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Introduction: Despite the considerable studies conducted on the quality of YouTube surgical videos as an educational resource in other surgical fields, there have been no such studies in the field of laparoscopic urology so far. Considering the great sensitivity in these procedures and the necessity of identifying the mistakes in these videos, we aimed to evaluate the quality of YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries. Materials and Methods: In this descriptive cross-sectional study, 131 YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries were reviewed. Two researchers familiar with laparoscopic urological surgery reviewed the videos based on the LAP-VEGaS checklist. A third professor reviewed the videos on which there were disagreements. Results: In the majority of the videos, the title was chosen accordingly and the surgeon was introduced appropriately. Furthermore, in most of the videos, patient anonymity was respected. The mean score of the videos was equal to 74.3 ± 5.4, the maximum score being 17 and the minimum 1. The average score of the partial nephrectomy videos was obtained as 98.3 ± 5.74, whereas the average score for adrenalectomy videos was 47.3 ± 4.5. The overall average score of the studied videos was 74.3 ± 5.40. Conclusion: The results of our study suggest that most of YouTube videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries are used for educational purpose. These YouTube videos are suboptimal in educational aspect and students should be advised to use them with caution. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis was designed to evaluate the post-operative outcomes between tubeless and standard percutaneous nephrolithotomy (PCNL) among children. Methods: Literature searches were performed following the Cochrane guidelines. We conducted a systematic review and meta-analysis that included three trials investigating the outcomes including the length of hospital stay, operation time, hemoglobin decrease, blood transfusion rate, perirenal fluid presence, post-operative fever, stone clearance rate, and the need for a second operation. Results: The patients who underwent tubeless PCNL had shorter length of hospitalization compared to standard PCNLs (mean difference -1.57, 95% confidence interval -3.2 to 0.07, p = 0.06). No significant decrease was detected in hemoglobin after tubeless PCNL compared to standard PCNL (mean difference 0.05, 95% confidence interval -0.03 to 0.13, p = 0.21). There were no significant differences in operation time (p = 0.7), perirenal fluid presence (p = 0.15), post-operative fever (p = 0.72), stone clearance (p = 0.68), and the need for a second operation (p = 0.90). Conclusions: This study showed no significant difference between tubeless and standard PCNLs in children. However, due to the lack of data, the results should be mentioned prudently. Future randomized trials with more sample sizes and longer follow-ups are warranted. [ABSTRACT FROM AUTHOR]

Objective: Biebersteinia (Geraniaceae) has a history of use in traditional medicine in some countries including Iran. In the present study, cytotoxic and apoptogenic properties of hydroethanol extract of B. multifidi was investigated on human prostate cancer cell lines (PC3 and DU 145) and human embryonic kidney 293 (HEK293) cells. Materials and Methods: Cells were cultured in RPMI-1640 medium supplemented with 10% FBS at 37°C in a humidified atmosphere of 95% air and 5% CO2. The root of the plant was macerated with EtOH 70%. Cytotoxic activity of ethanol extract of B. multifida was assessed using alamarBlue® assay after 48 hr of treatment. Apoptotic cells were stained with propidium iodide (PI) and detected by flow cytometry (sub-G1 peak). Results: B. multifidi had cytotoxic effect on malignant cells and normal HEK293 cells in a dose-dependent manner and significantly decreased the cell viability (IC50 values were between 199.2 and 302.9 µg/ml). B. multifida increased the sub-G1 peak in flow cytometry histogram of treated PC3 cells compared to control showing the induction of apoptosis and DNA fragmentation. Conclusion: Due to cytotoxic and apoptotic activity of B. multifida, the plant is suggested for further phytochemical analysis and mechanistic evaluation. [ABSTRACT FROM AUTHOR]

Because of antimicrobial, antioxidant, and anticancer potential, Salvia chorassanica Bunge (Lamiaceae) has been considered as a popular herb in Iranian traditional medicine. Previous studies have shown remarkable cytotoxic properties of the methanol, n-hexane and dichloromethane extract of S. chorassanica on human cervical cancer cells. To seek the therapeutic potentials of S. chorassanica, this study was undertaken to evaluate the cytotoxic activities of various extracts of this plant on human breast MCF-7 and prostate cancer DU 145 cells. The DU 145 cells were exposed to different concentrations of plant extracts (1-200 μg/ml). Cytotoxic activities were examined using alamarBlue® assay and apoptosis was assessed by acridine orange/propodium iodide double staining and evaluation of DNA fragmentation by flow cytometry. Our findings indicated that n-hexane and dichloromethane extracts had more cytotoxic activities against DU 145 and MCF-7 cell lines compared with other extracts (P<0.05). The acridine orange/propodium iodide staining showed apoptogenic properties of n-hexane and dichloromethane extracts which was consequently confirmed by flow cytometric histogram that exhibited an increase in sub-G1 peak in treated cells as compared with untreated cancer cell lines. Taken together, these observations demonstrated cytotoxic effects of S. chorassanica extracts on MCF-7 and DU 145 cell lines which is most likely exerted via apoptosis cell death. Therefore, further investigations on S. chorassanica extracts as potential chemotherapeutic agents are warranted. [ABSTRACT FROM AUTHOR]

Objective(s): Leptin exerts various effects on appetite and body weight. Disruption of the obesity gene is precedent to fatness. Insulin or glucose elevates leptin, but streptozotocin reduces it. However, controversial data exist for the effects of leptin on diabetes and leptin level in each gender. Leptin can damage the kidney function but little evidence exists for its hepatic effects. The aim of this study was to investigate the probable sex-dependent differences in blood sugar levels, lipid profile, and renal and hepatic biochemical factors in the obesity and streptozotocin-induced diabetic rats after leptin administration. Materials and Methods: Wistar rats of both sexes were randomly divided into two groups, namely obese and diabetic rats. Each group was further divided into male and female subgroups. Extra fat and carbohydrate was added to the diet to induce obesity. Furthermore, streptozotocin (55 mg/kg, IP) was injected to induce diabetes. The treatment groups received leptin (0.1 mg/kg SC) for 10 days, and then, blood samples were taken from the orbital sinus for laboratory evaluations. Results: Leptin resulted in a significant weight loss in both sexes (P<0.001), food intake reduction in male rats (P<0.05), LDL reduction in female rats (obese (P<0.05) and diabetic (P<0.001)), and glucose level decline in the female diabetic rats (P<0.001). However, total protein concentration, LFT (liver function tests), urea and creatinin concentrations among different groups did not show any significant changes. Conclusion: Leptin caused some discrepant results, especially regarding the LDL and glucose levels in diabetic female rats. [ABSTRACT FROM AUTHOR]

Background: Critical care patients are at higher risk for untreated pain. Pain has persistent and untreated effects on most of the body systems and results in development of complications, chronic pain, and increased length of stay. The aim of this study was to determine the effects of the implementation of a pain management program on the length of stay in patients with decreased level of consciousness, admitted in Al‑Zahra hospital intensive care units (ICUs) in 2013. Materials and Methods: In this clinical trial, 50 subjects with decreased level of consciousness were selected by convenient sampling from the ICU wards of Al‑Zahra hospital, Isfahan, Iran and were randomly assigned to two groups of study and control. Pain management program was applied on the study group and routine care was implemented in the control group. Data including demographic data and length of stay of patients in the ICUs were collected and analyzed using descriptive statistics and Chi‑square test, independent t‑test, and paired t‑test. Results: Results showed that out of 50 subjects attending the study, there were 40% female and 60% male subjects in study, and 52% female and 48% male subjects in control group. (P = 0.395). Overall mean length of stay of the patients in the ICUs was significantly lower in the case group [3.2 (1.4)] days compared to the control group [7.4 (4.8) days] (P < 0.001). Conclusions: This study showed that overall mean length of stay of patients in the ICUs was significantly lower in the study group compared to the control group. It is suggested to use this program for patients in ICUs with decreased level of consciousness after a general surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives: There are conflicting data on the effects of fasting in Ramadan in Muslim countries on Lipid profile. We aimed to evaluate the effect of fasting on lipid profiles and some ratios which are strong for predicting cardiovascular disease. Methods: This prospective observational study was done in Iran in 2012. Forty three persons were enrolled into the study. Their anthropometric measurement was done. Fasting plasma high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), total cholesterol (TC), and triglyceride (TG) were measured at baseline and after one month fasting during Ramadan by standard methods. Paired t test were used to compare lipid profiles before and after the intervention. Results: High density lipoprotein cholesterol was 33.10±6.53 mg/dL at baseline and increased to 42.49±8.44mg/dL (P < 0.001). Fasting in Ramadan decreased serum LDL/HDL and TG/HDL ratios significantly (P < 0.001). Triglyceride levels were unaffected. Low density lipoprotein and total cholesterol levels increased (P=0.008). Changes did not differ significantly between men and women. Conclusion: Fasting in Ramadan is effective to ameliorate High density lipoprotein, and LDL/HDL and TG/HDL ratios. Omitting one meal may be considered to control High density lipoprotein level. [ABSTRACT FROM AUTHOR]

Intravascular tumor extension in the major renal veins or their tributaries, as a rare but important clinical entity that can change the disease stage, prognosis, and approach to treatment. There is limited literature on the obstruction of renal vein and IVC by tumor thrombus in other types of renal tumors that are not of RCC type. We presented four different renal tumor cases with the presence of gross renal vein or IVC thrombosis. Although the incidence of renal vein and IVC tumor thrombus might be suggestive of (often diagnosed as) RCC, the possibility of other non-RCC renal tumors should be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) in elderly patients. Materials and Methods: We retrospectively reviewed 50 PCNLs performed in the elderly patients (age > 65 years) carried out in our clinic from 2001 through 2007 and compared those with 248 PCNLs performed in younger patients (age < 40 years) during the same period. Results: No significant difference was seen in calculus burden between the two groups. The success rates (stone-free patients and patients with residual calculi < 4 mm) were 85% for the elderly patients and 90% for the younger patients (P = .45). The major composition of calculi was calcium oxalate in 58% and 66.5% of the elderly and younger groups, respectively. No significant complication was observed in the elderly group. Fever without sign and symptoms of bacteremia was seen in 3 patients of each group (8.0% versus 1.2%, P = .004). The operative time was 75.0 ± 6.4 minutes and 76.0 ± 5.1 minutes (P = .25), and the mean hospital stay was 3.7 ± 0.3 days and 3.8 ± 0.9 days (P = .80) in the elderly and younger patients, respectively. Conclusion: We found that PCNL in patients over 65 years was a safe and reliable technique with a stone-free rate of 85% for all types of calculi. Well-controlled comorbidities do not increase the risk of operation. It seems that despite the higher medical risk in the elderly patients, PCNL could be safe and yields a high stone-free rate. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 38-year-old woman with abdominal pain, urgency, and frequency during menstruation since her second delivery. Following examinations, the patient revealed to have sessile irregular bluish lesion with a nodular surface on the bladder's posterior wall. She underwent transurethral resection of the bladder mass with loop coagulation of hemorrhagic vessels after unsuccessful hormone therapy. The findings then showed endometriosis with chronic bullous cystitis.

Infertility is one of the main social and health problems among young couples. Although a noticeable ratio of infertilities are asymptomatic, about half of the cases are observed among males. Various environmental factors such as life style, dietary patterns, and pathogens are associated with male infertility. Mutations and chromosomal abnormalities are also the most important genetic risk factors of male infertility. Similar to other populations, there is a dramatically rising trend of male infertility among Iranian. Regarding the high ratio of asymptomatic cases, it is required to clarify the molecular biology and cellular processes involved in male infertility in this population to suggest an efficient panel of diagnostic markers. In this review, we have summarized all of the cellular and molecular processes which have been reported among Iranian infertile males to clarify the molecular biology of male infertility in this population. It was observed that the stress response, cellular detoxification, and DNA repair processes were the most common aberrant cellular mechanisms among Iranian infertile males. This review paves the way of introducing a population-based diagnostic panel of genetic markers among Iranian infertile males., Competing Interests: None., (AJTR Copyright © 2021.)