Gastrointestinal helminths infection of free-roaming cats (Felis catus) in Southeast Iran.

BACKGROUND: Cats in Iran are definitive hosts for several zoonotic intestinal helminths, such as Toxocara cati, Dipylidium caninum, Toxascaris leonina, Physaloptera praeputialis and Diplopylidium nolleri. OBJECTIVE: This study aimed to determine the prevalence of intestinal helminth infection in free-roaming cats in southeast Iran, a region with a high free-roaming cat population. METHODS: From January 2018 to December 2021, 153 cadavers of free-roaming cats from Southeast Iran were necropsied for intestinal helminth infections. The carcasses were dissected, and the digestive systems were removed. The esophagus, stomach, small intestine, caecum and colon were tightly ligated. All adult helminths were collected, preserved and identified. RESULTS: The prevalence of gastrointestinal helminth infections was 80.39% (123/153). Of the cats from Kerman, 73% (73/100) were infected with at least one helminth, including D. caninum 70% (70/100), T. leonina 8% (8/100) and P. praeputialis 17% (17/100). Concurrent infection with two helminth species was found in 16% (16/100) and of three species infections was found in 3% (3/100) of the cats. Of the cats from Zabol, 94.33% (50/53) were infected with at least one of the helminths, including D. caninum 69.81% (37/53), T. leonina 11.32% (6/53), P. praeputialis 37.73% (20/53) and T. cati 5.66% (3/53). Concurrent infection with two helminth species was found in 28.3% (15/53), and three species were found in 1.88% (1/53) of the cats. Helminth infections were more prevalent in older cats. There was no association between sex and infection rate. CONCLUSION: Based on the very high prevalence of zoonotic intestinal helminth infections in free-roaming cats in southeast Iran, the potential public health risk emphasizes the need for intersectoral collaboration, particularly the provision of health and hygiene education to high-risk populations, such as pre-school and school-age children.

Peppermint as a promising treatment agent in inflammatory conditions: A comprehensive systematic review of literature.

Inflammation, a type of the body's defense against injury or infection, causes many chronic disorders including diabetes, cardiovascular disease, and cancer. Therefore, discovering natural compounds with numerous biological activities for the management of inflammation is highly recommended. Out of natural compounds, peppermint and its main component, menthol, has been suggested to possess antiinflammatory potential. Four databases including Web of Sciences, PubMed, Scopus, and Embase were searched to identify articles about peppermint and its antiinflammatory effects up to March 2023. Out of 3805 records screened, 14 articles met the study criteria. The evidence reviewed here proposed peppermint as an antiinflammatory agent. Peppermint may suppress inflammation by activating the AMP-activated protein kinase/unc-51 like kinase 1/nuclear factor-E2 associated factor 2 autophagy pathway, downregulating extracellular signal-regulated kinase-nuclear factor kappa B and mitogen activated protein kinases pathways, attenuating oxidative stress, suppressing the production of pro-inflammatory mediators and nitric oxide, and inducing the production of antiinflammatory prostaglandins. Due to the promising antiinflammatory effects of peppermint and the lack of human studies in this regard, future randomized clinical trials examining the effects of peppermint on inflammation and its related maladies are warranted.

Nasopharyngeal myiasis due to Cephalopina titillator in Southeastern Iran: a prevalence, histopathological, and molecular assessment.

The Cephalopina titillator is one of the most important causative agents of nasal myiasis in camels. This study aimed to explore the prevalence, histopathological effects, and molecular identification of C. titillator infestation in camels of Kerman province, South-Eastern Iran, between 2019 and 2021. The larvae were placed in 10% formalin for histopathological evaluation and species identification. Pieces of larval abdominal segments of C. titillator were selected for extraction of DNA. Partial mitochondrial CO1 genes were sequenced for final analysis. Out of the 870 camels examined, 339 (38.9%) were infested with larval stages of C. titillator. There was a significant difference between age and infection rate (P = 0.001), while no association between males and females (P = 0.074) was found. The infection rate was significantly higher in the winter (P < 0.001) than in the other seasons. In this study, different lesions depending on duration, locations, and the depth of larval adhesion notably degeneration changes, necrosis, and ulceration were observed. Also, in chronic cases, granulation tissue reactions were organized. Cephalopina titillator was confirmed by PCR sequencing analysis using mitochondrial CO1 region. A 582 bp nucleotide sequence was deposited in GenBank under the MW136151 accession number. Phylogenetic analysis of CO1 produced a single uniform sister clade to MZ209004 and MW167083 records from China and Iraq, respectively. The high prevalence of C. titillator in camels in this region and other areas of Iran declares that the country is in an endemic status and displays the existence of the potential risk for camels.

Anti-echinococcal effects of sumac, Rhus coriaria, in a murine model of cystic echinococcosis: Parasitological and molecular evaluation.

Sumac has been traditionally used by people as a medicinal plant for the treatment of different disorders. Cystic echinococcosis (CE) is one of the major zoonotic diseases of human with a worldwide distribution. Long term albendazole therapy is usually associated with side effects including impaired liver function and leukopenia. The present study investigated the efficacy of the methanolic extract of Sumac, Rhus coriaria, on the secondary hydatid cyst development in mice and evaluated sumac effects on the expression of a profile of genes with a potential role in parasite development. Thirty-six mice were intraperitoneally inoculated with of with 3000 protoscoleces and six months after induction of infection were divided into three groups that received either oral sumac extract, albendazole or distilled water. The mice were necropsied 45 days later and the volume and weight of cysts were measured. The expression level of five target genes were analyzed using RT-qPCR. The volume and weight of the cysts were significantly lower in the sumac group compared to the controls. Decreased expressions were found in four out of the five genes following sumac administration. While significantly lower expressions in the sumac group were found for the cdk6, b-raf, fgfr and ras genes, no significant difference was found in cdk2 expression as compared with the control groups. Findings of the present study indicate high efficacy of sumac on the size and volume of secondary hydatid cysts in a murine CE model. Further studies are required to explore the most active and effective ingredients of this natural product.

Narrative-focused Group Counseling Improves Intervention Outcomes in Women With Obesity.

OBJECTIVE: To investigate the effects of narrative group counseling combined with diet modification and exercise plans on weight loss in Iranian women with obesity. DESIGN: Parallel 2-arm clinical trial. PARTICIPANTS: Fifty-six Iranian women with obesity (aged 18-50 years). INTERVENTION: The intervention group included weekly diet, exercise, and narrative-focused group counseling, whereas the comparison group included dietary modification and exercise sessions for 8 months (32 sessions). MAIN OUTCOME MEASURE: Anthropometric and body composition parameters, blood biochemical parameters (high-density lipoproteins, low-density lipoproteins, triglycerides, fasting blood sugar, ghrelin, obestatin), physical activities, and appetite scores. ANALYSIS: McNemar test was used for the variables that were not normally distributed and for scaling. Furthermore, t tests were used to compare quantitative variables with normal distributions. The original P (0.05) was adjusted to P = 0.0031 using the Bonferroni correction. RESULTS: Weight, body mass index, body fat proportion, and hip circumference decreased significantly in the intervention vs comparison group. Serum low-density lipoproteins, triglycerides, total cholesterol, fasting blood sugar, appetite score, and ghrelin decreased, whereas obestatin increased significantly in the intervention vs comparison group. CONCLUSIONS AND IMPLICATIONS: Narrative-focused group counseling combined with traditional strategies was effective in achieving significant changes in weight, body mass index, and appetite. Future studies with a more diverse audience and a longer follow-up are warranted.

Clinical and genetic characteristics of hemoglobin H disease in Iran.

Hemoglobin H (Hb H) disease is a subtype of α-thalassemia caused by deletional and/or non-deletional mutations in three alpha-globin genes in which the various genotypes determine the disease severity. This study was aimed to investigate the frequency of alpha gene mutations and genotypes and their correlation with hematological and clinical characteristics in Iran. Among 202 patients diagnosed with Hb H disease through a national study in Iran according to standard methods, we had access to the hematologic and clinical findings and genetic data of 101 patients in whom genetic study was performed. Genomic DNA from peripheral blood was extracted and analyzed for identification of α-globin gene mutations using Multiplex Gap Polymerase Chain Reaction, Reverse Hybridization Assay, and finally Direct DNA Sequencing method. Twenty-one different mutations and thirty genotypes were detected in 101 patients with Hb H disease. In total, 39 patients (38.6%) were deletional and 62 patients (61.4%) were non-deletional type of the disease. The --MED mutation was highly prevalent in almost half of the patients (56.4%). Among various genotypes, -MED/-a3.7 (29.7%) and -α20.5/-α5NT (6.9%) were the most prevalent genotypes found in the studied group. Patients with non-deletional type presented with more severe hematological and clinical findings. Hb H percentage and serum ferritin levels were significantly higher in non-deletional patients in comparison to the deletional group (p < 0.05). 12 (11.9%) and 40 (39.6%) out of 101 patients were on regular and occasional transfusions, respectively. 83% of those with regular transfusion belonged to the non-deletional group. Among transfusion-dependent patients, -MED/αCSα and α20.5/-α5NT were the most common genotypes. In this study, two patients with -α20.5/αCSα and -MED/α-5NT genotypes experienced thrombotic events. This study indicated that although non-deletional genotypes of Hb H disease were responsible for more clinical severity of the disease, due to the presence of severe phenotypes even in deletional types, no definite correlation was found between genotype and phenotype.

A Proposal for Data Registry system for Urologic Cancers in Iran.

PURPOSE: Data registries are organized systems that facilitate collection, storage, and analysis of data related to a specific disease in a defined population. Here we introduce a data registry system which was designed to cover the four most common urologic cancers (prostate, bladder, renal and testis). MATERIALS AND METHODS: All contributing centers can enter data into the system after logging in with their unique usernames and passwords. In this system, the information of each individual patient will be entered in several structured forms covering various steps of management of the patients. RESULTS: Our proposed registry is an interactive, web-based database designed to collect complete data of patients with common urological cancers. We devised a council that functions as the central committee that will initiate, supervise, and monitor all steps of the projects including data collection, data audit, as well as data analysis and publication. To facilitate manuscript publication, the system will provide assistance and support throughout all the steps of statistical analysis and manuscript preparation. CONCLUSION: This proposed registry can have a national target and is designed to provide evidence-based information that could support strategic planning and national multi-centric studies.

Parasitic causes of meat and organs in cattle at four slaughterhouses in Sistan-Baluchestan Province, Southeastern Iran between 2008 and 2016.

This 8-year (from 2008 to 2016) retrospective study calculated the percentage of carcass and organ (lung and liver) condemnations and estimated the direct financial costs at four slaughterhouses in Sistan-Baluchestan Province, Southeastern Iran. Each carcass and organ (lung and liver) was thoroughly examined through inspection, palpation and incision following the standard protocol. Identification of the parasites was performed macroscopically. The total direct economic loss due to meat's condemnation was estimated by adding weights of each organ or carcass part and multiplying individual organ totals by their 2016 market unit price. A total of 857,039 cattle were slaughtered during this period, 64,497 livers (7.5%), 31,401 lungs (3.6%) and the carcasses of 1,171 cattle (0.1%) were condemned due to lesions caused by parasites. The main parasitic lesions in the condemned livers were attributed to Echinococcus granulosus (4.2%), Fasciola spp. (3.1%) and Dicrocoelium dendriticum (0.1%). All the condemned lungs were due to E. granulosus (3.6%). Taenia saginata cysticerci were detected in 0.1% of inspected animals. Liver condemnation due to cystic echinococcosis was the highest in fall (4.7%, p < 0.001); while lung condemnation was the highest during spring (3.98%, p < 0.001). Liver condemnation due to Fasciola spp. was the lowest in winter (2.99%, p < 0.001). Carcass condemnation as a result of cysticercosis was the highest in summer (p < 0.001). Considering the 2016 market prices, condemnations due to the studied parasites caused direct costs estimated U.S. $ 3,191,879. To the best of our knowledge, this is the first report estimating the monetary losses due to parasitic infections in the slaughterhouses of this province. Due to the high financial impact of the studied parasites, a control programme should be implemented to decrease this impact.

Laparoscopic Donor Nephrectomy Is a Safe Surgical Approach in Healthy Obese Kidney Donors: A 10-Year Single-Center Retrospective Study.

OBJECTIVES: A lack of donors continues to be a significant problem. Kidney donors with a body mass index ≥ 30 kg/m² are not suitable for laparoscopic donor nephrectomy; however, some studies have suggested that an obese donor could be an appropriate donor with similar surgical outcomes. Here, we report the results of our 10-year experience of laparoscopic donor nephrectomy, examining the effects of body mass index on the surgical results of laparoscopic donor nephrectomy. MATERIALS AND METHODS: We retrospectively reviewed medical records of patients who underwent laparoscopic donor nephrectomy at the Shahid Beheshti University Medical Science, Urology Center (Tehran, Iran) from 2005 to 2015. The collected information included pretransplant and posttransplant serum levels of hemoglobin and creatinine. We also collected data on surgical outcomes (operation time, cold and warm ischemia, need for blood transfusion, and conversion to open surgery, length of hospital stay, and complication rates) with respect to body mass index categories (≤ 24.9, 25-29.9, and ≥ 30 kg/m²). RESULTS: Of 1083 kidney donors, 732 donors had body mass index of ≤ 24.9 kg/m², 256 had body mass index between 25 and 29.9 kg/m², and 95 had body mass index of ≥ 30 kg/m². Differences among groups were not significant in terms of operation time (P = .558), warm or cold ischemic time (P = .829 and .951, respectively), blood transfusion (P = .873), and length of hospital stay (P = .850). CONCLUSIONS: The laparoscopic approach for donor nephrectomy is a safe and effective method in obese donors without significant postoperative complications.

Laparoscopic pyelolithotomy in patients with previous ipsilateral renal stone surgery.

OBJECTIVES: To evaluate the safety and efficacy of transperitoneal laparoscopic pyelolithotomy in renal stone cases with previous renal surgeries. PATIENTS AND METHODS: In this prospective study, 190 consecutive patients with renal stones, who were candidates for transperitoneal laparoscopic pyelolithotomy, were enrolled. The patients were divided into two groups. In group A, 163 patients without a history of renal surgery underwent standard laparoscopic pyelolithotomy, whereas in group B laparoscopic pyelolithotomy was performed in 27 patients with a history of kidney stone surgery including percutaneous nephrolithotomy or open stone surgery. All intraoperative data including the operating time and complications such as bleeding requiring transfusion were recorded. Postoperative data such as length of hospitalization, hemoglobin level alteration, and other complications were also recorded. RESULTS: There was no significant difference in the preoperative data such as stone size, stone site, age, sex, and stone side between the two groups. There was no significant difference in the stone-free rate between the two groups (p = 0.4). There was no significant difference between the two study groups regarding the operating time, hospital stay, stone-free rate, complications, and transfusion rate. CONCLUSION: Laparoscopic pyelolithotomy can be used as a safe and feasible treatment modality in the setting of previous renal surgery. The complications and stone-free rate of laparoscopic pyelolithotomy in patients with history of renal surgery are acceptable.

Partial nephrectomy and positive surgical margin, oncologic outcomes and predictors: a 15-year single institution experience.

INTRODUCTION: The aim of this article was to compare oncological outcomes after partial nephrectomy between patients with positive (PSM) and negative (NSM) surgical margins. MATERIAL AND METHODS: In this retrospective study, the data of 733 patients who underwent partial nephrectomy with diagnosis of renal cell carcinoma (RCC) were analyzed. A total of 80 patients from the NSM group were matched to 42 PSM patients. The Kaplan-Meier method was used to estimate freedom from local disease recurrence and metastatic progression and overall survival. Cox proportional hazards models were used to assess the predictors for recurrence/metastasis. RESULTS: The mean age was 58.4 ±11.4 years (range: 29 to 82). Median follow-up was 24 months (IQ25-75: 15-36.2). A total of 5 patients from the PSM group (6.2%) developed local recurrence and metastasis was detected in 2 (2.5%) of them while no metastasis or recurrence was observed in the NSM group. In the multivariate analysis, positive surgical margin was the only independent predictor for recurrence/metastasis (HR[CI] = 0.19[0.04-0.75], p = 0.019). Recurrence-free survival was higher in the NSM group (100% for the NSM group vs 88.1%, p = 0.002) and recurrence/metastasis-free survival was also higher in the NSM group (100% for the NSM group vs 85.7%, p = 0.001), but there were no differences in overall survival between the two groups (96.3% for the NSM group vs 97.6% for the PSM group, p = 0.68). CONCLUSIONS: Although tumor recurrence was more prevalent in positive surgical margin patients who underwent partial nephrectomy, there were no differences in overall survival between the two groups. Therefore, active surveillance against further surgery would be a proper option after finding the tumor-involved margins.

Experimentally Induced Cerebral Cystic Echinococcosis in Rats: A Suitable Animal Model for Cerebral Echinococcosis.

BACKGROUND: Echinococcus granulosus is a worldwide zoonotic cestode that lives mainly in the intestine of dog as definitive host. Its larval stage infects intermediate hosts and forms hydatid cysts mainly in the liver and lungs tissues and less other organs such as brain, eye and bone. In the experimental models, inoculation of protoscoleces into the peritoneum, thoracic cavity, subcutaneous and cerebrum produces hydatid cysts. Experimental echinococcosis in the animal models provides a good opportunity for study of the parasite-host relationship, different transmission ways of infection in the intermediate hosts and effect of new drugs. METHODS: The present study was conducted in the Veterinary School, Shahid Bahonar University of Kerman, Kerman, Iran in 2018. In this study, cerebral hydatidosis was investigated in 6 female Wistar rats weighing (200±20 gr). For this purpose, protoscoleces were collected from hydatid cysts of infected sheep liver. Overall, 300 protoscolices were injected directly in the lateral ventricle by an insulin syringe through the implanted cannula. RESULTS: After 4 months of inoculation, multiple thin-walled, transparent hydatid cysts were observed in the rat skull. All cysts were infertile. The cysts were localized prominently on the cerebral cortex and lesser in the parenchyma and ventricles. The cyst walls consisted of three layers consist of the outer layer (fibrous capsule), two parasitic layers and the endocyst layer (germinal layer). The cyst was surrounded by the inflammatory cells consist of lymphocytes, plasma cells and macrophages. CONCLUSION: To the best of our knowledge, this research is the first experimental cerebral hydatidosis arisen from larval stage of Echinococcus granulosus in the animal model.

Laparoscopic Pyelolithotomy for A Staghorn Stone in A Patient with History of Cystectomy and Ileal Conduit.

Laparoscopic pyelolithotomy has recently been introduced for renal stones. However, the use of this technique is limited in patients with history of extensive abdominal surgeries. We present a case of right side staghorn renal stone with history of abdominal open cystectomy who underwent laparoscopic pyelolithotomy with uneventful outcome.

Laparoscopic Pyelolithotomy for the Management of Large Renal Stones with Intrarenal Pelvis Anatomy.

PURPOSE: The role of laparoscopic pyelolithotomy (LPL) in the management of renal stones is evolving. One of the challenges in LPL for renal stones is patients with intrarenal pelvis. Here we present our experience with laparoscopic pyelolithotomy for the management of renal stones with intrarenal pelvis anatomy. MATERIALS AND METHODS: Patients candidate for laparoscopic pyelolithotomy from February 2014 to March 2015 were included. Intrarenal pelvis was defined as > 50% of the renal pelvis area contained inside renal parenchyma. Laparoscopic pyelolithotomy was done by transperitoneal approach. Residual stones were checked by computed tomography and/or intravenous pyelography and ultrasonography 6 weeks after the operation. RESULTS: 28 patients were included in this study. The mean±SD of patients' age was 45.8±12.5 years. 19 patients (68%) were male. Stone locations were pelvis, multiple, and staghorn in 22, 3, and 3 patients respectively. The mean±SD of operation duration was 160±48 minutes. Residual stones were observed in 3 patients with multiple (n=2) or staghorn (n=1) stones. Urinary leak was observed in 3 patients and was managed conservatively in 2 patients. In one patient ureteral stent was inserted by cystoscopy. No conversion to open surgery or re-operation occurred. CONCLUSION: Laparoscopic pyelolithotomy is a feasible operation for patients with renal stones and intrarenal pelvis in centers with adequate experience in laparoscopy. However, the success of LPL decreases in patients with multiple stones and intrarenal pelvis.

Percutaneous nephrolithotomy of staghorn renal stones in pediatric patients using adult-sized instrument.

INTRODUCTION: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone. METHODS: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter. RESULTS: The mean age was 108 ± 53 months (range, 14-180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred. CONCLUSION: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.

A New Touchless Technique for Suturing in Transperitoneal Laparoscopic Pyeloplasty.

BACKGROUND: The most difficult, time-consuming, and critical steps of laparoscopic pyeloplasty (LPP) are ureteral spatulation, apical ureteral stitch placement, and ureteropelvic anastomosis. To simplify these critical steps, avoid the risk of ureteral shortening, and also minimize ureteral manipulation, we present a modified dismembered technique for suturing with the outcome of patients who underwent LPP using this technique. MATERIALS AND METHODS: This study included 23 patients who were candidates for transperitoneal dismembered Anderson-Hynes LPP. The ureter was partially cut just below the ureteropelvic junction. The ureter was spatulated at its lateral aspect to cross the obstruction site and reach the normal ureter. The renal pelvis was obliquely cut equal to the size of ureteral spatulation. The ureter and pelvis were still connected partially. At this point, the first stitch was placed between the lower point of the spatulated ureter and the lowest corner of the renal pelvis. Anastomosis was performed by running sutures. RESULTS: No cases of internal organ injury and no cases of open surgery conversion were encountered. The radiologic success rate was 96%. After operation, in 1 patient, obstruction still existed and the patient underwent nephrectomy due to a nonfunctional obstructive kidney. CONCLUSIONS: This modification preserves total ureteral length and facilitates spatulation and suturing in transperitoneal laparoscopic dismembered pyeloplasty. The results showed that it is a useful method, especially for less-experienced surgeons.

In vitro effects of Artemisia sieberi on Echinococcus granulosus protoscolices.

Hydatidosis is a parasitic zoonotic disease. Surgery is one of its treatment modalities during which protoscolices are likely to be released into the peritoneal cavity and cause recurrence of the disease. Given the above problem and the complications associated with conventional anti-parasitic agents, it is imperative to find an effective and natural protoscolicidal agent. The present study was conducted to evaluate effects of Artemisia sieberi on Echinococcus granulosus protoscolices. Protoscolices were collected from slaughtered livestock in Kerman abattoir and the effect of three concentrations of aqueous extract of A. sieberi (25 mg ml-1, 50 mg ml-1 and 75 mg ml-1) was assessed over three different exposure periods. Results showed that scolicidal effect of this extract at exposure periods of 2, 5 and 10 min was 76 ±â€¯1.4, 76.8 ±â€¯1.41 and 85.7 ±â€¯3.29 percent at concentration of 25 mg ml-1 and 76.8 ±â€¯1.4, 78 ±â€¯3.18 and 86.4 ±â€¯24.9 percent at concentration of 50 mg ml-1 and finally 80 ±â€¯2.73, 90 ±â€¯0.79 and 92.6 ±â€¯1.27 percent at concentration of 75 mg ml-1, respectively. It can be concluded that the aqueous extract of A. sieberi has a protoscolicidal activity and can be considered a natural agent against hydatid cyst protoscolices.

Role of the gonadal vessels on the stone lodgment in the proximal ureter: Direct observation during laparoscopic ureterolithotomy.

INTRODUCTION: Previous radiological studies revealed that stones lodge more frequently in the ureterovesical junction (UVJ) as well as the proximal ureter. Factors that prevent stone passage from the proximal ureter are not well studied. AIM: To explore the site of the lodged stones in the proximal ureter with direct observation during laparoscopic ureterolithotomy. MATERIALS AND METHODS: Between November 2014 and February 2015, we included 26 patients including 18 men and 8 women with stones larger than 10 millimeters in the proximal ureter who were candidate for laparoscopic ureterolithotomy. We prospectively recorded the site of the lodged stones in the ureter during laparoscopic ureterolithotomy in relation with the sites of ureteral stenosis as well as the gonadal vessels. RESULTS: Among 26 patients with ureteral stone, in 19 cases stone was found close to the gonadal vein compared with seven cases that stone was in other locations of the ureter (p = 0.02). The characteristics of patients and stones were not different in cases that the stone was close to gonadal vessels compared with other locations. CONCLUSIONS: This study showed that most of the stones lodged in the proximal ureter were in close proximity with gonadal vessels. Gonadal vessels may be an extrinsic cause of ureteral narrowing.

Laparoscopic management of paraganglioma in a pregnant woman: a case report

ABSTRACT Introduction: Paraganglioma is an extremely rare catecholamine-producing tumor during pregnancy. Paraganglioma carries high risks of fetal and maternal mortality during pregnancy. We report a pregnant woman with paraganglioma in the second trimester. Case Description: A 24-year-old pregnant woman presented with severe hypertension in the 17th week of gestation. Hormonal examination and Magnetic Resonance Imaging (MRI) confirmed the diagnosis of extra adrenal pheochromocytoma (paraganglioma). She underwent laparoscopic tumor excision successfully. Conclusions: A high index of suspicion is needed to diagnose paraganglioma in a pregnant patient with hypertension. Laparoscopic tumor removal for paraganglioma seems to be a feasible and safe procedure during pregnancy.

Laparoscopic management of paraganglioma in a pregnant woman: a case report.

INTRODUCTION: Paraganglioma is an extremely rare catecholamine-producing tumor during pregnancy. Paraganglioma carries high risks of fetal and maternal mortality during pregnancy. We report a pregnant woman with paraganglioma in the second trimester. CASE DESCRIPTION: A 24-year-old pregnant woman presented with severe hypertension in the 17th week of gestation. Hormonal examination and Magnetic Resonance Imaging (MRI) confirmed the diagnosis of extra adrenal pheochromocytoma (paraganglioma). She underwent laparoscopic tumor excision successfully. CONCLUSIONS: A high index of suspicion is needed to diagnose paraganglioma in a pregnant patient with hypertension. Laparoscopic tumor removal for paraganglioma seems to be a feasible and safe procedure during pregnancy.