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Treatment of acute leukemia is gradually moving away from a "one-size-fits-all" approach, as scientific and clinical advances expand the arsenal of available targeted therapies. One of the recent additions is the group of menin inhibitors; oral, selective, small molecules that disrupt the interaction between the chromatin adapter menin, and an epigenetic regulator, the lysine methyltransferase 2A (KMT2A) complex. Two susceptible leukemia subtypes have been identified: (i) acute myeloid leukemia with a mutation in nucleophosmin 1 (NPM1), and (ii) any acute leukemia, myeloid or lymphoid, with a translocation resulting in the rearrangement of KMT2A. These leukemias share a distinct genetic expression, maintained by the KMT2A-menin interaction. Together they account for approximately 40% of patients with acute myeloid leukemia and 10% of patients with acute lymphoblastic leukemia. This spotlight review follows the journey of revumenib, as a representative of menin inhibitors, from bench to bedside. It focuses on the pathophysiology of leukemias sensitive to menin inhibition, delineation of how this understanding led to targeted drug development, and data from clinical trials. The important discovery of resistance mechanisms is also explored, as well as future directions in the use of menin inhibitors for treating leukemia.

Background: To evaluate children's and parents' practice and attitude toward oral hygiene and their knowledge about oral hygiene., Methods: This cross-sectional questionnaire-based study was conducted on randomly selected children who were seen in the Pediatric dentistry clinic in different Royal Medical Services hospitals. A modified questionnaire was used to gather information from the child or parents to gather the child's demographic data and evaluate the children's and parents' practice and attitude toward oral hygiene, their knowledge about oral hygiene, information about the parent and family, and oral examination, the questionnaire questions' reliability and validity were assessed by test-retest and Cronbach's Alpha test., Results: Three hundred seventy four patients were included, and the average age was 5.06 ± 3.58 SD years. Children's and parents' practice toward oral hygiene was inadequate where the majority (83.3%) brush their teeth occasionally, change their toothbrushes infrequently, apply toothpaste inappropriately, and less than half (47.2%) clean their tongue after teeth brushing. A significant number (73%) of candidates were aware that oral health has a significant role in their general health and can prevent dental problems. Participants agreed that maintaining a healthy mouth is an individual responsibility. The majority of participants came from large family size (the average family members 6.1 ± 1.7 SD) who live below the poverty line., Conclusion: Our study demonstrated that awareness of oral health status in children below the age of 12 was poor. Although their oral knowledge was good their attitude and behavior were inadequate. These findings urge the need for expanded, well-organized, preventive educational programs that include school's syllabus, house visits, and hospitals for parents and children alike., (© 2024. The Author(s).)

Although allogeneic hematopoietic cell transplantation (allo-HCT) remains the backbone of curative treatment for the majority of fit adults diagnosed with AML, there is indeed a subset of patients for whom long-term remission may be achieved without transplantation. Remarkable changes in our knowledge of AML biology in recent years has transformed the landscape of diagnosis, management, and treatment of AML. Specifically, markedly increased understanding of molecular characteristics of AML, the expanded application of minimal/measurable residual diseases testing, and an increased armamentarium of leukemia-directed therapeutic agents have created a new paradigm for the medical care of patients with AML. An attempt is herein made to decipher the decision to proceed to transplant for patients with AML in first complete remission on the basis of the current best available evidence. The focus is on factors affecting the biology and treatment of AML itself, rather than on variables related to allo-HCT, an area characterized by significant advancements that have reduced overall therapy-related complications. This review seeks to focus on areas of particular complexity, while simultaneously providing clarity on how our current knowledge and treatment strategies may, or may not, influence the decision to pursue allo-HCT in patients with AML.

Aim: The objective of this study was to determine whether penile Doppler ultrasonography (USG) examinations, combined with the administration of intracavernosal vasoactive agents, were correctly performed as a second-line diagnostic method with the proper indications in a select patient group., Methods: A total of 200 patients who underwent penile Doppler ultrasounds in our clinic were included in the study. Patients' demographic data were collected, information about their medical-sexual history was taken, physical examinations were performed, and laboratory analyses were conducted. Patients were informed in detail about the process, and their consent was given prior to the study. Procedure outcomes and complications were also recorded. The relationship of vasculogenic pathologies was analysed, and the rate of abnormal results and complications was compared with the existing literature., Results: Following the investigations, abnormal results were found in 24.5% of patients, while this rate was 6.8% in patients under the age of 40. Arterial insufficiency was found in 31 patients and venous insufficiency in 18 patients. Five patients had both pathologic conditions. No statistically significant correlation was found between arterial insufficiency and age, while venous insufficiency was significantly correlated with age (p=0.006)., Conclusion: Penile Doppler ultrasounds should only be ordered for a carefully selected patient group. Ordering ultrasounds without a proper indication can result in unnecessary labour and financial loss, as well as an increase in invasive procedures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Salman et al.)

Objective: To our knowledge, there is no study in the literature so far to investigate the effect of silodosin therapy on the ureteric jet parameters. Therefore, the objective of this study was to investigate the effect of silodosin 8 mg/day for medical therapy of lower urinary tract symptoms (LUTS) on the color flow Doppler parameters and patterns of the ureteric jets., Patients and Methods: This prospective cohort study included 34 male patients who presented to our outpatient clinic with the complaint of lower urinary tract symptoms (LUTS) and received silodosin 8 mg once a day as medical therapy. In the color flow Doppler examinations, ureteric jets were observed and mean flow rate (JETave), maximum flow rate (JETmax), flow duration (JETdura), and flow frequency (JETfre) were examined. In addition, patterns of the ureteric jets (JETpat) were also evaluated., Results: There was no statistically significant difference in JETave; however, JETmax, JETdura and JETfre were significantly higher at post-silodosin treatment. The patterns of ureteric jet were significantly changed following a 6-week treatment with silodosin (p<0.001). One ureter in the monophasic pattern group (9.1%) and three in the biphasic group (13.6%) turned to polyphasic pattern after silodosin use. None of the patients developed side effects that would require discontinuation of the drug., Conclusions: Six-week silodosin 8 mg/day therapy for the treatment of LUTS in men changed the parameters and patterns of ureteric jets at follow-up examination. Furthermore, comprehensive studies are needed on this issue.

We aimed to compare the efficacy of three tadalafil regimens for patients with type-2 diabetes mellitus (DM), at least one microvascular complication and erectile dysfunction (ED). Sixty patients attending our urology clinic with erectile problems and diagnosed with ED, having DM for at least 5 years, and at least one microvascular complication linked to DM were identified and randomly divided into three groups-Group I: used 5 mg tadalafil daily, Group II: used 20 mg tadalafil 2 h before sexual relations twice a week and Group III: used 5 mg tadalafil daily and an extra 15 mg tadalafil 2 h before sexual relations twice a week. After treatment, the median International Index of erectile function (IIEF-5) scores were significantly higher in Group III (15) compared to Groups I (8.5, p = 0.01) and II (9, p = 0.035). The groups were comparable in terms of the percentage of positive responses to the sexual encounter profile (SEP) 2 and the Global Assessment Questionnaires (GAQ)-1. However, the percentage of patients with positive responses to SEP-3 (20%, 40% and 75%, respectively) (p = 0.002) and GAQ-2 (20%, 45% and 75%, respectively) (p = 0.002) was significantly higher in Group III. Therefore, using a combination treatment (daily 5 mg + 15 mg when needed) to treat erectile function in patients with DM-related ED in the first stage may be more efficient with the same reliability and greater patient satisfaction., (© 2022 Wiley-VCH GmbH.)

Consolidation therapy forms the backbone of post-remission therapy for AML and is uniformly accepted as an integral part of therapy designed to achieve long-term survival. The need for post-remission therapy was initially described over four decades ago and has since undergone many variations in terms of dosage, number of cycles and intensity of therapy. There is much empiricism in the current understanding of consolidation therapy and much that has not been rigorously studied. This review will consider the many aspects of consolidation therapy, focusing on the number of cycles, differences between young and older adults, first and subsequent remission as well as therapy prior to an allogeneic transplant. Emphasis will be given to differentiate strategies that are clearly evidence-based from those that have been incorporated into standard of care while bypassing the need for rigorous data-driven approaches. Finally, consideration will be given to the current ability to assess the minimal measureable residual disease and the impact that this may have on therapeutic paradigms, including superseding many of the time-honored prognostic features., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: Women often feel embarrassed about urinary incontinence, hesitate to see a doctor and search the internet to gain information on the disease. The objective of this study was to evaluate the quality of the most viewed YouTube™ pertaining to female urinary incontinence., Material and Methods: Sixty videos that met the inclusion criteria were assessed by two urologists through Quality Criteria for Consumer Health Information (DISCERN), Journal of the American Medical Association (JAMA) and Video Power Index (VPI) scoring systems. Videos' image type, video uploaders, general content, length, view counts, date of uploading, comment, like and dislike counts were also recorded and analyzed., Results: Forty videos included real and 20 animation images. Nine videos were uploaded directly by physicians, 32 videos by health channels, 14 videos by hospital channels, 2 videos by herbalists and 3 videos by other sources. The mean comment, like and dislike counts of the videos were found as 49.4 ± 172.9, 642.5 ± 2,112.9 and 66.7 ± 192.4. The mean DISCERN score was found as 38.2 ± 11.5, JAMA score as 1.4 ± 0.6 and VPI score as 85.1 ± 12.1. There was no significant difference between physicians and non-physicians and between real and animated videos in terms of DISCERN and JAMA scores (p>0.05)., Conclusions: The quality of the videos on YouTube™ pertaining to female urinary incontinence was at an average level. Healthcare professionals should be encouraged for uploading more accurate quality health related contents. Policy makers should develop policies for supervision of the videos uploaded on the internet., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest regarding this study., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Radical cystectomy (RC) with urinary diversion (UD) is still the standard treatment method for muscle-invasive bladder cancer. Type of UD is determined according to some characteristics of the patient and the tumor. Even in the most experienced hands, alternative scenarios may require an alternative diversion, including emergency UD for complications requiring immediate take down of the initial UD, tumor recurrence impacting the urinary tract or the UD, progressive impairment of renal function (in patients with a continent UD), malfunction/complications of the initial UD, and patient dislike of a stoma. We report a case of undiversion with natural history and outcome in a patient who had previously undergone RC and ileal conduit performed.

Objectives: Sexual dysfunction occurs commonly in individuals with end-stage renal disease. Chronic renal failure as well as the treatments used for it generally has a negative impact on sexual function with a subsequent increase in the risk of depression. There is scarcity of published data on female sexual dysfunction and the degree of improvement in patients on hemodialysis (HD) and transplant (Tx) recipients. The aim of this study was to compare the sexual function and degree of depression in HD and Tx patients with control group. For this purpose, we used the validated Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI)., Materials and Methods: A total of 23 renal Tx, 29 HD, and 30 control patients were enrolled in the study. HD patients were required to be undergoing HD for ≥6 months, and for renal Tx recipients, the Tx had to be performed ≥6 months before study entry. All women underwent a general and urogynecologic examination. Demographic and clinical variables were documented. FSFI and BDI scale scores were compared among groups., Results: The rates of female sexual dysfunction were 56.7%, 89.7%, and 73.9% in the control, HD, and Tx, patients respectively. Total FSFI scores in HD group were significantly lower than those in Tx and control patients (P < .05). FSFI scores improved significantly in the Tx group. BDI scores in HD and control subjects were 23.24 and 14.17, respectively, with a significant difference between the 2 groups (P < .005). BDI score in the Tx group was 16.65 and the difference was statistically insignificant., Conclusions: This preliminary study documented that successful Tx may positively affect sexual life in women with chronic renal failure. A diagnosis of female sexual dysfunction should be made routinely in patients with chronic renal failure., (Copyright © 2017 Elsevier Inc. All rights reserved.)