Totally tubeless PCNL is a safe and effective procedure. The hospitalization and analgesia requirements are less and the return to normal activities faster with this technique.

Background: Cyclooxygenase 2 (COX-2) is important as an enzyme in the pathway leading to the production of prostaglandin E2 (PGE2) and arachidonic acid. This pathway is known to play a role in inflammation, tumor growth, invasiveness and metastasis, inhibition of apoptosis and angiogenesis. Inhibition of COX-2 has been shown to be a promising antitumor and antiangiogenic strategy in several tumor types, including renal cell carcinoma (RCC). Therefore, we decided to evaluate the immunohistochemical expression of this marker and its association with several clinicopathological characteristics in a series of cases. Materials and Methods: COX-2 expression was examined immunohistochemically in tumor tissues obtained from 96 patients who underwent radical (94 cases) or partial (2 cases) nephrectomy. Correlations between COX-2 expression and clinicopathologic findings including pathologic stage, nuclear grade and other indicator of prognosis were examined. Results: Of 96 tumors, 20.9% were positive for COX-2 expression. A correlation was found between COX-2 expression and tumor histological subtype (P=0.03).The papillary subtype showed maximum expression of this marker (43.8%) and the clear subtype minimum (14.7%). There were also possible links between COX-2 expression and pathologic stage, nuclear grade and nodal involvement but the results were not statistically significant (P=0.8, P= 0.14 and P=0.06, respectively). No correlation was found between COX2 expression and patient age, gender, tumor size, metastasis or survival. Conclusions: In our study, COX-2 expression was correlated with the histological subtype of RCC. Additional research is required to determine the link between COX-2 expression and prognosis and also evaluation of probable effectiveness of COX-2 inhibitor drugs in treatment of RCC patients.

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BackgroundOne of the issues in prostatectomy surgery is bleeding. Although tranexamic acid (TRA) is an antifibrinolytic agent for reducing bleeding, controversies surround its use.ObjectivesIn this study, the effect of local administration of TRA on reducing bleeding during prostatectomy surgery was evaluated.MethodsA total of 186 patients who underwent prostatectomy surgery were assessed in this clinical trial study. Patients were divided randomly into two groups. After prostate removal, TRA (500 mg TRA with 5 mL total volume) to the intervention group and normal saline to the control group were sprayed with the same volume. At the end of surgery, the prescribed blood bags were measured and recorded. Hemoglobin and platelet levels were recorded 6 hours after the test. Moreover, the amounts of blood inside the blood bags in the first 24 hours, the second 24 hours, and the total length of hospital stay were recorded and compared in each group.ResultsBy comparing the measured values before and after surgery, we found that the amounts of hemoglobin, hematocrit, and platelet decreased. The mean blood loss in the intervention group was recorded at 340 mL and that in the control group was 515 mL. The maximum bleeding in the control group was almost twice as much as that in the intervention group. Blood loss in the intervention group with the administration of TRA was significantly lesser than that in the control group (P = 0.01). The decrease in platelet level in the intervention group was significantly lower than that in the control group (P = 0.03).ConclusionsThe present study showed that local administration of TRA significantly reduces bleeding after prostatectomy surgery and is effective in preventing postoperative hemoglobin decrease.

The proposed surgical modifications are based on 14 years of experience and 1510 cases, and make LDN simple, safe, and cost-effective. The excellent recipient and graft outcomes with minimal morbidity obtained further confirm that LDN can be considered as the gold standard for kidney donation surgery.

Introduction:The use of traditional medicine has been emerged in the treatment of BPS (bladder pain syndrome) due to its high prevalence and expenses and its insufficient treatment by conventional therapies. Iranian traditional medicine has discussed such diseases. Considering the signs and symptoms of BPS and “reeh”, the proposed mechanism of flatulency as casualty of recurrent circulating pains seems to be a proper diagnose. So, as a preliminary study the authors administered Horse Mint as one of effective traditional herbs on flatulent pain in a patient with BPS.Case Presentation:A 60-year-old female was referred with the diagnosis of BPS. Six clinical visits with 2-week intervals were performed for patient, and the NIH-ICSI (National Institutes of Health Interstitial Cystitis Symptom Index) was completed, which was used as a pretreatment symptom quantifier and post-treatment outcome tool. Horse mint (Mentha longifolia) was prescribed twice a day for 12 weeks.Discussion:Clinical visits showed alleviation of signs, symptoms, and changes in the patient's NIH-ICSI score, suggesting further studies on this field.

Introduction: It is assumed that the outcome of kidney transplantation from living donors is more favorable than deceased donors. However, over the years there has been an overall improvement in transplant survival from both living and deceased donors. In this article we have evaluated and compared the most recent results in living and deceased donor kidney transplantations. Patients and Methods: Four hundred and forty six patients underwent kidney transplantation in our center from September 2009 to March 2014. The patients divided in two groups living (group A) and deceased (group B) donor transplantation groups. The patients were followed until September 2016. Acute rejection, graft survival, delayed graft function, renal artery thrombosis, graft nephrectomy, ureterocutaneous fistula, postoperative hypertension, mortality, hospital stay, hyperlipidemia, post transplantation diabetes and lymphocele rate measured and compared in two groups. Results: Most variables were not different between the two groups except lymphocele and delayed graft function. Lymphocele was more prevalent in group A (13.8% vs 3.1%, p-value = 0.02) and delayed graft function results were more desirable in living donor transplantation group (group B). Conclusion: Although, delayed graft function was less common in transplantation from living donors, short, and long term graft survival was not significantly different in this study.

Introduction: Testing for the presence of micro-organisms in the urinary tract, in order to diagnose asymptomatic bacteriuria or symptomatic urinary tract infections (UTI), is very common at all levels of health care. This study was conducted to assess the diagnostic values for bacteriuria and pyuria and evaluate their roles in therapeutic decision making. Methods: A total of 1770 urine samples were obtained by simple randomized method from the central Laboratory of the Ali-ebne-Abitaleb Hospital (Zahedan, Iran). Urine culture was done to compare urine microscopy profiles. Sensitivity, specificity, positive and negative predictive values of the findings of urine analysis was described. Results: 1055 (59.6%) of the cases were females. 13% (230/1770) of patients had positive urine cultures. The most prevalent cultured micro-organism was E. coli (63%). Sensitivity, specificity, positive and negative predictive values of microscopic pyuria were 85%, 88%, 51%, 97%, respectively. As the same for bacteriuria, these calculations were 97%, 98%, 90%, 99% and for the category with both bacteriuria and pyuria were 82%, 99%, 95%, 97%, respectively. Conclusion: According to the results, it is concluded that the urine microscopy features seems to be useful to exclude the presence of infection if the results of both bacteriuria and pyuria are negative, but positive test results have to be confirmed