Effects of hydrochlorothiazide on kidney stone therapy with extracorporeal shock wave lithotripsy

The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy [ESWL]. A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi [diameter

Preventive Effect of Tamsulosin on Postoperative Urinary Retention

PURPOSE: To investigate the prophylactic effect of Tamsulosin, a super-selective alpha-1a adrenergic blocking agent, on the development of urinary retention in men undergoing elective inguinal herniorrhaphy. MATERIALS AND METHODS: From May 2010 through November 2011, a total of 80 males who underwent elective inguinal herniorrhaphy in a university hospital were included in this study. Patients were randomly assigned to one of two groups. In group one (control), the patients were given two doses of placebo orally, 6 hours before surgery and 6 to 12 hours after surgery. Patients in group two were given 0.4 mg of Tamsulosin orally in the same manner as the placebo. All patients were closely followed for 24 hours post-operatively, and any voiding difficulties or urinary retention was recorded. RESULTS: There were 40 patients in group one (control group) and 40 patients in group two (Tamsulosin group). The patients' mean age was 64 years. In group one, 6 patients and in group two, 1 patient required catheterization. Thus, 15% of patients in group I and 2.5% of patients in group II had urinary retention. The difference in the requirement for catheterization was statistically significant (p=0.04). The technique of herniorrhaphy, the side of the body in which the hernia was located, the type of anesthesia, the duration of the surgery, and the severity of pre-operative urinary symptoms had no significant effect on the incidence of urinary retention. CONCLUSIONS: The use of perioperative Tamsulosin represents an effective strategy to reduce the risk of post-operative urinary retention following inguinal herniorrhaphy.

Psychiatric problems in general outpatient clinics: prevalence and reasons for help seeking

The aims of the present study are to examine the prevalence of psychiatric problems and the reasons for seeking care in urban health centers in district 17 of Tehran [capital of Iran], and to study the sensitivity and predictive value of the presence of psychiatric symptoms as chief complaint and self-report of a psychiatric history for correct recognition of a psychiatric problem. The present research was a cross-sectional and descriptive study. Two urban health centers located in district 17 in Tehran were randomly selected from a total of 7 health centers. Patients referring to outpatient clinics of the centers were consecutively asked to fill in General Health Questionnaire-28 and a pathways-to-care questionnaire. In total, 126 subjects [54% female] were included. Forty-two patients [33.3%] had psychiatric problem based on GHQ. Only 11 [8.7%] had psychiatric symptoms as chief complaints [reasons for referral] and 60 [47.6%] considered themselves having a psychiatric illnesses. Of all GHQ cases, 27 [64.2%] had never consulted for a psychiatric illness. The sensitivity of self-report of psychiatric complaint or illness was less than 70% with positive predictive values of less than 55%. In line with previous research, psychiatric disorders were commonly observed in outpatient clinics in Tehran. However, most of those with a problem had not sought care. In addition, sole reliance on patients' self-report of psychiatric complaint or illness might not lead to proper recognition of patients in primary care

Assessment of the immune system activity in Iranian patients with major depression disorder [MDD]

Major Depression Disorder [MDD] is a common disorder with prevalence of 15% among men and up to 25% among women. In recent years the association of immune system alterations and MDD has been investigated. Assessments of immunologic and inflammatory responses in these patients enhance our knowledge of the etiology and pathogenesis of this disease. To investigate the changes in immunoglobulin and cytokine serum levels and lymphocyte subsets in patients with MDD. We studied 37 adult patients with MDD, diagnosed based on DSM-IV diagnostic criteria, and 15 healthy controls matched with the patients. Plasma concentration of interleukin-4 [IL-4], IL-10, TNF alpha, and IFN gamma were measured by ELISA and serum immunoglobulins by SRID. Total number of NK cells [CD16 and CD56], B cells [CD19], and T cells [CD8, CD4, and CD3] were determined by flow cytometry. We found no significant differences in plasma concentration of IL-4, IL-10, TNF-alpha, IFN-gamma, and immunoglobulins as well as total number of NK cells, B cells, and T cells between major depressed patients and healthy control subjects. We conclude that in our patients, there were no significant differences in immune system activity between MDD patients and controls