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Introduction: Infertile couples frequently utilize the Internet to find various reproductive clinics and research their alternatives. Patients are increasingly using self-referral because of online information on health-care providers. The objective is to compare the image of infertility specialists to other team members on the websites of reproductive clinics. Methods: Information was gathered during November and December 2022 from two publicly accessible online registries which include the Human Fertilization and Embryology Authority located in the United Kingdom and the Society for Assisted Reproductive Technology located in the United States. We looked over every website that was accessible, paying close attention to how each team member was portrayed online. Results: We examined a total of 447 clinic websites. Only 8% of the profiles of male infertility doctors were included. Contrarily, most websites (96%), which specialize in reproductive endocrinology and infertility, feature the profiles of female infertility experts. Male infertility professionals also had significantly lower representation than other clinic employees, such as nurses (55.7%, P < 0.0001), directors of embryology laboratories (46.5%, P < 0.0001), office personnel (39.6%, P < 0.0001), and embryology specialists (29.7%, P < 0.0001). Conclusion: Although male factor infertility explains the existence of over half of all cases of infertility, urologists who specialize in male infertility are glaringly understated on websites for fertility clinics. By improving this issue, fertility clinics can draw in more patients by making all members of the care team more visible. [ABSTRACT FROM AUTHOR]

Introduction: Prostate cancer (PCa) staging is an integral part in the management of prostate cancer. The gold standard for diagnosing lymph node invasion is a surgical lymphadenectomy, with no superior imaging modality available at the clinician's disposal. Our aim in this study is to identify if a pre-biopsy multiparametric MRI (mpMRI) can provide enough information about pelvic lymph nodes in intermediate and high risk PCa patients, and whether it can substitute further cross sectional imaging (CSI) modalities of the abdomen and pelvis in these risk categories. Methods: Patients with intermediate and high risk prostate cancer were collected between January 2015 and June 2019, while excluding patients who did not undergo a pre-biopsy mpMRI or a CSI. Date regarding biopsy result, PSA, MRI results, CSI imaging results were collected. Using Statistical Package for the Social Sciences (SPSS) version 24.0, statistical analysis was conducted using the Cohen's Kappa agreement for comparison of mpMRI with CSI. McNemar's test and receiver operator curve (ROC) curve were used for comparison of sensitivity of both tests when comparing to the gold standard of lymphadenectomy. Results: A total of 143 patients fit the inclusion criteria. We further stratified our patients into according to PSA level and Gleason score. Overall, agreement between mpMRI and all CSI was 0.857. When stratifying patients based on Gleason score and PSA, the higher the grade or PSA, the higher agreement between mpMRI and CSI. The sensitivity of mpMRI (73.7%) is similar to CSI (68.4%). When comparing CSI sensitivity to that of mpMRI, no significant difference was present by utilizing the McNemar test and very similar receiver operating characteristic curve. Conclusion: A pre-biopsy mpMRI can potentially substitute further cross sectional imaging in our cohort of patients. However, larger prospective studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: Male infertility is the main issue that accounts for 50% of infertility in couples. There are about 25% of men suffering from nonobstructive infertility with chromosomal abnormalities and/or microdeletions of the long arm of the Y-chromosome. Materials and Methods: A retrospective chart review was performed on 241 men who performed Y-chromosome microdeletions and karyotype testing. Results: Six patients had microdeletions. Three patients had AZFc microdeletion, of which one had both AZFc/d microdeletions. Three patients had AZFb/c microdeletion. There was no AZFa microdeletion. One out of the six patients had abnormal karyotype (mos, X[17]/46, XY[13]). Four patients were azoospermic, two had severe oligospermia, with sperm count <5 million/ml, and two patients had small size testicles on ultrasound. All were advised microsurgical testicular sperm extraction. Three were done, and one was successful resulting in sperm retrieval. The most common karyotype abnormalities were 47, XXY (Klinefelter syndrome) in 27% of cases. Conclusion: Laboratory genetic testing is advised for males with nonobstructive infertility. Any abnormal finding can yield substantial consequences to assisted reproductive techniques or fertility treatment. It can offer a stable diagnosis for those with infertility issues. It is important to conduct counseling and routine genetic testing before assisted reproductive techniques. [ABSTRACT FROM AUTHOR]

Background: Burnout is a common issue among residents across the globe. Although several attempts were made to propose better working hours for residents, burnout is still prevalent as depicted by several studies. Objectives: The aim of the paper is to review several worldwide studies related to burnout in residents and propose potential suggestions. Methods: The following paper summarizes studies pertinent to burnout in residents from different countries categorized into three main regions: North and South America, Europe, and Middle East. The studies were collected from February 2018 to March 2019. Results: Numerous studies across the world have revealed high rates of burnout in residents during the last decades. Conclusions: Various awareness and wellness programs, as well as professional counseling sessions, are proposed to help residents overcome burnout. [ABSTRACT FROM AUTHOR]

A common health-care problem worldwide, urinary tract infection (UTI), represents a disease of significant impact on every country's economy, being the most common cause of hospitalization among elderly people and the most common cause of antibiotic prescription in primary care. Diagnosing and managing upper and lower UTI have always been a challenge to physicians, given its high prevalence, risk of recurrence and improper treatment, and the fact of worldwide increase in antibiotic resistance, necessitating implementation of a proper antibiotic stewardship. Urinary infections are twice more likely to occur in females compared to males and its prevalence increases with increasing age. The following is a comprehensive review paper about UTI in females, discussing the various factors leading to a complicated infection. The various etiologies and microbiologies of UTI are also highlighted. In addition to various usual antibiotic regimens for treating UTI, a significant number of nonantimicrobial treatment modalities are highlighted and described in this manuscript, including the novel use of intravesical antibiotics and vaccines for suppression treatment. Finally, a pathway is suggested for the proper diagnosis and treatment that ensures antibiotic stewardship in order to decrease long-term complications. [ABSTRACT FROM AUTHOR]

Introduction: The goal of the study is to assess burnout among postgraduate medical trainees, evaluate the association with sociodemographic features and offer potential wellness strategies for leaders responsible for their education, training, management, and wellbeing., Methods: The Oldenburg Burnout Inventory was used. The web-based, voluntary, and anonymous survey was sent to postgraduate medical trainees from various specialties and all years of training in a tertiary medical center in Beirut, Lebanon. Additional questions were added after the survey regarding reporting channels for burnout and possible interventions for wellbeing., Results: The total number of valid responses are 188. The prevalence rates of high burnout are 37.2% for disengagement and 51.1% for exhaustion. There is a significant difference between the mean of exhaustion and gender ( p = 0.003). There is a significant difference between the mean of disengagement and year of training ( p = 0.017). There is a significant difference between the mean of exhaustion and year of training ( p = 0.029). There is a significant difference between the frequency of disengagement and year of training ( p = 0.027)., Conclusion: The study reveals how postgraduate medical training program is impacted by the existing challenges from social, health, and financial standpoint, along with the instabilities encountered such as multiple wars and port blast in 2020 and how these variables aggravate burnout. Burnout severely impacts the education and training of PGMT and promoting wellbeing can help reverse the process. Findings contribute to establishing effective strategic interventions for leaders in healthcare management to adopt., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yacoubian, Demerouti, Degheili and El Hajj.)