Diagnostic Value of Chest Computed Tomography Scan for Identification of Foreign Body Aspiration in Children: A Systematic Review and Meta-analysis.

Introduction: Foreign body aspiration (FBA) is a common, life-threatening pediatric emergency and was shown to be associated with high risk of morbidity and mortality. This systematic review and meta-analysis aimed to investigate the diagnostic value of chest computed tomography (CT) scan for identification of FBA in children. Methods: From inception to May 2024, a systematic search was carried out across multiple databases including Medline, Scopus, and Web of Science, considering published papers in English language. Quality assessment of the included studies was performed using seven domains of Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results: The systematic literature search yielded 7203 articles. The pooled sensitivity and specificity of chest CT scan for identification of FBA were 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. The pooled positive likelihood ratio was 10.12 (95% CI: 4.59-22.20), and pooled negative likelihood ratio was 0.05 (95% CI: 0.02-0.1). Furthermore, the area under the summarized receiver operating characteristic (SROC) curve was 0.98. Conclusion: Our meta-analysis revealed that despite high heterogeneity, in the diagnostic characteristics of chest CT scan among studies, it has high diagnostic value in identifying FBA in suspected pediatric cases.

Evaluation of efficacy of cholecalciferol and silymarin in improving lower urinary tract symptoms of benign prostatic hyperplasia: A double-blind, randomized, controlled trial.

INTRODUCTION: Benign prostatic hyperplasia (BPH) mainly leads to lower urinary tract symptoms (LUTS) in aging men. The present study investigates the role of cholecalciferol, Silymarin, and their combined administration in patients with BPH suffering from LUTS. METHODS: This double-blind, randomized, controlled trial enrolled 80 participants (50-80 years) diagnosed with BPH, from March 2019 to March 2020. Based on serum 25-(OH) vitamin D levels we formed subgroups, each receiving specific interventions. Measurements of International Prostate Symptom Score (IPSS), Maximal Urinary Flow Rate (Q-max), Prostate Volume (PV), Post-Void Residual (PVR), and Prostate-Specific Antigen (PSA) were recorded at baseline and following 3 months of follow-up. RESULTS: Participants with serum concentration of 25-(OH) vitamin D below 20 ng/ml simultaneously received cholecalciferol and Silymarin that significantly improved IPSS, irritation, obstruction, PV, and PVR. In those with concentrations ⩾20 ng/ml, a single use of Silymarin significantly reduced IPSS, irritation, obstruction, and PVR. Adjustment of confounding variables revealed independent and significant effects of both cholecalciferol and Silymarin on PVR, IPSS, and obstruction. Cholecalciferol also improved irritation, while Silymarin reduced prostate volume. These findings highlight potential therapeutic benefits for BPH-associated LUTS, encouraging further exploration and clinical consideration. CONCLUSIONS: In this investigation, combination therapy with cholecalciferol at 50,000 IU/w for 8 weeks and Silymarin at a dosage of 480 mg for 3 months resulted in a notable improvement in the IPSS score, PV, and PVR, as well as both irritative and obstructive symptoms. However, the total PSA and free PSA amounts did not reach a significant difference.

Downward trend in male reproductive health and fertility in Eastern Iran.

This study aimed to assess the ten-year trend in semen quality among couples referred to the Infertility Center in Kerman between 2008 and 2017. The study included 2952 semen samples from men 18 to 60 years old referred to the infertility center as infertile couples living in Kerman province, Iran, whether they had normal or abnormal semen analysis. A total of 2952 sperm samples were included. Statistically significant changes were observed in semen parameters. Particularly, significant changes were observed for volume (-0.08 mL/year), sperm concentration (-2.34 (mio/mL)/year), total sperm count (-13.17 (mio/ejaculate)/year), progressive motility (-2.62%/year), non-progressive motility (-0.59%/year), immotile sperm (2.49%/year), and normal morphology (-0.134%/year). In bivariate analysis, the prevalence of oligozoospermia in this study showed a statistically significant association with age (OR = 1.019; 95% CI = 1.007-1.032; p = 0.003). Likewise, there was a statistically significant association with the year (OR = 1.087; 95% CI = 1.050-1.125; p = 0.000). Semen quality parameters showed a downtrend during the last 10 years in this study, emphasizing the importance of male reproductive health monitoring and warning public health coordinators to pay more attention to this important issue.

Endo-infundibulotomy of a hydrocalyx, mysterious pains after percutaneous nephrolithotomy: A case report.

Hydrocalyx is a dilated renal calyx due to obstruction of the infundibulum and a rare complication after percutaneous nephrolithotomy. We present a 22-year-old girl with hydrocalyx who had following percutaneous nephrolithotomy and its management. A 22-year-old female with recurrent right flank pain underwent percutaneous nephrolithotomy for a kidney stone. Despite interventions such as endoscopic infundibulotomy and double J stenting, the patient experienced persistent symptoms. Laparoscopy ultimately led to improvement. Hydrocalyx is a rare but significant complication post-percutaneous nephrolithotomy. Minimally invasive procedures and endoscopic interventions are the primary treatment options. Laparoscopy may be considered if initial interventions fail. Formation of hydrocalyx after percutaneous nephrolithotomy is a rare yet considerable complication and there are only a few articles in this field available to our knowledge.

Semen parameter enhancement after varicocelectomy: Insights into varicose vein diameter and BMI influence: A cross-sectional study.

INTRODUCTION: Varicocele is a condition in which the veins in the spermatic cord become enlarged and twisted. Varicocele is widely recognized as the leading cause of male infertility due to its significant impact on reproductive health in men. The aim of this study was to investigate the relationship between the diameter of the varicose vein and the recovery rate of the spermogram after varicocelectomy. Also, the effect of body mass index (BMI) on sperm parameters after varicocelectomy. METHODS: This descriptive and analytical cross-sectional study was conducted in Valiasr Hospital's urology clinic in Qaemshahr, Iran from August 2018 to August 2019 and involved 27 men with unilateral left varicocele who met the inclusion criteria for surgical repair. Before the operation, we recorded demographic information, the maximum diameter of varicose veins in the pampiniform plexus, and spermogram results. We repeated semen analysis 3 months after the operation and analyzed the data using Statistical Package for the Social Sciences version 21 software. RESULTS: Our findings showed that the diameter of the varicose vein before varicocelectomy was not significantly associated with the improvement of main semen parameters after the operation. Furthermore, our study suggested that a lower body mass index might contribute to a greater improvement in sperm motility, as individuals with lower BMI showed more significant improvement. DISCUSSION: There is a significant inverse relationship between BMI and sperm motility improvement after surgery. Patients with a lower BMI showed greater improvement in sperm motility.

Model-free adaptive task-space sliding mode control of a Delta robot using a novel reaching law.

This paper presents a model-free adaptive sliding mode control for the Delta robot with a novel reaching law for achieving a less conservative sign-function gain and protecting the Delta robot against overloads. A desired closed-loop system with asymptotic stability based on the Lyapunov theorem is proposed to derive the control law. The proposed control system can overcome uncertainties without prior knowledge of the bounding functions. The reaching time is adjusted adaptively to achieve a smooth convergence to the sliding surface, resulting in chattering attenuation. The gradient descent algorithm is utilized for the first time with a novel adaptation rule to estimate the Delta robot inverse Jacobian matrix. Instead of employing a numerical dynamic model, an analytical model is used for the proposed control law, stability analysis, and simulations. A simple, straightforward inverse-kinematics solution based on a geometrical approach is presented. Simulation results demonstrate a superior performance of the proposed reaching law through comparisons.

Impacts of Bariatric Surgery on Improvement of Incontinence Among Obese Asian Women: A Prospective Study and Literature Review.

INTRODUCTION: Limited studies investigate bariatric surgery's role in improving UI status among Asians, specifically Middle Eastern Asian women. The aim of this study is to investigate the effect of bariatric surgery on the three most prevalent urine incontinence (UI).We also reviewed the current literature exploring the studies performed in Asian countries. MATERIALS AND METHODS: A total of 77 women out of 200 who had UI and indications for bariatric surgery completed demographic information and the questionnaire (QUID) prior to surgery and 6 months after the surgery. For statistical analysis, the Mann-Whitney U test, Wilcoxon test, and Friedman test were utilized. We also performed a literature review with the aim of investigating studies performed in Asian countries. RESULTS: Among the initial analysis of 200 participants, 50.5% reported UI symptoms before surgery. The average weight loss was 29 kg, with a standard deviation of 7 kg. The mean BMI dropped 11.2 kg/m2, and the standard deviation was 2.5 after weight loss. Post-surgery, significant reductions in UI scores were observed across all severity levels, with a notable 44% achieving complete symptom resolution, indicating a substantial decrease in urinary incontinence. Stress, urine incontinence, and mixed urine incontinence symptoms had improved in 75%, 71%, and 30% of women, respectively. Notably, age and gynecological history were identified as critical factors influencing the extent of UI improvement. CONCLUSION: This study reveals significant improvements in urinary incontinence scores, with age and gynecological history playing pivotal roles in UI improvement.

Sudden cardiovascular collapse during the TUL procedure: A case series.

Although ureteroscopy is a minimally invasive procedure, there have been reports of some minor and major complications, from self-limited to complicated events such as ureteral avulsion, urosepsis, and even death due to cerebrovascular accidents and deep vein thrombosis. Herein, we aim to report seven patients who presented with cardiovascular collapse during ureteroscopy in a 19-year period from January 2002 to January 2021.

Percutaneous re-surgical approach for delayed bleeding caused by pseudoaneurysm following percutaneous nephrolithotomy.

Post percutaneous nephrolithotomy (PCNL) vascular complications included arteriovenous fistula and pseudoaneurysm can cause early or late bleeding and result in unstable condition. Selective trans-arterial embolization is the gold standard technique to manage arterial pseudoaneurysm. Herein, we present a case of pseudoaneurysm following PCNL and describe an alternative technique for its removal using a grasper under C-arm vision. Percutaneous re-surgical approach to post-PCNL hemorrhage due to pseudoaneurysm by using a nephro-grasper to pick up the renal artery pseudoaneurysm would be safe, effective and can provide a direct view of pyelocaliceal system for surgeons; And can be a proper alternative for angioembolization.

Induction of Apoptosis in the Rat Bone Marrow Mesenchymal Stem Cells Following Sodium Arsenite Treatment with the Dose Lesser than that Used for Treatment of Malignant Patient.

OBJECTIVE(S): Arsenic compounds are potent human carcinogen and produce a variety of stress responses in mammalian cells. Recently sodium arsenite has been recommended to be used as anti malignancy drug by American food and drug administration (FDA). In this study, we aimed to determine the apoptosis inducing effect of sodium arsenite on rat bone marrow mesenchymal stem cells exposed in vitro. METHODOLOGY: Cell morphology was studied with the help of Hoechst and propidium iodide as well as with single cell gel electrophoresis(comet assay), TUNEL assay and caspase activity base on immunocytochemistry using commercial kit were considered to study the mechanism of cell death. RESULTS: Our result showed that the sodium arsenite with concentration of 0.1 µM in 36 hr induces caspase dependent apoptosis in rat bone marrow mesenchymal stem cells. This concentration is the lowest level of sodium arsenite to be reported with apoptosis induction ability in stem cells. CONCLUSION: Since sodium arsenite is used in therapy, more research should be carried out on the effect of this chemical on stem cells, especially MSCs.