[ investigation about anthropometric indicator for inhabitants of Zanjan in comparison with NCHS standards]

Anthropometry is the most common way for measuring body growth in human which today is raised as a predictive indicator in epidemiologic, metabolic and appearing illness related to obesity as well. The research is part of a study named "a Healthy Heart" had been carried out among people of Zanjan in 2003 with cross-sectional research design. About 1821 people of Zanjan inhabitants above 15- year-old participated using multi-stages random cluster sampling method. Questionnaire consisted of personal information and anthropometric indicators which the results then compared with standard charts of NCHS. The average of the weight in men and women was respectively 68.7 +/- 12.5 and 61.7 +/- 11.8 kg, and average of the height was 170 +/- 7 and 156 +/- 7 cm respectively. The average of the BMI index men and women was 23.73 and 25.4 +/- 4.9 kg/m2 respectively. 32.8% of participants were overweight and 12.5% were obese. 27.7% of women and 10.7% of men had abdominal obesity [P < 0/05]. Positive and significant relation was observed between BMI and age [R = .36], BMI and marital status [R = .39]. A reverse and significant relation was observed between BMI and education level [R = -.18]. According to the findings of this study which reveals that considerable amount of women affected by abdominal obesity, paying attention to life style especially women's in all age groups is proposed

[ experimental model of hydatidosis in rabbit testis]

Although no part of human anatomy is invulnerable to hydatid disease, it has been reported to occur in most of vital organs. Hydatid disease of urinary tract is uncommon, accounting for only 2-3% of all such cases. Testes are extremely rare sites for echinococcosis. There are only three cases of testicular hydatid disease which were reported. In this laboratory animal model, we studied echinococcosis in rabbit testis. In this experimental trial study, 14 male Albino rabbits [body weight 2.5-3kg] were randomized into two groups: group A [study group], for testicular injection and group B [control group], for intraperitoneal injection of viable protoscoleces. All rabbits were infected, and then housed them under pathogen-free conditions for 10 weeks [70 days]. One rabbit from group A and three from group B died one day after injection, and the other rabbits survived during follow-up period. At 10th week they were all anaesthetized and then we studied all testes with ultrasonography. In group A all testes were excised, and in group B we removed liver, kidneys and took four biopsies from peritoneum, for histopathology investigation. There was demonstrable hydatid cyst [protoscoleces and germinative layer] in testes of five rabbits from group A, but in one rabbit both testes were normal. In group B, three out of four rabbits developed peritoneal hydatidosis. The mechanism of testicular resistance to echinococcosis could be blood-testis barrier because when we directly infected the testes of rabbits with protoscoleces, hydatid cyst developed

uncommon manifestation of renal cell carcinoma: contralateral spermatic cord metastasis

Renal cell carcinoma [RCC] is a common type of kidney cancer which demonstrates different symptoms such as uncommon metastasis and paraneoplastic syndrome. A sixty year man was diagnosed as having a left renal cell carcinoma and underwent for nephrectomy surgery seven years ago. After seven years from the surgery, he referred with complain for feeling a mass in the right hemi-scrotum. In his pathology report, he was diagnosed for metastatic RCC in his contralateral spermatic cord and underwent for orchidectomy surgery. This case is the first report for this type of metastasis. RCC can spread through retrograde flow from the renal vein to spermatic veins, so suggesting that a careful examination of the external genitalia should be performed in patients with RCC during the follow up period to exclude hidden metastases in these patients

[Protective effect of Captopril and Allopunnol against renal warm ischemia reperfusion injury in dogs]

Captopril and Allopurinol have protective effect against renal warm ischemia with different mechanisms. The aime of this study was to evaluate this protective effect against induced 1 hour warm ischemia in dog's kidneys. This experimental study was done in the year 2006. We performed the operation on 15 healthy dogs. During these procedures both kidneys were clamped for 1 hour, then left kidney was removed for pathologic evaluation and right kidney remained insitue for functional assessment. Five random dogs received 1 [mg/kg]d[day] Captopril orally before and after surgery [captopril group]; another five dogs received 10 [mg/kg]/day Allopurinol orally before and after surgery [allopurinol group]. Five dogs of control group received no drugs. Serum urea and creatinine were measured preoperatively and on postoperative days of 1, 3, 5, 10 and 16 in all groups. Serum levels of urea and creatinine elevated in all groups but in Captopril group maximum levels of urea and creatinine were significantly lower than control [P<0.05]. In Allopurinol group the maximum rise of creatinine was significantly lower in comparison to control group [p< 0.05], but the maximum levels of urea in this group had no significant difference when compared with control values [p< 0.05]. There was no significant difference in pathologic changes in the three groups. One hour warm ischemia results in ATN so it is not safe for dog's kidneys. Althogh Captopril and Allopurinol do not prevent ATN after one hour warm ischemia; they can reduce its severity and improve renal function after warm ischemia

Circumcision for the prevention of urinary tract infection in preschool boys

Urinary tract infection [UTI] is common in childhood with serious sequela. Among infants, boys are more likely to develop UTI. The aim of this study was to determine circumcision effects in decreasing UTI incidence. During a 7.5 years period prospective study 1 66 boys less than 6 years old with UTI allocated into 2 groups. They had not any urinary tract abnormalities. in the first group 79 boys ranging in age from 2 months to 5.5 years [mean 11.3 +/- 3.1 mo] were circumcised after UTI treatment and then observed for 6 month period with taking urinalysis [U/A] and urine culture [U/C] I -2 monthly. The second group as control subjects 87 boys aged 40 days to 5.5 years [mean 12. 1 +/- 3.4] after treatment of UTI were followed for 6 month period with taking U/A and U/C then circumcised and followed for another 6 months period. Incidence of UTI in first group [circumcised] and second [uncircumcised period] was compared with use of Chi-square test. For comparing the incidence of UTI in second group [6 months before and 6 months after circumcision] we use Mc nemar method. UT1 is more common in boys aged 11.7 +/- 3.2mo. In the first 6 months follow-up period, UTI occurred in 2 cases of circumcised group whereas in 12 on uncircumcised group. In a 6 months period after circumcision in second group, UTI occurred only in one case. There was significant difference [P=0.009] in occurring of UTI between first and second group. There was also significant difference [P=.00 1] in incidence of UTI in 6 month period before and after the circumcision in second group patients. The present study indicated that circumcision decreases the risk of UTI in boys, independent of the age. Therefore circumcision should be considered in newborn period and any patient with UTI or urinary tract abnormalities. Routinely performing ultrasonography and cystourethrography in boys with first attack of UTI is recommended. In this study there were not abnormal VCUG in the cases without urinary tract abnormalities [proven by history, physical examination and sonography]

Laparascopic management of impalpable cryptorchiol testis

Laparoscopy has been widely used in the diagnosis and treatment of impalpable testises. This study was done to report the first experience of the use of laparoscopy in impalpable testises in the Mashhad university of medical sciences [MUMS]. During 6 years, 43 patients with UDT were treated. In those were no evidence of existence of gonad in physical examination and ultrasonography, laparoscopy was done by the 5 [mm] [0 [deg]] lens. Position of testis, complications of operation and duration of admission in hospital was recorded. In the 13 patients from 43 patients [30.23%] testis was not palpable in the inguinal canal. Also ultrasonography didn't detect the existence of testis.Therefore, laparoscopy was used. Average age of patients was 11.88 +/- 8.38 years. In 3 patients small remnant of testis was seen. Two patients had no testis. In 8 patients, normal gonads were seen that the treatment was done. No severe or mild complications were seen. All of the patients except one were discharged 24 hours after operation. Our study showed that laparoscopy is a beneficial and safe instrument to correct diagnosis in impalpable testises and in some situation prevents from an unnecessary exploration of inguinal region and laparotomy. Also in patients that previous exploration was not beneficial for them causes a correct diagnosis

[ comparison between colour doppler ultrasonography and intravenous urography in diagnosis of ureteral obstruction due to ureteral stone]

Urinary stone is one of the most common cause ofureteral obstruction. Degree of obstruction has an important role in choosing time and method of treatment. The aim of this cross-sectional study is comparison between Color Doppler Ultrasound and Intravenous Urogram in diagnosis ofureteral obstruction in patients with ureteral stone. 35 patients with unilateral renal colic were studied from October 2004 to June 2005. In all patients the presence of stone in the ureter was confirmed by Sonography. Mean age was 36.9 +/- 9.1 years. After analgesia and determination of serum creatinin level, color Doppler ultrasound [CDU] was done with semi-distended bladder. Number, velocity, and duration of ureteral jets were observed in five minutes, bilaterally. Immediately after CDU, the patients were transferred to the next room to perform standard IVU. All data was recorded and analyzed with statistical methods.%71.4 of patients were male and 28% were female. Mean serum creatinine was 0.9 +/- 0.18 mg/dl. In all patients with complete ureteral obstruction in IVU, ureteral jets were diminished [42.1%] or absent [57.9%] in CDU. In patients with partial obstruction in IVU, diminished jets in CDU were noted in 86.7%; and only in 2 patients [13.3%] normal jets were seen. Number of jets in one minute was 0.84 +/- 1.46 in patients with complete obstruction, and 5.18 +/- 3.4 in partial obstruction [P<0.001]. There was a significant difference in velocity and duration of jets between complete and partial obstruction [P<0.01 and P<0.001 respectively]. The number, velocity, and duration of the jets in the normal side was not significantly different between the two groups of patients [P=0.31, P=0.51, and P=0.27 respectively]. This study showed that CDU can determine ureteral obstruction in renal colic patients in most cases. It is a safe, fast, and noninvasive test. CDU of ureteral jets is recommended as a functional test in renal colic patients

Laparoscopic adrenalectomy: a report of the first experiment in Iran

To report the first experiment in laparoscopic adrenalectomy and study its success and immunity in treating different adrenal diseases. From March 1997 to July 2001, 11 patients underwent laparoscopic adrenalectomy through transperitoneal approach. Five of whom were males and 6 were females. Their mean age was 35.5 [range 28 to 52] years. Lesion was located at left in 6 patients and at right in 5. All necessary steps were preoperatively taken including CT scan, MRI, MIBG scan, and endocrine tests such as ACTH, cortisol, mineralocorticoid, 17-hydroxyprogesterone, and VMA. Three [5, 10, and 12 mm] trocars were used in left laparoscopic adrenalectomy and three or four [12, 10, 5, and 5 mm] trocars were applied in right laparoscopic adrenalectomy. All patients have been followed up for three months by physical examination and paraclinical tests. Mean operation time [including anesthesia and surgery] was 205 +/- 65.95 [range 130 to 310] minutes. No significant difference was seen between the operation time in the left and the right adrenalectomy [p=0.5]. Mean hospitalization was 5.54 +/- 3.4 [range 3 to15] days. Mean size of mass was 5.45 +/- 1.7 [range 2 to 8] cm. Blood transfusion was performed in 2 patients and open surgery was conducted for one because of high adhesion. No mortality was reported. During a 3-month follow-up, hormonal tests and blood pressure were normal for all patients, with no medical treatment. This experiment showed that transperitoneal laparoscopic adrenalectomy is an effective and safe approach in the treatment of adrenal masses with the least morbidity

Treatment of renal colic using intracutaneous injection of sterile water

To evaluate the intracutaneous injection of sterile water in the treatment of renal colic. One hundred patients with renal colic were randomly divided into two groups of 50 patients and underwent the treatment. In the first [study] group 0.5 ml of sterile water and in the control group, 0.5 ml of normal saline was intradermally injected. The severity of pain was assessed by visual analogue scale [VAS] system before and 30 and 90 minutes after the injection. Patients in whom the presence of stone was not proved were excluded from the study. Before the treatment mean pain severity in the study group was 9.86 +/- 0.4 and in the control group was 9.96 +/- 0.19, so that the difference was not statistically significant [p=0.12]. Thirty and 90 minutes after the injection, the means were 0.76 +/- 2.3 and 1.02 +/- 2.63 in study group and 5.94 +/- 4 and 6.7 +/- 4.19 in control group, respectively. The results in 30 and 90 minutes between the two groups were statistically significant [p=0.000 and p=0.000, respectively]. Pain in all patients in the study group was relieved; however, only%34 of the patients in the control group reported a decrease in pain. There was no complication among the patients of both groups and only a severe and transient pain during injection was reported by the patients. This study along with many other existing studies indicates the efficacy of intradermal injection of sterile water for the treatment of severe pain syndromes such as renal colic. The advantages of this method are its efficacy, availability, cost benefits, and easy application. We recommend the use of this approach for the treatment of renal colic

Laparoscopic adrenalectomy: a report of the first experience in Iran

To report the first experience in laparoscopic adrenalectomy and to study its efficacy and safety in the treatment of different adrenal diseases. From March 1997 to July 2001, 11 patients underwent laparoscopic adrenalectomy through transperitoneal approach, five of whom were males and 6 were females. Their mean age was 35.5 [range 28 to52] years. Lesion was located on the left side in 6 patients and on the right side in 5. All necessary evaluations were done preoperatively including CT scan, MRI, MIBG scan, and endocrine tests such as ACTH, cortisol, mineralocorticoid, 17-hydroxyprogesterone, and urinary VMA. Three [5, 10, and 12 mm] trocars were used in left laparoscopic adrenalectomy and three or four [12, 10, 5, and 5 mm] trocars were applied in right laparoscopic adrenalectomy. All the patients were followed up for three months with physical examination and paraclinical tests. Mean operative time [including anesthesia and surgery] was 205 +/- 65.95 [range 130 to 310] minutes. No significant difference was seen between the operative time in the left side and the right side adrenalectomy [p=0.5]. Mean hospitalization was 5.54 +/- 3.4 [range 3 to15] days. Mean size of mass was 5.45 +/- 1.7 [range 2 to 8] cm. Blood transfusion was performed in 2 patients and open surgery was conducted for one because of extensive adhesions. No mortality was reported. During a 3-month follow- up, hormonal tests and blood pressure were normal for all the patients, with no medical treatment being required. Our study demonstrated that transperitoneal laparoscopic adrenalectomy is an effective and safe approach in the treatment of adrenal masses with the least morbidity

[Ureteral stone in pediatric and treatment with lithotripsy]

Background and Objective: transureteral lithotripsy is an effective procedure in lower ureteral stone. This study was done to evaluate lithotripsy method in pediatric ureteral stones in Mashhad's Imam-Reza Hospital

Materials and Methods: in our institute 38 patients went under ureteroscopy and lithotripsy for ureteral stones. Mean age in our patients was 6.8 years [Range 2-13 years]. 16 patients were male and 22 patients were female. The mean stone size was 7 mm [Range 6-16 mm]. Ultrasonography and KUB or IVP was performed in all cases. After general anesthesia and cystoscopy guide wire introduced in ureter, ureteroscopy were performed for lithotripsy used ultrasound pneumatic or electrohydrolic

Results: stone were located in the distal ureter in 32 patients, in the midureter in 4 and in the proximal ureter in 2 cases. Ureteroscopy was successfully in 35 cases. Lithotripsy was used: Ultrasound, electrohydrolic or pneumatic. We were unable to introduce the ureteroscope into the ureter in 3 patients. In 3 patients stone migrated to the kidney after ureteroscopy. Then, they candidated for ESWL. Stone free was done in 32 cases [85%]. A complication was 25% and treated with medical treatment

Conclusion: our investigation demonstrates the high success rate ureteroscopy in pediatric group especially with a small caliber ureteroscope. Ureteroscopy should be considered the first choice for treatments of calculi in the distal ureter in children