM) is an alkylating chemical warfare agent with high military significance due to its high toxicity, resistance and availability. SM was widely used in military conflicts, the last being the Iran-Iraq war with more than 100,000 Iranians exposed, one-third of whom are still suffering from late effects. The intensity of the delayed complications correlates to the extent, the area and the route of exposure. The clinical manifestations most commonly involve respiratory, ocular and dermal effects. Respiratory complications include dyspnea, cough and expectorations and various obstructive and restrictive lung diseases. Dermal complications are itching, burning sensation, blisters, dry skin, dermatitis and pigmentary changes. Ocular complications include photophobia, red eye, tearing, corneal ulcers and blindness. Although the picture remains incomplete the major mechanisms responsible for the clinical and pathological effects of SM are: DNA alkylation and cross-linking, protein modification and membrane damage in addition to induction of inflammatory mediators in the target tissues causing extensive necrosis, apoptosis and loss of tissue structure. The current report reviews long-term complications of SM exposure, focusing on new treatments tested in clinical trials conducted on humans. Such treatments include: N-acetyl cysteine, bronchodilators, corticosteroids, Interferon-gamma, furosemide and morphine for the respiratory complications. Ocular complications may entail: Invasive procedures treating corneal complication, limbal ischemia and stem cell deficiency. Treatment for dermatological complications include: anti-depressants, pimercrolimus, Unna's boot, capsaicin, phenol and menthol, Aloe vera and olive oil, curcumin and Interferon-gamma.

Background and Objectives: Sexual concerns are prevalent among ICD recipients. Our goal was to evaluate the prevalence of sexual dysfunction (SD), depression, and quality of life (QOL) in male recipients of ICD with and without shock delivery., Patients and Methods: ICD implanted males were asked to fill-out 3 self-administered questionnaires: Florida Patient Acceptance Survey (FPAS), Centre for Epidemiologic Studies Depression Scale (CES-D), and Arizona Sexual Experiences Scale (ASES). All patients were offered a referral to a sex clinic., Results: A total of 47/72 patients (65%), agreed to participate. Patients were classified into no-shock [NS] (66%) and at least one shock [S] (34%) groups. SD defined as worse than median ASES male score was found in 42.6% of the patients, 52% and 25% in NS/S groups, respectively (p = 0.08). ICD related deterioration in sexual function (SF) was reported by 71% vs. 44% of NS/S groups, respectively (p = 0.069), and by 85% of the patients with SD vs. 44.4% of the better SF group (p = 0.005). Twenty three (49%) patients were referred to a sex clinic. Depression (CES-D score= 16) was found in 36% of the study group. CES-D score mean ranks were 21 vs. 30 in the NS/S groups respectively, (p = 0.049). QOL was similar in NS/S groups. No correlation was found between SD and depression or QOL, however, depression correlates with low QOL (Pearson correlation = 0.416, p = 0.04)., Conclusions: ICD implantation seems to impair male SF. Receiving a shock might be associated with a protective effect on SF. ICD implanted males are at risk for depression S > NS. QOL was similar in NS/S groups. ICD implanted males should be screened and treated for SD and depression.