Serum Resistin levels in bladder cancer

Background: Adipokines play a role in pathogenesis and progression of certain cancers. Resistin is an adipokine with diverse findings in disease development and progression. The present study aimed to determine Resistin serum levels in bladder cancer cases in order to identify novel tumor markers.Methods: This research was based on a case-control study, including 45 patients with bladder cancer and 45 healthy controls. Resistin levels were measured by ELISA in both groups. Height and weight were measured and body mass index (kg/m2) was calculated.Results: Resistin levels were significantly different between bladder cancer and the control group (p<0.0001) but Resistin levels in different stages were not significantly different. Also there was no correlation among sex, age, body mass index and the serum Resistin levels.Conclusions: These results suggest that changes in serum Resistin levels play an important role in the diagnosis and could act as a biomarkers for bladder cancer.

Effects of monosodium glutamate on testicular structural and functional alterations induced by quinine therapy in rat: An experimental study

Background: Quinine (QU) as an anti-malarial drug induces alterations in testicular tissue. Toxic effects of monosodium glutamate (MSG) on the male reproductive system have been recognized. Objective: To investigate the impact of MSG administration on the intensity of gonadotoxicity of QU. Materials and Methods: Sixty eight-wk old Wistar rats weighing 180-200 gr were divided into six groups (n = 10/each): the first group as a control; the second and third groups received low and high doses of MSG (2 & 4 gr/kg i.p.), respectively, for 28 days; the fourth group received QU for seven days (25 mg/kg); and in the fifth and sixth groups, QU was gavaged following the MSG administration (MSG + QU) from day 22 to day 28. Serum testosterone and malondialdehyde (MDA) levels were measured. Testes samples were prepared for tissue MDA levels, histomorphometry, and immunohistochemistry of p53. Sperm analysis was performed on cauda epididymis. Results: Serum and tissue MDA levels were increased in treated groups compared to the control group. This increment was higher in the MSG + QU groups. The testosterone levels were reduced significantly (p < 0.0001) in all treated groups. In addition, histomorphometric indices and tubular epithelium population were reduced significantly (p < 0.0001) in QU, MSG + QU, and consequently in high-dose MSG, QU, MSG + QU groups. All spermatogenic indices were reduced in the treated groups, particularly in the MSG + QU groups. Sperm motility and viability indices were reduced significantly (p = 0.003) in the MSG + QU groups. Finally, the overexpression of p53 was observed in the MSG + QU groups. Conclusion: The administration of MSG before and during QU therapy may intensify testicular tissue alterations. Key words: Male reproductive system, Monosodium glutamate, Quinine hydrochloride, Rat

Surgical Management of Vesical Stones in Children: A Comparison Between Open cystolithotomy, Percutaneous Cystolithotomy and Transurethral Cystolithotripsy with Holmium-YAG Laser

Introduction: Bladder stone in children is rare but is more common in developing countries. In recent years, the urologists have trend to minimal invasive approaches. The aim of this study, was to compare the outcomes of surgical bladder stone management in our single tertiary center.Methods and materials: The 159 children younger than 18 years with vesical stones treated during January 2000 to January 2015 in Shohada e Tajrish hospital, Tehran, Iran that 146 subjects entered to the study. According to type of intervention, patients stratified to three groups. First group was included 80 patient’s that open cystolithotomy(OCL) was done for them, second group, 39 patients who underwent percutaneous cystolithotomy(PCCL)and third group,27 patients who treated by transurethral cystolithotripsy with holmium-YAG laser(TULL). Demographic data, operation time, hospital stay, and post operation complications were extracted and compared between groups.Results: Mean age was 8.3±5.1 years (8.6±5.1, 6±4.2 years for boys and girls, respectively). Mean stone size was 2.76±1.07 cm that was not significant between three groups but it was larger in OCL group. Mean operative time was 29.15(±7.12) min that in separate, mean operative time in TULL was significantly higher than PCCL and OCL respectively (36.3±5.97, 30.54±5.27 and 26.06±6.32 min/P:0.000). Mean hospital stay in OCL group was 3.55±1 day that was higher than PCCL and TULL groups significantly (P=0.000).Conclusion: based on our study, Ho:YAG lithotripsy is a safe with high success rate minimally invasive management method for children bladder calculi if proper equipment was available and done in expert hands

Is Holmium Laser an Appropriate Modality to Treat Genital Warts?

Introduction: Genital warts in young adults aged 18-28 years are very common. Several approaches are routinely used in the treatment of warts, viz., medical treatment (podophyllin and trichloroacetic acid), conventional surgery (excision or electrocautery), cryotherapy, and laser treatment. Because of high recurrence rates after treatment, complications and long duration of treatment, newer modalities have been developed. One of these newer methods is laser, which has been used in several urologic diseases. However, there are only a few studies about use of Holmium laser for treatment of genital warts. This retrospective study compared the success rate of Holmium laser with other available treatments for genital warts.Methods: Between October 2011 and May 2016, 142 patients with genital warts attended the urology clinics at Shohada-e-Tajrish hospital in Tehran, Iran. Out of these, a total of 101 patients were included in this study consisting of 42, 39, 11 and 9 patients treated with cryotherapy, laser, conventional surgery and podophyllin respectively.Results: The most successfully cleared lesions were seen in the holmium laser treatment group (P = 0.001). The lowest recurrence rate was observed in the holmium laser treatment group (P = 0.001). 17 patients had one of these following problems: dysuria, initial hematuria or a change in the force and caliber of their urinary stream that after physical examination showed them to have a meatal wart. These patients then underwent cystoscopy up to urinary sphincter. All of them in addition to the meatus wart had a penile shaft lesion(s). Thirteen patients had meatal lesions, 9 of whom received holmium laser therapy and 4 patients were treated with electrocautery. Based on routine follow up after treatment, none of the patients treated with holmium laser had urinary stricture, but one case treated with electrocautery returned with a penile urethral stricture.Conclusion: This study showed that treatment with Holmium laser has the highest clearance rate (92.2%) and lowest recurrence rate (14.3%) compared to other available treatments in this study. It may be concluded that holmium laser is a safe and effective treatment for genital warts with a low rate of recurrence

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

Introduction: Transurethral lithotripsy (TUL) is an appropriate treatment for ureteral stones and is usually used for stones in the middle and lower part of the ureter. Different devices such as Holmium laser, stone basket and stone cone exist to prevent any fragments from retropulsion during TUL. The present study aims to compare the advantages and disadvantages of the Holmium laser, stone basket and stone cone. Methods: A retrospective study was conducted from September 2016 to January 2018 comparing various TUL methods in 88 subjects with proximal ureteral calculi. The study participants were devided into four matched groups. The first one included 20 patients undergoing TUL with no device (Group 1), the second group included 22 patients undergoing TUL while using the stone retrieval basket, the third group included 18 patients undergoing TUL while utilizing the stone cone and the fourth group included 28 patients undergoing TUL while using Hol-YAG laser. Results: A residual stone ≥ 3 mm was recorded in 15.9% of the patients. stone free rate were seen in 100%, 90.9, 83.3%and 55% in Holmium laser group, retrieval basket group, stone cone group and no device group respectively(p:0.001). Lowest rate of surgery complications including ureteral perforation, Post-operative fever and mucosal damage between 4 groups (p: 0.003) and highest time of surgery (p: 0.001) belong to laser group. If we want to ignore the laser group, success rate for lithotripsy was better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone. Conclusion:We can safely conclude that laser significantly help to prevent stone migration during TUL. If we want to ignore the laser group, success rate for lithotripsy was significantly better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone

Machine Learning Approaches to predict Intra-Uterine Insemination Success Rate- Application of Artificial Intelligence in Infertility

Introduction: Assisted Reproductive Technology (ART) has been widely utilized for infertility management. Despite its low success rate, Intra-Uterine Insemination (IUI) is one of the first alternatives and most important approaches regarding many cases of infertility treatment. Given the numerous influencing factors and limitations associated with time and resources, the development of a reliable model to predict the success rate of ART methods can significantly contribute to decision-making processes. Materials and methods: We reviewed the demographic, clinical, and laboratory data regarding 157 IUI treatment cycles among 124 women using their partner’s sperm from May2017 to June2019. Primary outcome measures were clinical pregnancy and live birth. Some prediction models were constructed and compared to the logistic regression analysis. Results: Woman’s mean age was 30.1 ± 5.2 years and the infertility had a female cause in 24.3% of the cases, male cause in 32.6% of cases, and combined causes in 32.6% of the cases. Concerning the first IUI cycle, the clinical pregnancy rate per cycle was 16.9% (N= 21). Data were prepared according to cross-industry standard process for data mining (CRISP-DM) methodology, and the following models were fitted to the data: J48 Decision Tree, Perceptron Multilayer (MLP) Neural Network, Support Vector Machine (SVM) with radial basis function (RBF) kernel, K-Nearest Neighbors (KNN) with one neighborhood, and Bayesian Network. J48 Decision Tree, with a sensitivity of 95% and specificity of 98%, had the most optimal performance, and the KNN model was the weakest one. Conclusion: To predict the results of IUI as a simple and less invasive therapy for infertile couples, some models were applied based on artificial intelligence and J48 Decision Tree was recommended

Characteristics of Traumatic Urogenital Injuries in Emergency Department; a 10-year Cross-sectional Study

Introduction: Urogenital system injuries (UGIs) are seen in 10% of adult cases with multiple trauma. Although UGIs are rarely life threatening, they can cause major long-term morbidities. This study aimed to evaluate the characteristics of traumatic UGIs in patients who were referred to emergency department following multiple traumas.  Methods: This retrospective cross-sectional study was conducted on multiple trauma patients who were presented to emergency department during a 10-year period (2008-2017). All patients with kidney, ureter, bladder, urethra, or external genitalia injuries were studied. The patients’ data were extracted from their clinical profiles. Results: Out of the 13598 admitted patients in our trauma center, UGIs were seen in 267 (1.9%) cases. The mean age of patients with UGIs was 27.3 ± 6.1 years (74.15% male).  The highest incidence of UGI was seen in those aged between 21 and 30 years (39.7%) and motorcycle accidents (49%) was the most frequent cause of trauma. 221 patients had an unstable situation and were emergently transferred to operation room (13.57% with traumatic kidney injury). The most common injured sites of urogenital system were kidney with 155 (58%) cases, followed by external genitalia with 91 (34.1%) cases. 77.5% of cases were managed conservatively and the rest (22.5%) underwent surgical procedures. Conclusion: UGIs comprise a low percentage (2%) of traumatic injuries, which are mostly caused by blunt trauma due to road traffic accidents. Kidney is the most common injured organ and UGIs mostly happen in young ages

Primary Signet-Ring Cell Carcinoma of the Urinary Bladder Successfully Managed with Radical Cystectomy in a Young Patient

Primary signet-ring cell adenocarcinoma of bladder is a rare neoplasm, usually seen in middle age adults. We report the case of an 18-year-old man who presented with intermittent gross hematuria. Computed tomography imaging showed multifilling defects in the bladder. The patient underwent a transurethral resection of the bladder tumor. Histological findings were consistent with poorly differentiated mixed mucinous and signet-ring cell adenocarcinoma. We ruled out other possible origins of tumor by gastrointestinal endoscopy and colonoscopy. The patient was treated with radical cystectomy with prostate and seminal vesicle sparing technique and orthotopic diversion using “W” ileum pouch with pelvic lymphadenectomy to the bifurcation of the aorta was done. Six-month follow-up of patient showed normal conditions without metastatic spread or any recurrence

The Study of the Demographic and Clinical and Laboratory Findings in Naltrexone Poisoning Patients Admitted to Razi Hospital, Rasht, During 2007-08

Background: Naltrexone is a competitive opioid receptor antagonist blocking the euphoric effects of exogenous opioids. When used concomitantly with opioids, naltrexone causes severe withdrawal symptoms. The main aim of the study is to determine the symptomatology and outcome of patients who consumed naltrexone in conjunction with an opioid substance. Methods: This cross-sectional study was performed on the patients hospitalized with history of naltrexone usage coincided with opioid substances at Razi Hospital, Rasht, Iran. The collected data were demographic information, abuse information, clinical signs and symptoms, laboratory findings, and therapeutic measures taken. Data analysis was performed by descriptive tests using SPSS software version 16. Results: The mean age of the patients was 33.7±10.2. The majority of the cases were male (95.6%) and urban (96.7%). The main cause of withdrawal symptoms in 91.1% of the patients was inappropriate naltrexone usage. The main poisoning agent in 80% of the cases was consumed naltrexone alone. The route of consumption in 90.1% of the cases was oral and in 9.9% the cases was IV injection. The major clinical features were nausea, vomiting, and agitation. The main therapeutic measures were supportive intravenous fluids (94.8%) and opioid administration in the form of methadone. The mean hospitalization period was 21.8±18 hours. Conclusion: Severity, clinical course, and outcome of opioid withdrawal by accidental or intentional naltrexone abuse varies greatly among patients and is unpredictable. Common findings upon presentation were gastrointestinal symptoms and agitation and the main therapeutic measures for these patients were support with intravenous fluids and anti-nausea drugs administration as plasil and opioid administration as methadone