mojtaba teimoori

Prostate cancer is considered as one of the most common malignancies in males. Despite the decreasing trend during the past decade, the incidence continues to rise in adolescents worldwide. Recently, new emerging technologies beside TRUS-guided prostate biopsy were introduced and showed high potential in the diagnosis of prostate cancer. The current study aimed at investigating the role of blood cell count and its prognostic value on pathologic findings. The current prospective analysis was conducted on patients with abnormality from January 2013 to January 2015. A total of 168 CBC tests including absolute Neutrophil and lymphocyte counts were performed on males at the Department of Urology, Razi University Hospital (Guilan, Iran). Of these, all males had both CBCs and free:total (F/T) prostate-specific antigen (PSA) ratio. Average age of patients was 63.5±7. It was observed that Neutrophil count and Neutrophil percentage was not significantly different among the groups with different pathologies. In comparison to biopsy findings none of the cell count had suitable specificity and sensitivity. In the multivariate analysis to predict malignancy, only age (B=0.1, S.E=0.04, EXP [B]) =1.1 and sig=0.00) and PSA level (B=0.1, S.E=0.04, EXP [B]) =1.1 and sig=0.00) were significant. In comparison to biopsy findings, none of the cell counts (absolute or percent) had suitable specificity and sensitivity, and the cell count and percentage before biopsy were not different among the groups with different pathologies. Powerful and long-term studies are required to evaluate prognostic values of cell count on adenocarcinoma.

Context: An immunosuppressive drug, Cyclosporine (CsA), has been commonly used in kidney transplants. A safe dosing of CsA often causes nephrotoxity, bone marrow toxicity, and infection. Pharmacokinetic characteristics of CsA and CsA marker relation to the immune suppression have not been completely described in clinical practices yet.
This review summarizes our achievements on pharmacokinetic and CsA level Marker in kidney transplant patients.
Search methods and Selection criteria: A literature review was done using the National Center for Biotechnology Information’s Pubmed Medline, Ovid Medline and Embase, and Iranian registries (Iranmedex, SID, MagIran, and IranDoc). Titles and abstracts were then reviewed to select studies based upon the predefined inclusion criteria. Our study defined a population of adult solid organ transplant recipients receiving the cyclosporine that Cyclosporine monitoring was done.
Data Collection and Analysis: Two reviewers independently appraised the quality of each trial and extracted the data from the included trials.
CsA pharmacokinetics is very different between kidney transplant recipients, in order to CsA profiling, no pharmacodynamic tools has been confirmed yet in clinical practices and the best way to individualize calcineurin inhibitor therapy is still a controversial issue. C0 levels do not exactly predict the CsA level or rejection risk, patient monitored by C2 levels have upper doses of CsA and have a lower frequency of early acute allograft rejection than patients profiled with C0 and although CA is highly heterogeneous closely post-transplant and seems to be unhelpful early after post-transplant it is more favorable after first months after.
Establishing a biological CsA marker may be helpful in clinical decisions on the dose. It seemed to be logical that we should re-inspect the possibility of using them as a supplementary tool towards better therapeutic drug monitoring of cyclosporine or it needs to be reevaluated and needs to find a new target for a therapeutic plan in kidney transplant patients.

Priapism is well-defined by persistent, painful penile erection which happens without sexual stimulation. Currently, the hirudotherapy is practiced to treat venous congestion and subsequent compartment syndrome. Here we will report a case of a male with priapism treated by leeches. The case was a 26 yr old young single male referred to the Razi Hospital Emergency Department, Guilan University of Medical Sciences, Rasht, Iran due to long-time spontaneous erections. The patient had no history of mental disorders, trauma or sickle cell anemia. we insert two leeches in each side of penile shaft for two hours, after a one hour break we insert do in same manner for another cycle. At follow-up two days later he had significantly decreased pain, though still had cavernosal swelling and tenderness to palpation. The patient was subsequently discharged after three days of admission. The pain and perineal swelling completely resolved over the course of one month. In this case, chronology indicates that leech therapy was possibly treatment option for priapism. This procedure seems to be non-invasive treatment strategy worth to discussing in such patients.

For 50 years, the term gene is synonymous with regions of the genome gene that coding by mRNAs and translate to protein. nonetheless, Genome wide Recent studies have revealed that regulating gene expression through degradation or translational inhibition of their point mRNAs and thus attend in a wide variety of physiological and pathological cellular processes including: development, cell proliferation, differentiation, and apoptosis pathways by thousands of regulatory non coding RNA such as lncRNAs and microRNAs. According to a recent survey, it is known this RNAs have vital role in regulation cellular pathways at transcriptional, posttranscriptional and epigenetic levels. These noncoding genes are often aberrantly expressed in a variety of human cancers. However, the biological functions of most ncRNAs remain largely in doubt. In this review, we proved that a remarkable part of the genetic etiology of cancer is imposed by noncoding regulatory sequences. The purpose of this review is aimed to give an outlook of using of noncoding RNA as diagnostic markers and therapeutic targets. These observations emphasized that the recognition of coding genes and Research continued evolution and function of non-coding RNAs for a comprehensive understanding human complex diseases like cancer are essential.

To compare results of studies on supine and prone percutaneous nephrolithotomy (PCNL) techniques to find the best position for treating kidney stones.
A systematic literature review was done in April 2016 using PubMed, Scopus, and Web of Science databases to identify the relevant studies. Article selection was based on the preferred reporting elements of systematic reviews and meta-analysis criteria. A subgroup analysis was done comparing standard prone and supine PCNLs separately.
Twenty studies were selected for the analysis including 7733 PCNL cases: 2110 cases were (27.3%) in supine and 5623 cases were (72.7%) in prone position. Supine and prone PCNL had a similar stone-free rate (OR: 0.95; 95% CI: 070-1.27; P = 0.73), operation time (difference in means = -0.01, 95% CI: -0.07 to 0.03; P = .53), hospital stay (differencein means = 0.01, 95% CI: -0.07 to 0.03; P = .52), complication rate (OR: 0.88; 95% CI: 0.76-1.02; P = .09) and urinary leakage (OR: 1.14; 95% CI: 0.50-2.59; P = .75). However, patients received less blood transfusion (OR: 0.72; 95% CI: 0.55-0.94; P = .01) and had less fever rates (OR: 0.65; 95% CI: 0.52-0.80; P Supine PCNL has similar stone-free rate, operation time, and hospital stay relative to prone PCNL. However, the supine position has the advantage of less fever and need for blood transfusion. Although both prone and supine PCNLs are suggested for treatment, supine PCNL may have advantages especially in patients with comorbidity.

Subjectives: Prevalence of benign joint hypermobility syndrome (BJHMS) without systemic disease seems to be high in children. Little literature is currently available related to urinary tract diseases in patients with BJHMS. Here, we report an association between the urinary tract disease and BJHMS.. We conducted a prospective case series study of 62 pediatric patients with musculoskeletal pain to detect urinary tract diseases in Tehran, Iran from October 2009 to October 2010. The Brighton criteria score was used to diagnose BJHMS. The collected data included age, gender, grading of vesicoureteral reflux (VUR), ultrasonography findings, urodynamic results and biochemical tests. Voiding cystourethrography was used for detection and grading of VUR.. VUR was observed in 60% of patients with BJHMS. However, sonography was normal in 66.7% of patients. The most common grading of reflux was grade II of VUR (37.5%). Seventy percent of patients with BJHMS and neurogenic bladder had failure to thrive.. Our findings showed an increased frequency of VUR in patients with BJHMS. We suggest that Infants and children with BJHMS should be screened for VUR..

There is a greater risk of mortality and morbidity for patients with left bundle branch block (LBBB). In most cases, LBBB is accompanied by left ventricular dysfunction. We investigated the electrocardiographic characteristics of LBBB patients with and without congestive heart failure to determine parameters for the follow-up of this group of patients. In this cross-sectional study, all patients who referred to our tertiary center with LBBB (with preserved left ventricular function) candidated for cardiac resynchronization therapy were included between January 2007 and January 2008. Electrocardiographic characteristics such as QRS notching, intrinsicoid deflection, and QRS duration were compared between two groups. Seventy-five patients were enrolled (mean age = 60.20±12.55 years, range=18-77). There was a statistically significant relationship between QRS notching in the precordial leads and severe left ventricular dysfunction (72.7% of patients with severe left ventricular dysfunction vs. 27.8% of patients with preserved left ventricular function; p value=0.04). The relationship between QRS notching in the limb leads and severe left ventricular dysfunction was not statistically significant (70.7% in patients with severe left ventricular dysfunction vs. 29.3% in patients with preserved left ventricular function; p value >0.05). Our study showed a significant relationship between QRS wave duration in the precordial and limb leads and severe left ventricular dysfunction (p value <0.05), but there was no significant relation between intrinsicoid deflection and severe left ventricular dysfunction (p value >0.05). QRS wave fragmentation (presence of a notch in R or S) may be associated with inactivation and dyssynchronization, both of which can reflect ischemic condition. There are reports of a correlation between this disorder and dyssynchronization; this can be one of the causes of the pathophysiology of congestive heart failure. Increase in QRS duration in the ECG was strongly associated with some changes in left ventricular function and structure, which can be allied to congestive heart failure. Also, dyssynchronization due to LBBB can increase the risk of congestive heart failure.

Solid organ transplantation patients are at high risk for opportunistic air-borne fungal infections due to using the potent immunosuppressive agents.. The current study aimed to qualitatively and quantitatively evaluate the fungal flora present in the air of Kidney transplant unit of Baqiyatallah hospital.. In this prospective study, air samples from patient room, baths site, ICU and isolated room, corridor site and outside the ward were obtained by settled plate technique using plates containing Sabouraud''s dextrose agar medium. In the current study, 36 agar plates containing Sabouraud dextrose agar medium were used. The plates were exposed for 20 min at height of 100-150 cm above the ground in units of hospital. Immediately after collection, samples were incubated at 27 ± 2ºC for four weeks. The slide culture method and Lacto-phenol cotton blue were used for definitive identification and staining fungal cultures, respectively.. The mean of colony forming units (CFUs) on indoor and outdoor plates was 6.6 ± 1.3 and 6 ± 1.9 / plate respectively. Statistical analysis showed that the observed difference is not significant. Also, the results showed that the mean of CFUs in the air of patient''s rooms (6.8 ± 1.7), halls (4.5 ± 1.7), bathrooms (6.8 ± 1.5), and ICU rooms (3.2 ± 1.8) were not significantly different. The mean of different fungal genera isolated from indoor and outdoor plates were 1.9 ± 0.2 and 4 ± 0.5 genera/plate respectively, that indicates significant difference between indoor and outdoor air quality (P < 0.001).. Lack of difference between quantity of outdoor and indoor air fungi indicates inefficiency of air control measures, and indoor lower genus diversity compared to outdoor air shows that there may be conditions that facilitate fungal growth in the environment of kidney transplantation unit..

HLA typing analysis is important in renal transplant patients. We made a plan to determine the most frequent HLA antigens in Iranian kidney transplant patients.Patients and In a retrospective cross sectional study, HLA patterns were defined in 512 kidney transplant recipients (67% male and 33% female) from different transplant centers of Tehran, Iran between 2008 and 2011 by microcytotoxicity assay. The studies samples were of different ethnic groups of the Iranian kidney transplants. Considerable variations were observed in each HLA sub class. A2, A1, A3, A24 and A26 were the most frequent HLA-A antigens. Among HLA-B, the predominant antigens were B35; B13, B15, B13 and B18. The most frequent HLA-DR antigens were DR 4, DR11, DR1, DR3 and DR15. DQ1 showed the highest frequency and followed by DQ3 and DQ2. These results showed considerable heterogeneity in both HLA class I and class II antigens, which reflects recent admixture of this group with neighboring Middle East populations.

Clinical information concerning cyclosporine dose reduction in Iranian kidney transplant recipients is limited. There are data in Asian, Caucasian, and Iranian ethnic kidney transplant recipients that recommend the trough level (C0) and 2-hour postdose level (C2) of cyclosporine may be different. Our aim was to determine therapeutic levels of C0 and C2 at different time after transplantation among Iranian transplant patients. Blood concentrations of cyclosporine were assessed in 4419 samples of kidney transplant recipients between 2008 and 2010. The patients were divided into 3 groups according to the time of laboratory studies (< 3 months, 4 to 12 months, and > 1 year after transplantation). Both univariable and multivariable analyses were performed to determine the correlation between cyclosporine blood levels and serum creatinine. A total of 1270 kidney transplant patients with 4419 blood samples enrolled. The mean age of the donor was 28 ± 6 years (range, 6 to 64 years) and 82.6% were men and 17.4% were women. In the subset of patients with serum creatinine values of at least 1.6 mg/dL for men and 1.4 mg/dL for women, we determined C0 and C2 levels between therapeutic and undertherapeutic creatinine ranges at 3 different time interval after transplantation, as follows: the first 3 months, 230 ng/mL to 240 ng/mL and 725 ng/mL to 775 ng/mL; 4 to 12 months, 135 ng/mL to 156 ng/mL and 535 ng/mL to 612 ng/mL; and after 1 year, 95 ng/mL to 120 ng/mL and 420 ng/mL to 479 ng/mL for C0 and C2, respectively. The present study suggests that the cyclosporine levels for Iranian kidney transplant patients are lower compared to the recommended levels in western countries.

Clinical information concerning cyclosporine dose reduction in Iranian kidney transplant recipients is limited. There are data in Asian, Caucasian, and Iranian ethnic kidney transplant recipients that recommend the trough level (C0) and 2-hour postdose level (C2) of cyclosporine may be different. Our aim was to determine therapeutic levels of C0 and C2 at different time after transplantation among Iranian transplant patients. Blood concentrations of cyclosporine were assessed in 4419 samples of kidney transplant recipients between 2008 and 2010. The patients were divided into 3 groups according to the time of laboratory studies (< 3 months, 4 to 12 months, and > 1 year after transplantation). Both univariable and multivariable analyses were performed to determine the correlation between cyclosporine blood levels and serum creatinine. A total of 1270 kidney transplant patients with 4419 blood samples enrolled. The mean age of the donor was 28 ± 6 years (range, 6 to 64 years) and 82.6% were men and 17.4% were women. In the subset of patients with serum creatinine values of at least 1.6 mg/dL for men and 1.4 mg/dL for women, we determined C0 and C2 levels between therapeutic and undertherapeutic creatinine ranges at 3 different time interval after transplantation, as follows: the first 3 months, 230 ng/mL to 240 ng/mL and 725 ng/mL to 775 ng/mL; 4 to 12 months, 135 ng/mL to 156 ng/mL and 535 ng/mL to 612 ng/mL; and after 1 year, 95 ng/mL to 120 ng/mL and 420 ng/mL to 479 ng/mL for C0 and C2, respectively. The present study suggests that the cyclosporine levels for Iranian kidney transplant patients are lower compared to the recommended levels in western countries.

The number of elderly people undergoing kidney transplantations is increasing. In recent years, the issue of anemia in the elderly has gained importance and has been extensively discussed; however, scientific evidence regarding the prevalence of anemia in geriatric patients undergoing kidney transplantation is limited. This study aimed to determine the prevalence and risk factors associated with late anemia among geriatric patients undergoing kidney transplantation.Patients and Between 2008 and 2011, we retrospectively studied 214 cases of kidney transplants in elderly patients to determine the prevalence of late post-transplant anemia (PTA). We defined anemia as a condition in which hemoglobin (Hb) concentration was 13 mg/dL or less in men and 12 mg/dL or less in women; severe anemia was defined as a condition in which the Hb concentration was 10 mg/dL or less in men and women. Univariate and multivariate analyses were performed to establish the correlation of PTA with risk factors such as renal allograft function, blood levels of cyclosporine A (CsA), and other laboratory test. The mean age of the recipients was 68 ± 8 years (range, 60 to 84 years); 63% of them were men and 37% women. We found that the prevalence of PTA 1 year after transplantation was 35.5% (n = 76); mild to moderate anemia was observed in 27.6% (n = 59) of the recipients and severe anemia in 7.9% (n = 17). Multivariate logistic regression analysis after adjustment for variable were significant in univariate analysis revealed that only plasma creatinine concentration was associated with a high probability of PTA. Anemia is very common in elderly patients undergoing kidney transplantation, particularly in patients with deteriorated allograft function. Anemia in elderly patients undergoing kidney transplantations is a serious adverse effect, which should be extensively studied.

Anemia is a frequent complication among pediatric transplant recipients. However, limited published studies are currently available about anemia in these patients. We conducted a retrospective study to determine the prevalence and risk factors of late post-transplant anemia (PTA) among pediatric kidney transplant patients.Patients and A total of 78 kidney transplant patients ≤ 18 years old were enrolled. Prevalence of late PTA, beyond 1 year after transplantation, in children was evaluated between 2008 and 2011. We considered anemia as hemoglobin concentration of ≤ 11 mg/dl and less than 10 mg/dl as a severe anemia. Both univariate and multivariate analyses were performed to determine the correlation of PTA with other risk factors such as renal allograft function and other laboratory parameters. The mean age of recipients was 10 ± 3 years (range: 3 to 18 years); 58% male and 42% female. The prevalence PTA in this survey was 15.4% (n = 12). The prevalence of late PTA was not different in both boys and girls (p = 0.38). At univariate analysis, a significant relationship was seen between serum creatinine concentrations and Hb levels (P = 0.005, r = 0.32) and there was also a significant relationship between serum Hb and cyclosporine trough blood level (p = 0.009, r = 0.29) and 2 hour post dose level of cyclosporine (p = 0.03, r = 0.29). At multivariate logistic regression after adjustment for other factors, however, renal allograft impairment was the only a risk factor for late PTA (P = 0.05, EXP (B) = 2.5; 95 % CI = 1.0- 6.3). The prevalence of late PTA in our children was lower than previously reported in literature from both adult and pediatric transplant patients.

In the recent few years endometriosis has been identified as the third common gynecologic disease among the women aged 15 to 44 years old having been discharged from the hospitals. Not only does this disease cause pains, dysmenorrheal, abnormal bleeding and infertility, but also it reduces the quality of life and produces depression leading to expending much more on thetreatment. In this study we tend to evaluate the common complaints about the disease and find out about the most engaged sites through reviewing our laparoscopic findings. Our descriptive cross-sectional study was conducted prospectively. The study group were selected among the patients of Najmieh Hospital from March, 1996 to March, 2006. Those patients with the chief complaints about chronic pelvic pains, dysparonia, dysmenorrheal and infertility, as diagnosed by a surgeon, underwent the laparoscopy surgery. Then, a pathologist confirmed the diagnoses through biopsy. Those patients with only clinical diagnosis or without any pathology results recorded were excluded from the study. For each one of the subjects, data on surgical and demographical findings were collected using a questionnaire that contained questions about demographical background, the chief complaints, the engaged site and the surgeon’s findings. The average age of the participating patients was 28.7±6.2 with a minimum of 17 and a maximum of 49 years old. The chief complaints were recorded about: 43% primary infertility, 24% chronic pelvic pains, 14% having a cyst resistant to the treatment, 8% secondary infertility, 7% dysmenorrheal, 4% recurrent abortion and vaginal hemorrhage. The incidence of endometriosis was found to be 28% in this study. The most affected sites by endometriosis were anterior and posterior choledosac in 12 and 16 cases, respectively; the right ovary and the left one in 7 and 11 cases, respectively; and the left and right tubes were respectively affected in 10 and 6 cases. According to the findings of this study, pelvic pains are the most prevalent incident of the clinical complications related to endometriosis. So, it is recommended here that those women complaining about pelvic pains undertake laparoscopic surgery to avoid the negative consequences on their married life as well as on the quality of their social life. Also, further studies are needed to confirm the unlikelihood of the effect of endometriosis on infertility.