The Effect of Laser Acupuncture on Semen Parameters in Infertile Men With Oligospermia: A Randomized Clinical Trial.

Introduction: Currently, infertility is a main concern, and it is estimated that 15% of couples are considered infertile. Conventional therapies such as vitamins, antioxidants and supplements have been used widely, but they may not be sufficiently effective. This study evaluated the effect of laser acupuncture on semen parameters in infertile patients with oligospermia. Methods: This study is a clinical trial with a double-blind control group. 35 patients in the intervention group underwent laser acupuncture twice a week for consecutive 5-weeks. In the control group, sham laser acupuncture was performed. The two groups were compared in terms of semen parameters including semen volume, sperm concentration, sperm motility and sperm morphology as the primary outcome. The secondary outcome was a successful pregnancy rate. After data collection, statistical analysis was performed with SPSS version 20. Results: The mean age of all patients was 27.46±2.88 years; in the intervention group, their age was 27.82±2.6 years, and in the control group, it was 27.11±2.96 years, and there was no significant difference (P=0.396). During the study, 4 patients (5.4%) reported adverse effects; three patients in the control group complained of mild weakness and itching, and one patient in the intervention group reported dizziness. The volume of semen and sperm morphology did not differ significantly in both control and intervention groups (P ˃ 0.05), while sperm motility and sperm concentration had a significant difference (P=0.0001). Conclusion: Laser acupuncture as a non-invasive procedure is effective in improving sperm mobility and concentration in infertile patients with oligospermia. Due to the surface contact of the laser probe with the skin and the lack of need to insert needles in the skin, laser acupuncture is more convenient and better tolerated by patients.

Iranian Urology Association Coronavirus Disease 2019 (COVID-19) Taskforce Pamphlet (IUA-CTP) Recommended Practice based on National Epidemiologic Analysis.

Since the emergence of Covid19 epidemics different guidelines and protocols have been published by Urology associations. Most of these recommendations have focused on the aptitude of any disease or condition for postponement. With the evolution of the outbreak, it is clear that postponement of procedures is not the policy we can rely on exclusively. We must know where do we stand? Where are we going in our country? How useful our recommendations have been for urology practitioners? We try to draw a clearer although-to some extent- conjectural picture and to adjust our protocols to this picture of outbreak evolution. Assuming that anything in this predicament is subject to unexpected changes. For these goals, we raise these arguments in three sections. First, where do we stand and where are we going? Explaining the present situation and best available statistics of the disease, the velocity the disease is spreading and our approximate predicted date its subsidence or partial remission. In a web form survey, we tried to evaluate that in the absence of a clear picture of outbreak progress in a specific area, how useful experts' points of view will be for the urologists working in non-referral centers especially in relevance to equivocal and challenging cases. Will there be any significant difference at all? In the third section, we try to give the plot to guide scheduling or postponing procedures in any given are according to the level of involvement. Here we considered both the characteristics of the special urology condition and also the situation and progress of the outbreak in that area.

Bradykinin as a Probable Aspect in SARS-Cov-2 Scenarios: Is Bradykinin Sneaking out of Our Sight?

The new virus SARS-CoV-2 is savagely spreading out over the world. The biologic studies show that the target receptor for the virus might be angiotensin-converting enzyme 2 (ACE2). This peptide is responsible for converting angiotensin II (Ang II), which is a profoundly active peptide, into Ang 1-7 with quite a balancing barbell function. It is emphasized that the direct target of the virus is ACE2 underlining the obvious difference with ACE. Nevertheless, we hypothesized that a back load build up effect on Ang II may usurp the ACE capacity and subsequently leave the bradykinin system unabated. We think there are clinical clues for dry cough and the presumed aggravating role of ACE inhibitors like captopril on the disease process. Thereby, we speculated that inhibition of bradykinin synthesis and/or blockade of bradykinin B2 receptor using Aprotinin/ecallantide and Icatibant, respectively, may hold therapeutic promise in severe cases and these molecules can be advanced to clinical trials.

The demographic profile of urolithiasis in Iran: a nationwide epidemiologic study.

OBJECTIVE: The marked variations in urinary stone disease prevalence by age, gender, race, and geographic location may provide clues to their etiology and prevention. We investigated the demographic profile of urolithiasis across Iran to draw out implications for national healthcare policies. MATERIALS AND METHODS: In a nationwide multi-center epidemiologic study from September 2006 to August 2007, a multi-stage stratified sampling was taken in 12 ecologic zones across Iran during four seasons. 6,089 imaging-proven cases were identified out of 117,956 referrals to the radiologic centers. The demographic characteristics of positive cases were determined by a detailed questionnaire. Target population characteristics were derived from the most recent formal national census (2006). RESULTS: Male-to-female ratio was 1.38 (male: 58%, female: 42%). Uneducated people ratio was significantly greater among stone formers. (Mean difference = 10.4%, 95% CI = 9-12%).Mean age at presentation was 41.5 years +/- 16.3 and the peak incidence range was between 55 and 65 years. The most frequent co-existence diseases were hypertension (15.8%) and diabetes (11.4%). It ranged from 2.8 to 21.3 for diabetes and 6.1 to 30.4 for hypertension compared to 1 to 4.2% and 4 to 7.7, respectively, in the general population. Surprisingly, the number of current smokers among stone formers was significantly less than the general population. BMI failed to show a significant correlation. CONCLUSIONS: The putative risk factors for urinary stone disease were male gender, hypertension, diabetes mellitus, and lack of education. Preventive strategies based on indigenous demographic data may have a role in public healthcare policies.

Palliative treatment of intractable hematuria in context of advanced bladder cancer: a systematic review.

INTRODUCTION: In a patient with bladder urothelial cancer that is not suitable for or does not choose curative treatment, intractable hematuria is a disastrous condition. In this article, we tried to review the literature and extract a stepwise approach for palliative treatment of hematuria in these patients. MATERIALS AND METHODS: The MEDLINE was searched with the help of the Medical Subject Headings system using different combinations of terms urinary bladder neoplasm, hematuria, carboprost, cyclophosphamide, cystitis, alum, and hyperbaric oxygenation. The articles were separately reviewed by the two authors and verified by each other. Eventually, a decision tree was developed for management of gross hematuria in patients with bladder cancer. RESULTS: Although, there was not any reported randomized controlled trial or prospectively designed study, the available case series were rather expressive to draw out a logical approach. Formalin has a grave adverse effect profile and recommended only in special circumstances. For management of each case of gross hematuria in bladder cancer, the etiology of bleeding is the most important determinant. CONCLUSION: Hematuria in the context of advanced bladder neoplasms can now be effectively treated with fewer side effects using all available modalities in a logical holistic approach. We proposed a decision tree for management of hematuria in this context. However, regarding lack of well-designed trials, a treatment method should be based on individualized scenarios and clinical experience, bringing into account the patient's preferences.