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Objectives: This study is aimed at assessing the therapeutic efficacy of photobiomodulation therapy (PBMT) for the management of recurrent herpes labialis (RHL) by evaluating both pain and clinical recovery., Material and Methods: A randomized, double-blind, controlled trial was conducted on 40 patients with RHL, and they were randomly divided into two groups, where 20 patients received treatment with PBMT (650 nm, 100 mW, 4.7 J/cm 2 ), continuous mode, for 120 s, and placebo cream, while another 20 patients (control group) were treated with acyclovir cream 5% (5 times/5 days) and passive laser. Pain was assessed at five different times. The day when the complete disappearance of the pain was observed and the day when the crust fell off spontaneously were also recorded., Results: The pain level in the control group was significantly higher than that in the PBMT group after the second application of the laser, while the differences were not significant between the two groups at other times. The pain in the PBMT group disappeared faster than that in the control group, but the difference was not significant in terms of clinical recovery., Conclusions: Photobiomodulation therapy of herpes labialis reduced pain significantly faster than acyclovir, but there was no difference in healing time between the groups in light of the parameters used in this study., Clinical Relevance: PBMT is a promising treatment that may be an effective alternative to acyclovir in the management of recurrent herpes labialis., Trial Registration Isrctn: com ID: ISRCTN87606522., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To evaluate the role of botulinum toxin in treating erectile dysfunction as a novel treatment strategy avoiding morbid and irreversible surgeries., Methods: A systematic review of literature was conducted from January 1990 through July 31, 2021. Search engines used included PubMed, Embase and Medline databases, to identify studies investigating botulinum toxin in erectile dysfunction, published in English. Seven studies in total were included in our review including two pre-clinical studies. A meta-analysis was performed on three outcomes included commonly in at least two studies. Among the different parameters assessed were, Erection Hardness Score (EHS), Peak Systolic Velocity in cavernosal artery (PSV) and the Sexual Health Inventory for Men (SHIM) score., Results: A clear benefit was noted for intracavernosal injection (ICI) of botulinum toxin (BoNT-A) on PSV with a mean difference (MD) of 10.82 [4.99, 16.65] and a heterogeneity of I2=61%. EHS results favored BoNT-A as well over placebo with a MD of 0.7 [0.47, 0.93] and heterogeneity of I2=94%. As for SHIM score, with a heterogeneity of I2=85%, no statistically significant difference was found (MD 0.58 [-0.03, 1.20])., Conclusion: Our review and meta-analysis have shown statistical significance for the benefit of BoNT-A in terms of EHS and PSV. However, this statistical significance should be interpreted in light of the given limitations: small sample size, heterogeneity in data collection, patient selection bias, and clinical significance of the measured differences. ICI of BoNT-A should currently be limited to clinical studies to further elucidate its clinical benefit., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: We came up with a dynamic anatomical study intended to validate the safety of intercostal approach used by our center to access the upper pole of the kidney during percutaneous surgery., Materials and Methods: A total of 101 patients presenting randomly to the radiology department for CT evaluation of the abdomen and superior pelvis were involved in this study. Deep inspiration and expiration sequences in the prone position were evaluated to establish the location of the parietal pleura in relation to different anatomical landmarks. Three-dimensional reconstruction was performed to simulate the access needle course through the retroperitoneum., Results: Our data show that the position of parietal pleura is invariably higher on the right side irrespective of anatomical relation or respiratory changes. Higher position of the parietal pleura was noted in all considered landmarks upon full expiratory sequences. Using the midclavicular line as a landmark, our data show that on the right side, the parietal pleura was higher than the 10th intercostal space (ICS) in 100% of patients. Going up to the level of the ninth and eighth ICS, the pleura is higher in 89.1% and 66.3% of patients, respectively. Moreover, on the left side, the level of the parietal pleura was higher than the 11th ICS in 100% of patients. Reaching the 10th ICS, the parietal pleura still is higher in 92.07% of cases. Going up to the ninth ICS reduces the margin to 64.35% and using the eighth ICS would convey a margin of 24.7%., Conclusions: Supracostal access for percutaneous nephrolithotomy carries a risk of pulmonary complications, limiting its use worldwide. We have shown in this study that using the differences in inspiration and expiration along with the right anatomical landmarks could substantially lower the risk of complications. However, regardless of the side or landmark used, supracostal access is safe in >90% of cases.