Frequency and timing of renal biopsy complications.

Background: Percutaneous renal biopsy is the primary diagnostic tool for renal diseases. In this study, we evaluated renal biopsy complications and the timing of complications. Methods: A cross-sectional study was performed on adult patients who underwent renal biopsy. The data gathering sheet collected patient characteristics. Complications were categorized as minor and major which needed an intervention. Data were analyzed using SPSS, and a p-value <0.05 was considered significant. Results: This cross-sectional study was conducted on 215 patients (mean age: 33.1±16.4 and 54.4%: women) who underwent percutaneous renal biopsy in Shiraz Nemazi Hospital for one year. Of the 298 complications that occurred, 90.2% were minors (56.1%of them microscopic hematuria). Moreover, 2 (0.7%) patients developed major complications and received a transfusion. In addition, most of the complications (98.9%, 295 ones) developed within 8 hours post-procedure. Only hemoglobin drop was significantly higher in women (41.0% vs. 21.4%, P=0.003). Conclusion: This study indicates that renal biopsy is a safe procedure; the results revealed that the significant post-biopsy complications were rare and occurred in the first 8 hours.

Comparative Study of Intravenous Immunoglobulin and Leflunomide Combination Therapy With Intravenous Immunoglobulin Single Therapy in Kidney Transplant Patients With BK Virus Infection: Single-Center Clinical Trial.

OBJECTIVES: Nephropathy due to BK virus infection is a major cause of graft dysfunction and loss. No specific treatment has been developed for the BK virus. Here, we compared the combination of intravenous immunoglobulin and leflunomide versus intravenous immunoglobulin to treat BK virus nephropathy after renal transplant. MATERIALS AND METHODS: This study was a randomized controlled clinical trial. Sixteen kidney transplant patients with BK virus infection were randomly divided into 2 groups; 1 group received intravenous immunoglobulin, and another group received leflunomide and intravenous immunoglobulin. P < .05 was considered statistically significant. RESULTS: Results of a polymerase chain reaction test for BK virus after 2 months of treatment were negative in 3 patients in the intravenous immunoglobulin group and in 7 patients in the intravenous immunoglobulin + leflunomide group. The amount of BK virus decreased significantly in each group, and a significant difference was observed between the 2 groups after 3 months (P = .014). The average level of creatinine in the intravenous immunoglobulin group at 1, 2, and 3 months after treatment was 1.7 ± 0.23, 1.8 ± 0.5, and 1.5 ± 0.3, respectively, and in the intravenous immunoglobulin + leflunomide group was 2.1 ± 0.75, 1.76 ± 0.37, and 1.4 ± 0.18, respectively (P > .05). CONCLUSIONS: Although BK viral load decreased significantly in both groups, there was a significant difference between patients who received intravenous immunoglobulin versus those who received the combination of intravenous immunoglobulin + leflunomide after 3 months. The addition of leflunomide to the intravenous immunoglobulin treatment seems to have a better effect in reducing BK viral load. However, further studies with a larger sample and longer duration are needed.

Survival Rate of Renal Transplant and Factors Affecting Renal Transplant Failure.

OBJECTIVES: The most important complication in kidney transplant is acute/chronic rejection. In this study, we investigated the factors affecting kidney rejection and transplant survival. MATERIALS AND METHODS: In this survival analysis study, 352 patients (mean follow-up of 12.9 ± 4.4 years) who underwent renal biopsy due to increased creatinine level from 2012 to 2016 were identified by glomerular filtration rate level and rejection. Probable factors affecting renal function and survival rate after transplant rejection were assessed. P < .05 was considered as significant. RESULTS: Among our study patients, 40.9% developed early and 59.1% developed late acute kidney injury. Graft survival rates at 1 and 5 years were 98.9% and 68.5%, respectively, which was significant when rejection type was considered (P = .002). In addition, patient survival rates at 1 and 5 years were 99.7% and 98.6%, respectively. Graft survival at 5 years was significantly lower among older subjects, those with diabetes, those who received deceased donor organs, and those with late acute kidney injury (P < .002). Patient survival was significantly higher among young patients, those with systemic lupus erythematosus, those who received living donor organs, and those without cytomegalovirus infection (P < .003). CONCLUSIONS: We observed that recipient age, type of donor, underlying disease, infection, and late acute kidney injury had great negative impacts on renal dysfunction and survival. In our center, because of the large number of kidney transplants from deceased donors, the necessity of antithymocyte globulin induction therapy was considered, since this study showed that patients who received rabbit antithymocyte globulin induction had better outcomes.

Sialic acid: an attractive biomarker with promising biomedical applications.

This broad, narrative review highlights the roles of sialic acids as acidic sugars found on cellular membranes. The role of sialic acids in cellular communication and development has been well established. Recently, attention has turned to the fundamental role of sialic acids in many diseases, including viral infections, cardiovascular diseases, neurological disorders, diabetic nephropathy, and malignancies. Sialic acid may be a target for developing new drugs to treat various cancers and inflammatory processes. We recommend the routine measurement of serum sialic acid as a sensitive inflammatory marker in various diseases.

Detection of human papillomavirus (HPV) DNA in benign laryngeal lesions and role of cigarette smoking as an inducing factor.

The association of human papillomavirus (HPV) in laryngeal malignancies is largely known. This study evaluated the association between HPV and benign laryngeal lesions and also the role of smoking and alcohol consumption in increasing the prevalence of HPV in such benign lesions. Seventy-eight specimens of benign laryngeal lesions including 26 polyps, 26 dysplasia, and 26 other lesions such as nodules and cysts were enrolled in this study. Polymerase chain reaction (PCR) technique was used to detect HPV DNA in the tissues. The role of smoking and alcohol consumption in the prevalence of HPV was also evaluated through appropriate statistical tests. This study showed that the prevalence of HPV in benign laryngeal lesions was not statistically significant. The Cohen's effect size for comparing polyps vs. other lesions was nearly 0.7, indicating that HPV prevalence in laryngeal polyps may be clinically meaningful. Another finding in our study is the role of smoking in increasing the HPV prevalence in laryngeal polyps (P = 0.034). In benign laryngeal polyps, HPV prevalence may be clinically important. Smoking acts as a co-factor to induce HPV infection in laryngeal polyps in our study.

Endoscopic findings in hemodialysis patients upon workup for kidney transplantation.

Upper gastrointestinal (GI) abnormality is believed to be higher in patients with end-stage renal disease (ESRD) which can make a big trouble for whom undergo kidney transplant. We conducted this study to assess upper GI findings of patients with ESRD. In the present retrospective study we recorded upper GI endoscopy results in hemodialysis patients who were candidate for renal transplantation during a 10-year period. We reviewed files of 1256 patients with a mean age of 37.6 ± 13.4 years. Half of patients (50.6%) had an abnormal endoscopy. Two most common abnormalities were mild gastritis (35.6%) and gastro-esophageal reflux disease (16.7%). GI ulcers were observed in 11% of patients. Duodenal ulcer was the most common ulcer which was seen in 6.8% of patients. Helicobacter pylori was positive in 32.9% of patients and correlated with GI lesions (P = 0.000, r = 0.371). Longer dialysis duration and older patients revealed more upper GI abnormality (P = 0 .032, <0.001). As long as more than half of our patients have at least one upper GI involvement, we recommended that endoscopy must be done as a pretransplantation evaluation for patients without symptoms who have risk factors for ulcers.

Comparison Between Processus Vaginalis Sac Tightening Technique and the Conventional Technique in Orchiopexy Surgery Over 10 Years.

BACKGROUND: Undescended testis (UDT) is a common congenital urogenital anomaly that is treated by orchiopexy. We aimed to introduce patent processus vaginalis (PPV) sac tightening (PVST) technique and compare it to the conventional technique. METHODS: We retrospectively studied all the operated UDT patients during 10 years. In the conventional technique, it was necessary to ligate PPV sac after being peeled off from the spermatic cord. PVST was dissected longitudinally from the two sides of where the PPV sac wall was attached to the spermatic cord till the proximal part, and only a narrow thin layer sticking to the spermatic cord was left and the proximal PVV sac opening was tightened as much as possible with vicryl suture at the internal inguinal ring level. The significance level was <0.05. RESULTS: Of 821 orchiopexy (mean age 24.5±24.2 months), 36.3% were done by conventional and 63.7% by PVST technique. Hematoma, edema, hydrocele, and wound infection were lower in the PVST technique, but it was not significant (p>0.05). Testicular atrophy and operation time were significantly lower in the PVST than the conventional technique (p<0.001). CONCLUSION: The orchiopexy PVST technique has lower complications and seems to be easier, faster and safer than the conventional technique.

Review of Renal Biopsies, A Single Center Experience.

No large study has been conducted on biopsy-proven nephropathies. Our aim was to report clinical and pathological pattern of kidney disease diagnosed by kidney biopsy in our center. This is a retrospective study on kidney biopsy during 7 years; we analyzed the results of kidney biopsies and their clinical data. Data were analyzed by SPSS 18.0 and a P < .05 was considered. In 1355 kidney biopsies (55.7% women, age = 33.2 ± 16.4), primary glomerulonephritis (GN) was the main feature (57.1%). The most common presentation was asymptomatic urine abnormality (32.3%). Lupus nephritis (24.5%), membranous GN (17.0%), and focal segmental glomerulosclerosis (13.9%) were the most frequent diagnosis. This study highlights the histopathological patterns of kidney disease in southern Iran. lupus nephritis, membranous GN, and focal segmental glomerulosclerosis are currently the three major diseases. These results have an important role in organizing renal health plans as an initial phase in our population.

Comparison of Normal Saline, Ringer's Lactate, and Sodium Bicarbonate for Prevention of Contrast-induced Nephropathy in Patients with Coronary Angiography: A Randomized Double-blind Clinical Trial.

Contrast-induced nephropathy (CIN) is one the most important renal complications following contrast injection in percutaneous coronary intervention. We compared the protective effect of normal saline (NLS), Ringer's lactate (RL), and sodium bicarbonate (Bi). In this study, patients with coronary angiography indication were divided into three groups by simple randomization method: NLS, RL, and Bi solution groups. Creatinine (Cr) alterations, glomerular filtration rate, and urine pH were evaluated prior and after the procedure. Data were analyzed with SPSS and P value less than 0.05 was taken as significant. In this study, 300 patients [150 men (50%), mean age 59.1 ± 10.6 years] were studied. The CIN incidence overall was 10% (30 patients): 8.3% (8 patients) in NLS; 16.5% (17 patients) in RL; and 5% (5 patients) in Bi group. It was significantly different among three groups (P = 0.018), and CIN incidence was significantly lower in Bi vs. RL group (P = 0.012). Baseline Cr clearance was higher in patients who developed CIN (78.4 ± 26.0 vs. 69.8 ± 21.6 mL/dL, P = 0.044). Urine pH after trial in CIN group was lower than the patients without CIN (5.5 ± 1.4 vs. 6.3 ± 1.8 mL/dL, P = 0.024). Higher urine pH and its change during study were seen in Bi group (P < 0.05). Cr at the initiation of study and the use of RL vs. Bi may be prognostic factors in CIN progression (P < 0.002). Sodium barcarbonate as fluid had more protective effect than NSL or RL on prevention of CIN in patients undergoing coronary angiography. The risk factors for CIN in our study were higher baseline serum Cr and use of RL as hydration fluid.

Treatments of uremic pruritus: A systematic review.

Till now many treatments attempted to relieve uremic pruritus (UP) though none of them are definite treatment. In this study, we gathered all studies conducted on UP treatment since 2000-2016. We conducted a systematic review by searching the electronic databases (PubMed, Scopus, and Google scholar). Patients were with chronic kidney disease who complained of UP. Clinical trials and pilot studies in English and Persian which were done on patients with ESRD who complained of itching between 2000 till 2016 were gathered. A total of 166 articles were collected. After excluding articles 41 articles were remaining. Then UP treatments classified into two main groups: Medical (chemical and herbal medicine) and non-medical. Most studies measured UP by VAS scoring system in which patients described the severity. This scoring system is individual dependent. There are lots of studies on UP treatment though there are lots of controversies in studies. Finding a definite cure for this unpleasant symptom can improve patients' quality of life. Conducting further studies for each treatment on larger population is essential to improve quality of life among the end stage renal disease patients.

Survival of Kidney Retransplant Compared With First Kidney Transplant: A Report From Southern Iran.

OBJECTIVES: Kidney retransplant is increasingly performed, but patient survival is controversial. The aim of this study was to evaluate the outcomes of patients with second kidney grafts and compare survival rates of recipients with first and second kidney transplant procedures. MATERIALS AND METHODS: This was a retrospective study analyzing records from the Shiraz University of Medical Sciences transplant ward. Survival rates of retrans?lanted patients were compared with a randomly selected group of first kidney recipients. Factors related to retransplant survival were evaluated. Data were analyzed by SPSS version 16.0, and P < .05 was consi?ered as significant. RESULTS: This study included 200 patients with first kidney transplants and 68 patients with kidney retransplants. We found that 1-, 3-, 5-, and 7-year graft survival rates were 91.9%, 87.2% ,86.3%, and 86.3% among retransplanted patients versus 98.3%, 95.4%, 90.2%, and 88.7% among the first transplant group (P = .130). Hospital stay duration after transplant, kidney rejection rate during hospitalization, delayed graft function, and creatinine levels at discharge were significantly associated with survival in retransplanted patients (P < .05). CONCLUSIONS: Kidney retransplants can yield desirable outcomes and is the treatment of choice in patients who have lost their graft. Careful screening for risk factors should be consider for obtaining better results in second kidney transplant procedures.

Prevalence of hypothyroidism and thyroid nodule in chronic hemodialysis Iranian patients.

INTRODUCTION: End stage renal disease (ESRD) reasons several changes in the function of thyroid gland as; lower levels of thyroid hormones, altered hormone metabolism, and increased iodine storage. The aim of this study was to evaluate the prevalence of nodular goiter and hypothyroidism in hemodialysis (HD) patients compared with normal population. METHODS: This cross-sectional study was conducted among HD patients and healthy people as the control group for thyroid function evaluation. Thyroid gland was evaluated by physical examination and ultrasonography. Blood level of FT3, FT4, TSH, TPO Ab, and urinary iodine excretion were checked in both groups. Data were analyzed using SPSS-17 and P-value less than 0.05 was considered as the significance level. FINDINGS: Eighty six HD patients (57.2 ± 17.2 mean age, 48 men) and 86 healthy people (56.6 ± 16.8 mean age, 48 men) were enrolled in this study. Goiter was confirmed by physical examination in 29.0% of the HD patients and 12.8% of the control group (P = 0.04). Nodular goiter that was shown by ultrasonography was found in 27.9% and 3.5% of the HD and control groups, respectively (P = 0.01). HD patients had a higher frequency of reduced FT3 (40.9% vs. 4.6%, P < 0.01) and increased TSH (18.6% vs. 8.1%, P < 0.03(. TPO Ab was positive in 15.1% of the HD and 11.6% of the control groups (P = 0.14). DISCUSSION: The high incidence of nodular goiter and hypothyroidism in ESRD patients shows that screening for thyroid dysfunction and goiter, using appropriate laboratory tests, should be considered in evaluations of ESRD patients.

Histopathological features of intra-ductal carcinoma of prostatic and high grade prostatic intraepithelialneoplasia and correlation with PTEN and P63.

BACKGROUND: The main morphologic differential diagnosis of intra-ductal carcinoma of prostate (IDC-P) is high grade prostatic intraepithelialneoplasia (HGPIN). Since IDC-P, unlike PIN, was strongly correlated with aggressive prostate cancer, differentiation of these is too necessary. So we evaluated immunohistopathological patterns and the prognostic factors of IDC-P and HGPIN, in radical prostatectomy samples. METHODS: We evaluated 250 radical prostatectomy and detected 210 cases of prostatic adenocarcinoma without IDC-P foci, 40 cases with adenocarcinoma concomitant IDC-P, and 40 cases HGPIN; therefore, we evaluated immunohistopathological criteria in these groups. Data were analyzed using SPSS and P-value <0.05 was considered as the statistical significant level. RESULTS: PSA level was significantly higher in IDC-P compared with non-IDC-P patients (15.7 ± 3.1 vs. 10.2 ± 4.3, P = 0.041). All pathological and morphologic features, also invasions factors were higher in IDC-P compared to non-IDC-P groups (P < 0.001). P63 was positive expressed in all IDC-P and HGPIN specimen. PTEN protein was diffusely expressed in the cytoplasm of all HGPIN but in 4 (11.1%) of IDC-P. PTEN and P63 were negative in adenocarcinoma foci. CONCLUSION: We found that IDC-P had a unique histoclinical feature and was strongly associated with poor prognostic factors. Diagnosis and report of IDC-P should be considered in all prostate specimens. Also, we recommend PTEN IHC application for differentiated IDC-P from HGPIN in biopsies.

Pattern of in-hospital pediatric mortality over a 3-year period at University teaching hospitals in Iran.

INTRODUCTION: Causes of death are different and very important for policy makers in different regions. This study was designed to analyze the data for our in-patient children mortality. MATERIALS AND METHODS: In this cross-sectional study from March 2011 to March 2013, all patients from 2 months to 18 years who died in pediatric intensive care unit, emergency room or medical pediatric wards in the teaching hospitals were studied. RESULTS: From a total of 18,915 admissions during a 2-year-period, 256 deaths occurred with a mean age of 4.3 ± 5 years and mortality 1.35%. An underlying disease was present in 70.7% of the patients and in 88.5% of them the leading causes of death were related to the underlying diseases. The most common underlying diseases were congenital heart disease and cardiomyopathy in 50 (27.6%). The four main causes of deaths were sepsis (14.8%), pneumonia (14.5%), congestive heart failure (9.8%), and hepatic encephalopathy (9.8%). CONCLUSION: We may conclude that after sepsis and pneumonia, congestive heart failure, and hepatic encephalopathy are the leading causes of death. Most patients who died had underlying diseases including malignancies, heart and liver diseases as the most common causes.

Ergotamine-induced acute tubulo-interstitial nephritis.

Ergotamine has been used for the treatment of migraine for many years, and its use in adults is considered to be safe and effective. In this report, we present a 22-year-old female patient, a known case of migraine, who was on ergotamine tartrate and presented with hypertension and renal failure. Renal biopsy indicated features of acute tubulo-interstitital nephritis.

Residual pulmonary hypertension after retrograde pulmonary embolectomy: long-term follow-up of 30 patients with massive and submassive pulmonary embolism.

OBJECTIVES: Pulmonary hypertension is a major cause of morbidity and mortality in patients following acute pulmonary embolism. Although thrombolytic therapy decreases pulmonary arterial pressure, compared with anticoagulation alone, it has the propensity for haemorrhagic complications, distal embolization and incomplete recanalization, with the potential risk of late pulmonary hypertension. Surgical embolectomy-once performed solely on critically-ill patients-has now gained favour in a wider range of patients. In this paper we present the outcomes of patients who underwent surgical embolectomy complemented with retrograde technique and follow-up systolic pulmonary arterial pressure (SPAP). METHODS: From January 2004 to December 2010, 30 consecutive patients with a mean age of 58±15 years underwent pulmonary embolectomy at our centre. The patients were followed for a mean period of 30.5±12 months. Their New York Heart Association (NYHA) classifications were assessed and their SPAPs were measured by echocardiography. RESULTS: The overall mortality rate was 13.2% (4/30). Of the remaining patients, 19 patients (73.1%) were in NYHA classes I and II, 7 patients (26.9%) in class III and no patient in class IV. The patients' preoperative and postoperative mean SPAPs were 44.9±5.7 and 34.9±7.1 mmHg, respectively, which showed a significant reduction (P<0.001). The mean SPAP in the follow-up was 29.4±11.5 mmHg, which again showed significant reduction compared with early postoperation values (P<0.001). No significant correlations were found between the level of SPAP reduction in patients' follow-up with age (P=0.727) and total days of ICU admission (P=0.700), but weak correlations with sex (P=0.016) and total intubation time were noticed (P=0.035). CONCLUSIONS: This is the first series reporting the long-term outcome of patients undergoing surgical embolectomy complemented by retrograde embolectomy technique, demonstrating the safety and favourable long-term outcome of this technique. It is also a new element in the growing body of evidence regarding the relevance of surgical embolectomy in patients with acute pulmonary embolism. We concluded that, following surgery, not only does the pulmonary arterial pressure drop immediately, but also the trend toward normalization continues long after operation.

Oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis: a randomized and placebo-controlled study.

OBJECTIVE: Despite highly expensive treatments, lupus nephritis remains a major cause of morbidity and mortality in patients with relapsing or refractory lupus nephritis. Meanwhile, experimental studies indicate that curcumin attenuates both the binding of autoantibodies from systemic lupus erythematosus patients to their cognate antigens and also the inflammatory responses of tumor necrosis factor-alpha-stimulated human endothelial cells. Therefore, in this study we investigated effect(s) of oral curcumin supplementation on patients suffering from relapsing or refractory lupus nephritis. DESIGN: A randomized and placebo-controlled study was carried out. SETTING: The present study was conducted in Lupus clinic of Hafez Hospital, Out-Patient Department of Shiraz University of Medical Sciences. PATIENTS: A total of 24 patients with relapsing or refractory biopsy-proven lupus nephritis, who were randomized in 2 groups (trial [n = 12] and control [n = 12] groups) were included in this study. INTERVENTION: With each meal, each patient in the trial group received 1 capsule for 3 months, which contained 500 mg turmeric, of which 22.1 mg was the active ingredient curcumin (3 capsules daily). The control group received 3 capsules (1 with each meal) for the same period, which contained starch and were identical in color and size to capsules given to patients in the trial group. MAIN AUTOMATIC MEASURE: Data were analyzed using Statistical Package for the Social Sciences software version 15.0. RESULTS: A significant decrease in proteinuria was found when comparing pre- (954.2 ± 836.6) and 1, 2, and 3 months supplementation values (448.8 ± 633.5, 235.9 ± 290.1, and 260.9 ± 106.2, respectively) in the trial group. Also, systolic blood pressure and hematuria were found to decrease significantly when pre- and post-turmeric supplementation values were compared in the trial group. However, placebo capsules did not exert any statistically significant effect on measured variables in the control group over 3 months of the study. No adverse effect related to turmeric supplementation was observed during the trial. CONCLUSION: Short-term turmeric supplementation can decrease proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis and can be used as an adjuvant safe therapy for such patients.

Epidemiologic status of bladder cancer in Shiraz, southern Iran.

BACKGROUND: Bladder cancer is the second most common malignancy of the genitourinary tract worldwide after prostate cancer. However, in Iran it is the most common cancer of the genitourinary system and the third most common cancer in males. The increasing trend in bladder cancer incidence in recent decades, along with the lack of research on this malignancy in Iran, make epidemiologic research important in light of its preventability through early recognition and limiting exposure to risk factors. The present study aimed to assess the epidemiology of bladder cancer in Shiraz, a large city in southern Iran, during a 2-year period. METHODS: The data for this study were obtained from the population-based cancer registry of the Vice-Chancellery for Health Affairs of Shiraz University of Medical Sciences and Shiraz hospitals between March 1, 2007 and March 1, 2009. Demographic, clinical and pathological aspects of 216 patients with bladder cancer were investigated through careful review of their medical records. Statistical analyses were performed with SPSS software. P values less than 0.05 were considered statistically significant. RESULTS: We analyzed data for 179 (82.9%) men and 37 (17.1%) women (mean age of 65.1∓12.7 years). Tobacco and opium use were found in 109 (65.3%) and 44 (34.1%) patients, respectively. Cigarette smokers and water pipe smokers were mostly men (P=0.001 and P=0.04, respectively). The most common type of tumor was transitional cell carcinoma (95.7%) and most tumors were of low malignant potential grade (39.7%). Nearly half of the patients suffered recurrence. CONCLUSION: Comparisons with previous studies showed that bladder cancer tends to appear slightly more often in the elderly and that the tumors tend to have a higher grade of malignancy in our region. There is a need for more epidemiologic studies on the trends in the incidence and other epidemiologic indices.

Oral supplementation of turmeric attenuates proteinuria, transforming growth factor-ß and interleukin-8 levels in patients with overt type 2 diabetic nephropathy: a randomized, double-blind and placebo-controlled study.

OBJECTIVE: End-stage renal disease (ESRD) due to type 2 diabetic nephropathy is a very common condition which is increasing in prevalence, and is associated with high global levels of mortality and morbidity. Both proteinuria and transforming growth factor-ß (TGF-ß) may contribute to the development of ESRD in patients with diabetic nephropathy. Experimental studies indicate that turmeric improves diabetic nephropathy by suppressing TGF-ß. Therefore, this study investigated the effects of turmeric on serum and urinary TGF-ß, interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α), as well as proteinuria, in patients with overt type 2 diabetic nephropathy. MATERIAL AND METHODS: A randomized, double-blind and placebo-controlled study was carried out in the Diabetes Clinic of the Outpatient Department of Shiraz University of Medical Sciences on 40 patients with overt type 2 diabetic nephropathy, randomized into a trial group (n = 20) and a control group (n = 20). Each patient in the trial group received one capsule with each meal containing 500 mg turmeric, of which 22.1 mg was the active ingredient curcumin (three capsules daily) for 2 months. The control group received three capsules identical in colour and size containing starch for the same 2 months. RESULTS: Serum levels of TGF-ß and IL-8 and urinary protein excretion and IL-8 decreased significantly comparing the pre- and post-turmeric supplementation values. No adverse effects related to turmeric supplementation were observed during the trial. CONCLUSION: Short-term turmeric supplementation can attenuate proteinuria, TGF-ß and IL-8 in patients with overt type 2 diabetic nephropathy and can be administered as a safe adjuvant therapy for these patients.

Application of amniotic membrane as xenograft for urethroplasty in rabbit.

OBJECTIVES: Uroepithelium repair has always been the subject of discussion in urology surgeries. Using human amniotic membrane allograft has already proved to be useful in other fields. In this study, we use amniotic membrane to repair uroepithelium injuries in rabbits. METHODS: Twenty healthy rabbits underwent surgery to induce a 10-mm incision, 10 mm from the meatus on ventral part of the urethra. Then a 5 x 10 mm patch of amniotic membrane was sutured to the incised urethra. All of the rabbits were catheterized for a week and then the patches were removed. The rabbits were studied for a month for any signs of infection and fistula formation. RESULTS: All samples revealed complete re-epithelialization of reconstructed urethra by transitional epithelium. There was one case of infection and following fistula (5%). There were two cases of urethral strictures (10%). CONCLUSION: The result from this study suggests that amniotic membrane is an inexpensive, easy, and biodegradable graft with very little antigen effect which seems to be the ideal solution for urethroplasty.