Comparison between the Holmium Laser (Made in Iran) and Pneumatic Lithotripsy in Patients Suffering from Upper Ureteral Stone between 1-2cm

INTRODUCTION: The aim of this study is to compare holmium laser (LL) with pneumatic lithoclast (PL) in patients with upper ureteral stones and their ability to destruct the stones and making the patient stone free. We also compare the duration of these procedures and their complications, such as urosepsis, perforation, and pushing the stone backward.METHODS: This has been a clinical randomized trail study in 26 patients with upper ureteral stone more than 1 cm. Patients were divided into 2 randomized groups, each treated with one of the following approaches: pneumatic lithoclast(14 patients), or holmium laser(12 patients). The goal of lithotripsy was to break the stone into particles less than 3 mm. IVP (Intravenous Pyelogram) was performed 4 weeks after.RESULTS: The immediate stone free rate was 100% in LL group and 42.9% in PL group (P=0.001). Stone pushing back was 0% in LL group and 57.1% in PL group. Complications such as a perforation, or urosepsis, or bleeding were not seen in any of these groups. Fever more than 38º C was observed in 1.8% in LL, and 3.8% in PL group (p=0.56). After 4 weeks no complication was seen in IVP.CONCLUSION: According to our experience, for upper ureteral stones larger than 1 cm, lithotripsy with holmium laser is preferred approach with high success rate and low complication.

Diode Laser Treatment of Human Prostates

INTRODUCTION: Laser-assisted vaporization of prostate tissue by means of the potassiumtitanyl- phosphate (KTP) laser is in clinical use. Alternative laser sources are available but are lacking clinical experience.The 980 nm wavelength diode laser provides good hemostasis, in addition to a more rapid ablation rate. The aim of this study is approving the capability, feasibility, and good post-operative outcome of vaporization of prostate by means of a diode laser in a long-term follow up.METHODS: The light (980 nm, 100 W) of a diode laser was transmitted to prostate tissue. The study included 70 men suffering from bladder outlet obstruction due to benign prostatic hyperplasia (BPH). The prostatic lobes were vaporized within the prostatic capsule. Post-operative outcome and voiding were evaluated during a follow-up period of 24 months.RESULTS: During surgery, no significant blood loss or any fluid absorption occurred. Catheters were removed in the 20.1±4.6 hours. All patients except two were satisfied with their voiding outcome. After removing the catheter, the mean peak urine flow rate significantly increased from 6.8±2.5 ml/s pre-operatively to 15.6±3.1 ml/s postoperatively. No evidence of urgency, dysuria, hematuria, or incontinence was observed. Four patients required re-catheterization, and two of them needed consecutive TURP. After a 1- month, as well as after a 6-month, a 12-mouth, and a 1-year follow-up, all patients were still satisfied with the outcome.CONCLUSION: This long term experience showed that 100 W-980 nm-diode-laser vaporization prostatectomy was feasible and appeared to be safe and effective for quickly relieving bladder outlet obstruction due to BPH

Health from the perspective of monotheistic school

For downloading the full-text of this article please click here.From the perspective of monotheistic school, health will be meaningful with a comprehensive knowledge of the origin of the universe and God's attention to all the creatures. As reflected in the narratives, the health as one of the greatest divine blessings along with security are more neglected and ingratitude. Health is not limited only to physical, social and psychological aspects and at present, the fourth dimension added to the health is the spiritual health.  Definitely more dimensions will be inserted to it in the future... .For downloading the full-text of this article please click here

Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for the Treatment of Renal Pelvis Stones of 10–20 mm in Obese Patients

Introduction: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (ESWL) as treatment of choice.Methods: A total number of 46 patients with renal pelvic stones 10-20 mm and body mass index (BMI) >30 randomized in two groups underwent RIRS and ESWL from 2011 to 2014 and followed for 3 months.Results: The patients mean ± SD age was 36.1 ± 13.1 years in ESWL and 33.2 ± 11.4 years in RIRS groups (P = .1) with comparable BMI in both groups (36.2 vs 38.1). In ESWL and RIRS groups, the operation time was 72.2 ± 21 vs 66.5 ± 19 minutes (P = .061), respectively. Stone free rate (SFR) at 3 months was 68% in ESWL group vs 90.4% in RIRS group (P = .019). The complication rate was 20% in ESWL group vs 14.2% in RIRS group (P = .211) but all of them were minor and managed conservatively.Conclusion: According to our study, RIRS procedure in comparison with ESWL is a safe and successful option of treatment for renal pelvis stone of 10-20 mm in obese people

Alterations in Auditory Electrophysiological Responses Associated With Temporary Suppression of Tinnitus Induced by Low-Level Laser Therapy: A Before-After Case Series

Introduction: Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. The treatment is difficult due to multiple etiologies and great psychological influence. The purpose of this study was to determine alterations in auditory physiological and electrophysiological responses associated with temporary suppression of tinnitus induced by low-level laser (LLL) irradiation.Methods: This study was conducted on 20 subjects with subjective tinnitus. All subjects signed the informed consent form and satisfied all the study eligibility criteria. Visual analog scale (VAS) for loudness, loudness matching of tinnitus (LMT), pitch matching of tinnitus (PMT), Persian-tinnitus questionnaire (P-TQ) and Persian-tinnitus handicap inventory (P-THI) were conducted pre- and post-low level laser therapy (LLLT) for all the subjects. Electrocochleography (ECochG) and distortion product otoacoustic emissions (DPOAEs) were recorded in 11 subjects. Continuous wave diode lasers, including red (630 nm) and infra-red (808 nm) were applied, and were both designed by the Canadian Optic and Laser (COL) Center. Twelve sessions of laser therapy were performed, 2 sessions per week for each subject. Total dose was 120 Joule/ear/session.Results: LLL irradiation could cause a significant decrease in subjective tests scores consisting of VAS for loudness, PMT, P-TQ, P-THI, but did not result in a significant improvement of objective evaluating parameters except for compound action potential (CAP) amplitude.Conclusion: LLLT might be a subjectively effective treatment for short-term improvement of tinnitus. Defining a new protocol for optimizing LLLT parameters may be an option to improve parameters of objective tests

Direct Vision Internal Urethrotomy with Application of Holmium: YAG Laser

INTRODUCTION: Male urethral stricture is a complicated urologic disease that could be successfully treated using internal urethrotomy. Laser internal urethrotomy has been used in many cases with favorable outcome in many studies. Holmium: YAG laser with its incisional properties on tissue is one of the laser types applied for internal urethrotomy.METHODS: We present a 19 year-old male with history of aortic valve stenosis and metallic aortic valvoplasty on prescription of oral anti-coagulant therapy (Warfarin) who was a candidate for internal urethrotomy due to bulbar urethral stricture. Holmium laser core-through urethrotomy was performed for him.RESULTS: Internal urethrotomy was done using the ablative 50-watt Holmium: YAG laser 2140 nm (manufactured by the Atomic Energy Organization of Iran [AEOI]). No complication was observed intra- and post-operatively. After 6 months of followup no evidence of urethral stricture was observed.CONCLUSION: According to our study, Ho-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic urethral stricture with high risk of urethral bleeding due to anti-coagulant therap

An Investigation of Executive Functions and Cognitive Emotion Regulation in Labor Children Undergoing Training at Educational Centers

The aim of this study is to determine the comparison of executive functions and cognitive emotion regulation between labor children undergoing training at educational centers and normal children. The sample included 29 male children (mean=9.58, SD=0.50) which was selected from a childcare center. For the control group, 27 third-grade children were selected from a normal primary school (mean= 9.40, SD=0.50). Two questionnaires were used: 1-The extended version of executive function deficiency in everyday life (Barkley, 2011); 2-The child version of cognitive emotion regulation (Garnefski et al., 2007). Part one of this study showed that the scale of executive functions revealed that labor children under training in educational institutions were significantly different in terms of self-direction and time management and self-organization from normal children. Part two of this study showed that there is a significant reverse relationship between planning refocusing, self-regulation, and time management (r value < 0.05). Moreover, there was a significant reverse relationship between positive reappraisal and spontaneity (r value < 0.01), and a significant negative relationship between positive reappraisal and executive functions (r value < 0.05). Overall, it can be posited that children undergoing training in educational institutions are not different from normal children in terms of cognitive emotion regulation

The Hidden Aspects of A Century of Substance Use Policymaking in Iran

The use of substances, especially opiates, has been a longstanding and significant problem in Iran. In response, Iran has experimented with a wide range of policies including nonintervention, regulation, legalization, prohibition, and criminalization. Exploring Iran’s substance use policies suggests that the Iranian government has been more concerned with byproducts of policies such as financial revenue, promoting diplomacy, and maintaining power, rather than genuinely alleviating the substance trade and addiction. First, we explore how opium taxation was the core substance use policy before oil became the main source of government income. Second, we discuss how conflicts of power between the health sector and other stakeholders relegated the role of the health sector and medical professionals. Lastly, we analyze the post-1979 revolution policies when Iran experienced social desolations, such as during the Iraq-Iran war and the subsequent economic recessions. We reveal that stigmatization and scapegoating of people who use substances have been used as a cover-up to obscure deeper social problems. This historical analysis ultimately reveals that Iran’s substance use policies have largely neglected medical approaches in favor of more oppressive, but politically expedient options

Spectroscopic characteristics of Xeloda chemodrug

Introduction: Spectroscopic properties of Xeloda chemodrug have been studied over varying concentrations ranging between 0.001 and 10 mg/mL, using laser-induced fluorescence (LIF) spectroscopy. The alternative photoluminescence (PL) and near infrared (NIR) measurements are carried out to authenticate the obtained results by the LIF method.Methods: The XeCl laser as the excitation coherent source with 160 mJ/pulse at 308 nm is employed for LIF measurements of the fluorophore of interest in the modular spectroscopic set-up.Results: Xeloda as a significant chemodrug acts as a notable fluorophore. LIF, PL and NIR spectroscopy techniques are employed to investigate the spectral properties of the chemodrug in terms of concentration. The maximum LIF peak intensity of Xeloda is achieved at λmax=410.5 nm and the characteristic concentration of CP1=0.05 mg/mL. PL signals are in good agreement with the data given by the LIF measurements. The characteristic NIR spectra of Xeloda as solid evidence of chemical bonding formation attest to fluorescence quenching at the fluorophore concentration of ~ 0.2 mg/mL. Besides, the spectral shift of fluorescence signals which is obtained in terms of fluorophore concentration- demonstrating as a diagnostic marker for the purpose of optimized chemotherapy.Conclusion: Xeloda exhibits outstanding fluorescence properties over the allowable concentration in human serum (Cmax). These characteristics could benefit the potential advantage of simultaneous laser-based imaging of cell-chemodrug interaction over in-vivo studies. DOI: 10.34172/jlms.2021.5