[Incidence of kidney stones in hypertensive patients]

As the population grows older and more obese, hypertension eventually develops in more people during their life span. The prevalence of kidney stone disease is estimated at 1% to 15%, varying in degree according to age, gender, race and geographic location. The objective of this study was to determine the frequency of nephrolithiasis in hypertensive patients. Using simple non probability sampling, a total of 200 patients were referred to Aria and Bahman 22[nd] Hospitals entered this study. The exclusion criteria were determined as: those subjects that had used carbonic anhydrase or thiazide; those who had a history of surgery on their urinary system; those who had been diagnosed with HTN before affected by nephrolithiasis. The main group was divided into 2 groups: Group 1 who had normal blood pressure [control group] and group 2, hypertensive patients [case group]. All the patients were examined using both ultrasound and supine abdominal X ray [KUB] for stone scanning. Then, statistical analyses were conducted using t-test, chi-square test and Fisher's Exact Test. All the subjects signed a testimonial before the rest. The comparison of sex and age distribution between the case and the control groups showed no significant differences. Also, the results of Ultra sonograms showed echogenic density of the urinary system prevailing in 4.2% of the patients in the control group and in 25% of those in the hypertensive [case] group [P<0.05]. Moreover, KUB revealed significantly lower frequency of stone density in kidneys in the control group [4.2%], as compared to the hypertensive group [21%]. As a whole, nephrolithiasis was observed in 4% of the patients in the control group and 21% in those subjects in the hypertensive group. Such a difference between the two groups was statistically significant [P<0.001]. we believe that urinary stone is significantly more frequent in hypertensive subjects than normal subjects

Serum testosterone level as a predictor of response of infertile males to clomiphene

Background and Purpose: Clomiphene is the most common drug for the male idiopathic infertility treatment with different results, and no valuable factor ha been suggested for prediction of treatment. Therefore, the present study was designed to investigate the relationship between early morning total Serum Testosterone Level [STL] before treatment and post-clomiphene changes in the spermogram

Methods and Materials: This clinical trial study was conducted on 172 idiopathic infertile men, from 2001 to 2006 in Mashad, Iran. Demographic and spermogram data were recorded via questionnaires, and patients were divided into 6 groups by their pre-treatment STL. Spermogram parameter changes before and after clomiphene therapy were analysed with SPSS software using t-test, ANOVA, and Fisher's test

Results: Mean age of patients was 31 years; and mean Serum Testosterone Level was 361.3 ng/dl. After prescribing clomiphene, recovery was observed in the spermogram of in 125 patients [72.7%] with Total Serum Testosterone Level of 200-500 ng/dl [P=0.031]

Conclusion: Early morning Serum Testosterone Level can be used as a criterion for predicting the efficacy of clomiphene in male idiopathic infertility

case report of left median ureteral transitional cell carcinoma

Ureteral transitional cell carcinoma [TCC] is the most common cellular type of upper urinary tract cancers which remains undiagnosed for a long time due to its nonspecific symptoms and the unlikelihood of being detected at early stages of investigation. As a result, it is often so well-developed and progressed at the time of admission that it usually leads to a poor survival and high rate of recurrence, even by applying appropriate medical and surgical approaches. Conversely, early diagnosis and therapy is usually associated with a good prognosis. A report of a 65 year old woman with a history of 3 years of recurrent, painless hematuria is presented. The IVP showed a masked left ureteral turtusity associated with mild dilatation of the left ureteral and renal pelvic. The CT scan revealed hypodence foci at the left upper ureter accompanied with dilatation of the left pyelocalyciel system as well as that of the upper and middle parts of the left ureter. Finally, as a result of removing the bladder cuff through a left nephroureterectomy, both ureteroscopy and tissue sampling confirmed a low grade TCC

Surveying ESWL impact on pancreatic enzymes

Urinary stones are the third most common disease of urinary tract. More than 90% of renal stones are successfully treated by ESWL with a success rate of 68-86%. The present study was conducted to survey ESWL impact on pancreatic enzymes. This descriptive-analytic study was performed on 87 patients suffered from renal stone. For all patients, a questionnaire including the demographic features, stone characteristics, and ESWL data, was filled, then, the serum lipase and amylase titers were obtained both before and 24 hours after ESWL. Data were analyzed by SPSS software. The study population included 58 men and 31 women with the mean age of 40 years. 48 had right-sided renal stones versus 39 with left-sided stone. The serum titers of amylase and lipase showed an increment in 57.5% and 61%, respectively, however, this increment was above normal range in only two patients. There was statistically significant association between the increment of serum amylase and lipase [P=0.0001]. The increased serum amylase and lipase was more common in left ESWL. Only in one case of right renal stone, the serum lipase and amylase showed significant elevation following ESWL. In spite of the harmlessness of ESWL for pancreas, it is recommended to measure serum lipase or amylase in ESWL of right kidney to detect the rare cases of acute pancreatitis