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Leishmaniasis is considered one of the most critical health concerns in the world. Unfortunately, no protective vaccines exist and conventional treatments are relatively ineffective. Therefore, new strategies are necessary against leishmaniasis. In recent years, exosomes have shown promising therapeutic outcomes in various diseases, including infectious diseases. In this regard, we aimed to explore the effect of the exosome, pyrimethamine and their combination on the anti-parasitic function of RAW264.7 cells against Leishmania major. Exosomes were isolated from the C57BL/6 peritoneal macrophages. L. major infected and non-infected RAW264.7 cells treated with exosomes, pyrimethamine (PM), and exosomes along with PM. The effect of the treatments was analysed on phagocytosis, efferocytosis, the intracellular parasite count, arginase activity, nitric oxide (NO) and reactive oxygen species (ROS) production. Exosomes could significantly elevate the phagocytosis, efferocytosis, NO and ROS in both infected and non-infected groups (Pv < 0.05). The exosomes reduced the arginase activity in both groups (Pv < 0.05). The intracellular parasite count was significantly lower after treatment with exosomes (Pv < 0.05). These results demonstrate that MQ-derived exosomes can enhance in vitro anti-parasitic responses against L. major. This provides a potential pathway for more effective treatments and underscores the importance of further research in this area., (© 2024 John Wiley & Sons Ltd.)

Purpose: Percutaneous nephrolithotomy (PCNL) has undergone extensive modification to reduce complications. One of the recent advances in minimally invasive procedures is the advent of ultra-mini PCNL (UM-PCNL), which provides miniaturized access to the kidney. However, the specific instruments applied in UM-PCNL may not be found in centers with limited resources. This study evaluated the safety, feasibility, results, and short-term complication rates of performing UM-PCNL using a semi-rigid ureteroscope in preschool children., Materials and Methods: Between September 2013 and September 2021, a total of 68 patients, including 42 boys and 26 girls with a mean age of 3.2 ± 2.4 years, underwent UM-PCNL with a 4.5French tip ureteroscope instead of an ultra-mini nephroscope in children aged less than 7 years old. The procedure was done under general anesthesia in the prone position. The nephrostomy tract was dilated to 12F. Stones were fragmented using a pneumatic lithotripter. Irrigation was done with normal saline., Results: The early stone-free rate (SFR) was 91%, and the short-term total SFR was 97%. No statistically significant difference was found in pre-operative and post-operative Hb, BUN, Cr, Na+, and K+. Fever (11 patients) and ileus (5 patients) constituted the majority of complications, and only one patient required a blood transfusion. None of the cases undergoing UM-PCNL with this method required a re-do PCNL., Conclusion: Our experience shows that with sufficient experience in handling semi-rigid ureteroscopes, urologists practicing in centers with limited resources could perform UM-PCNL with relatively favorable outcomes.

Background: The biomechanical analysis of spine and postural misalignments is important for surgical and non-surgical treatment of spinal pain. We investigated the examiner reliability of sagittal cervical alignment variables compared to the reliability and concurrent validity of computer vision algorithms used in the PostureRay ® software 2024. Methods: A retrospective database of 254 lateral cervical radiographs of patients between the ages of 11 and 86 is studied. The radiographs include clearly visualized C1-C7 vertebrae that were evaluated by a human using the software. To evaluate examiner reliability and the concurrent validity of the trained CNN performance, two blinded trials of radiographic digitization were performed by an extensively trained expert user (US) clinician with a two-week interval between trials. Then, the same clinician used the trained CNN twice to reproduce the same measures within a 2-week interval on the same 254 radiographs. Measured variables included segmental angles as relative rotation angles (RRA) C1-C7, Cobb angles C2-C7, relative segmental translations (RT) C1-C7, anterior translation C2-C7, and absolute rotation angle (ARA) C2-C7. Data were remotely extracted from the examiner's PostureRay ® system for data collection and sorted based on gender and stratification of degenerative changes. Reliability was assessed via intra-class correlations (ICC), root mean squared error (RMSE), and R 2 values. Results: In comparing repeated measures of the CNN network to itself, perfect reliability was found for the ICC (1.0), RMSE (0), and R 2 (1). The reliability of the trained expert US was in the excellent range for all variables, where 12/18 variables had ICCs ≥ 0.9 and 6/18 variables were 0.84 ≤ ICCs ≤ 0.89. Similarly, for the expert US, all R 2 values were in the excellent range (R 2 ≥ 0.7), and all RMSEs were small, being 0.42 ≤ RMSEs ≤ 3.27. Construct validity between the expert US and the CNN network was found to be in the excellent range with 18/18 ICCs in the excellent range (ICCs ≥ 0.8), 16/18 R 2 values in the strong to excellent range (R 2 ≥ 0.7), and 2/18 in the good to moderate range (R 2 RT C6/C7 = 0.57 and R 2 Cobb C6/C7 = 0.64. The RMSEs for expert US vs. the CNN network were small, being 0.37 ≤ RMSEs ≤ 2.89. Conclusions: A comparison of repeated measures within the computer vision CNN network and expert human found exceptional reliability and excellent construct validity when comparing the computer vision to the human observer.

Aging is a significant risk factor for Alzheimer's disease (AD), although the precise mechanism and molecular basis of AD are not yet fully understood. Epigenetic mechanisms, such as DNA methylation and hydroxymethylation, mitochondrial DNA methylation, histone modifications, and non-coding RNAs (ncRNAs), play a role in regulating gene expression related to neuron plasticity and integrity, which are closely associated with learning and memory development. This review describes the impact of dynamic and reversible epigenetic modifications and factors on memory and plasticity throughout life, emphasizing their potential as target for therapeutic intervention in AD. Additionally, we present insight from postmortem and animal studies on abnormal epigenetics regulation in AD, as well as current strategies aiming at targeting these factors in the context of AD therapy., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: 10%-15% of the world's population suffers from kidney stones. Nearly 50% increase was observed in diagnosing and treating nephrolithiasis in the last decades. Effective medical treatment for the disease is not yet well established. Moreover, there is an increasing global demand to manage diseases using complementary and alternative medicine. This study aimed to formulate and assess the safety and efficacy of a multi-ingredient formulation from traditional Persian medicine (TPM) known as Mofatet powder in patients suffering from calcium kidney stones., Materials and Methods: The aqueous extract of Mofatet powder was prepared, freeze-dried, and formulated as capsules. 26 patients in the drug group and 25 patients in the placebo group used 500 mg capsules of the drug/placebo twice daily for 5 weeks. Ultrasonography/kidney, ureter and bladder imaging, urine analysis, and biochemical parameters were evaluated before and after the intervention., Results: The imaging results showed a 60.73% decrease ( P < 0.001) in stone size in the drug group. Moreover, the urinary calcium decreased ( P = 0.02) and the urinary magnesium increased ( P < 0.001) in the drug group. No remarkable changes were observed in the placebo group in these parameters. No significant effect was observed in aspartate transaminase, alanine transaminase, serum creatinine, and blood urea nitrogen levels in none of the groups., Conclusion: This study suggests that Mofatet powder was effective in reducing calcium kidney stones size with no potential nephro/hepatotoxicity. After confirming these results in larger clinical trials with longer duration, this formulation can be considered a treatment for nephrolithiasis., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Research in Medical Sciences.)

Background and Aim: Metabolic syndrome (MetS) increases the risk of atherosclerosis and diabetes, but there are no approved predictive markers. This study assessed the role of specific genetic variations in MetS susceptibility and their impact on clinical manifestations., Method: In this study, a genotype-phenotype assessment was performed for IKZF3 (rs907091), microRNA-let-7a-2 (rs1143770), and lncRNA-CDKN2B-AS1 (rs1333045)., Results: Analyses indicate that while rs907091 and rs1143770 may have potential associations with MetS susceptibility and an increased risk of atherosclerosis and diabetes, there is an observed trend suggesting that the rs1333045 CC genotype may be associated with a decreased risk of MetS. The genotypes and allele frequencies of rs1333045 were significantly different between studied groups (OR = 0.56, 95% CI 0.38-0.81, p = 0.002, and OR = 0.71, 95% CI 0.55-0.92, p = 0.008), with the CC genotype displaying increased levels of HDL. Furthermore, the rs907091 TT genotype was associated with increased triglyceride, cholesterol, and HOMA index in MetS patients. Subjects with the CC genotype for rs1143770 had higher HbA1c and BMI. In silico analyses illustrated that rs907091 C remarkably influences the secondary structure and the target site of a broad spectrum of microRNAs, especially hsa-miR-4497. Moreover, rs1333045 creates a binding site for seven different microRNAs., Conclusion: Further studies on other populations may help confirm these SNPs as useful predictive markers in assessing the MetS risk., (© 2024 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Transition to novel environments, such as groundwater colonization by surface organisms, provides an excellent research ground to study phenotypic evolution. However, interspecific comparative studies on evolution to groundwater life are few because of the challenge in assembling large ecological and molecular resources for species-rich taxa comprised of surface and subterranean species. Here, we make available to the scientific community an operational set of working tools and resources for the Asellidae, a family of freshwater isopods containing hundreds of surface and subterranean species. First, we release the World Asellidae database (WAD) and its web application, a sustainable and FAIR solution to producing and sharing data and biological material. WAD provides access to thousands of species occurrences, specimens, DNA extracts and DNA sequences with rich metadata ensuring full scientific traceability. Second, we perform a large-scale dated phylogenetic reconstruction of Asellidae to support phylogenetic comparative analyses. Of 424 terminal branches, we identify 34 pairs of surface and subterranean species representing independent replicates of the transition from surface water to groundwater. Third, we exemplify the usefulness of WAD for documenting phenotypic shifts associated with colonization of subterranean habitats. We provide the first phylogenetically controlled evidence that body size of males decreases relative to that of females upon groundwater colonization, suggesting competition for rare receptive females selects for smaller, more agile males in groundwater. By making these tools and resources widely accessible, we open up new opportunities for exploring how phenotypic traits evolve in response to changes in selective pressures and trade-offs during groundwater colonization., (© 2023 John Wiley & Sons Ltd.)

The aberrant regulation of the Notch signaling pathway, which is a fundamental developmental pathway, has been implicated in a wide range of human cancers. The Notch pathway can be activated by both canonical and noncanonical Notch ligands, and its role can switch between acting as an oncogene or a tumor suppressor depending on the context. Epigenetic modifications have the potential to modulate Notch and its ligands, thereby influencing Notch signal transduction. Consequently, the utilization of epigenetic regulatory mechanisms may present novel therapeutic opportunities for both single and combined therapeutics targeted at the Notch signaling pathway. This review offers insights into the mechanisms governing the regulation of Notch signaling and explores their therapeutic potential.

Objectives: To investigate the predictive factors of delayed post-percutaneous nephrolithotomy (PCNL) haemorrhage because of arteriovenous fistula (AVF) or pseudoaneurysm (PA) and compare the factors between AVF and PA., Patients and Methods: This is a case-control study with a case-to-control ratio of 1:3. Out of 5077 patients who underwent PCNL from April 2015 to April 2018 in three different teaching hospitals, 113 had post-PCNL haemorrhages because of AVF and/or PA. Seventy-two patients met the inclusion criteria and entered the study as cases, while 216 patients without any postoperative complications were selected as controls., Results: Of all 72 studied patients with complications after PCNL, 35 (48.6%) had AVF, and the rest had PA. The regression model revealed that a history of diabetes (odds ratio [OR]: 2.799, 95% confidence interval [CI]: 1.392-5.630, p -value = 0.004) and renal anomalies (OR: 2.929, 95% CI: 1.108-7.744, p -value = 0.03) were associated with developing delayed post-PCNL haemorrhage. However, no differences were seen between AVF and PA regarding selected variables ( p -value > 0.05)., Conclusion: History of diabetes and renal anomalies were predictive factors for delayed post-PCNL haemorrhage, but no predictive factors were found to differentiate PA and AVF from one another., Competing Interests: Not applicable., (© 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)

Objectives: Stuttering is a common problem at all ages that is required to be treated since childhood. Atomoxetine is currently used for the treatment of attention deficit hyperactivity disorder (ADHD). It can be effective for the treatment of stuttering due to its selective inhibition of norepinephrine reuptake and dopaminergic properties. Therefore, this randomized controlled trial aimed to evaluate the effect of atomoxetine on children's stuttering., Materials & Methods: The children aged 4-12 years and diagnosed with stuttering, referred to Pediatric Neurology and Psychology clinics , were randomly divided into experimental (n=50) and control (n=50) groups. One group received atomoxetine plus speech therapy, and the other group received only speech therapy. Both groups completed the Stuttering Severity Instrument-Fourth Edition at the baseline (on the first visit) and 3 months after the intervention. The results were compared between the two groups using SPSS software (version 21)., Results: Most of the children (67%) were male. Moreover, 24%, 46%, and 30% of the subjects were within the age ranges of < 60, 60-95, and > 95 months, respectively. Nearly half of the patients (52%) had a positive family history of stuttering. Stuttering severity was the highest within the age range of 60-95 months, in left-handed children, in those who used formula, and in those who felt insecure in the family; however, there was no difference in stuttering severity based on child's gender, concomitant ADHD, multilingualism, facial or movement tics, sleeping hours, and using teats. The mean stuttering severity reduced in both groups (P<0.001), with a greater decrease in the experimental group, compared to that of the control group (P=0.011)., Conclusion: Atomoxetine plus speech therapy is effective for the treatment of children's stuttering and can be used as a complementary treatment strategy in such patients., Competing Interests: The present study wasnt financially supported by anyone, (© 2022 The Authors.)

Nowadays, the entry of organic compounds into water resources is one of the leading global concerns due to the lack of water resources and rapid population growth. In this research, anodic oxidation (AO) method was used to remove 5-fluorouracil (5-FU) from aqueous solutions via Ni/RuO 2 and Ti/IrO 2 -TiO 2 -RuO 2 electrodes as cathode and anode, respectively. For this purpose, the characterization analysis of the electrodes, including X-ray diffraction, scanning electron microscopy, energy dispersive X-ray, and atomic force microscopy were performed. The electrochemical performance of the anode was investigated via cyclic voltammetry analysis. Then, the effect of operational variables, including applied current (mA), initial pH of the solution, initial 5-FU concentration (mg/L), and process time (min) on the 5-FU removal efficiency under the AO process was evaluated via artificial neural network (ANN) modeling. The results revealed that the maximum 5-FU removal efficiency was 96.96%. The applied current intensity, pH, initial 5-FU concentration, and process time were 300 mA, 5, 20 mg/L, and 140 min, respectively. Moreover, the investigation of 5-FU removal by-products and mineralization efficiency of the AO process was carried out via gas chromatography-mass spectrometry and total organic carbon analysis, respectively. The total organic carbon mineralization efficiency was 84.80% after 6 h of reaction time. The reusability and stability of the Ti/IrO 2 -TiO 2 -RuO 2 anode on 5-FU removal efficiency were measured and showed an approximately 5% decay in 5-FU removal efficiency after eight consecutive runs. The overall results and analysis confirmed this method is capable of removing 5-FU through Ti/IrO 2 -TiO 2 -RuO 2 anode and Ni/RuO 2 cathode from aqueous medium., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The objective of the study was to assess the outcome and feasibility of ultrasonography (US)-guided minimally invasive percutaneous nephrolithotomy (mini-PCNL) in children., Materials and Methods: Twenty-five children with upper urinary tract stones who had undergone US-guided mini-PCNL from June 2017 to June 2020 were enrolled in this study. Patients' demographic information and post-treatment results were retrospectively gathered and analysed. Pyelocaliceal system was punctured in prone position using US guidance, and the tract was dilated using single-shot dilation technique. All steps of renal access were done using only US. Mini-PCNL in all cases was done by using 15 Fr rigid nephroscope. Stones were fragmented with a pneumatic lithotripter and evacuated., Results: The patients' mean age was 6.30 ± 3.25 years (range: 1.5-15). The mean stone size was 16.04 ± 3.93 mm (range: 10-30). The mean access time to the stone was 1.50 ± 0.62 min (range: 1-4). The mean operation time was 94.66 ± 3.05 min (range: 90-100 min). The final stone-free rate was 96%. Post-operation fever occurred in 4 (16%) patients who were treated successfully with an antibiotic. No major complications occurred., Conclusions: We recommend US-guided mini-PCNL as a harmless alternative treatment option, in children with renal calculi due to its excellent outcomes and little complications., Competing Interests: None

Background: The relationship between dietary variety, adequacy, moderation, and balanced diet as diet quality indices and cardiovascular risk factors has not been yet evaluated amongst patients with Mmyocardial Iinfarction (MI)., Method: This cross-sectional study was conducted on 225 males and 93 females with MI who were admitted in two heart hospitals, Shiraz, Iran from November 2019 to April 2020. Dietary intake was assessed using a validated food frequency questionnaire and the Diet Quality Index-International (DQI-I). DQI-I included four subscales, namely variety (20 scores), adequacy (40 scores), moderation (30 scores), and balanced diet (10 scores)., Results: The mean age of the participants was 54 ± 8 years. The mean scores of total DQI-I and variety, adequacy, moderation, and balanced diet subscales were 58 ± 12.2, 12.7 ± 3.8, 28.5 ± 7.0, 9.88 ± 5.6, and 7.8 ± 1.1, respectively. The results showed that waist circumference (WC) was influenced by adequacy (-0.26 ± 0.04) and moderation (-0.28 ± 0.03) subscales, while body mass index (BMI)was only related to the moderation subscale (0.15 ± 0.07). Additionally, low density lipoprotein (LDL) cholesterol was influenced by variety (-0.18 ± 0.01), adequacy (-0.14 ± 0.02), moderation (-0.2 ± 0.02), and balanced diet (-0.2 ± 0.003) subscales, while total cholesterol was associated with the adequacy subscale (-0.18 ± 0.01). In addition, high density lipoprotein (HDL) cholesterol was related to variety (0.16 ± 0.03), moderation (0.14 ± 0.04), and balanced diet (0.13 ± 0.01) subscales,while triglyceride was only influenced by the variety subscale (-0.15 ± 0.004)., Conclusion: Dietary advice based on variety, adequacy, moderation, and balanced diet could be useful in practice to provide personalized messages to improve the risk factors amongst patients with MI., (© 2022. The Author(s).)

Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Leukodystrophies are the main subgroup of inherited CNS white matter disorders which cause significant mortality and morbidity in early years of life. Diagnosis is mostly based on clinical context and neuroimaging findings; however, genetic tools, particularly whole-exome sequencing (WES), have led to comprehending the causative gene and molecular events contributing to these disorders. Mutation in Alkaline Ceramidase 3 (ACER3) gene which encodes alkaline ceramidase enzyme that plays a crucial role in cellular growth and viability has been stated as an uncommon reason for inherited leukoencephalopathies. Merely only two ACER3 mutations in cases of progressive leukodystrophies have been reported thus far., Results: In the current study, we have identified three novel variants in ACER3 gene in cases with new neurological manifestations including developmental regression, dystonia, and spasticity. The detected variants were segregated into family members., Conclusion: Our study expands the clinical, neuroimaging, electroencephalographic, and genetic spectrum of ACER3 mutations. Furthermore, we reviewed and compared the findings of all the previously reported cases and the cases identified here in order to facilitate their diagnosis and management., (© 2021. The Author(s).)

Current SARS-CoV-2 pandemy mortality created the hypothesis that some populations may be more susceptible to SARS-CoV-2. TMPRSS2 encodes a transmembrane serine protease which plays a crucial role in SARS-CoV-2 cell entry. Single nucleotide polymorphisms (SNPs) in TMPRSS2 might influence SARS-CoV2 entry into the cell. This study aimed to investigate the impact of SNPs on TMPRSS2 function and structure. In silico tools such as Ensembl, Gtex, ExPASY 2, GEPIA, CCLE, KEGG and GO were engaged to characterize TMPRSS2 and its expression profile. The functional effects of SNPs were analyzed by PolyPhen-2, PROVEN, SNAP2, SIFT and HSF. Also, Phyre2, GOR IV and PSIPRED were used to predict the secondary structure of TMPRSS2. Moreover, post-translational modification (PTM) and secretory properties were analyzed through Modpredand Phobius, respectively. Finally, miRNA profiles were investigated by PolymiRTS and miRSNPs. Out of 11,184 retrieved SNPs from dbSNP, 92 showed a different frequency between Asians and other populations. Only 21 SNPs affected the function and structure of TMPRSS2 by influencing the protein folding, PTM, splicing and miRNA function. Particularly, rs12329760 may create a de novo pocket protein. rs875393 can create a donor site, silencer and broken enhancer motifs. rs12627374 affects a wide spectrum of miRNAs profile. This study highlighted the role of TMPRSS2 SNPs and epigenetic mechanisms especially non-coding RNAs in appearance of different susceptibility to SARS-CoV-2 among different populations. Also, this study could pave the way to potential therapeutic implication of TMPRSS2 in designing antiviral drugs.Communicated by Ramaswamy H. Sarma.

Background: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children., Materials and Methods: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients' demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group., Results: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041)., Conclusions: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

Purpose: Renal calculi are becoming more common among children. Although, extracorporeal shock wave lithotripsy (ESWL) is the first choice in this age group, minimal invasive surgeries, such as percutaneous nephrolithotomy (PCNL), are indicated for some patients. Recently, PCNL devices have become smaller in size with acceptable efficacy and lower complications. We evaluated the outcomes and complications of mini-PCNL (MPCNL) surgery in our referral training centers. Materials and Methods: Between September 2012 and January 2020, a total of 112 children under the age of 18, who had shown failure of ESWL, and/or their parents refused to do it, underwent MPCNL (15 Fr). The patients' profiles were reviewed for data collection including preoperative and stone data, operation information, and postoperative complications. Results: Of 112 patients, 69 were boys, and 43 were girls. Their mean age was 8.6 years (14 months to 18 years). Mean stone size was 20 mm (14-34 mm). Seventy-four cases had renal pelvic stone, 22 had pelvis and lower pole, and 16 had staghorn. The mean operation time was 65 min (35-100 min), and mean radiation time was 0.6 min (0.2-1.4 min). Low-grade fever was detected in 14 patients (12.5%). Four patients needed blood transfusion and two had increased creatinine, which improved with conservative management. One patient developed urosepsis that resolved with antibiotic therapy. None of the patients had kidney perforation or other organ injury or death. Early stone-free rate (SFR) after operation was 90.2% (101 patients). Six patients had residual fragment <5 mm, which passed spontaneously in 2 weeks after operation (total SFR 95.3%). Three patients underwent second-look nephroscopy, and ureteroscopy was done for two patients due to migrated stone fragments to the distal ureter. Conclusion: MPCNL is recommended as a safe alternative option for treatment of the nephrolithiasis in children with good outcome and acceptable complications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hosseini, Irani, Altofeyli, Eslahi, Basiratnia, Haghpanah, Adib and Ahmed.)

The COVID-19 pandemic emerges a reminder that wide spectrum discrepancy in response to SARS-CoV-2 infection and antiviral drugs among different populations might be due to their different ACE2 SNPs and/or miRNAs profile. ACE2 is the major component for SARS-CoV-2s' cell entry, and disruption of its 3D structure could influence virus-ACE2 interaction. In this study we aimed to investigate the consequence of 16,860 SNPs within ACE2 on its expression as well as protein folding, function, and stability by using several beneficial bioinformatics tools. Only 64 SNPs including 60 intronic, and 4 missense showed different frequencies among different populations. Two missense SNPs including rs149039346 and rs147311723 have been predicted to strongly influence the function and stability of ACE2. rs1514283 creates new acceptor splice site. Also, rs4646175 creates new donor and acceptor splice site. PolymiRTS, and miRSNPs have predicted that rs3746444, rs113808830, and rs3751304 showed a MAF > 0.001, and disrupted mRNA target sites or mRNA function. Finally, rs3746444 hsa-miR-499a-3p, rs113808830 hsa-miR-4532, rs3751304 hsa-miR-6763-3p and hsa-miR-26b-5p were strongly hybridized with ACE2 and might influence its function. Collectively, this study shed some light on fundamental roles of ACE2 SNPs for its interaction with COVID-19, and consequently susceptibility to virus. Therefore, different responses of patients with COVID-19 to ACE2 blocker drugs might be due to their unique ACE2 SNPs. We further discussed the impact of SNPs on miRNAs profile as a factor that may modulate drug response or susceptibility to COVID-19., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 Elsevier Inc. All rights reserved.)

In the current work, the heterostructures highly PEC activity photoelectrodes composed of mixed metal oxides (TiO 2 -RuO 2 -Ta 2 O 5 (TRT)), polypyrrole- N doped reduced graphene oxide (PPy-NrGO) were prepared by electrodeposition of PPy-NrGO films on the TRT- coated titanium (Ti) plates as substrates. The TRT coatings were deposited on Ti plates via the sol-gel technique. The effects of the Ta 2 O 5 molar ratios were followed using physical and PEC measurements. Morphology studies showed that the surface structure of photoelectrodes alters remarkably by changing the Ta 2 O 5 content in the mixture of metal oxides. TRT/PPy-NrGO photoelectrodes indicated to have a decreasing impact on the charge transfer resistance at the photoelectrode/electrolyte interfaces. The overall PEC water splitting performances of photoelectrodes were compared by measuring photocurrent density at 0 and 1.23 V vs. RHE, Tafel slopes, charge carrier density, stability, hydrogen evaluation reaction (HER) and oxygen evaluation reaction (OER) efficiencies. The highest HER (43.68% at -0.4 V) and OER (17.51% at 0.45 V) efficiencies were obtained in photoelectrodes comprising of 20 mol% Ta 2 O 5 which possessed charge carrier density (5.9 × 10 18 ) of about 1.7 times higher than that considered for TRT (0%)/PPy-NrGO with no Ta 2 O 5 in the mixture of metal oxides., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Antimalaria drugs such as chloroquine (CQ) and hydroxychloroquine (HCQ) have been administered to several inflammatory diseases including rheumatoid arthritis and systemic lupus erythematosus, and infectious diseases such as acquired immune deficiency syndrome and influenza. Recently, several patients infected with novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were given HCQ, and showed a discrepant response. HCQ inhibits SARS-CoV-2 cell entry, and inflammatory cascade by interfering with lysosomal and endosomal activities, and autophagy, impeding virus-membrane fusion, and inhibiting cytokine production resulted from inflammatory pathways activation. Despite ongoing administration of HCQ in a wide spectrum of disorders, there are some reports about several side effects, especially retinopathy in some patients treated with HCQ. Cytochrome P450 (CYP450) and its isoforms are the main metabolizers of HCQ and CQ. Pharmacokinetic properties of CYP enzymes are influenced by CYP polymorphism, non-coding RNAs, and epigenetic mechanisms such as DNA methylation, and histone acetylation. Accumulating evidence about side effects of HCQ in some patients raise the possibility that different response of patients to HCQ might be due to difference in their genome. Therefore, CYP450 genotyping especially for CYP2D6 might be helpful to refine HCQ dosage. Also, regular control of retina should be considered for patients under HCQ treatment. The major focus of the present review is to discuss about the pharmacokinetic and pharmacodynamic properties of CQ and HCQ that may be influenced by epigenetic mechanisms, and consequently cause several side effects especially retinopathy during SARS-CoV-2 therapy., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Innovations in extraction phases, extraction modes and hyphenated instrument configurations, are the most important issues to address for progress in the solid phase microextraction (SPME) methodology. In this regard, we have embarked on the development of a novel biocompatible 96-monolithic inorganic hollow fiber (96-MIHF) array as a new configuration for high-throughput SPME on a 96-well plate system. An arrangement of highly ordered 96 titania/Hydroxyapatite (TiO 2 /HAP) nanocomposite hollow fibers and corresponding stainless-steel needles on a Teflon plate holder were used as the extraction module. The inorganic hollow fibers were prepared via a rapid and reproducible template approach (Polypropylene hollow fiber) in combination with a sol-gel method in the presence of polyvinyl alcohol (PVA), as a network maker. The hollow fiber-shape sorbents were obtained with excellent precision by weight (RSD% = 4.98, n = 10) and length (RSD% = 1.08, n = 10) criteria. The proposed design can overcome a number of geometrically dependent drawbacks of conventional high-throughput SPME methods, mainly the ones related to sorbent amount and surface area due to possessing inner/outer surfaces without additional internal supports. The SPME platform, for the first time, was successfully applied for the extraction and preconcentration of doxorubicin from urine and water media without requiring sample preparation and free from significant matrix effect. The extracted analyte was analyzed by liquid chromatography-ion trap tandem mass spectrometry (LC-MS/MS). Highly satisfactory analytical figures of merit were obtained under optimized conditions. The limit of detection (LOD), limit of quantification (LOQ) and linearity of determination were 0.1 ng mL -1 , 0.25 ng mL -1 and 0.25 to 4000 ng mL -1 , respectively. The interday, intraday and inter sorbent precisions for three concentration levels ranged from 2.01 to 8.09 % (n = 3), 1.02 to 8.65 % (n = 5) and 0.99 to 1.02% (n = 15), respectively. The mean intra-well RSD value for 96 individual wells in 96-MIHF-SPME-LC-MS/MS (n = 3) at the medium concentration level was 7.81%., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier B.V.)

Interleukin-1 receptor-associated kinase 1 (IRAK1), an essential mediator of innate immunity and inflammatory responses, is constitutively active in multiple cancers. We evaluated the role of IRAK1 in acute myeloid leukemia (AML) and assessed the inhibitory activity of multikinase inhibitor pacritinib on IRAK1 in AML. We demonstrated that IRAK1 is overexpressed in AML and provides a survival signal to AML cells. Genetic knockdown of IRAK1 in primary AML samples and xenograft model showed a significant reduction in leukemia burden. Kinase profiling indicated pacritinib has potent inhibitory activity against IRAK1. Computational modeling combined with site-directed mutagenesis demonstrated high-affinity binding of pacritinib to the IRAK1 kinase domain. Pacritinib exposure reduced IRAK1 phosphorylation in AML cells. A higher percentage of primary AML samples showed robust sensitivity to pacritinib, which inhibits FLT3, JAK2, and IRAK1, relative to FLT3 inhibitor quizartinib or JAK1/2 inhibitor ruxolitinib, demonstrating the importance of IRAK1 inhibition. Pacritinib inhibited the growth of AML cells harboring a variety of genetic abnormalities not limited to FLT3 and JAK2. Pacritinib treatment reduced AML progenitors in vitro and the leukemia burden in AML xenograft model. Overall, IRAK1 contributes to the survival of leukemic cells, and the suppression of IRAK1 may be beneficial among heterogeneous AML subtypes.

Objective: Glioblastoma multiforme (GBM) is the most prevalent and aggressive primary cerebral tumor. The median survival time is 15 months despite maximum treatment because the tumor is resistant to most therapeutic modalities. Several studies have indicated chemopreventive and chemotherapeutic activity of cyanidin-3-glucoside (C3G) as an anthocyanin component. We aimed to illustrate the cytotoxic and apoptogenic effects of C3G in the U87 cell line (human GBM cell line)., Methods: Cytotoxic activity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium assay after treatment with C3G at different concentrations in the U87 cell line. Cisplatin was used as a positive control for 24 and 48 hours. The percentage of apoptotic cells was determined using an Annexin V/propidium iodide assay, and the expression of bax, bcl2, and p53 genes was assessed using real-time polymerase chain reaction., Results: Treatment of U87 cells with 40 μg/mL of C3G resulted in 32% apoptotic cells after 24 hours. To further confirm that C3G treatment induced apoptosis in U87 cells, RNA expression of bax, bcl2, and p53 genes was investigated after treatment. Real-time polymerase chain reaction indicated that the expression of bax and p53 increased, whereas the expression of bcl2 decreased., Conclusions: C3G had an apoptogenic effect in the GBM cell line. New information regarding the therapeutic effects of C3G in GBM could ultimately lead to the production of new drugs., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Buprenorphine is a partial mu agonist and kappa antagonist which is used for the treatment of pain and opioid addiction. A mixture of buprenorphine hydrochloride and naloxone hydrochloride has been approved for the treatment of opioid dependence. In this study a third order derivative spectrophotometric method based on zero-crossing technique has been used for the simultaneous determination of buprenorphine hydrochloride and naloxone hydrochloride in tablets. The measurements were carried out at wavelengths of 257.8 (zero-crossing point of naloxone hydrochloride) and 252.2 nm (zero-crossing point of buprenorphice hydrochloride) for buprenorphine hydrochloride and naloxone hydrochloride, respectively in the third order derivative spectra obtained in methanol and 0.1 M NaOH (50:50) as solvent. The method was found to be linear in the range of 20-80 µg/mL for buprenorphine hydrochloride and 5-20 µg/mL for naloxone hydrochloride. The within-day and between-day coefficient of variation and error values were less than 2.5% and 1.8%, respectively. The proposed method was successfully used for simultaneous determination of these drugs in pharmaceutical dosage form without any interference from excipients or need to prior separation before analysis.

Purpose: Urolithiasis during pregnancy poses risks for mother and the fetus with specific challenges in diagnosis and management. We report our experience with urgent percutaneous nephrolithotomy (PCNL) in seven pregnant patients with symptomatic renal stone in early pregnancy., Materials and Methods: Seven pregnant patients with symptomatic renal stones were reviewed. The technique comprised PCNL with complete access under guide of ultrasonography in prone position under general anesthesiausing pneumatic lithoclast for stone fragmentation., Results: There was no significant residual fragment of stone in the operated kidneys. The patients discharged without complications and delivered their babies healthy., Conclusion: PCNL should not be considered as the first therapeutic method in the first trimester of pregnancy, unless in urgent situations such as symptomatic renal pelvic stone with moderate to severe hydronephrosis in patients who do not tolerate or are complicated by nephrostomy or internal stent. However, this procedure could be technically demanding and should be done in centers with enough experience and equipment in percutaneousnephrolithotomy.

Background: Transurethral resection of prostate (TURP) is the most common treatment for benign prostatic hyperplasia (BPH). Urinary tract catheter is inserted post-operatively which results in catheter-related bladder discomfort (CRBD) in many patients. The purpose of this study was to assess the preventive effect of hyoscine N-butyl bromide on CRBD caused by a urinary tract catheter after TURP surgery in patients with BPH., Methods: Twenty-four and twenty-six patients in the treatment and control groups were enrolled, respectively. At the end of the surgery, slow intravenous injection of 20 mg hyoscine N-butyl bromide was administered to the patients of treatment group. The severity of CRBD was followed up at five different time periods and up to 2 h after surgery., Results: On arrival to PACU and after 30 min of injection, statistically significant less CRBD was seen in the treatment group comparing to the control group (P ≤ 0.05 and P ≤ 0.007). The total utilized meperidine dose during PACU stay and the time to discharge for the intervention group were significantly lower than those for the control group (P ≤ 0.0001) with no significant difference in adverse effects (P > 0.05)., Conclusions: Hyoscine N-butyl bromide could reduce the severity of CRBD related to TURP in patients with BPH and their need for analgesic consumption either. It shortened the length of stay in the recovery room. Regarding its availability and low cost, it can be an effective pain relief drug for CRBD discomfort related to TURP in BPH patients.

Aim: To compare open suprapubic transvesical prostatectomy (OSP) without insertion of suprapubic cystostomy, OSP with insertion of cystostomy, and transurethral resection of the prostate (TURP)., Patients and Methods: A total of 104 patients with an indication for prostatectomy were retrospectively assigned to TURP (group 1), OSP with cystostomy (group 2), and OSP without cystostomy (group 3). They were evaluated for length of the operation, length of hospital stay, post-operative complications, hemoglobin drop, changes of blood pressure, and intraoperative blood loss., Results: Mean age was 67.2 ± 8.7 in group 1, 73.3 ± 8.4 in group 2, and 74.0 ± 5.7 in group 3. Prostatic volume was 35.9 ± 13.8, 74.1 ± 33.8, and 74.3 ± 31.8 in groups 1, 2, and 3, respectively. There was no significant difference in prostatic volume between groups 2 and 3 (P = 0.99), but in group 1 it was lesser than groups 2 and 3 (P = 0.00). Length of the operation was 1.2 ± 0.2 in group 3 and 1.1 ± 0.2 in group 2, without a significant difference (P = 0.45). Length of hospital stay in group 3 (2.3 ± 0.4 days) was lesser than that in group 2 (2.6 ± 0.7) (P = 0.01). The amount of hemoglobin drop was 1.1 ± 0.9 in group 1, 1.1 ± 0.7 in group 2, and 1.4 ± 0.91 in group 3 without a significant difference between all groups. The amount of bleeding during operation was 173 ± 103 in group 2 and 161 ± 78 in group 3 (P = 0.98)., Conclusion: OSP without insertion of cystostomy tube is a relatively safe method; however, larger studies are needed. It is also comparable to TURP in terms of postoperative efficacy and complications.

Acute coronary syndrome (ACS) is the most serious form of coronary artery disease. Inflammatory processes participate in different stages of this disorder. FOXP3 gene plays an important role for the development and function of regulatory T cells. Consequently, the expression level and polymorphisms of this gene have been studied in many immune related diseases. In the present study, we analysed the expression of FOXP3 as well as the association between two variants in this gene (rs3761548A/C and rs5902434del/ATT) and occurrence of ACS in Iranian patients. FOXP3 expression analysis showed a significant decrease in patients with ACS compared with controls (P = 0.029). In addition, a significant decrease has been detected in female patients compared with normal female subjects (P = 0.020). No significant change has been observed in FOXP3 expression in male patients compared with normal male subjects. In addition, no difference has been detected between ACS and normal subjects in combined genotype frequencies of both polymorphisms and the allele frequencies of rs5902434. However, rs3761548 C allele was more prevalent in controls compared with patients with ACS (P = 0.024). Consequently, our data demonstrated that FOXP3 expression is markedly decreased in female patients with ACS, which highlight the role of immune responses in plaque destabilization in such patients. Copyright © 2016 John Wiley & Sons, Ltd., Significance Paragraph: Considering the role of immune system in different stages of acute coronary syndrome (ACS), we evaluated the expression of FOXP3 gene as a master regulator of immune response in these patients compared with normal subjects. We detected a significant down-regulation of this gene in patients with ACS. Such decreased expression was more prominent in female patients, which implies the role of immune responses in plaque destabilization in such patients., (Copyright © 2016 John Wiley & Sons, Ltd.)

Purpose: To assess the safety and effectiveness of pure ultrasound-guided percutaneous nephrolithotomy., Patients and Methods: Three hundred fifty-seven patients were treated; 139 women and 218 men, with a mean age of 33.7 years (range 21-69 years) and a mean stone size of 33.5 mm in maximum diameter (range 20-52 mm). Stone locations were renal pelvis (174), lower calyx (68) or both (115) with mild to moderate hydronephrosis seen on excretory urography. A ureteral stent was inserted by cystoscope, and saline was injected for better localization of the pelvicaliceal system (PCS), if needed. Puncture of the PCS was done by an 18-gauge nephrostomy needle through the lower pole calyx, and all the steps, including dilatation, were done under the guidance of ultrasonography., Results: The day after the operation, 318 (89.07%) patients were stone-free in the kidneys, ureters, and bladder x-rays. Nineteen patients (5.3%) had multiple fragments that measured equal or less than 5 mm and passed them spontaneously in 2-4 weeks (total stone-free rate 94.4%). Access failure occurred in ten obese patients (2.8%) and fluoroscopy was required. Residual fragments with sizes of 10-12 mm were seen in seven patients, all of who underwent shock wave lithotripsy. In one patient, a fragment measuring 7-8 mm migrated into the distal part of the ureter. It was fragmented with ureteroscopy and pneumatic lithoclast 2 days after the operation. In two patients who had large (>15 mm) residual stone redo percutaneous nephrolithotomy was performed 48 h after the first procedure., Conclusion: Percutaneous nephrolithotomy guided by ultrasonography seems to be as effective as fluoroscopy in selected cases and poses no risk of surgeon and patient exposure to radiation; however, more experience is required.

Some patients with nephrolithiasis who become candidates for percutaneous nephrolithotomy (PCNL) have a single kidney. This poses a challenge for the physician regarding the safety and efficacy of this procedure for these patients. This study has aimed to evaluate the safety and efficacy of PCNL in these patients. Between 2002 and 2014, out of 10,800 cases who underwent PCNL in our centres, 412 had a single kidney. We recorded the results and complications in these patients. Out of 412 patients, 279 were men and 133 women. Their mean age was 46.4 years (range 19-71) and mean stone size was 26.5 mm (range 21-55); 161 of them had a functional single kidney, 36 were congenital, and the remaining 215 had undergone contralateral nephrectomy because of stones, trauma, infection or tumour. Comorbidities included 104 hypertensive, 66 diabetic, 65 morbidly obese, 56 uremic and 47 ischemic heart disease cases. The stone-free rate was 91.3% (376/412) on postoperative X-ray/sonography. However, 42 patients required ancillary measures. Complications include fever (T > 38.3 °C) in 34 cases (8.2%), bleeding requiring transfusion 19 cases (4.6%), UTI nine cases (2%), sepsis one case (0.2%), perinephric collection three cases (0.7%), hydro/pneumothorax two cases (0.4%), access failure in five morbidly obese cases (1.2%), pyonephrosis two cases (0.4%), myocardial infarction four cases (1%), transient increasing of blood urea nitrogen (BUN) and serum creatinine (Scr.) in four normal functioning kidney (1%) and eight uremic cases (1.9%), and two cases resulted in death (0.4%). PCNL seems a safe and effective option in cases of a single kidney, but it needs more attention in order to prevent even minor complications that can result in an anephric state.

Background and Objectives: Staphylococcal food poisoning is a gastrointestinal disease, which is caused by consumption of contaminated food with enterotoxins produced by Staphylococcus aureus (SEs). Milk and its products are known sources of food borne diseases. This study was carried out to evaluate the prevalence of enterotoxigenic S. aureus strains in organic milk and cheese in Tabriz - Iran., Materials and Methods: A total of 200 samples (100 milk samples and 100 cheese samples) were collected from farms and milk collection points in Tabriz - Iran. The samples were cultured and identified by standard bacteriological methods, then PCR was performed to detect sea gene., Results and Conclusion: Staphylococcus aureus was found in 27% of all samples (milk and cheese). Results of PCR showed that 12.96% of S. aureus isolates possessed sea gene. It suggested the potential public health threat of S. aureus resulting from contamination of dairy products. So, efforts are required to improve safety standards for preventing staphylococcal food poisoning.

Purpose: To compare dilutional effect of distilled water with saline solution as an irrigation fluid in percutaneous nephrolithotomy (PCNL)., Materials and Methods: Three hundred twenty eight adult patients (191 men, 137 women) who were candidates for PCNL were randomly assigned into two groups (distilled water, n = 158, group 1; saline solution, n = 162, group 2). Stone size, operation time, irrigation fluid volume, blood hemoglobin level, urea nitrogen, creatinine, sodium and potassium levels were checked before and at 6 and 12 hours after operation., Results: The mean age of the patients was 37.8 years, and the mean stone diameter was 31.5 mm. There was no clinical case of transurethral resection (TUR) syndrome. Serum sodium depletion was significantly more in group 1 than group 2 (P < .0001). Group 1 had significant decreased post-operative serum sodium levels (P < .0003). Similarly in group 2, postoperative serum sodium levels were significantly lower than the preoperative concentration (P < .01), but it was not the same 6 hours after the operation (P = .23). Serum sodium concentrations remained within normal limits in all cases, without causing clinical signs and symptoms of hyponatremia., Conclusion: We found that distilled water is safe irrigation fluid for PCNL in adults. In addition, it is more available and cost effective.

Background: Prostate is an important male reproductive system gland and its disorders can affect men's quality of life and health. Prostatitis, benign prostatic hyperplasia (BPH), and prostate adenocarcinoma are major disorders that can be found in all men in different ages., Objectives: The aim of this study was to investigate the association of diet with serum prostate specific antigen (PSA) level as well as prostate volume., Patients and Methods: In this cross-sectional study, 950 men older than 40 years of age who had attended our clinic for a screening program for prostate cancer were enrolled. Data was extracted from the program database. The eligible cases included all noncancerous subjects with available data concerning serum PSA level and prostate volume; the patients had completed a 50-item self-administered food frequency questionnaire about their diet during the preceding two year., Results: No overall association was found between the consumption of foods and prostate volume as well as serum PSA level. There was a significant correlations between age and serum PSA level (r = 0.24) as well as with prostate volume (r = 0.22) (P < 0.001). In addition, there was a significant correlation between serum PSA level and prostate volume (r = 0.41 and P < 0.001)., Conclusions: The results of this study confirmed the previous reports regarding the serum PSA level correlation with prostate volume. There was no evidence that dietary patterns might have any important effect on prostate volume and serum PSA in this Iranian population.

To prospectively compare the outcome of laparoscopic pyelolithotomy (LP) versus percutaneous nephrolithotomy (PCNL) in patients with a solitary renal pelvis stone larger than 30 mm. We analyzed demographic and perioperative parameters and intermediate outcome in 30 adults who underwent transperitoneal LP for solitary renal pelvis stone larger than 30 mm (Group I) and compared the results with 30 patients who underwent PCNL (Group II). The two groups were matched for age, sex and stone size (Group I 35.3 ± 7.33 mm, Group II 36.6 ± 7.0 mm; P = 0.47). Mean operative time was significantly longer in LP group (120.5 ± 39.94 min versus 98.1 ± 23.28 min; P = 0.01, 95 % CI 5.43-39.23). Stone-free rate after LP was significantly higher than after PCNL (100 % versus 76.7 %; P = 0.01). On the discharge day, no residual stone was found in LP group, and significant residual stone (mean size 9.8 mm, range 7-15 mm) was found in seven patients (23.3 %) in PCNL group. After the ancillary procedures, the stone-free rates were 100 % in LP and 96.6 % in PCNL group at the end of follow-up. The average overall treatment cost was significantly lower in LP (683.9 USD versus 815.9 USD; P < 0.001). Mean postoperative decreases in hemoglobin was similar in both groups. Given adequate laparoscopic experience, for patients with a solitary renal pelvis stone larger than 3 cm, LP can be considered as an appropriate second choice to PCNL. It can be a potentially cost-effective treatment option in terms of one-session stone-free rate and postoperative complications. However, the potential benefits of LP need to be weighed against the more invasive nature of this procedure.

Primary microcephaly (MCPH) is a genetic disorder in which affected individuals present with a head circumference 3 standard deviations (SDs) below the age- and sex-related mean and is accompanied by mental retardation without further associated malformations. Here we report a patient with sporadic MCPH from Northwest of Iran who was investigated for MCPH1 locus. Clinical examination and karyotype analyses were performed and microsatellite based mapping was done by using flanking and intragenic short tandem repeat (STR) markers for MCPH1 locus. For these markers the affected individual was homozygote and the parents were heterozygote. According to this pattern of allele sharing and also the cytogenetic findings, mutation screening of Microcephalin gene was performed and subsequent sequencing revealed a novel mutation in Microcephalin gene.

A rare case of congenital entrapment of the left ureter in an iliac bone canal causing left side hydroureteronephrosis is reported. The patient represented a case of congenital ureteral entrapment in a reversed C-shaped iliac bone canal that was missed before his laparoscopy. The ureter also had a retro-iliac course. The patient was successfully managed by laparoscopic ureteroureterostomy. Interestingly, in our experience, laparoscopy provided a minimally invasive milieu for both diagnosis and correction of this rare cause of obstructive uropathy., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: The aim of the present study was to evaluate the metallic artifacts in MRI of the orthopedic patients after removal of metallic implants., Subjects and Methods: From March to August 2009, 40 orthopedic patients operated for removal of orthopedic metallic implants were studied by post-operative MRI from the site of removal of implants. A grading scale of 0-3 was assigned for artifact in MR images whereby 0 was considered no artifact; and I-III were considered mild, moderate, and severe metallic artifacts, respectively. These grading records were correlated with other variables including the type, size, number, and composition of metallic devices; and the site and duration of orthopedic devices stay in the body., Results: Metallic susceptibly artifacts were detected in MRI of 18 of 40 cases (45%). Screws and pins in removed hardware were the most important factors for causing artifacts in MRI. The artifacts were found more frequently in the patients who had more screws and pins in the removed implants. Gender, age, site of implantation of the device, length of the hardware, composition of the metallic implants (stainless steel versus titanium), and duration of implantation of the hardware exerted no effect in producing metallic artifacts after removal of implants. Short TE sequences of MRI (such as T1 weighted) showed fewer artifacts., Conclusion: Susceptibility of metallic artifacts is a frequent phenomenon in MRI of patients upon removal of metallic orthopedic implants., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Purpose: Previous renal surgery is a relative contraindication to laparoscopic nephrectomy because adhesion formation makes surgical dissection difficult. We determined whether previous surgery at the same anatomical site would affected the surgical outcome in patients who underwent transperitoneal laparoscopic nephrectomy., Materials and Methods: During the study period 79 consecutive patients who underwent transperitoneal laparoscopic nephrectomy were evaluated prospectively. All patients had symptomatic nonfunctioning small or hydronephrotic kidneys. Patients were divided into 29 with and 50 without prior surgery at the same anatomical site. Previous surgery included open nephrolithotomy in 16 patients, percutaneous nephrolithotomy in 8, open and percutaneous nephrolithotomy in 3, pyelolithotomy in 1 and pyeloplasty in 1., Results: Patients who underwent prior surgery were older than patients who did not (average age 46.6 vs 34.9 years, p=0.008). Other patient characteristics, including gender ratio, body mass index and side of surgery, did not differ significantly between the 2 groups. Mean operative time was longer in patients with previous surgery than in the other group (98.6 vs 62.3 minutes, p=0.03). Other operative data, including blood loss, intraoperative and postoperative complications, open conversion and hospital stay, were similar in the groups. One case per group was converted to open surgery due to difficult pedicle dissection., Conclusions: Transperitoneal laparoscopic nephrectomy in patients with a history of ipsilateral renal surgery can be done safely in timely fashion. Although mean operative time was longer, there was no significant increase in the operative complication rate in patients with prior surgery., (Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Metabolic disorders are one of the etiologic factors in renal stone formation. The aim of present study was to evaluate prevalence of metabolic disorders in patients with renal stone., Methods: From 572 patients referring to our urologic clinics, 376 patients participated in the study. Patients were divided to first time stone former (group A) and recurrent renal stone (group B). Twenty-four hour urine specimens were obtained for urinary calcium, oxalate, magnesium, citrate, uric acid, phosphor and 24-h urine volume. Venous blood samples were obtained evaluating serum phosphate, uric acid, and calcium. The prevalence of each metabolic disorder was detected, and two groups were compared regarding metabolic disorders., Results: The prevalence of renal stone in male patients was 63.04% versus 36.96% in female patients (P < 0.05). The most common abnormality observed in patients was low 24-h urine volume (58.24%) followed by hypercalciuria (17.18%) and hyperuricosuria (15.15%). Hyperuricemia was found in 6 first time stone former patients and 14 patients with recurrent renal stone (P = 0.04). There was no statistically significant difference between group A and B in other metabolic abnormalities (P > 0.05)., Conclusion: Low 24-h urine volume was the most common abnormalities in patients with nephrolithiasis in our region. Metabolic evaluation must be performed in all patients with renal stone even those with first time stone formation.

Background: A 32-year-old man was referred to a tertiary care center for stone management. The patient had initially presented to his primary physician 3 months earlier with right flank pain of 2 month's duration. Abdominopelvic ultrasonography and intravenous urography had revealed left-to-right crossed fused renal ectopia with a 25 mm opaque stone in the crossed kidney. The patient had received two sessions of extracorporeal shock wave lithotripsy, which had failed to remove the renal stone., Investigations: Noncontrast CT, blood tests (hemoglobin and creatinine levels), abdominopelvic ultrasonography and intravenous urography., Diagnosis: Left-to-right crossed fused ectopia with a 25 mm opaque renal stone in the anomalous kidney., Management: The patient underwent laparoscopic nephrolithotomy to remove the renal stone. Intravenous urography and abdominopelvic ultrasonography 1 month after surgery confirmed that the patient was stone free and had functional renal units. The patient will be followed up every 3 months with abdominopelvic ultrasonography for early detection of stone recurrence.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrolithotomy (PCNL)., Patients and Methods: Between August 2003 and December 2007, 47 patients were treated, 29 men and 18 women, with a mean age of 33.4 years (range 21-67 yrs) and a mean stone size of 31.5 mm (range 24-46 mm). All stones were located in the renal pelvis with mild to moderate hydronephrosis seen on intravenous urography. A ureteral stent was inserted cystoscopically, and saline was injected for more localization of the pelvicaliceal system (PCS), if needed. Puncture of the PCS was performed with an 18-gauge nephrostomy needle through the lower pole calyx, and all the stages, including dilatation, were performed under ultrasonography guidance., Results: Thirty-nine patients were stone free in the kidneys, ureters, and bladder the day after the operation. Five patients had multiple fragments that measured about 4 to 5 mm, which passed in 4 weeks (total stone-free rate: 93.61%); failure occurred in two patients, and fluoroscopy was needed; two patients who had residual fragments that measured 10 and 12 mm underwent shockwave lithotripsy; and in one patient, a fragment that measured 7 to 8 mm migrated into the ureter--it fragmented and was removed with a ureteroscope 2 days after the operation., Conclusion: PCNL using sonography is a good alternative to the fluoroscopic method. It is performed without radiation exposure to the surgeon and patient; however, more experience is needed.

We here report the incidence of different types of genitourinary cancers among the Iranian population according to the records of the Iran Ministry of Health and Medical Education. In a population-based cancer-registry study in 2005, all recorded data in pathology laboratories, freestanding cancer clinics and treatment centers, physician offices, and other state central registries were obtained with the assistance of Iran Universities of Medical Sciences and sent to the Diseases Management Center in the Health Ministry. The prevalences of urological cancers were as follows: bladder cancer 48.3%; prostate cancer 33.4%; renal cell carcinoma 10.3%; renal pelvis and ureter cancer 0.75%; testicular cancer 6.15%; penile cancer 0.15%; urethral cancer 0.45%; and other unspecified urinary cancers 0.43%. The male to female ratios for the various common urological cancers varied between 1.69 (renal cell carcinoma) and 7.75 (unspecified urinary cancers). The incidence of prostate cancer among our population was dramatically higher than in other countries of Asia. However, bladder cancer was found to be the commonest of the genitourinary cancers, especially in elderly patients, among our population.