Diagnosis and treatment of renal stone are very important especially according to non-special symptoms and risk of complication in children. According to invasive surgical methods for treatment of these patients, this study was done to evaluate oral potassium citrate solution efficacy in children with urolithiasis. This quasi experimental study was done on 150 children who referred to nephrology department or clinic with renal stone and without urinary obstruction (2002-2010). All children were treated with potassium citrate solution initially 1 ml/kg/day and then it was increased till urine PH reached to above 6.5-7. Urinary ultrasonography was done every 3 months and response to treatment was evaluated according to the stone size, age and duration of treatment. The age of children was 25 days to 15 years (Mean 36.7±37.4 month). Eighty five cases (56.6%) were male and 65 (43.4%) were female. The rate of complete response to drug (absence of stone) was 78.7% during one year. Mean of follow up was 15.9± 14.6 months and the risk of relapse (recurrence of stone) was 12.4%. There weren’t significant difference between response to treatment and stone size, age and children sex. Potassium citrate has been found to be significantly effective in treatment of renal stone, so we suggest using this drug for treatment of renal stone in all children without urinary obstruction.

Microlithiasis is a common increasing disorder, especially in infants and young children, defined as sonographic detection of hyperechogenic deposits in the pelvic area of the ureter and calyces which are less than 3 mm in diameter. Potassium citrate is one of the drugs used in nephrolithiasis. Citrate prevents the formation of calcium deposits. It also inhibits calcium oxalate crystals, which can be the nidus for kidney stones. The aim of this study was to compare the effect of potassium polycitrate versus no treatment in the infants with microlithiasis.

In this descriptive-retrospective study, 112 patients referred to a pediatric nephrology clinic were enrolled. Children less than two years old with microlithiasis in kidneys or urinary tract confirmed by ultrasonography imaging were included in the study. Patients were randomly divided into two groups: the first group received potassium citrate solution of 1-2 mEq/kg of body weight daily for two months, and the second group did not receive any specific medication. Follow-up was performed every two months for six months using ultrasound by a skilled radiologist with a fixed ultrasound device. To minimize drug side effects and treatment response, the allergic responses were measured once every two months, and the physician decided drug will or will not continue. Data analysis was done by SPSS 19. The P values <0.05 were considered significant.

The mean age of the study population was 4.13 ± 2.27 months. The mean weight in the total study population was 6.62±1.36 kg and the mean birth weight in the total study population was 3±0.41 kg. According to the results of the study, the decrease in the size or number of stones in one or both kidneys was more in the recipients of polycitrate solution and the increase in the size or number of stones in one or both kidneys was more in the infants not receiving polycitrate (P<0.001).

Factors such as age, sex, current weight, birth weight and type of nutrition have no effect on improving and/or reducing the size and number of renal stones. However, in the group receiving potassium polycitrate solution, there was a significant reduction in the size and number of stones compared to the non-receiving group.

Urolithiasis is increasingly recognized in pediatric patients in Iran. Development of stone depends on particulate physicochemical factors such as promoters and inhibitors of solute crystallization which are not fully investigated in our country. Several treatment methods including increased fluid intake and dietary modification, medical therapies such as potassium citrate and use of Extracorporeal Shock Wave Lithotripsy (ESWL) and finally surgery methods are used for treatment of urolithiasis.

The aim of this study was to evaluate the etiological and clinical characteristics and level of response to medical therapy with polycitra in children with urolithiasis.

Study population comprised all patients less than 14 years old with urolithiasis visited at Mofid children's hospital in last five years. One hundred thirty four patients had urolithiasis of whom 109 cases followed the treatment instructions and fulfilled the inclusion criteria for this study and Struvite stones were excluded. All other patients who had an initial ultrasonography showing stone in urinary tract were treated with polycitra-k (potassium citrate 220 grams, citric acid 66.8 grams in 1 liter of distilled water) irrespective of the cause of the stone. At the end, complete resolution or passage or a decrease in the size of stone in later sonography was defined as response to treatment.

From 109 patients 91 cases continued medical therapy with polycitra-k and 51 patients had response to it (56% of patients who used polycitra-k). Hypercalciuria and hyperuricosuria were found to be etiological factor in 25% and 19% of patients respectively. The stone analysis revealed that 50% were composed of ca-oxalate. Stone disease was more common between the ages of 1-3 years and most common complaint was hematuria (20%). ESWL was performed in 42% of patients who did not respond to polycitra and had surgically active stones. Calcium Oxalate stones were the most frequent stone which responded to polycitra. The response rate in girls and boys was equal and in different age groups the response rate was almost equal.

Based on the response rate of medical therapy with polycitra-k as a noninvasive method and its cost effectiveness in comparison with other methods Potassium citrate is recommended for treatment of urolithiasis in children.

Background and Nephrolithiasis in the pediatric population includes 7% of all kidney stone disorders in all age groups. Potassium citrate is one of medical agents used in treatment of these disorders. This study investigated the role of potassium citrate in treatment of patients with kidney stones without any metabolic or infectious risk factors.
A clinical trial was conducted in all patients less than 16 years of age in whom ultrasonography confirmed kidney or urinary tract stones A total of 149 patients with nephrolithiasis was assessed of whom 80 included in current study. Improvements in number of stones was seen in 29 (76%) patients in group I and 17 (57%) in group II (P=0.403). Improvements in maximum size of stones were found in 30 (79%) cases in group I and 22 (73%) patients in group II (P=0.791). Total burden of stones showed improvements in 82% of patients in group I and 73% of those in group II (P=0.887). There were no significant differences between the two groups in any of these items.
Potassium citrate can reduce the size and number of stones in most children with renal stones less than 7mm who have no underlying risk factor. But current study found non-pharmacological supportive treatments to yield similar results.

Purification of the desired protein from the fermentation broth containing a wide variety of biomolecules is one of the major challenges in the biotechnology industry. The aim of this work was partitioning of protease from the fermentation broth using aqueous two-phase systems (ATPS). ATPS has proved to be a valuable tool for separating and purifying mixtures of biomolecules. In this study, the various aqueous two-phase systems containing polyethylene glycol (PEG 2000 and 8000) at a concentration of 40, 50, and 60% (w/w) with salts sodium citrate, potassium citrate at a concentration of 40 and 50% (w/w) were investigated for extraction of protease from fermentation broth. The results showed that the polyethylene glycol 2000/ sodium citrate system was suitable for the extraction of protease from fermentation broth of Bacillus licheniformis and the best operating system was contained the 40% (w/w) polyethylene glycol 2000, 40%(w/w) sodium citrate resulted in enzyme activity recovery of 48.9% and purification factor of 12.7.

This study was conducted to compare the effects of letrozole (5mg) and clomiphene citrate (100 mg) in treatment of infertility in patients with polycystic ovary syndrome. This clinical trial carried out on total 100 infertile women with polycystic ovary syndrome refered to Asali hospital and private clinic in 2008 and were randomized into two group of 50 that treated with 5 mg letrozole or 100 mg clomliphen citrate from day 3 to 7 of menstrual cycle. Transvaginal ultrasound usually was performed on day 12-16 of the cycle, and more often as needed to monitor the number and mean size of developing follicles in each ovary, and the endometrial thickness. Data were analyzed by t-test and chi-square test using SPSS version 15. P-value less than 0.05 defined asstatistically significant. The means of ages, body mass index, and duration of infertility in both groups were similar. The total numbers of follicles were significantly higher in the clomiphene citrate group compared to letrozole group (2.32 1.58 vs. 1.30 0.50). Endometrial thickness was greater in the letrozole group compared to clomiphene citrate group (9.71 1.27 mm vs. 6.08 3.06 mm). The duration of stimulation was similar in two groups. Ovulation occurred in 44 (88%) of 50 patients in the letrozole group and clomiphene citrate group that was not significantly different. Letrozole and clomiphene citrate usage resulted in similar pregnancy rates. The results of this study showed that Letrozole could be used as a good alternative for clomiphene citrate for treatment of infertile women with polycystic ovary syndrome.

Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients. To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients. The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the clinics which were affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The subjects were randomly assigned to two groups receiving either chromium picolinate (200μg daily) or metformin (1500mg daily) for 3 months. Anthropometric and hormonal profile were measured and compared both before and after the treatment. Ovulation and pregnancy rate was measured in the two study groups, as well. Chromium picolinate significantly decreased fasting blood sugar (FBS) after 3 months of treatment (p=0.042). In the same way, the serum levels of fasting insulin had significantly decreased leading to an increase in insulin sensitivity as measured by QUICKI index (p=0.014). In comparison to the patients who received chromium picolinate, those who received metformin had significantly lower levels of testosterone (p=0.001) and free testosterone (p=0.001) after 3 months of treatment. Nevertheless, no significant difference was found between the two study groups regarding ovulation (p=0.417) and pregnancy rates (p=0.500). Chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women. These effects were comparable with metformin; however, metformin treatment was associated with decreased hyperandrogenism. Overall, chromium picolinate was better tolerated compared to metformin; nonetheless, the two study groups were not significantly different regarding ovulation and pregnancy rates.

In this study, biodegradable/biocompatible nanofiber electrospun mats of polylactic acid (PLA), with 8% and 16% of celecoxib (CX), was used for sustained release formulations of CX. After optimize condition, the best solvent for electrospinning of PLA system was chloroform/methanol 20% v/v. The morphology of the nanofiers, distribution of the drug inside the nanofiers and possible reactions between polymers and CX in nanofiers were studied by scanning electron microscopy, X-ray diffraction and fourier transform infrared spectroscopy technics. In vitro CX release from the nanofiber mats were evaluated in solution of HCl (pH = 1.5), citrate buffer (pH = 3) and carbonate buffer (pH = 8) by using UV-Vis spectroscopy technic. Drug release was dependent to polymer type, CX percent and release environment. CX release in nanofiber mats of PLA with 8% and 16% w/w of CX, was increased, respectively. Korsemeyer-Peppas release exponent (n) indicates that CX release mechanism was non-Fickian diffusion for formulations of PLA nanofiber mats.