Background Urinary tract infection (UTI) is a common clinical problem in pregnant women. Bacteriuria in pregnancy without antibiotic treatment could result in complications. This study aims to investigate the etiology and prevalence of UTI and asymptomatic bacteriuria (ASB) in pregnant women in Iran. Method This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To avoid bias, all steps of the study were carried out independently by two researchers. We conducted a comprehensive search on all the related literature in national databases, including IranDoc, SID, Barakat Knowledge Network System, RICST, Magiran, Iranian National Library and international databases, including Scopus, Embase, Science Direct, PubMed/ Medline, Cochrane Library, Web of Sciences, EBSCO, as well as Google Scholar search engine until June 2018. After considering the inclusion/exclusion criteria and qualitative evaluation, studies were analyzed based on random effects model using Comprehensive Meta-Analysis Software Version 2. Results In 31 studies with a sample size of 20,309, the prevalence of ASB in pregnant Iranian women was estimated to be 8.7% (95%CI: 7.2–10.4). The lowest and highest prevalence of ASB were observed in the third trimester (6.1% [95%CI: 2.1–16.4]) and first trimester (11.7% [95%CI: 7.9–16.9]), respectively. Subgroup analysis of the prevalence of ASB based on geographical region ( P = 0.002) and province ( P < 0.001) was significant but for the quality of studies ( P = 0.51) was not significant. In 17 studies including 48,731 pregnant women, the prevalence of UTI was estimated to be 9.8% (95%CI: 7.6–12.5). The test for subgroup differences of prevalence of UTI for province ( P < 0.001) was significant but for geographical region ( P = 061) and quality of studies ( P = 0.11) was not significant. Meta-regression model for the prevalence of UTI and ASB in pregnant women in Iran based on year of the studies was significant ( P < 0.001). The most common microorganism involved in the etiology of UTI (61.6% [95%CI: 51.6–70.7]) and ASB (63.22% [95%CI: 51.2–73.8]) was E. coli . Conclusion UTI and ASB are prevalent in pregnant women in Iran. Therefore, UTI screening is essential in pregnant women. The most common microorganism involved in the etiology of UTI and ASB in pregnant women in Iran is E.coli .
The objective of this study was to analyze the outcome of percutaneous nephrolithotomy (PCNL), laparoscopic and open anatrophic nephrolithotomy (AN) for management of patients with large staghorn renal stones. We analyzed the peri-operative parameters, overall treatment costs and changes in the function of the affected kidney on technetium-99 dimercaptosuccinic acid renal scintigraphy, done before the operation and before the final follow-up visit, in 45 adults who underwent PCNL (n = 16) versus laparoscopic (n = 15) versus open (n = 14) AN for large staghorn renal stones. All three groups had statistically similar preoperative characteristics, including the function of the operated kidney on renal scan. On the discharge day, the PCNL group had the lowest stone-free rate (43.75 %) compared to the laparoscopic (80 %) and open AN groups (92.85 %) (P = 0.009). After a mean follow-up period of 12.1 months, the decrease in the function of the operated kidney was greatest in the open AN group (-8.66 ± 4.97) compared to the laparoscopic AN (-6.04 ± 6.52) and PCNL group (-2.12 ± 2.77) (P = 0.003). The need for ancillary procedures to manage residual stones was greatest in the PCNL group and lowest in the open AN group. A similar trend was seen in overall treatment costs (P < 0.001). For management of large staghorn renal stones, the more invasive the procedure, the higher the one-session stone-free rate and the lower the need for ancillary procedures; however, greater renal functional loss can be anticipated. The need for ancillary procedures is a major determining factor in the overall cost of treatment, which was highest in the PCNL group.
Background: Extracorporeal shock wave lithotripsy (ESWL) is an effective and relatively safe method for crushing urinary tract stones Objectives: The purpose of this study was to compare the effect of running on treadmill and rope jumping exercises on the excretion of mass-like urinary stones following ESWL in the patients referred to the Asia clinic in the city of Ilam. Methods: This was a quasi-experimental study. The subjects were selected by the convenience sampling method and randomly divided into three groups, including control, treadmill running, and rope jumping (n = 50 per group). Data were collected by a questionnaire to record the sonographic characteristics of the stones before and after lithotripsy and analyzed by SPSS software version 24 using Chi-square, unpaired t-test, and one-way ANOVA at the significance level of 5%. Benieman-Hashberg method was used to correct multiple comparisons. Results: There was a significant difference in the number of excreted stones comparing the control, treadmill running, and rope jumping groups (F = 8.851, P = 0.002). There were significant differences between the control and both treadmill running (P = 0.038) and rope jumping (P = 0.002) groups regarding the rate of stone excretion. However, there was no significant difference between the treadmill running and rope jumping groups regarding the rate of stone excretion (P = 0.293). Conclusions: Rope jumping and treadmill running exercises can help to better and faster expel kidney stones, depending on their location, after lithotripsy.
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