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Background and purpose: Prostate cancer is the most common male urogenital malignancy in many regions of the world, which has been increasing in recent years all over the world, including Asian countries, as well as in Iran. The relative risk of prostate cancer for those who have a family history of this disease in close relatives is almost 2 to 3 times, and the incidence rate increases with the increase in the number of affected relatives. Although family history of prostate cancer is a proven risk factor for this disease, few studies have investigated the relationship between the presence of family history of prostate cancer and the degree of prostate cancer risk. The purpose of this study is to investigate the relationship between the existence of a family history of prostate cancer and the degree of prostate cancer risk at the time of diagnosis. Materials and methods: This case-control study was conducted on 322 patients available prostate cancer patients referred to medical centers affiliated with Babol University of Medical Sciences. Patients were divided into two groups: case (family history of prostate cancer) and control (no family history of prostate cancer). Information about family history, Gleason score, PSA, and clinical stage was extracted from all patients. It was extracted through the file and phone call. A positive family history of prostate cancer is defined as follows: patients who have at least two of their first-degree relatives with prostate cancer at any age. Also, patients who have one first-degree relative and at least two second-degree relatives at any age with prostate cancer. In hereditary prostate cancer, at least 3 first-degree relatives have prostate cancer, or prostate cancer occurs in three consecutive generations of the same family (paternal or maternal). At least two first- or second-degree relatives had early onset prostate cancer under the age of 55. The relationship between the existence of a family history of prostate cancer first-degree relatives include: father, brother, and child, and second-degree relatives include: grandfather, uncle and cousin. the degree of prostate cancer in three groups (Low risk with PSA20 or Gleason score>7) at the time of diagnosis was investigated. Results: The average age of patients when diagnosed with prostate cancer was 67.23±8.97 years, who were in the age range of 43-93 years. 23.3% of the studied patients had a family history of prostate cancer and 1.9% had a hereditary family history of prostate cancer. With the increasing age of diagnosis, the degree of risk of prostate cancer increased, which is statistically significant. Thus, 63.9% of patients who were diagnosed with prostate cancer at the age of 71 years had high-risk prostate cancer, which shows that the risk level of prostate cancer should increase as the age of prostate cancer diagnosis increases (P=0.001). Between the ages of 61 and 70 years, 62 people (44.9%) were at a high risk level, while at the age of 60 years, 33 people were at a high risk level (P

ObjectiveExpression of CD44 variant 6 (CD44v6) as a homing-associated cell adhesion molecule (HCAM), hasproved to change most cancer cells. Aim of the study is the effect of mutant allele of CD44 (rs8193C>T) and Pum2regulatory element as a prognosis factor of prostate neoplasms: a case-control and in silico studies in the Mazandaranprovince-Iran.Materials and MethodsIn a case-control study, CD44-rs8193C>T genotyping of the 420 prostate neoplasms (210benign prostatic hyperplasia (BPH) patients and 210 prostate cancer patients) and 150 healthy samples are performedby the touchdown polymerase chain reaction with confronting two-pair primers (PCR-CTPP) method. The T mutantallele effects on the mRNA structure and cell pathways were also investigated in silico methods.ResultsOur results showed that the increase of T mutant allele frequency was significantly associated with BPHcompared with prostate cancer. Furthermore, results showed TT genotype was significantly associated with BPH[odds ratio (OR)=0.572 and P=0.015], and also influenced the CD44v6 transcript secondary structure, miRNA binding,and regulatory element-binding site for Pum2 protein. Attachment of Pum2 to standard CD44 transcript may lead totranscript isoform-switching and shift-expression to a variety of CD44 isoforms, which can trigger some of the cellsignaling pathways, such as Nanog-Stat, PKC-Nanog, and PKC-Twist.ConclusionBased on this, the presence of the T mutant allele of CD44 (rs8193C>T) in the populations may createa regulatory element-binding site for Pum2. So, it could be known as a prognosis factor and prediction of prostateneoplasms. However, more comprehensive studies in different populations (with various ethnicities and large populationsizes), and also CD44v6 gene expression studies in protein and transcript levels are required to confirm our data.

This article reports a pelvic hydatid cyst in a 10-year-old boy who initially presented with right flank pain. Computed tomography (CT) revealed a cystic lesion containing internal densities, which was found to be a hydatid cyst between the bladder and rectum during surgery. The lesion was excised and sent to a pathology laboratory for further examination.

Background: It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. Cardiac myxosarcoma is a rare neoplasm that appears to rise from the same cellular source like myxoma. It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Myxosercoma tumor requires surgery and chemoradiotherapy, but myxoma is treated only by surgery. Case Presentation: We describe a case of a 58-year-old patient with a left atrium myxosarcoma, presenting with congestive heart failure. Transthoracic echocardiogram (TTE) showed a large polypoid and mobile mass in the left atrium, the patient underwent cardiac surgery and the tumor was successfully extracted, and histopathological result revealed typical features of myxoma. 15 days after surgery, he underwent explorative laparatomy because of progressive GI bleeding. Laparatomy revealed extensive metastatic masses in abdomen and the pathology diagnoses was myxosaroma. Unfortunately, in spite of supportive care, the patient expired on postoperative day one. Conclusion: It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Maybe magnetic resonance imaging can help us to achieve more data suggesting malignancy.

Background: Xanthogranulomatous pyelonephritis (XGP) is a rare and intense type of chronic kidney infection characterized by subversion of the renal tissue and its replacement by lipid- laden macrophages. XGP combined with emphysematous pyelonephritis (EPN) is rare and up until now only 7 cases with these presentations have been reported; so abundant clinical skills and appropriate radiographic imaging is required to reach the correct diagnosis. In this report, we present a case with two uncommon variants of pyelonephritis. Case Presentation: A 55-year-old female presented with a history of type 2 diabetes mellitus, and a stroke leading to a left-sided hemiplegia state for 7 years, coronary artery bypass grafting (CABG), hypertension (HTN), seizure, progressive fatigue, loss of appetite , fecal and urinary incontinence and right costovertebral angle tenderness. According to clinical signs, symptoms and documentation of gas within the renal parenchyma on computed tomography (CT) of abdomen, of EPN diagnosis was suggested; however histopathologic evaluation showed acute emphysematous pyelonephritis on chronic xanthogranulomatous pyelonephritis. Conclusion: EPN can emerge in a patient suffering from XPG which would add to the severity of the situation. In the case presented, concurrent underlying diseases such as diabetes mellitus, stroke, CABG, HTN along with severe fatigue and loss of appetite existed. Surgical treatment produces dramatic results.

Background: Congenital adrenal hyperplasia (CAH) refers to group of congenital diseases resulting from impaired adrenal steroidogenesis, and its most common cause is 21-hydroxylase deficiency. Testicular adrenal residual tumor (TART) is one of the major complications of CAH, possibly resulting from ectopic remnants of intra-testicular adrenal tissue which is stimulated by excessive secretion of adrenocorticotropic hormone (ACTH). This tumor can be misdiagnosed as Leydig cell tumor (LCT) in these people. Case Presentation: The patient we are presenting is a 20-year-old man with a history of precocious puberty and a height below 3% of the population who underwent radical left testicular orchiectomy with a complaint of bilateral testicular mass, which is reported LCT in the pathology report. In preoperative imaging examinations, bilateral adrenal hyperplasia is observed. In hormonal examinations, the patient is diagnosed with CAH and has been treated with corticosteroids for one year. Conclusion: In patients who present with bilateral testicular mass, it is the best image by abdominopelvic CT scan before surgery to detect CAH.

Background and purpose: Spinal anesthesia is commonly used in transurethral resection of the prostate (TURP). To reduce the complications of spinal anesthesia, opioids could be helpful in decreasing the amount of anesthetic drug. The aim of this study was to evaluate the effect of low doses of bupivacaine and fentanyl on the levels of sensory block and motor block. Materials and methods: A clinical trial was conducted in 80 TURP candidates in Babol Rouhani Hospital, 2016-2017. They were randomly divided into two groups (n= 40 per group) to receive either 7.5 mg bupivacaine 0.5% and 25 mcg of fentanyl (BF group) or 10mg bupivacaine 0.5% (B group). Duration of anesthesia, motor block (using Bromage score), pain intensity during the operation, and mean arterial pressure were recorded. Data were analyzed in SPSS V20. Results: There were no significant differences between the two groups in duration of anesthesia and mean arterial pressure (P

Medicinal plants have long been considered for the treatment of many diseases among Iranians and in recent years the use of medicinal plants has increased. In traditional Iranian medicine, many plants have been described to eliminate kidney stones, dissolve kidney stones or prevent stone formation. Based on the results Medicinal plants Cichorium intybus L. Biarum straussii Engl., Tribulus terrestris L., Nasturtium officinale R. Br., Alhagi camelorum Fisch., Adiantum Capillus-Veneris L., Anchusa italic, Alhagi maurorum, Achila mellifolium, Capsella bursa-pastoris (L.) Medicus., Adiantum capillus- Veneris L., Pistacia khinjuk, Acanthophyllum khuzistanicum Rech. F., Malva parviflora L., Allium iranicum (Wendelbo Wendelbo), Centaurea solstitialis L., Cerasus vulgaris Miller, and etc. are medicinal plants that are used in different parts of Iran used to treat kidney stones. It was found that plant families including Fabaceae (10 plants), Asteraceae(10 plants), Brassicaceae (6 plants) and Zygophyllaceae (6 plants) have the most medicinal plants in the discussion of medicinal plants affecting kidney stones and parts such as Leaf (27%), Fruit (15%), Aerial parts (15%) and Flower (14%) are the most plant organs that are used in this area for the treatment of kidney stones. The great tendency of people in the knowledge of ethno-botany and plant flora in traditional medicine is evident in the use of medicinal plants and the historical history of the use of medicinal plants. Iranian ethno-botanical knowledge can play a good role in presenting pure ideas of traditional medicine for modern medicine.

Background: Prostate cancer is a global health concern. In Iran, its epidemiology is not precisely recognized. We aimed to evaluate incidence of prostate cancer among Iranian populations. Methods: In this systematic review, we searched the databases PubMed, Web of Sciences, Scopus and Google Scholar for English studies and the databases Magiran, Scientific information Database, IranMedex and IranDoc for Persian studies, using related keywords. The cross sectional articles published from inception to 31 December 2018 were included. Meta-analysis was conducted on the collected data with STATA software using random effects model. Results: Out of 763 articles initially obtained, 9 articles were finally included after applying the predefined exclusion criteria. Analysis of 9 studies on the incidence of prostate cancer showed a crude rate of 7.1 per 100000 population (95% confidence interval [CI]: 5.6-8.6). Also, the pooled age-standardized incidence rate was 8.7 per 100000 (95% CI: 6.7-10.4). Studies performed in the period 2004-2012 had significantly a higher pooled estimate of the crude incidence rate (9.2 per 100000 [95% CI: 7.9-10.4]) compared with those conducted in the period 1996-2003 (4.5 per 100000 [95% CI: 2.8-6.2]). This trend was also observed based on the age-standardized incidence rate (11 per 100000 [95% CI: 9.4-12.5] versus 6.3 per 100000[95% CI: 4-8.5]).Conclusion: Despite low rate of prostate cancer occurrence in Iran, it is recommended that preventive measures be taken against this disease by health policymakers. Also, more epidemiological studies are needed to better find out the pattern of prostate cancer among Iranian populations.

While some biomolecules have been explored to identify potential biomarkers for the prognosis of COVID-19 patients, there is no reliable prognostic indicator of the disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection outcome. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe (n = 175) and nonsevere cases (n = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of the receiver operating characteristic (ROC) curve found that CRP could be used as an independent factor in predicting the severity of COVID-19. Also, patients with CRP >64.75 mg/L were more likely to have severe complications. In conclusion, CRP serum levels can predict the severity and progression of illness in patients with COVID-19.

Background and purpose: External genital abnormalities are amongst the most common congenital disorders, specially in boys. The aim of this study was to determine the prevalence of genital abnormalities in male neonates born in Babol Ayatollah Rohani Hospital, 2015-2016. Materials and methods: This cross-sectional study was conducted in 787 live-born male infants. Written consent was obtained from their parents. The exclusion criteria were dead infants, female infants and lack of parental consent. The information of Newborns (weight, height, head circumference, gestational age, and kind of abnormality) and their parents (mother's age, history of illness in mother, drug addiction, and any medication taken by mother) were recorded in a checklist. Results: There was undescended testis in 28 (3.6%), hydrocele in 46 (5.8%), hypospadias in 6 (0.8%), and epispadias in 7 (0.9%) newborns. Mean weight of these newborns was 2841.26±434.77 gr. Mean gestational age was 37.34±1.68 weeks and mean age of their mothers was 30 ±7.94 years. Conclusion: The results showed that hydrocele and undescended testis were the most common abnormalities in male neonates. Low birth weight, underlying diseases in mother and advanced maternal age were the predisposing factors of these abnormalities.

Background: Kidney stone (nephrolithiasis) is one of the most common diseases. During the past several decades, its prevalence and incidence have increased markedly in elderly population. Objectives: This study was conducted to evaluate the risk factors for nephrolithiasis in elderly population. Patients and Methods: This study was based on the Amirkola Health and Ageing Project (AHAP). Elderly people with kidney stones in every size, type and number were considered to be the case group and other subjects without a history of kidney stones served as control group. Demographic and anthropometric data, smoking, diabetes and metabolic syndrome (MetS), calcium (Ca), vitamin D, parathyroid hormone (PTH), uric acid and urine pH were compared in both groups. Results: In this study, 1390 elderly people with the mean age of 69.37 ± 7.42 years were evaluated which 202 (14.53%) cases had renal stones. The patients with nephrolithiasis were younger (P = 0.010) and had higher uric acid and body mass index (BMI) levels (P = 0.041 and P = 0.006, respectively). Age

Context: Pediatric nephrolithiasis is a noticeable cause of morbidity among children. Although, nephrolithiasis is a common disease in adults, its incidence has had a rising trend in children. Objectives: Here in, we reviewed the current state regarding evaluation and management of children with nephrolithiasis in the last decade. Data Sources: The current literature regarding incidence and trend, along with diagnostic evaluation and management of children aged less than 18 years old with nephrolithiasis was searched on MEDLINE and Google scholar from January 2005 to March 2016. Study Selection and Data Extraction: The search terms included, “kidney stone OR nephrolithiasis OR urolithiasis and Pediatric OR children”. English language and human studies were included. Expert opinions, editorials and case reports were excluded. Consequently, the authors independently reviewed the abstracts and the papers, which matched the inclusion criteria. Results: From a total of 1050 studies identified through the database search, 71 articles were selected for the review. According to the results of this review, pediatric nephrolithiasis has an increasing rate worldwide. Recent studies in this regard indicated that the number of girls with nephrolithiasis has increased. The change of life style, diet, obesity and metabolic syndrome and popular imaging study along with referral of the patients to pediatric centers could be contributed to this trend. Conclusions: Evaluation of patients, particularly young children, includes metabolic assessment. Stone analysis and 24-urine collection analysis are very helpful for determining underlying diseases. Medical as well as surgical approaches are used to prevent kidney injuries.

Background: Insertion of rectal foreign bodies intentionally or unintentionally is not unusual. Case presentation: A 19-years-old unmarried male was admitted to our hospital due to a lump of left lower quadrant of abdomen. He denied sexual assault .The abdomen was soft on physical examination. Abdominal x-ray and CT scan showed a foreign body in lower abdomen and pelvis. The patient was operated and a slice of glass was extracted. Conclusion: In patients with rectal foreign body, the history is not always reliable and sexual assault may deny. The foreign object inserted in the rectum may migrate to peritoneal cavity without peritonitis.

Context Pediatric nephrolithiasis is a noticeable cause of morbidity among children. Although, nephrolithiasis is a common disease in adults, its incidence has had a rising trend in children. Objectives Here in, we reviewed the current state regarding evaluation and management of children with nephrolithiasis in the last decade. Data Sources The current literature regarding incidence and trend, along with diagnostic evaluation and management of children aged less than 18 years old with nephrolithiasis was searched on MEDLINE and Google scholar from January 2005 to March 2016. Study Selection and Data Extraction The search terms included, “kidney stone OR nephrolithiasis OR urolithiasis and Pediatric OR children”. English language and human studies were included. Expert opinions, editorials and case reports were excluded. Consequently, the authors independently reviewed the abstracts and the papers, which matched the inclusion criteria. Results From a total of 1050 studies identified through the database search, 71 articles were selected for the review. According to the results of this review, pediatric nephrolithiasis has an increasing rate worldwide. Recent studies in this regard indicated that the number of girls with nephrolithiasis has increased. The change of life style, diet, obesity and metabolic syndrome and popular imaging study along with referral of the patients to pediatric centers could be contributed to this trend. Conclusions Evaluation of patients, particularly young children, includes metabolic assessment. Stone analysis and 24-urine collection analysis are very helpful for determining underlying diseases. Medical as well as surgical approaches are used to prevent kidney injuries.