ABSTRACT
Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models. This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multistate models. During 4.06 years [median] of follow-up; 28 [6.9%] recipients died and allograft failure occurred in 51 [12.6%] recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure [HR=0.38; 95% CI: 0.17- 0.87], pre-transplant hypertension [HR=2.94; 95% CI: 1.54- 5.63] and serum creatinine levels >1.6 upon discharge from the hospital [HR=7.38; 95% CI: 3.87- 7.08] increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly [HR=0.18; 95% CI: 0.04- 0.93]. It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type
ABSTRACT
Penoscrotal diseases and inguinal hernia are abnormalities that are often not diagnosed in childhood because most parents do not know the normal anatomy of this region. We designed a cross-sectional study in order to determine the prevalence of inguinal hernia and penoscrotal abnormalities in the elementary school boys in Zahedan city. We studied 3100 elementary-school boys, aged 7-12 years, who underwent clinical examination of the groin and genitalia in 2008. Abnormalities were detected in 167 children [5.38%]. The most frequent anomaly was indirect inguinal hernia, seen in 81 children [2.6%]. The other abnormalities were undescended testis in 39 boys [1.2%], hydrocele in 25 boys [0.8%], hypospadiasis in 11 boys [0.3%], epispadiasis in 1 boy [0.03%], varicoceles in 3 boys [0.09%] and micropenis in 7 boys [0.2%]. Since these abnormalities are most common disorder in children, education of the public and medical staff about these abnormalities and screening system are needed to improve the outcome
ABSTRACT
Kidney transplantation is the best treatment option for kidney failure. Major medical progress has been made in the field of renal transplantation over the last 40 years. The surgical procedure has been standardized and the complication rate is low. Overall, the outcome of renal transplantation is excellent and has improved over time. Vascular complications after renal transplantation are the most frequent type of complication following urological complications. Renal artery spasm [RAS] following manipulation of renal artery is a common problem during live donor nephrectomy [LDN]. The aim of this study was to determine whether or not it is necessary to wait for reverse of RAS and resumption of urinary flow before nephrectomy. In this clinical trial 16 cases of LDN who developed RAS during surgery received intra-arterial injection of 40 mg papaverine. In 8 cases surgery continued towards nephrectomy and in other 8 cases we waited for reverse of RAS. All analyses were performed using SPSS-11. In both groups urinary flow started a few minutes [Mean, 12 min] after declamping of transplanted kidney and normal renal consistency and color were achieved. There was no significant difference between urinary volume during 12 h after transplantation in two groups. The results showed that it might not be necessary to wait for reverse of RAS before LDN. Both patient [less anesthesia complications] and hospital [less expenses] will benefit from this time saving
ABSTRACT
Treatment for urinary tract infection should be based on common uropathogenes and their resistance to antibiotics. The aim of this study was to evaluate antibiotic resistance patterns in urinary tract infection. In this cross-sectional study, 11 common antibiotics were evaluated with antibiogram on urine samples of 2876 cases with urinary tract infection during 2010-2011. The most common uropathogen was E. coli [62.41%] and highest resistance of pathogen was against cefixime [84.5%] in this study. As the least resistance of uropathogens was against ciprofloxacin, we propose this antibiotic as the first line treatment for urinary tract infection.