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1.
Phytother Res ; 37(7): 2800-2810, 2023 Jul.
Article in English | MEDLINE | ID: mdl-36808781

ABSTRACT

This trial was designed to evaluate the effect of a standardized capsule of Aloe vera gel (AVG) on the quality of life (QOL) in patients with systolic heart failure (HF). Forty-two patients were randomly divided into two groups to receive either AVG 150 mg or harmonized placebo capsules twice a day for 8 weeks. The patients were evaluated before and after the intervention using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), New York Heart Association (NYHA) functional class, six-minute walk test (6MWT), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and STOP-BANG questionnaires. Post-intervention, AVG group indicated a significant reduction in the total score of MLHFQ (p < 0.001). The changes in MLHFQ and NYHA class were statistically significant after taking medication (p < 0.001 and p = 0.004, respectively). The change of 6MWT in the AVG group was more advanced; however, it was not statistically significant (p = 0.353). Moreover, in the AVG group, the severity of insomnia and obstructive sleep apnea decreased (p < 0.001, p = 0.01 respectively) and the sleep quality improved as well (p < 0.001). There were significantly fewer adverse events reported in the AVG group (p = 0.047). Therefore, AVG combined with standard medical therapy could provide more clinical benefits for patients with systolic HF.


Subject(s)
Aloe , Heart Failure, Systolic , Sleep Initiation and Maintenance Disorders , Humans , Quality of Life , Heart Failure, Systolic/drug therapy , Sleep Initiation and Maintenance Disorders/drug therapy , Plant Preparations , Double-Blind Method , Treatment Outcome
2.
Phytother Res ; 35(11): 6101-6113, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34355443

ABSTRACT

Cardiovascular diseases (CVDs) comprise the most prevalent causes of morbidity and mortality in both men and women worldwide. CVDs are associated with several risk factors such as hyperlipidemia, diabetes mellitus, hypertension, obesity, tobacco smoking and an unhealthy diet. Currently, in addition to the use of related pharmacological treatments in the management of CVDs, the investigation of other suitable healthcare approaches for these disorders such as the identification of herbal medicines has been considered in the scientific communities. Aloe vera (L.) Burm.f. is a perennial medicinal plant. The innermost leaf layer of this plant contains transparent gel, which is used as food. Pre-clinical studies have shown several biological activities of A. vera gel (AVG), including antidiabetic, lipid-lowering, antioxidant, antiinflammatory, hepatoprotective, and immunomodulatory effects. Other pharmacological activities of AVG such as anti-fibrotic, anti-hypertensive, and anti-atherosclerotic effects have been reported. Moreover, several clinical studies have demonstrated the ameliorating effects of AVG on some markers of CVDs risk factors. Thus, this study was conducted to review clinical trials besides in vitro and in vivo studies on the cardiac beneficial effects of AVG. However, further high-quality studies are needed to firmly establish the clinical efficacy of the plant.


Subject(s)
Aloe , Cardiovascular Diseases , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Humans , Hypoglycemic Agents , Plant Extracts/pharmacology , Plant Preparations
3.
Int Q Community Health Educ ; : 272684X21991375, 2021 Feb 20.
Article in English | MEDLINE | ID: mdl-33615900

ABSTRACT

INTRODUCTION: Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.

4.
World J Urol ; 36(4): 667-671, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29349571

ABSTRACT

OBJECTIVES: To present the safety and efficacy of fluoroscopy-free ultrasound-guided PCNL for the treatment of renal calculi in pediatric patients of all ages. METHODS: 30 children with mean age of 5 years (6 months-12 years) underwent totally ultrasound-guided PCNL from March 2013 to August 2016. The pyelocalyceal system was punctured in prone position using only ultrasonography guidance, and the tract was dilated using a single shot dilation technique. No fluoroscopy was used during any of the stages of renal access. The procedure was performed using adult-sized instruments. RESULTS: The mean stone size was 27.1 ± 8.7 mm. Mean access time was 4.3 ± 2 min. Mean nephroscopic time was 34.6 ± 15.2 min. Mean hospital stay of patients was 3 days (range 2-5). 21 patients were stone-free after the procedure (70% success rate). Only four patients out of 30 experienced postoperative complications. CONCLUSIONS: The results of this study showed that fluoroscopic-free ultrasound-guided PCNL in pediatric patients of all ages is safe, highly efficient, and minimizes potential radiation exposure risks associated with the procedure.


Subject(s)
Kidney Calculi/surgery , Kidney , Nephrolithotomy, Percutaneous , Radiation Exposure/prevention & control , Surgery, Computer-Assisted/methods , Ultrasonography/methods , Child , Child, Preschool , Female , Humans , Infant , Iran , Kidney/diagnostic imaging , Kidney/surgery , Male , Nephrolithotomy, Percutaneous/adverse effects , Nephrolithotomy, Percutaneous/methods , Postoperative Complications , Retrospective Studies , Treatment Outcome
5.
Public Health Nutr ; 21(6): 1139-1146, 2018 04.
Article in English | MEDLINE | ID: mdl-29233205

ABSTRACT

OBJECTIVE: Metabolic syndrome (MetS) refers to a group of risk factors that increase the risk of cardiovascular mortality and morbidity. Dietary habits are among the most important risk factors for MetS. The current study aimed at assessing the effect of dietary habits on the risk of MetS in a 10-year follow-up study in central Iran. DESIGN: Cohort study. SETTING: Yazd, Iran. SUBJECTS: Participants aged 20-74 years without any history of MetS, who were originally recruited for Yazd Healthy Heart Project (YHHP) during 2005-2006, were revisited during 2015-2016. At phase I of YHHP, demographic data, anthropometric measurements, five components of MetS, biochemical tests and dietary habits were evaluated; and the same data were collected in phase II. RESULTS: A total of 1092 participants were eligible to be included in the present study. After follow-up, the 10-year cumulative incidence of MetS was 56·1 %. After adjustment for potential confounders, increased risk of MetS (hazard ratio; 95 % CI) was found in those who did not try to control their body weight (1·57; 1·06, 2·35), did not usually eat salad (1·91; 1·22, 3·00) and added salt to their food (1·57, 1·06, 2·33). These associations were stronger in men than in the total population after subgroup analysis, but were not present in women. CONCLUSIONS: Dietary habits affect the risk of MetS in the Iranian population. Lifestyle interventions are needed to improve dietary habits to reduce the risk of MetS. Future studies are highly recommended to confirm our results in other populations.


Subject(s)
Diet/statistics & numerical data , Metabolic Syndrome/epidemiology , Adult , Aged , Feeding Behavior , Female , Follow-Up Studies , Humans , Iran/epidemiology , Male , Middle Aged , Risk Factors , Young Adult
6.
Int J Urol ; 22(5): 514-9, 2015 May.
Article in English | MEDLINE | ID: mdl-25689730

ABSTRACT

OBJECTIVE: To report our 12-year experience with endoscopic management of patients with concomitant anterior and posterior urethral valves. METHODS: We retrospectively reviewed the charts of patients referred to us for management of urethral valves from 2000 to 2012 to find cases with concomitant anterior and posterior valves. The diagnosis of valves was first suspected on voiding cystourethrography and confirmed by urethrocystoscopy. We collected available data on patients' age at diagnosis, clinical presentations, ultrasound and urodynamic findings, and surgical treatments. The final outcome at last follow up was also recorded. RESULTS: From 38 cases with anterior urethral valve, six (15.8%) presented concomitant anterior and posterior valves. The age at diagnosis in these patients ranged from antenatal diagnosis to 13 years. Initial presenting symptoms were recurrent urinary tract infection, incontinence, urosepsis and poor urinary stream. All valves were ablated by transurethral fulguration/resection using small-sized urethrocystoscopes. Among those with concomitant anterior and posterior valves, four patients had vesicoureteral reflux at presentation that resolved in two patients after valve ablation. One patient progressed to renal failure and required dialysis. Bladder hypercontractility and detrusor overactivity were the main urodynamic patterns in these patients. CONCLUSIONS: Concomitant anterior and posterior valves seem to be more prevalent than previously assumed, and might be missed on initial assessment. Oblique view voiding cystourethrography with full-length delineation of the urethra is of paramount diagnostic importance when obstruction is suspected. A meticulous urethrocystoscopy should follow for confirming the diagnosis and endoscopic ablation/resection of the valves.


Subject(s)
Urethra/diagnostic imaging , Urinary Bladder Diseases/diagnostic imaging , Urinary Bladder/diagnostic imaging , Urodynamics , Aged , Child , Child, Preschool , Cystoscopy , Follow-Up Studies , Humans , Infant , Male , Pediatrics , Radionuclide Imaging , Retrospective Studies , Technetium Tc 99m Dimercaptosuccinic Acid , Urinary Bladder Diseases/surgery , Urinary Tract Infections
7.
Middle East J Anaesthesiol ; 23(1): 35-42, 2015 Feb.
Article in English | MEDLINE | ID: mdl-26121893

ABSTRACT

BACKGROUND: Postoperative cognitive dysfunction (POCD) is a well-recognized complication of cardiac and noncardiac surgery. However, contradictory results concerning postoperative mental function have been reported. The aim is to determine the effect of anesthetic techniques (general or spinal) on cognitive functions using more sensitive neuropsychological tests in patients undergoing urological surgery. MATERIAL AND METHODS: A total of thirty patients were enrolled in the study and assigned to receive either general (n = 15) or spinal (n = 15) anesthesia. A battery of neuropsychological tests including Wisconsin Card Sorting Test, Iowa Gambling Task, Stroop Color-Word Test, N-back Task and Continuous Performance Test was performed preoperatively and three days later. RESULTS: The two experimental groups were similar at baseline assessment of cognitive function. Although there were no statistically significant differences between general and spinal anesthetic groups with respect to Wisconsin Card Sorting Test and Iowa Gambling Task, a significant intergroup difference between pre-and postoperative N-back scores was detected in the general anesthesia group (p = 0.001 & p = 0.004). In addition, patients within this group had significantly higher error rates on the Stroop Color-Word (p = 0.019) and Continuous Performance Tests (p = 0.045). In contrast, patients receiving spinal anesthesia exhibited little change or marginal improvement on all subscales of the battery. CONCLUSIONS: Our findings indicate significant decline in specific aspects of mental function among patients who were administered general anesthesia compared with the other technique. It seems that spinal anesthesia contributes to lower disturbance after surgery.


Subject(s)
Anesthesia, General , Anesthesia, Spinal , Cognition Disorders/etiology , Urologic Surgical Procedures/adverse effects , Adult , Aged , Female , Humans , Male , Middle Aged
8.
Int Braz J Urol ; 40(3): 373-8, 2014.
Article in English | MEDLINE | ID: mdl-25010303

ABSTRACT

OBJECTIVE: To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4 mg plus sildenafil 50mg in group A and tamsulosin 0.4 mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient's ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. RESULTS: Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively). CONCLUSION: It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.


Subject(s)
Adrenergic alpha-1 Receptor Antagonists/administration & dosage , Phosphodiesterase 5 Inhibitors/administration & dosage , Piperazines/administration & dosage , Prostatic Hyperplasia/drug therapy , Sulfonamides/administration & dosage , Sulfones/administration & dosage , Urinary Retention/drug therapy , Acute Disease , Analysis of Variance , Drug Synergism , Drug Therapy, Combination , Humans , Lower Urinary Tract Symptoms/physiopathology , Male , Middle Aged , Prostatic Hyperplasia/physiopathology , Purines/administration & dosage , Sildenafil Citrate , Tamsulosin , Time Factors , Treatment Outcome , Urinary Catheterization , Urinary Catheters , Urinary Retention/physiopathology
9.
Urol Int ; 90(4): 394-8, 2013.
Article in English | MEDLINE | ID: mdl-23594973

ABSTRACT

PURPOSE: To assess the surgical outcomes and peri- and postoperative complications following percutaneous nephrolithotomy (PCNL) in high- and low-risk patients according to the American Society of Anesthesiologists (ASA) score. MATERIALS AND METHODS: We reviewed the patient records of 2,281 cases older than 18 years who had undergone PCNL in the 3 previous years. The patients were divided into two groups: a low-risk group (ASA score 1, 2: 1,922 cases) and a high-risk group (ASA score 3, 4: 359 cases). RESULTS: Analysis of the location and size of the stone, number and type of access, surgical approach, post-PCNL serum hemoglobin and decrease in glomerular filtration rate revealed no significant difference between the two groups. The stone-free rate was similar in both groups and the hospital stay in the high-risk patients was significantly greater than in the low-risk cases. 95% of low-risk and 91% of high-risk cases had surgical complications compatible with grade ≤II (Clavien system) and overall distribution of different grades of surgical complications was similar between the two groups (p = 0.177). CONCLUSION: Success rate and surgical complications of PCNL in high-risk patients were comparable to low-risk patients. It seems that PCNL may be a safe and effective procedure even in high-risk patients.


Subject(s)
Kidney Calculi/surgery , Nephrostomy, Percutaneous/adverse effects , Postoperative Complications/etiology , Adult , Aged , Chi-Square Distribution , Humans , Iran , Kidney Calculi/diagnosis , Length of Stay , Middle Aged , Postoperative Complications/therapy , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome
10.
Urologia ; 90(1): 83-88, 2023 Feb.
Article in English | MEDLINE | ID: mdl-35191332

ABSTRACT

BACKGROUND: To compare the disease course, histopathological features and survival rates of prostate cancer (PCa) between patients aged ⩽ 55 and > 55 year old. MATERIALS AND METHODS: In this retrospective study, we enrolled 644 patients with organ-confide prostate cancer who had undergone radical prostatectomy from 2005 to 2018. Seventy-six (11.8%) patients were under 55 years of age (group 1) and 568 (88.2%) patients were >55 years old (group 2). RESULTS: Pre-operative hypertension was detected in 4 (5.3%) patients of group 1 and 80 (14.1%) patients of groups 2 (p = 0.029). The mean (±SD) prostate volume was higher in group 2 compared with group 1 (34.1(±8.4) ml vs 54.1(±9.9) ml, p < 0.001). Positive surgery margin was observed in 15 (19.7%) and 58 (10.2%) patients in group 1 and 2, respectively (p = 0.020). Co-existence of diabetes mellitus, mean pre-operative PSA, Gleason's score, and permanent pathology and pathologic stage were similar between the two groups. Log-rank test failed to show any statistical difference in terms of biochemical-relapse free survival, local recurrence-free survival, and metastasis-free survival between the two groups (p = 0.316, 0.441, 0.654, respectively). After performing multivariate analysis, positive surgical margin was the only factor that was independently predictive of biochemical relapse (p < 0.001) and local recurrence/metastasis (p < 0.001). CONCLUSION: No difference was observed in terms of histopathologic features, biochemical relapse, and local recurrence/metastasis-free survival rates between patients younger and older than 55 years of age.


Subject(s)
Prostate-Specific Antigen , Prostatic Neoplasms , Male , Humans , Aged , Middle Aged , Prostate/pathology , Retrospective Studies , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Prostatectomy/adverse effects , Margins of Excision , Disease-Free Survival , Neoplasm Recurrence, Local/pathology , Neoplasm Staging
11.
Urol Res Pract ; 49(1): 25-32, 2023 Jan.
Article in English | MEDLINE | ID: mdl-37877835

ABSTRACT

OBJECTIVE: The objective of this study is to evaluate oncologic outcomes in patients with PT3aNxM0 renal cell carcinoma following radical nephrectomy and also to investigate these outcomes in each specific subgroup of PT3a renal cell carcinoma and to determine predictive factors of recurrence, metastasis, and mortality. MATERIALS AND METHODS: In this retrospective cohort study, we included 94 patients with stage PT3a renal cell carcinoma who had undergone radical nephrectomy from 2011 to 2016. All patients who had survived had at least 60 months of follow-up. Demographic and clinical data were collected; univariable and multivariable Cox proportional hazards regression analysis was performed to identify predictors of metastasis, recurrence, and cancer-related mortality. RESULTS: Patients' mean age was 58.07 ± 11.17 years and 62/94 (65.9%) were male. The mean follow-up time was 48.1 ± 25.5 months. Forty-three patients (45.7%) had experienced cancer-related mortality. The mean cancer-specific survival time was 60.94 months and the mean metastasis-free and local recurrence-free survival times were 57.06 and 88.72 months, respectively. Metastasis and local recurrence had occurred in 42 (44.6%) and 4 (4.25%) patients, respectively. After performing multivariate analysis, higher nuclear Fuhrman's grade (P < .001) and simultaneous involvement of the renal vein and perinephric fat (P < .001) were found to be predictive of cancerrelated mortality. Advanced nuclear Fuhrman's grade was the only independent predictor of metastasis (P=.001). CONCLUSION: Based on our results, advanced nuclear Fuhrman's grade and sarcomatoid change can independently predict mortality in patients with stage PT3aNxM0 renal cell carcinoma. Close monitoring during the follow-up period is recommended in patients with the mentioned risk factors.

12.
Urol J ; 19(1): 28-33, 2021 Dec 20.
Article in English | MEDLINE | ID: mdl-34927230

ABSTRACT

PURPOSE: To compare the performance and outcomes of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) in the management of staghorn kidney stones. MATERIALS AND METHODS: This study was a parallel-group randomized clinical trial study carried out on 68 patients with staghorn stones (one single piece or maximally two-piece stones with large extra renal part) over 18 years referred to Labbafinejhad Hospital. Patients were randomly divided on a ratio of 1:1 into two groups of LPL and PCNL using random allocation software. The primary outcome was the stone free rate, which was evaluated with KUB, and ultrasonography. Secondary outcomes were duration of surgery, bleeding, fever, post-operative pain, length of hospital stay, and postoperative complications. RESULTS: The mean±SD age of patients in PCNL and LPL groups were 48.50 ± 13.33 years and 52.17 ± 15.74 years, respectively (P=.303). LPL was associated with a higher duration of surgery (196.55 ± 26.58 minutes versus 110.88 ± 34.82; P=.001). Hemoglobin drop in the PCNL group was higher than the LPL group (2.67 ± 2.61 g/dL versus -0.7912 ± 1.06 g/dL; P=.001). Stone free status was observed in 29 (85.3%) patients in the LPL group, which was significantly higher than the PCNL group (22 patients, 64.7%; P =.050). CONCLUSION: The results of this study indicate that LPL offers a higher stone free rate with less bleeding in patients with single particle or limited particles staghorn stones with extrarenal pelvis but is associated with a higher duration of operation. The application of LPL in patients with multiple stones carries a lower achievement and is not encouraged.


Subject(s)
Kidney Calculi , Laparoscopy , Nephrolithotomy, Percutaneous , Nephrostomy, Percutaneous , Staghorn Calculi , Adult , Humans , Kidney Calculi/surgery , Laparoscopy/adverse effects , Middle Aged , Nephrolithotomy, Percutaneous/adverse effects , Nephrostomy, Percutaneous/methods , Nephrotomy/methods , Staghorn Calculi/surgery , Treatment Outcome
13.
Urol J ; 18(6): 646-651, 2021 Jul 06.
Article in English | MEDLINE | ID: mdl-34247358

ABSTRACT

PURPOSE: Cutaneous ureterostomy after radical cystectomy is less preferred compared with other permanent urinary diversions due to bilateral stomas. Single umbilical stoma for bilateral ureterostomy (SUSBU) may be a choice, in this study we reviewed the outcomes of SUSBU in seventeen patients who underwent radical cystectomy. METHODS AND MATERIALS: This was a case-series study conducted from April 2016 to Dec 2017. Seventeen male patients with confirmed PT2 bladder urothelial carcinoma who were not suitable for performing conduit or orthotopic urinary diversion, including those with high-risk patients underwent single umbilical stoma for bilateral ureterostomy after radical cystectomy. All patients were prospectively followed up for 24 months ± 2 months, this study was done in a teaching center mainly by senior residents. RESULTS: The mean age of patients was 68.6 ± 6.41 years. The mean length of operation time was 176.7 ± 15.1 minutes (from intubation to extubation from anesthesia). Sixteen patients were diagnosed with PT2 and one patient had a PT4 diagnosis. The decrease in hemoglobin level after surgery was 1.72 mg/dl ± 0.35 and creatinine increased by 0.15 ± 0.05 mg/dl. None of our patients had oliguria. One case developed constipation and no gas passing, with the suspicion of obstruction, underwent abdominal exploration, however, no obstruction or urine leakage was found and the patient was treated conservatively. One patient developed a fever during admission, in which atelectasis was identified as the cause. One patient underwent a second operation because of fascia dehiscence. CONCLUSION: It seems that this technique is suitable for high-risk patients with acceptable operating time, surgical complications, and fast recovery after the operation and one ureterostomy bag instead of two one's comparing to bilateral cutaneous ureterostomy.


Subject(s)
Carcinoma, Transitional Cell , Urinary Bladder Neoplasms , Urinary Diversion , Aged , Carcinoma, Transitional Cell/surgery , Cystectomy/adverse effects , Humans , Male , Middle Aged , Ureterostomy , Urinary Bladder , Urinary Bladder Neoplasms/surgery , Urinary Diversion/adverse effects
14.
J Endourol ; 35(5): 749-752, 2021 05.
Article in English | MEDLINE | ID: mdl-26058433

ABSTRACT

Purpose: To present the safety and efficacy of totally ultrasonography-guided percutaneous nephrolithotomy (PCNL) for managing urinary stones in pediatric patients. Patients and Methods: Ten children with a mean age of 5.4 (3-11) years underwent totally ultrasonography-guided PCNL from March 2013 to November 2013. The pyelocaliceal system was punctured with the patient in the prone position by using ultrasonographic guidance, and the tract was dilated using a single-shot dilation technique. All steps of renal access were performed by using ultrasonography; no fluoroscopy was used. PCNL in all cases was performed by using adult instruments. Results: The mean stone size was 28.9±6.7 mm (range 17-35 mm). The mean access time to stone was 4.45±2.25 minutes (range 3-10 min). The mean nephroscopic time was 45.9±17 minutes (range 20-80 min). The stone-free rate was 83%. Mean hospital stay of patients was 3 days (range 2-5 days). No major complications were happened. Only one patient needed ureteral stent insertion because of urinary leakage from the nephrostomy tract. Conclusion: Our experience with totally ultrasonography-guided PCNL using adult size instruments in children revealed proper results and acceptable complications compared with the standard technique of PCNL. Likewise, this alternative method has the advantage of preventing radiation hazard.


Subject(s)
Kidney Calculi , Nephrolithotomy, Percutaneous , Nephrostomy, Percutaneous , Adult , Child , Child, Preschool , Humans , Kidney/diagnostic imaging , Kidney/surgery , Kidney Calculi/diagnostic imaging , Kidney Calculi/surgery , Treatment Outcome , Ultrasonography
15.
Clin Nutr ; 39(1): 282-290, 2020 01.
Article in English | MEDLINE | ID: mdl-30850269

ABSTRACT

BACKGROUND: Dietary habits are proposed to affect the risk of metabolic syndrome (MetS). The present study aimed to investigate the association between a dietary habits score (DHS) and the risk of MetS and its components among Iranian adults. MATERIALS AND METHODS: In this cohort study 1092 participants without MetS were followed up to 10 years. The baseline data on general characteristics as well as dietary habits were assessed through interview. The modified National Cholesterol Education Program, adult treatment panel III guideline was used to define MetS. The hazard ratio for the association between each dietary habit and MetS was used to calculate the DHS for each participant and the participants were categorized into quartiles based on their final calculated score. RESULTS: In total, 809 (74.1%) with mean age of 43 ± 14.4 years were followed. The risk of abdominal obesity (HR = 3.43, 95%CI: 1.97-5.94), low HDL cholesterol (HR = 3.01, 95%CI: 1.62-5.62), hyperglycemia (HR = 3.06, 95%CI: 1.58-5.94), and hypertension (HR = 3.44, 95%CI: 1.85-6.37) and MetS (HR = 2.94, 95%CI: 1.6-5.39) were significantly higher in those with the highest DHS compared with subjects categorized in the lowest quintile of DHS after adjustment for all possible confounders. There was a linear trend between the dietary habit score and the risk of developing MetS and its components (P < 0.05). CONCLUSION: The DHS was significantly associated with an increased risk of MetS and some of its components. Future studies are needed to confirm the approach used to calculate the DHS and its association with the risk of MetS and its components in other populations.


Subject(s)
Diet/methods , Feeding Behavior , Metabolic Syndrome/epidemiology , Adult , Cohort Studies , Female , Follow-Up Studies , Humans , Iran/epidemiology , Male , Risk Factors
16.
Urol J ; 18(2): 165-170, 2020 Oct 20.
Article in English | MEDLINE | ID: mdl-33078384

ABSTRACT

PURPOSE: Partial adrenalectomy (PA) is an emerging modality typically performed for the treatment of hereditary and sporadic bilateral tumors, to reduce the risk of adrenal failure. In this study, we evaluated the recurrence and functional outcomes after partial and total adrenalectomy (TA). MATERIALS AND METHODS: From March 2005 to July 2018, 284 patients with functional tumor or > 5 cm adrenal mass underwent clipless and sutureless laparoscopic partial or total adrenalectomy (PLA and TLA). Patients with a pathological diagnosis of pheochromocytoma, Cushing or Conn's disease and more than two year follow up were included in this study. Pre-operative and operative variables were collected retrospectively and functional outcomes and recurrence were gathered prospectively. RESULTS: One hundred forty patients (mean age: 43±5.1years) were included in the study. PLA and TLA were performed for pheochromocytoma (total n=78; PLA=12 (15%), TLA=66 (85%)), Cushing syndrome (toal n=17; PLA = 4 (24%), TLA = 13 (76%)), and Conn's disease (total n=45; PLA=7 (16%), TLA=38 (84%)). In pheochromocytoma patients, improvement of hypertension, palpitation, and headache was not different between patients who underwent PLA versus TLA (all P > 0.05). Two recurrences were observed in patients with pheochromocytoma who had undergone TLA. In patients with Cushing disease, central obesity, fascial plethora, and hypertension were improved in all patients six months after treatment, muscle weakness was improved one year after surgery, and acne and hyperpigmentation only improved two years after surgery. The length of time for resolution of symptoms was not different in patients who underwent PLA versus TLA. In Conn's disease hypertension was resolved in all patients and no patient required potassium supplements post-operatively. In follow up no recurrence was observed in patients with a pathological diagnosis of Cushing or Conn's disease. CONCLUSION: In our experience, PLA can provide excellent control of the symptoms parallel with TLA and with no statistically significant difference in recurrence making PLA an attractive option in patients with an adrenal mass.


Subject(s)
Adrenal Gland Neoplasms/surgery , Adrenalectomy/methods , Laparoscopy , Neoplasm Recurrence, Local/epidemiology , Pheochromocytoma/surgery , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Remission Induction , Retrospective Studies , Time Factors , Treatment Outcome
17.
Urol J ; 15(4): 214-216, 2018 07 10.
Article in English | MEDLINE | ID: mdl-29464677

ABSTRACT

A 40-year-old man was referred to our urology clinic due to vague abdominal pain and hematuria. Computed tomography (CT) without contrast material visualized an ectopic kidney in the left iliac fossa with a complete staghorn stone. Under general anesthesia, operation was done in supine position with a gentle lateral elevation on the right side. The surgeon stands on the right side of the patient. First, a 12 mm port was inserted at the umbilicus using the Hasson technique. After creation of pneumoperitoneum, operation was done by three 5 mm trocars were arranges as paraumbilical, the point between umbilicus and inguinal canal at left and right side.A vertical pyelotomy incision was made over the anterior pelvic wall and then extended to a cross figure. The stone extracted intact with a laparoscopic stone grasper and placed in endobag. A short double J stent was placed via the pyelotomy incision and renal pelvis was closed using continuous 4.0 vicryl sutures. He was discharged from hospital after 3 days without any complication.


Subject(s)
Kidney/abnormalities , Laparoscopy/methods , Staghorn Calculi/surgery , Adult , Humans , Kidney/diagnostic imaging , Male , Pelvis , Staghorn Calculi/diagnostic imaging
18.
ESC Heart Fail ; 5(6): 1060-1068, 2018 12.
Article in English | MEDLINE | ID: mdl-30334369

ABSTRACT

AIMS: Echocardiography is known as the most useful diagnostic test in the assessment of patients with heart failure (HF), and the prognostic significance of echocardiographic findings in HF is well known. In this report, we aim to present the prognostic significance of a limited set of echocardiographic parameters obtained within 24 h of admission of patients enrolled in the Rajaie Acute Systolic Heart Failure registry. METHODS AND RESULTS: A total of 230 patients with the diagnosis of acute systolic HF (left ventricular ejection fraction ≤ 35%) were enrolled into the study. Transthoracic echocardiography was performed for all study population within 24 h of admission. The primary endpoint of the study was the occurrence of worsening renal function (WRF) during the hospitalization course.Acquiring data of transthoracic echocardiography within 24 h of admission was feasible in all study participants. The median (inter-quartile range) of left ventricular ejection fraction was 20% (15-23%). Severe right ventricular dysfunction was observed in 21.5% of patients. The grade of inferior vena cava collapse and right ventricular systolic dysfunction were associated with WRF. In multivariable analysis, right ventricular systolic dysfunction was among the independent predictors of WRF [ß = 0.8, P = 0.01, odds ratio (OR) = 2.4 (1.2-4.9)] and in-hospital mortality [ß = 0.6, P = 0.04, OR = 1.5 (0.5-4.6)]. CONCLUSIONS: Echocardiographic parameters are useful for baseline assessment and provide additional information besides other clinical variables for prognostication. Right ventricular dysfunction is the most important risk factor in developing WRF and in-hospital mortality in patients with acute HF.


Subject(s)
Echocardiography/methods , Heart Failure, Systolic/diagnosis , Kidney/physiopathology , Registries , Renal Insufficiency/physiopathology , Stroke Volume/physiology , Acute Disease , Creatinine/blood , Disease Progression , Female , Follow-Up Studies , Glomerular Filtration Rate , Heart Failure, Systolic/mortality , Heart Failure, Systolic/physiopathology , Hospital Mortality/trends , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Renal Insufficiency/etiology , Renal Insufficiency/metabolism , Risk Factors , Survival Rate/trends
19.
J Laparoendosc Adv Surg Tech A ; 27(12): 1269-1274, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28631946

ABSTRACT

INTRODUCTION: This systematic review and meta-analysis were designed to evaluated the efficacy and safety of stented versus stentless laparoscopic ureterolithotomy (LU). METHODS: We conducted a systematic review and meta-analysis that included six trials that investigated the outcomes, including the rate of prolonged urine leakage, operative time, time to drain removal, and estimated blood loss, between stented versus stentless LU. RESULTS: Four studies with 289 participants were included in the study. There was no significant difference between two groups in rate of prolonged urine leakage (odds ratios [OR] 0.35, 95% confidence intervals [CI] 0.09-1.46, p = 0.15). Significant longer operative time was detected in patients who underwent stented LU compared with stentless group (mean difference 11.36, 95% CI 7.53-15.20, P < .00001). There was no significant difference between two groups in day of drain removal (mean difference -1.09, 95% CI -2.33-0.15, P = .08). No significant difference in blood loss in patients who underwent stented LU compared with stentless group was detected (mean difference 7.67, 95% CI -0.29-15.64, P = .06). CONCLUSION: Our study demonstrated that the rate of prolonged urine leakage, time to drain removal, and estimated blood loss were not significantly different between stented and stentless LU.


Subject(s)
Stents/adverse effects , Ureter/surgery , Ureterolithiasis/surgery , Ureteroscopy/methods , Female , Humans , Male , Operative Time , Postoperative Complications/epidemiology , Treatment Outcome , Ureteroscopy/adverse effects
20.
Exp Clin Transplant ; 15(5): 532-535, 2017 Oct.
Article in English | MEDLINE | ID: mdl-27855587

ABSTRACT

OBJECTIVES: Our objective was to evaluate the effect of kidney graft weight-to-recipient body weight ratio as a nonimmune factor that may affect long-term graft function. MATERIALS AND METHODS: We retrospectively collected data from 2531 living donor kidney transplant procedures performed between 1994 and 2010 at Shahid Labbafinejad Medical Center; 635 patients were included in this study. Each kidney was weighed after cold wash. The kidney weight-to-recipient body weight ratio was calculated. As an indicator of graft function, we used the Modification of Diet in Renal Disease Study Group equation to estimate glomerular filtration rate. For statistical analyses, we used simple linear regression analysis and the mixed model test using SPSS version 17.0 software (SPSS, Chicago, IL, USA). RESULTS: Mean age of recipients and median follow-up duration were 37.5 years (range, 6-77 y) and 36 months (range, 25-84 mo). Long-term graft function showed a positive correlation with kidney graft-to-recipient body weight ratio but not with the graft weight alone. The magnitude of this correlation was higher early after surgery (day 7) and decreased with long-term follow-up but was still statistically significant (P < .001). CONCLUSIONS: From our results, we conclude that kidney graft-to-recipient body weight ratio is correlated with the kidney graft function; graft size matching may be considered for kidney donor selection.


Subject(s)
Body Weight , Donor Selection , Glomerular Filtration Rate , Kidney Transplantation/methods , Kidney/surgery , Living Donors , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Graft Survival , Humans , Iran , Kidney/pathology , Kidney/physiopathology , Kidney Transplantation/adverse effects , Linear Models , Male , Middle Aged , Multivariate Analysis , Organ Size , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome , Young Adult
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