Renal Actinomycosis in Presence of Renal Stones in a Patient with End Stage Renal Disease

Renal actinomycosis is a rare infection, and actinomycosis mostly acts as a normal flora in mouth, colon and vagina. We present a case of 56 years old man, who referred to our center for renal transplantation with kidney stone and diagnosed  with renal actinomycosis.  This case has risen possibility of rare infection that can be considered in the setting of renal transplantation

Accuracy of CBCT, Digital Radiography and Cross-Sectioning for the Evaluation of Mandibular Incisor Root Canals

ntroduction: The aim of this study was to compare the accuracy of cone-beam computed tomography (CBCT), digital radiography and tooth sectioning in evaluating root canal morphology of mandibular incisors in an in vitro setting. Methods and Materials: A total of 76 samples were imaged using CBCT, and digital radiography in straight and angled views. The samples were then sectioned at different distances from the apex for further visualization under stereomicroscope. The agreement between the observers was statistically analyzed by kappa correlation coefficient and the chi-square test. Results: The results showed that the majority of the samples had a single canal (Vertucci’s Type I). CBCT analysis reported more frequent multi-canal roots in comparison with the other techniques. In pairwise comparisons, the highest agreement was found between digital radiographic imaging and microscopic cross-sectioning both in terms of canal configuration and the number of root canals. Conclusion: None of the used imaging techniques per se could adequately show the exact internal anatomical configuration in accordance with the gold standard.Keywords: Anatomy; Cone-Beam Computed Tomography; Digital Radiography; Incisor Teet

Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose Derived Stem Cells for Treatment of Female Stress Urinary Incontinence: A Phase One Clinical Trial

Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001) and ICIQ-SF scores (P<0.001), especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002). This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy

Translation, Cultural Adaptation, and Validation of Psychometric Properties of the Parent Section of Parent-Child Interaction Coding System

Objectives: Most of the tests regarding parent-child interaction have dealt with this issue from the emotional-behavioral point of view; however, studying these interactions from a combined verbal-behavioral aspect requires a tool consistent with Iranian culture. Parent-Child interaction coding system–3rd edition (DPICS-III, 2009) is allotted to evaluate parent-child interaction. This study was conducted on mothers of 3- to 6-year-old children to translate, adapt to the Persian language, and determine the validity and reliability of the parent section of this test. Methods: This research was descriptive-analytic with a non-experimental design. This test was adapted to the Persian language, and its face validity was examined to clarify the items. Moreover, the correlation between live and video observations of 10 mothers and children was evaluated to determine the validity of observations. Later on, the same rater reviewed the videos of 10 mothers—recorded for the correlation between live and video observations—again within a week for intra-rater reliability and verify the credibility of the rater. Moreover, the Spearman and interclass correlation coefficients were used to determine inter-rater reliability. Data analysis was done by calculating ICC, the Pearson correlation coefficient, and the Spearman correlation coefficient. Results: The translation process led to an appropriate version of the test in Persian language. The Pearson and Spearman correlation coefficients were used for analysis. The correlation between live observation and video was significant (P0.05, 0.99-0.83=Pearson). The reliability of intra-rater was also high (P0.05, 0.99-0.87=Pearson). Furthermore, inter-rater reliability was also high (P<0.05, 0.99-0.81=spearman and P<0.05, 1-0.79=ICC). Discussion: According to the study results, the parent section of DPICS is applicable in the Persian language with appropriate validity and reliability. This applicable test is either as live observation or video recording, with no differences

Prostate Cancer Predicting Factors A Preliminary Report from Tehran

Purpose: To determine the probability of having prostate cancer (PCa) using the combination of serum level of prostate-specific antigen (PSA) and age. Materials and Methods: A total of 160 patients and 190 controls were enrolled in this hospital-based case-control study. Using a logistic regression model and the odds ratio of age and PSA level, the probability of PCa was estimated based on serum level of PSA and age of the participants. Results: The mean age of patients with PCa and benign prostatic hyperplasia (BPH) was 67.75 ± 8.81 and 62.07 ± 8.71 years, respectively (P< .000). Using univariate analysis, we found that increase in life decades of the cases almost doubles the risk of having PCa (odds ratio = 1.95; P = .00), and the probability of developing cancer may increase by 74% in ketchup consumers. After multiple variable regressions, it was revealed that the odds of developing PCa increase by 90% only for every decade, and other variables did not have any significant association with PCa. Conclusion: In clinical practice, PSA level combined with the age at presentation can be used as predictors of PCa probability and the necessity of biopsy

Salivary and serum periostin in kidney transplant recipients.

IntroductionEnd-stage renal disease (ESRD) treatment includes dialysis and kidney transplantation. Transplant rejection is a major barrier to transplant success. One of the markers mentioned in previous studies on renal function in patients with renal failure for various reasons is periostin (POSTN). The expression of POSTN correlates with interstitial fibrosis and reduced renal function. One of the limitations in this regard is the effect of oral lesions on the POSTN level. This study was conducted aimed to measure the relationship between salivary and serum POSTN and renal function in patients with a history of a kidney transplant, taking into account all the conditions affecting POSTN.MethodsIn this study, serum and saliva samples were taken from 23 transplant patients with normal function (NF) and 29 transplant patients with graft failure (GF). At least one year had passed since the transplant. Before sampling, a complete oral examination was performed. Salivary and serum POSTN was examined by ELISA. The results were analyzed by SPSS software.ResultsThe POSTN level in the serum of the NF group (191.00 ± 33.42) was higher than GF patients (178.71 ± 25.68), but the difference was not significant (P = 0.30). Salivary POSTN in NF patients (2.76 ± 0.35) was significantly higher than GF patients (2.44 ± 0.60) (P = 0.01).ConclusionsThe superiority of saliva as a diagnostic fluid includes ease of collection and storage, and non-invasiveness, all of which can lead to the replacement of blood with this bio-fluid. The significant results of salivary POSTN may be due to the lack of serum disturbing factors. Saliva is an ultra-filtered fluid from serum and therefore there are fewer proteins and polysaccharides attached to biomarkers in saliva and the accuracy of measuring these biomarkers in the saliva is more valuable than serum

The gene expression profile and DNA methylation pattern of CDH1 and DNMT1 genes in acute promyelocytic leukemia (APL)

Background:DNA methylation is an epigenetic modification that has the ability to alter gene expression and function. These epigenetic changes have been associated with the development of cancer. Previous research has found that DNA methylation patterns can predict disease prognosis for patients with Acute Promyelocytic Leukemia (APL). The role of DNMT1 and CDH1 in regulating the extension of cells are studied in this study. Methods: DNA was extracted from peripheral blood samples of APL patients and treated with bisulfite. DNMT1 and CDH1 gene promoter methylation was subsequently analyzed using methylation-specific PCR (MSP). Real-time PCR was used to measure the expression level of DNMT1 and CDH1 genes. Results: Partial methylation of the CDH1 gene promoter was detected in 20% of APL patients and an unmethylated status was detected in 80% of patient samples. Additionally, an unmethylated status in the DNMT1 gene promoter was detected in 100% of APL patient samples. Conclusions: Our study found the CDH1 gene promoter to be unmethylated in almost all APL patients, while the DNMT1 promoter was unmethylated in all APL patients. Furthermore, we observed an increase in both CDH1 and DNMT1 gene expression in APL patients compared to healthy controls. These findings suggest that DNMT1 may not have a specific role in inhibiting CDH1 gene expression in APL. Applying higher resolution techniques would help to better uncover the DNA methylation patterns in patients with APL. Further research is required to determine the role of DNA methylation and CDH1 and DNMT1 gene expression in APL

The influence of socioeconomic factors on deceased organ donation in Iran

Background : There is a large gap between the number of patients on organ waiting lists and the number of available organs for donation. This study investigated the socioeconomic factors in Iran that influenced decisions for organ donation among the families of brain-dead donors. Methods : This retrospective cross-sectional study was performed among the families of 333 organ donors in Iran. Two trained researchers interviewed family members about the donor’s age, sex, cause of brain death, education level, marital status, number of children, history of addiction, the financial status of the donor’s family, and reasons for which they considered refusing organ donation. Results : The mean age of the donors was 37.23±16.59 years. During 2017–2019, significant differences were found according to income (P<0.001), marital status (P<0.001), sex (P=0.04), and occupation (P=0.04). More than half of the organ donors were of low socioeconomic status, and nearly half were the sole income earners of large families. Trauma was the most common cause of death (44.6%). The most common reasons for which the families considered refusing organ donation were unfamiliarity with the concept of brain death, denial, and the expectation of a miracle. Conclusions: The donor’s socioeconomic status and availability of social services, such as insurance coverage, psychological services, and mourning therapy courses, play an important role in organ donation. Adequate support for the deceased’s family after organ donation is imperative

Is there any relationship between red blood cell distribution width and prognosis of brain death?

Background: Accumulating evidence has demonstrated that RDW (red blood cell distribution width) may independently predict clinically important outcomes in many populations. However, the role of RDW has not been elucidated in brain death. We conducted this study with the aim of evaluating the predictive value of RDW in brain death. Methods: A retrospective study of seventy-seven of brain death cases during 36 months were evaluated at university hospitals, affiliated in Tehran, Iran. Demographical data include age, sex, BMI and cause of brain death, also laboratory results (red blood cell distribution, mean corpuscular volume, hemoglobin) collected by checklists from patient records. Having the three RDW measurements (days of hospital admission, day of brain death, and day of cardiac arrest) required. Results: Time interval from hospital admission until brain death was 5.27±4.07. The mean age of brain death cases was 32.65±16.53. The mean RDW values on days of hospital admission, the day of brain death, and the day of cardiac arrest were 14.53±1.98, 15.12±1.93 and 15.18±2.07, respectively. Results of the repeated-measures ANOVA test reveal that RDW level was constantly higher in the traumatic patient group compared to the non-traumatic ones (P=0.008). Conclusion: The frequency of brain death was high in patients with high RDW values. RDW might be a prognostic biomarker for brain death. More prospective studies with large sample size and long follow-up period should be carried out to determine the prognostic significance of RDW and brain death in future

Does Hypertension Remain after Kidney Transplantation?

Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN) in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61%) patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8%) the cause of end-stage renal disease (ESRD) was unknown followed by HTN (26.3%). A total of 166 (41.5%) patients had been hypertensive before transplantation and 234 (58.5%) had normal blood pressure. Among these 234 individuals, 94 (40.2%) developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8%) remained hypertensive after transplantation. Totally 180 (45%) patients had post-transplantation HTN and 220 patients (55%) didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients