Background:Patients, who survived from shotgun injuries, often have some retained lead pellets in their bodies. Several cases of lead toxicity have been reported regarding these patients.Objectives:This study seeks to compare the serum lead level in patients who have retained lead pellets in their bodies with the control group.Patients and Methods:In this case-control study, we gathered the serum lead levels of 25 patients with some retained lead pellets in their bodies due to shotgun and 25 volunteers without similar lead exposure and compared them in view of the age, gender, and living place.Results:While the mean serum lead level in both groups was lower than the standard level (i.e. 40 µg/dL) , the mean ± SD of serum lead level were 29 ± 12.8 µg/dL and 25.3 ± 6.4 µg/dL in the case and control groups, respectively without any significant difference (P = 0. 30) . However, a positive relationship was seen between serum lead level, and the number of retained lead pellets (r = 0.447, P = 0. 025) .Conclusions:Although extensive surgery to remove the lead pellets is not recommended in patients injured with shotguns, those with many retained lead pellets in their bodies should be considered at risk for lead poisoning and monitored carefully.

Bladder cancer (BC) is one of the most prevalent cancers around the world and, if not treated well, has high morbidity and mortality. Many studies have indicated that there may be various roles for the aryl hydrocarbon receptor (AHR) in the immune system. The aim of this study was to determine the frequency of Foxp3+ regulatory T (Treg) and T helper 17 cells (Th17) in BC tissue in comparison with controls and determine the relationship between AHR, Foxp3+ Treg and Th17 cells in BC. A total of 40 patients with BC were enrolled in this study. The control group was selected from non‐tumoural parts of bladder tissues from the patients who have undergone cystoscopy. The percentage of regulatory T cells (Foxp3+/CD4+) and Th17 (IL‐17+/CD4+), as well as AHR+ cells in BC tissues and controls, were determined by immunohistochemistry. The results of this study showed that the number of Foxp3+ Treg and Th17 is significantly higher in bladder tumour tissues in comparison with non‐tumoural tissues. Also, the percentage of AHR+ lymphocytes and AHR+ cells was increased significantly in bladder tumour tissues rather than non‐tumoural tissues. This study also found a relation between AHR and Foxp3+/CD4+ T lymphocytes ratio cells in BC. The percentage of Foxp3+ Tregs and AHR+ cells were significantly correlated with the grade and stage of BC. An increase in the percentage of Foxp3+ Treg and Th17 cells may play an important role in tumour immunity; and determining the relationship between AHR and differentiation of Th17/Foxp3+Treg in BC can lead to a potential cancer therapeutic possibility.

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Introduction: Patient position during surgery is an important issue that can affect vital indices. Objectives: This study was conducted to compare hemodynamic changes, movements, surgery length, and pain during transurethral lithotripsy (TUL) in supine and lateral positions. Patients and Methods: This double-blind clinical trial was conducted on 76 patients who were candidate for TUL, randomized to two groups of 38 for each. In the lateral group, after inducing spinal anesthesia, the patients were positioned lateral and in supine group, the patients were positioned supine immediately after injecting anesthetic. Vital signs were recorded at six intervals; 5 minutes before anesthesia and 1, 5, 10, 15, and 20 minutes after anesthesia. In addition, movements and pain during surgery were assessed. Data analysis was conducted by descriptive statistics, independent t test, and repeated measures ANOVA in SPSS 22. Results: There were significant differences in changes in systolic blood pressure, diastolic blood pressure, and mean arterial pressure at different intervals between the two groups in such a way that hemodynamic stability was greater in the lateral group (P<0.05). There were no significant differences in changes in heart rate at all studied intervals between the two groups (P>0.05). Surgery length, movement and pain during surgery were not significantly different between the two groups (P < 0.05). Conclusion: Hemodynamic changes especially blood pressure were less remarkable in patients undergoing spinal anesthesia in TUL at lateral position than those in supine position. Additionally, no significant differences in patients’ movement and surgery, and surgery length between the two positions was detected.