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.

Evaluation of Vibration Analysis to Assess Bone Mineral Density in Children

The effectiveness of vibration analysis to assess bone mineral density (BMD) in children with suspected reduction in bone density was studied. A system was designed that measured the ulna's vibration responses in vivo. The system was evaluated on the ulnae of 48 children (mean age=12.0, std=3.5 years), 31 of whom had been confirmed to have osteogenesis imperfecta (OI). All children had dual energy X-ray absorptiometry (DXA) scan as part of their routine clinical care and vibration analysis was performed on the same day. Frequency spectra of the ulnae's vibration responses were obtained and processed by principal component analysis. Four main principal components were selected and together with age, sex and right hand ulna's length were used in a regression analysis to estimate BMD. Regression analysis was repeated using the children's leave-one-out and partitioning methods. The percentage similarity and correlation between the DXA-derived and vibration analysis estimated BMDs using the leave-one-out were 80.34% and 0.59 and for partitioning were 74.2% and 0.64 respectively. There was correlation between vibration analysis BMD readings and those derived from DXA however a larger study will be needed to better establish the extent to which vibration analysis can assist in assessing bone density in clinical environments

Assessing material densities by vibration analysis and independent component analysis

The aim of this study was to investigate vibration analysis and independent component analysis (ICA) to assess the density of multiple materials making up a single structure. Density is important as it reveals information about physical properties of materials. The density of a single material can be determined from the relationship between its mass and volume. However, when a structure consists of multiple materials, identification of their individual densities from the structure is complicated. Vibration analysis is a technique that reveals information about an object’s physical properties such as its density. The investigation was carried out using a plastic test tube filled separately with three liquids of known densities; water, Chloroform and Methanol. Vibration was inducted into the tube, through an electronic system that produced a single impact at a predefined location on the tube. The resulting vibration signals were recorded using two vibration sensors placed on the tube. A signal source separation technique called ICA was used to obtain the vibration effects of the liquid and the tube. The power spectral densities (PSD) of ICA extracted vibration signals were examined. The frequency of the largest peak in the PSD was related to the liquid’s density under test. The study indicated that vibration analysis may be effective in assessing materials’ densities in a structure that contains multiple materials, however a larger study is needed to explore the findings

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

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

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

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

Vibration analysis as a tool for bone mineral density assessment in children

Dual energy x-ray absorptiometry (DXA) is the current gold standard for assessing bone mineral density (BMD). However DXA uses ionising radiation and has some limitations for assessing BMD in children. In this study, vibration analysis is introduced as a new method to assess BMD in children

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