Publications by authors named "Alireza Yousefi"

30 Publications

  • Page 1 of 1

In Vivo Intravascular Pacing Using a Wireless Microscale Stimulator.

Ann Biomed Eng 2021 Feb 3. Epub 2021 Feb 3.

Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA.

Millions of patients worldwide are implanted with permanent pacemakers for the treatment of cardiac arrhythmias and conduction disorders. The increased use of these devices has established a growing clinical need to mitigate associated complications. Pacemaker leads, in particular, present the primary risks in most implants. While wireless power transfer holds great promise in eliminating implantable device leads, anatomical constraints limit efficient wireless transmission over the necessary operational range. We thereby developed a transmitter-centered control system for wireless power transfer with sufficient power for continuous cardiac pacing. Device safety was validated using a computational model of the system within an MRI-based anatomical model. The pacer was then fabricated to meet the acute constraints of the anterior cardiac vein (ACV) to enable intravascular deployment while maintaining power efficiency. Our computational model revealed the wireless system to operate at > 50 times below the tissue energy absorption safety criteria. We further demonstrated the capacity for ex vivo pacing of pig hearts at 60 beats per minute (BPM) and in vivo pacing at 120 BPM following pacer deployment in the ACV. This work thus established the capacity for wireless intravascular pacing with the potential to eliminate complications associated with current lead-based deep tissue implants.
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http://dx.doi.org/10.1007/s10439-021-02729-8DOI Listing
February 2021

Strengths of Iran for internationalization of medical sciences education.

J Educ Health Promot 2020 28;9:92. Epub 2020 Apr 28.

Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Science, Isfahan, Iran.

Introduction: Internationalization of higher education involves mutual exchanges as well as a consensus based. Political, economic, sociocultural, and scientific reasons recommend the need to move toward the internationalization of higher education. The current study highlights the strengths of the internationalization of Iran's medical sciences education.

Materials And Methods: This descriptive exploratory study was carried out in 2016-2017 in Iran. The techniques used for data collection included review of articles, interview with subject experts, and the focus group and the nominal technique group to explore the views of various stakeholders. The data were analyzed with the qualitative content analysis method.

Results: The inductive qualitative content analysis of all data generated 13 categories and 88 subcategories. The categories were geographical and geostrategic position of Iran; the historical, cultural, religious, and tourist attractions of Iran; the security of Iran; priority to internationalization policies and programs in Iran's macro plans; the existence of regulations, laws, and approvals for international activities; same language with neighboring and regional countries; the low cost of studying and living in Iran; the ability of Iranian faculty members and experts for internationalization; the background, reputation, and the progress of medical education, health, and care in Iran; the cheaper forces of Iran and their welcome to foreigners; the existence of motivation, zeal, and belief for internationalization; the existence of proper infrastructure; and the existence of a suitable capacity for internationalization.

Conclusions: Iran has some positive points that can be used to promote international activities, provided it does some good advertising in this regard. It is suggested that the challenges, opportunities, and threats to Iran's internationalization should be collated from the perspective of the various stakeholders.
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http://dx.doi.org/10.4103/jehp.jehp_488_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271916PMC
April 2020

A Multi-Dimensional Analysis of a Novel Approach for Wireless Stimulation.

IEEE Trans Biomed Eng 2020 12 19;67(12):3307-3316. Epub 2020 Nov 19.

The elimination of integrated batteries in biomedical implants holds great promise for improving health outcomes in patients with implantable devices. However, despite extensive research in wireless power transfer, achieving efficient power transfer and effective operational range have remained a hindering challenge within anatomical constraints.

Objective: We hereby demonstrate an intravascular wireless and batteryless microscale stimulator, designed for (1) low power dissipation via intermittent transmission and (2) reduced fixation mechanical burden via deployment to the anterior cardiac vein (ACV, ∼3.8 mm in diameter).

Methods: We introduced a unique coil design circumferentially confined to a 3 mm diameter hollow-cylinder that was driven by a novel transmitter-based control architecture with improved power efficiency.

Results: We examined wireless capacity using heterogenous bovine tissue, demonstrating >5 V stimulation threshold with up to 20 mm transmitter-receiver displacement and 20° of misalignment. Feasibility for human use was validated using Finite Element Method (FEM) simulation of the cardiac cycle, guided by pacer phantom-integrated Magnetic Resonance Images (MRI).

Conclusion: This system design thus enabled sufficient wireless power transfer in the face of extensive stimulator miniaturization.

Significance: Our successful feasibility studies demonstrated the capacity for minimally invasive deployment and low-risk fixation.
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http://dx.doi.org/10.1109/TBME.2020.2983443DOI Listing
December 2020

Surgical management of penile sarcoid in a stallion.

J Equine Sci 2019 18;30(4):99-104. Epub 2019 Dec 18.

Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia 5756151818, Iran.

This report describes surgical management and breeding implications of a case of penile sarcoid associated with penis laceration in a 4-year-old Kurdish stallion. A large fleshy mass on the distal end of the penis that resulted in urethral meatus deviation and dysuria was detected in a physical examination. No evidence of local extent or metastasis was detected. Under general anaesthesia, the involved distal portion of the penis was removed through partial phallectomy. Histopathological examination of the mass confirmed a fibroblastic sarcoid. Partial phallectomy was successful for management of penile sarcoid and resulted in no postoperative complications or tumour recurrence in long-term follow up; however, successful ejaculation and semen collection have not been achieved.
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http://dx.doi.org/10.1294/jes.30.99DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920054PMC
December 2019

Antioxidant activity of var kernel oil and it's unsaponifiable matters.

J Food Sci Technol 2019 Dec 10;56(12):5336-5345. Epub 2019 Aug 10.

5Department of Food Science, Faculty of Food Engineering, State University of Campinas (UNICAMP), Rua Monteiro Lobato, 80, Caixa Postal: 6121, Campinas, Sao Pulo CEP 13083-862 Brazil.

In this research, antioxidant activity of var (a wild type of pistachio in Iran) kernel oil (PAKO) and unsaponifiable matters of kernel oil (UKO) were compared with those of sesame seed oil (SSO) and rice bran oil (RBO) as well as with their unsaponifiable matters (USO and UBO) and α-tocopherol (natural antioxidant) was selected as control. Also, some chemical properties such as (FRAP, DPPH radical-scavenging, rancimat and oven assays (peroxide value and carbonyl value) were assessed. The amount of unsaponifiable matters of studied oils was between 1.4 and 3.5%. The highest total phenolics was observed in SSO (1024 mg/kg), followed by RBO, and PAKO was 174, and 75 mg/kg, respectively. In DPPH radical-scavenging assay, the EC values of PAKO, SSO, RBO, UKO, USO, UBO, and α-tocopherol were determined as 38.9, 50, 48.4, 14, 12.7, 15.9 and 61.4 mg/mL, respectively. In FRAP assay, the highest value was nominated for UKO (434 mmol/L); followed by USO, UBO, PAKO, SSO, RBO and α-tocopherol (404, 357, 364, 298, 210 and 58 mmol/L; respectively). Also, considering the results of oven test, the incorporation of UKO into pure sunflower oil resulted in the highest oxidative stability; followed by UBO, USO, PAKO, SSO, RBO and α-tocopherol. According to results of the rancimat test, the incorporation of unsaponifiable matters (UKO, USO, and UBO) resulted in the highest oil/oxidative stability index (OSI) in pure sunflower oil, followed by oils studied (PAKO, SSO, and RBO). According to results, UKO had the highest antioxidant activity, followed by USO, UBO, PAKO, SSO, RBO, and α-tocopherol.
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http://dx.doi.org/10.1007/s13197-019-04004-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838301PMC
December 2019

Iran's international collaborative articles in medical sciences.

Med J Islam Repub Iran 2019 17;33:84. Epub 2019 Aug 17.

Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Forecasting is the process of predicting future behavior. In reviewing databases, no predicted value associated with international collaboration publications in Iran was found. Thus, the present study aimed at forecasting Iran's international collaborative articles in medical sciences. The number of Iran's articles and international collaborative articles in medical sciences written over 56 years was extracted from SCOPUS. Data were extracted from 1960 up to 2016. The time series method was used for forecasting using the Minitab software Version 17. There was no increase in the number of medical articles from Iran from 1960 to 2001. However, the data showed incremental growth between 2001 and 2016. This was similar to Iran's medical sciences international collaboration articles. In 2016, the percentage of Iran's international collaboration articles was 15.2, which is expected to reach 19.9 in 2025. An investigation was performed on the number of international collaboration articles in the field of medical sciences in Iran. Future trends show an incremental growth. The number of Iran's articles can be increased with international cooperation. However, an increase or decrease in Iran's articles without international cooperation has to be investigated.
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http://dx.doi.org/10.34171/mjiri.33.84DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825373PMC
August 2019

Fabrication of novel tubular scaffold for tendon repair from chitosan in combination with zinc oxide nanoparticles.

Vet Res Forum 2018 15;9(2):105-111. Epub 2018 Jun 15.

Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.

Chitosan bears numerous properties, such as biocompatibility, biodegradability and non-toxicity making it suitable for use in different biomedical fields. Zinc (Zn) is required for fibroblasts proliferation and collagen synthesis as essential elements of wound healing. Its nanoparticles are well known for their capability to enhance wound healing by cell adhesion and migration improvement through growth factors-mediated mechanisms. Poor blood supply and unique histological characteristics of tendon make its regeneration always slow. Also, adhesion formation between tendon and its surrounding tissues is another problem for neotendon to return to its normal structure and functional activities. In this study, a novel tubular scaffold of zinc oxide (ZnO) nanoparticles loaded chitosan has been fabricated for tendon repair. Experimental complete tenotomy of deep digital flexor tendon in a rabbit model was done and scaffolds were placed in the transected area after two ends suturing. After four and eight weeks, adhesion formation around the tendons and tissue reaction to the scaffolds were evaluated macroscopically. Inflammation, angiogenesis and collagen fibers arrangement were also analyzed in histopathological evaluations. After eight weeks, the scaffolds were absorbed completely, adhesions around the tendon were decreased and there was no sign of significant tissue reaction and/or infection in histopathological analyses. The reduced adhesion formation, improved gliding function and better histopathological characteristics suggest this scaffold application as a potential therapy in treatment of tendon acute injuries.
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http://dx.doi.org/10.30466/VRF.2018.29979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047579PMC
June 2018

The Factors Affecting Teaching and Learning Professionalism Among Medical Teachers.

Health Care Manag (Frederick) 2018 Apr/Jun;37(2):164-174

Author Affiliations: Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Iran.

Given the special importance of medical professionalism, a successful faculty development strategy not only teaches professionalism in cognitive domain but also creates practical instructors who can act as role models for students. This study proposed to identify themes that can explain effective factors in teaching and learning professionalism among medical teachers. The study was qualitative. Twenty-four experts in medical education participated in the study from all medical universities of Iran. Data gathering was performed via semistructured interviews. Interviews were transcribed and analyzed by classic content analysis. At the end, the factors were confirmed by the focus group consisting of six experts. One hundred seventy-seven codes were extracted. Codes were categorized into 24 subcategories and five main categories: (1) culture, (2) educational factors, (3) background, (4) attitude, and (5) organizational factors. There are many effective factors for a proper faculty development in teaching and learning professionalism. These factors could be individualized, organizational, or external. We cannot design a program without considering these factors.
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http://dx.doi.org/10.1097/HCM.0000000000000213DOI Listing
August 2018

Internationalization or globalization of higher education.

J Educ Health Promot 2018 10;7. Epub 2018 Jan 10.

Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Studies about globalization and internationalization demonstrate different attitudes in explaining these concepts. Since there is no consensus among Iranian specialists about these concepts, the purpose of this study is to explain the concepts of internationalization and globalization in Iran.

Materials And Methods: This study is a systematic review done in the first half of 2016. To explain the concept of globalization and internationalization, articles in Scientific Information D atabase, Magiran database, and Google Scholar were searched with the keywords such as globalization, scientific exchange, international cooperation, curriculum exchange, student exchange, faculty exchange, multinational cooperation, transnational cooperation, and collaborative research. Articles, used in this study, were in Persian and were devoted to internationalization and globalization between 2001 and 2016. The criterion of discarding the articles was duplicity.

Results: As many as 180 Persian articles were found on this topic. After discarding repetitive articles, 64 remained. Among those, 39 articles mentioned the differences between globalization and internationalization. Definitions of globalization were categorized in four categories, including globalization, globalizing, globalization of higher education, and globalizing of higher education. Definitions about internationalization were categorized in five categories such as internationalization, internationalization of higher education, internationalization of the curriculum, internationalization of curriculum studies, and internationalization of curriculum profession.

Conclusion: The spectrum of the globalization of higher education moves from dissonance and multipolarization to unification and single polarization of the world. One end of the spectrum, which is unification and single polarization of the world, is interpreted as globalization. The other side of the spectrum, which is dissonance and multipolarization, is interpreted as globalizing. The definition of internalization is the same as that of globalizing. In other words, it is possible to say that internalization is similar to globalizing but different from globalization.
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http://dx.doi.org/10.4103/jehp.jehp_25_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791431PMC
January 2018

Effects of Aloe Vera and Chitosan Nanoparticle Thin-Film Membranes on Wound Healing in Full Thickness Infected Wounds with Methicillin Resistant Staphylococcus Aureus.

Bull Emerg Trauma 2018 Jan;6(1):8-15

Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.

Objective: To assess effect of Aleo vera with chitosan nanoparticle biofilm on wound healing in full thickness infected wounds with antibiotic resistant gram positive bacteria.

Method: Thirty rats were randomized into five groups of six rats each. Group I: Animals with uninfected wounds treated with 0.9% saline solution. Group II: Animals with infected wounds treated with saline. Group III: Animals with infected wounds were dressed with chitosan nanoparticle thin-film membranes. Group IV: Animals with infected wounds were treated topically with Aloe vera and Group V: Animals with infected wounds were treated topically with Aloe vera and dressed with chitosan nanoparticle thin-film membranes. Wound size was measured on 6, 9, 12, 15, 18 and 21days after surgery.

Results: Microbiology, reduction in wound area and hydroxyproline contents indicated that there was significant difference (<0.05) between group V and other groups. Quantitative histological studies and mean rank of the qualitative studies demonstrated that there was significant difference (<0.05) between group V and other groups.

Conclusion: The Aloe vera with chitosan nanoparticle thin-film membranes had a reproducible wound healing potential and hereby justified its use in practice.
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http://dx.doi.org/10.29252/beat-060102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787358PMC
January 2018

Inductively powered wireless pacing via a miniature pacemaker and remote stimulation control system.

Sci Rep 2017 07 21;7(1):6180. Epub 2017 Jul 21.

Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.

Pacemakers have existed for decades as a means to restore cardiac electrical rhythms. However, lead-related complications have remained a clinical challenge. While market-released leadless devices have addressed some of the issues, their pacer-integrated batteries cause new health risks and functional limitations. Inductive power transfer enables wireless powering of bioelectronic devices; however, Specific Absorption Rate and size limitations reduce power efficiency for biomedical applications. We designed a remote-controlled system in which power requirements were significantly reduced via intermittent power transfer to control stimulation intervals. In parallel, the cardiac component was miniaturized to facilitate intravascular deployment into the anterior cardiac vein. Given size constraints, efficiency was optimal via a circular receiver coil wrapped into a half-cylinder with a meandering tail. The pacemaker was epicardially tested in a euthanized pig at 60 beats per minute, 2 V amplitude, and 1 ms pulse width, restoring mean arterial pressure from 0 to 37 mmHg. Power consumption was 1 mW at a range of > 3 cm with no misalignment and at 2 cm with 45° displacement misalignment, 45° x-axis angular misalignment, or 45° y-axis angular misalignment. Thus, we demonstrated a remote-controlled miniaturized pacing system with low power consumption, thereby providing a basis for the next generation of wireless implantable devices.
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http://dx.doi.org/10.1038/s41598-017-06493-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522478PMC
July 2017

The expected results of faculty development programs in medical professionalism from the viewpoint of medical education experts.

J Res Med Sci 2016 23;21:11. Epub 2016 Feb 23.

Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Despite the great emphasis on teaching professionalism in universities, creating changes in one's professional behavior is a serious challenge in medical education. In this regard, one cannot ignore the role of faculty members. The present study was set to investigate the opinions of medical education experts about the expected results of faculty development programs regarding teaching and learning professionalism.

Materials And Methods: The study was carried out in two phases including content analysis study and Delphi. In the first phase, 10 medical education experts participated in the study. Data gathering was carried out using semi-structured interviews. Codes were analyzed using classic content analysis method. In the second phase, a six-member focus group and Delphi with 23 experts from across the country participated, and themes from the previous phase were confirmed and finalized.

Results: Analysis of the content of the interviews in the first phase and discussing in the focus group and Delphi showed two main themes: 1) direct results and 2) indirect results with six subthemes. Direct results included three subthemes of creating role model faculty members, scientific improvement, improving professionalism, and inspiring the students; indirect results included three subthemes of change in educational environment of the university, change in the university system, and effects on the society's culture.

Conclusion: Faculty development in professionalism can contribute to university faculty members to become better role models and inspire their students, peers, and even the society. Therefore, improving professional behavior in university faculty members can have direct and indirect effects on improving the society due to their crucial role.
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http://dx.doi.org/10.4103/1735-1995.177370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122003PMC
February 2016

Management of Stress and Anxiety Among PhD Students During Thesis Writing: A Qualitative Study.

Health Care Manag (Frederick) 2016 Jul-Sep;35(3):231-40

Author Affiliations: Department of Medical Education, Medical Education Research Center, University of Medical Sciences, Isfahan (Drs Bazrafkan, Yousefi, and Yamani); and Applied Linguistics, Shiraz University of Medical Sciences (Dr Shokrpour), Shiraz, Iran.

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.
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http://dx.doi.org/10.1097/HCM.0000000000000120DOI Listing
June 2017

Cystostomy-free open suprapubic transvesical prostatectomy: Is it a safe method?

Urol Ann 2016 Apr-Jun;8(2):213-7

Department of Surgery, Peymanieh Hospital, Jahrom University of Medical Sciences, Jahrom, Iran.

Aim: To compare open suprapubic transvesical prostatectomy (OSP) without insertion of suprapubic cystostomy, OSP with insertion of cystostomy, and transurethral resection of the prostate (TURP).

Patients And Methods: A total of 104 patients with an indication for prostatectomy were retrospectively assigned to TURP (group 1), OSP with cystostomy (group 2), and OSP without cystostomy (group 3). They were evaluated for length of the operation, length of hospital stay, post-operative complications, hemoglobin drop, changes of blood pressure, and intraoperative blood loss.

Results: Mean age was 67.2 ± 8.7 in group 1, 73.3 ± 8.4 in group 2, and 74.0 ± 5.7 in group 3. Prostatic volume was 35.9 ± 13.8, 74.1 ± 33.8, and 74.3 ± 31.8 in groups 1, 2, and 3, respectively. There was no significant difference in prostatic volume between groups 2 and 3 (P = 0.99), but in group 1 it was lesser than groups 2 and 3 (P = 0.00). Length of the operation was 1.2 ± 0.2 in group 3 and 1.1 ± 0.2 in group 2, without a significant difference (P = 0.45). Length of hospital stay in group 3 (2.3 ± 0.4 days) was lesser than that in group 2 (2.6 ± 0.7) (P = 0.01). The amount of hemoglobin drop was 1.1 ± 0.9 in group 1, 1.1 ± 0.7 in group 2, and 1.4 ± 0.91 in group 3 without a significant difference between all groups. The amount of bleeding during operation was 173 ± 103 in group 2 and 161 ± 78 in group 3 (P = 0.98).

Conclusion: OSP without insertion of cystostomy tube is a relatively safe method; however, larger studies are needed. It is also comparable to TURP in terms of postoperative efficacy and complications.
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http://dx.doi.org/10.4103/0974-7796.162245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839242PMC
May 2016

A qualitative inquiry into the challenges and complexities of research supervision: viewpoints of postgraduate students and faculty members.

J Adv Med Educ Prof 2015 Jul;3(3):91-8

Medical Education Department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;

Introduction: The supervision of academic theses at the Universities of Medical Sciences is one of the most important issues with several challenges. The aim of the present study is to discover the nature of problems and challenges of thesis supervision in Iranian universities of medical sciences.

Methods: The study was conducted with a qualitative method using conventional content analysis approach. Nineteen faculty members, using purposive sampling, and 11 postgraduate medical sciences students (Ph.D students and residents) were selected on the basis of theoretical sampling. The data were gathered through semi-structured interviews and field observations in Shiraz and Isfahan universities of medical sciences from September 2012 to December 2014. The qualitative content analysis was used with a conventional approach to analyze the data.

Results: While experiencing the nature of research supervision process, faculties and the students faced some complexities and challenges in the research supervision process. The obtained codes were categorized under 4 themes Based on the characteristics; included "contextual problem", "role ambiguity in thesis supervision", "poor reflection in supervision" and "ethical problems".

Conclusion: The result of this study revealed that there is a need for more attention to planning and defining the supervisory, and research supervision. Also, improvement of the quality of supervisor and students relationship must be considered behind the research context improvement in research supervisory area.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530006PMC
July 2015

Pure ultrasonography-guided radiation-free percutaneous nephrolithotomy: report of 357 cases.

Springerplus 2015 3;4:313. Epub 2015 Jul 3.

Shiraz Nephrology-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To assess the safety and effectiveness of pure ultrasound-guided percutaneous nephrolithotomy.

Patients And Methods: Three hundred fifty-seven patients were treated; 139 women and 218 men, with a mean age of 33.7 years (range 21-69 years) and a mean stone size of 33.5 mm in maximum diameter (range 20-52 mm). Stone locations were renal pelvis (174), lower calyx (68) or both (115) with mild to moderate hydronephrosis seen on excretory urography. A ureteral stent was inserted by cystoscope, and saline was injected for better localization of the pelvicaliceal system (PCS), if needed. Puncture of the PCS was done by an 18-gauge nephrostomy needle through the lower pole calyx, and all the steps, including dilatation, were done under the guidance of ultrasonography.

Results: The day after the operation, 318 (89.07%) patients were stone-free in the kidneys, ureters, and bladder x-rays. Nineteen patients (5.3%) had multiple fragments that measured equal or less than 5 mm and passed them spontaneously in 2-4 weeks (total stone-free rate 94.4%). Access failure occurred in ten obese patients (2.8%) and fluoroscopy was required. Residual fragments with sizes of 10-12 mm were seen in seven patients, all of who underwent shock wave lithotripsy. In one patient, a fragment measuring 7-8 mm migrated into the distal part of the ureter. It was fragmented with ureteroscopy and pneumatic lithoclast 2 days after the operation. In two patients who had large (>15 mm) residual stone redo percutaneous nephrolithotomy was performed 48 h after the first procedure.

Conclusion: Percutaneous nephrolithotomy guided by ultrasonography seems to be as effective as fluoroscopy in selected cases and poses no risk of surgeon and patient exposure to radiation; however, more experience is required.
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http://dx.doi.org/10.1186/s40064-015-1078-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489965PMC
July 2015

Natural immunity against Haemophilus influenza type B in splenectomised Beta-thalassaemia children.

Pak J Biol Sci 2014 Nov;17(11):1190-4

Patients with beta-thalassaemia major and asplenia have an increased risk of encapsulated bacterial infections. The aim of this study was to determine the Haemophilus influenza type b (Hib) antibody concentrations in beta-thalassaemia patients with or without spleens. The Hib antibody concentrations were investigated in 850 patients with thalassaemia major, of whom 437 had undergone splenectomy. Hib antibody levels equal or greater than 1.0 μg mL(-1) were classified as long-term protection, those between 0.15 and less than 1.0 μg mL(-1) as short-term protection and those less than 0.15 μg mL(-1) as no protection. The mean Hib antibody level was lower in asplenic subjects than in non splenectomised subjects (0.39 ± 0.5 vs. 1.08 ± 0.55 μg mL(-1), p < 0.001). The protective antibody level prevalence in asplenic patients was significantly lower than that in patients with spleens (32.3% vs. 85.7%, p < 0.001). Protection against Hib decreased as the time interval after splenectomy increased from 57.2% at a less than 60 months interval to 10.8% at a greater than 120 months interval (p = 0.001). Nearly 30% of the 437 splenectomised subjects had long-term protection against Hib, whereas 64.4% of the 413 non splenectomised subjects had long-term protection (p < 0.001). Asplenic subjects had lower Hib antibody levels than non splenectomised subjects. Additionally, the antibody levels decreased as the time interval increased after splenectomy. A Hib vaccine recommendation for splenectomised thalassaemia major seems essential.
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http://dx.doi.org/10.3923/pjbs.2014.1190.1194DOI Listing
November 2014

Empowerment needs of women with breast cancer: a qualitative study.

Iran Red Crescent Med J 2014 Nov 15;16(11):e16379. Epub 2014 Nov 15.

Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran.

Background: Due to the increasing number of women suffering from breast cancer worldwide, promoting the empowerment of these patients is an important factor affecting their survival.

Objectives: Few studies have investigated the empowerment needs of the breast cancer women, especially in Iran. Therefore, this study was performed to explain the empowerment needs of women with breast cancer in Iran.

Patients And Methods: In this qualitative study, 19 women with breast cancer were interviewed regarding their empowerment needs using the individual open-ended and, in-depth interviews and then the qualitative data were analyzed through content analysis.

Results: Three main categories of empowerment needs from the participants' perspectives were as follows: 1- information: the initial empowerment plans (timely and comprehensive information, coordination and continuity of information, easy and full-time access to information), 2- beliefs: the approval of the empowerment plans for execution (actuality, trust and hope and new beliefs), and 3- skills: efficient execution of the empowerment plans (communication skills, expression the needs, emotions, questions and use of the internet).

Conclusions: It seems that promoting the empowerment of women with breast cancer is essential. Factors found in this study and also in similar studies, in which empowerment needs are explained in-depth through the experiences of the patients, should be considered and used in the treatment, educational and counseling programs to promote the empowerment of women with breast cancer.
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http://dx.doi.org/10.5812/ircmj.16379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329958PMC
November 2014

Percutaneous nephrolithotomy in solitary kidneys: experience with 412 cases from Southern Iran.

Urolithiasis 2015 Jun 28;43(3):233-6. Epub 2014 Nov 28.

Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,

Some patients with nephrolithiasis who become candidates for percutaneous nephrolithotomy (PCNL) have a single kidney. This poses a challenge for the physician regarding the safety and efficacy of this procedure for these patients. This study has aimed to evaluate the safety and efficacy of PCNL in these patients. Between 2002 and 2014, out of 10,800 cases who underwent PCNL in our centres, 412 had a single kidney. We recorded the results and complications in these patients. Out of 412 patients, 279 were men and 133 women. Their mean age was 46.4 years (range 19-71) and mean stone size was 26.5 mm (range 21-55); 161 of them had a functional single kidney, 36 were congenital, and the remaining 215 had undergone contralateral nephrectomy because of stones, trauma, infection or tumour. Comorbidities included 104 hypertensive, 66 diabetic, 65 morbidly obese, 56 uremic and 47 ischemic heart disease cases. The stone-free rate was 91.3% (376/412) on postoperative X-ray/sonography. However, 42 patients required ancillary measures. Complications include fever (T > 38.3 °C) in 34 cases (8.2%), bleeding requiring transfusion 19 cases (4.6%), UTI nine cases (2%), sepsis one case (0.2%), perinephric collection three cases (0.7%), hydro/pneumothorax two cases (0.4%), access failure in five morbidly obese cases (1.2%), pyonephrosis two cases (0.4%), myocardial infarction four cases (1%), transient increasing of blood urea nitrogen (BUN) and serum creatinine (Scr.) in four normal functioning kidney (1%) and eight uremic cases (1.9%), and two cases resulted in death (0.4%). PCNL seems a safe and effective option in cases of a single kidney, but it needs more attention in order to prevent even minor complications that can result in an anephric state.
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http://dx.doi.org/10.1007/s00240-014-0743-3DOI Listing
June 2015

Percutaneous nephrolithotomy: is distilled water as safe as saline for irrigation?

Urol J 2014 Jul 8;11(3):1551-6. Epub 2014 Jul 8.

Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To compare dilutional effect of distilled water with saline solution as an irrigation fluid in percutaneous nephrolithotomy (PCNL).

Materials And Methods: Three hundred twenty eight adult patients (191 men, 137 women) who were candidates for PCNL were randomly assigned into two groups (distilled water, n = 158, group 1; saline solution, n = 162, group 2). Stone size, operation time, irrigation fluid volume, blood hemoglobin level, urea nitrogen, creatinine, sodium and potassium levels were checked before and at 6 and 12 hours after operation.

Results: The mean age of the patients was 37.8 years, and the mean stone diameter was 31.5 mm. There was no clinical case of transurethral resection (TUR) syndrome. Serum sodium depletion was significantly more in group 1 than group 2 (P < .0001). Group 1 had significant decreased post-operative serum sodium levels (P < .0003). Similarly in group 2, postoperative serum sodium levels were significantly lower than the preoperative concentration (P < .01), but it was not the same 6 hours after the operation (P = .23). Serum sodium concentrations remained within normal limits in all cases, without causing clinical signs and symptoms of hyponatremia.

Conclusion: We found that distilled water is safe irrigation fluid for PCNL in adults. In addition, it is more available and cost effective.
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July 2014

Iranian caregivers, silent mediums in caring for relatives suffering from cancer.

Iran J Nurs Midwifery Res 2014 Feb;19(7 Suppl 1):S83-90

Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Poor interaction of treatment personnel with patients' families leads to informational contrast in families, which may ultimately increase the tension and pressure in these conditions. Considering the necessity of caregivers' contribution for an optimized treatment, continuation of care, and supporting patients, and with regard to caregivers' important role, and also considering the emphasis placed by previous studies on the significance of the caregivers' experiences and as there are a limited number of studies on eastern countries, the present study attempts to justify caregivers' understanding of their own needs for interaction with the treatment team.

Materials And Methods: This study is a qualitative research conducted through a content analysis method with an inductive approach. 23 familial caregivers of breast cancer patients from Seyed-Al-Shohada and ayat- ollah khan sari Hospital of Isfahan and Arak were selected through purposive sampling. Data were gathered through in-depth interviews and field notes. The content was read for several iterations and units of meaning and primary codes were extracted, and then categories were extracted based on the centrality and similarity of meanings.

Results: Four categories were extracted: a) caregivers' contribution and acknowledging them in the treatment system, b) training in efficient caregiving, c) efficient interaction of the medical team with caregivers, and d) easy and dynamic access to the medical services.

Conclusions: The results of the study showed that family caregivers should cooperate and interact with the medical team. They also need training from the medical team on caregiving to cancer patients. An understanding of caregivers' experiences and needs in their interaction with the medical team and identifying their needs as an important aspect in cancer care system assists in designing evidence-based healthcare interventions and a comprehensive family-cantered care program.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402981PMC
February 2014

Is topical zinc effective in the treatment of melasma? A double-blind randomized comparative study.

Dermatol Surg 2014 Jan 14;40(1):33-7. Epub 2013 Nov 14.

Department of Dermatology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.

Background And Objectives: Zinc plays a role in skin health, and preliminary data have shown its beneficial effects for melasma. We compared the effect of topical zinc with that of hydroquinone as the standard treatment on severity of melasma.

Patients And Methods: Ninety-three women with melasma were randomized to receive zinc sulfate 10% or hydroquinone 4% solutions once daily for 2 months. They were followed for an additional 3 months while using sunscreen. The severity of melasma was assessed at baseline and at 2 and 5 months using the Melasma Area and Severity Index (MASI).

Results: Eighty-two patients completed the study. The MASI score fell significantly in both groups, but a greater decrease was seen in those who received hydroquinone (43.5 ± 15.5% vs 18.6 ± 20.8%, p < .001). Postinflammatory pigmentation occurred in 5.2% of the zinc group and irritation in 30.9% of the hydroquinone group.

Conclusion: Topical zinc therapy is not highly effective in reducing the severity of melasma, but further trials are needed to determine whether adding zinc to current topical treatments could improve treatment response.
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http://dx.doi.org/10.1111/dsu.12296DOI Listing
January 2014

Acetyl salicylic acid locally enhances functional recovery after sciatic nerve transection in rat.

Neurol Med Chir (Tokyo) 2013 21;53(12):839-46. Epub 2013 Oct 21.

Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University.

Local effect of acetyl salicylic acid (ASA) on peripheral nerve regeneration was studied using a rat sciatic nerve transection model. Forty-five male healthy White Wistar rats were divided into three experimental groups (n = 15), randomly: Sham-operation (SHAM), control (SIL), and ASA-treated (SIL/ASA) groups. In SHAM group after anesthesia left sciatic nerve was exposed through a gluteal muscle incision and after homeostasis the muscle was sutured. In SIL group the left sciatic nerve was exposed the same way and transected proximal to tibio-peroneal bifurcation leaving a 10-mm gap. Proximal and distal stumps were each inserted into a silicone tube and filled with 10 μl phosphate buffered solution. In SIL/ASA group defect was bridged using a silicone tube filled with 10 μl acetyl salisylic acid (0.1 mg/ml). Each group was subdivided into three subgroups of five animals each and were studied 4, 8, and 12 weeks after surgery. Data were analyzed statistically by factorial analysis of variance (ANOVA) and the Bonferroni test for pair-wise comparisons. Functional study confirmed faster and better recovery of regenerated axons in SIL/ASA than in SIL group (p < 0.05). Gastrocnemius muscle mass in SIL/ASA was significantly more than in SIL group. Morphometric indices of regenerated fibers showed that the number and diameter of the myelinated fibers in SIL/ASA were significantly higher than in control group. In immuohistochemistry, location of reactions to S-100 in SIL/ASA was clearly more positive than in SIL group. Response to local treatment of ASA demonstrates that it influences and improves functional recovery of peripheral nerve regeneration.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508728PMC
http://dx.doi.org/10.2176/nmc.oa2012-0330DOI Listing
April 2015

Reliability and validity of the ''personal well-being index- cognitive disability'' on mentally retarded students.

Iran J Psychiatry 2013 Jun;8(2):68-72

Associate Professor of Psychology Payam-e-Noor University, Tehran, Iran.

Objective: Having a good quality of life has always been desirable for humans, and the concept of a good life and the ways of achieving it have become important over the years. Personal wellbeing is the mental component of quality of life. Thus, the current study was conducted to assess the reliability and validity of the ''Personal Well-Being Index- Cognitive Disability'' on mentally retarded students.

Method: 200 mentally retarded students in north districts of Tehran (districts 1, 2 and 3) were selected by systematic random sampling. The collected data using Personal Well-Being Index- Cognitive Disability was analyzed by Cronbach's alpha coefficient for internal consistency and linear multivariate regression for construct validity.

Results: Results confirmed the reliability and validity for the Personal Well-Being Index- Cognitive Disability in mentally retarded students of exceptional schools. Studying the internal consistency of seven items showed that all the items were correlated with the total score and their scores averages were similar to each other. This indicates that the test's questions have reliability with regard to evaluation of a common feature and results showed Personal Well-Being Index- Cognitive Disability had the most extensive coverage of construct validity.

Conclusion: Personal Well-Being Index- Cognitive Disability scale could be applied to measure personal wellbeing in mentally retarded students.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796296PMC
June 2013

Local effect of celecoxib on peripheral nerve repair combined with silicone tubulization in rat.

Chin J Traumatol 2013 ;16(5):265-71

Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia 57153 1177, Iran.

Objective: To assess local effect of celecoxib on nerve regeneration in a rat sciatic nerve transection model.

Methods: Forty-five male healthy white Wistar rats were randomly divided into three experimental groups (n equal to 15 for each): sham-operation (SHAM), control (SIL) and celecoxib treated (SIL/CLX) groups. In SHAM group after anesthesia left sciatic nerve was exposed and after homeostasis muscle was sutured. In SIL group the left sciatic nerve was exposed in the same way and transected proximal to tibioperoneal bifurcation leaving a 10 mm gap. Proximal and distal stumps were each inserted into a silicone tube and filled with 10 microlitre phosphate buffered solution. In SIL/CLX group defect was bridged using a silicone tube filled with 10 microlitre celecoxib (0.1 g/L).

Results: Functional study and gastrocnemius muscle mass confirmed faster and better recovery of regenerated axons in SIL/CLX than in SIL group (P less than 0.05). Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers in SIL/CLX were significantly greater than those in control group. In immunohistochemistry, location of reactions to S-100 in SIL/CLX was clearly more positive than that in SIL group.

Conclusion: Response to local treatment of celecoxib demonstrates that it influences and improves functional recovery of peripheral nerve regeneration.
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July 2014

Functional effects of local administration of thyroid hormone combined with chitosan conduit after sciatic nerve transection in rats.

J Oral Maxillofac Surg 2013 Oct 1;71(10):1763-76. Epub 2013 May 1.

Assistant Professor, Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran. Electronic address:

Purpose: To assess the local effect of triiodothyronine (T3) on peripheral nerve regeneration in a rat model of sciatic nerve transection.

Materials And Methods: Forty-five male healthy white Wistar rats were divided randomly into 3 experimental groups (n = 15): sham operation, control (CHIT), and T3 treatment (CHIT/T3). In the sham-operated group, the left sciatic nerve was exposed under anesthesia through a gluteal muscle incision and the muscle was sutured after homeostasis. In the CHIT group, the left sciatic nerve was exposed the same way and transected proximal to the tibioperoneal bifurcation, leaving a 10-mm gap. Each proximal and distal stump was inserted into a chitosan conduit, which was filled with phosphate buffered solution 10 μL. In the CHIT/T3 group, the defect was bridged using a chitosan conduit filled with T3 10 μL. Each group was subdivided into 3 subgroups of 5 animals each and studied 4, 8, and 12 weeks after surgery. Data were analyzed statistically by factorial analysis of variance and the Bonferroni test for pairwise comparisons.

Results: Behavioral testing and sciatic nerve function study confirmed a faster and better recovery of regenerated axons in the CHIT/T3 group than in the CHIT group (P < .05). Gastrocnemius muscle mass was significantly larger in the CHIT/T3 group than in the CHIT group. Morphometric indices of regenerated fibers showed that the number and diameter of the myelinated fibers were significantly larger in the CHIT/T3 group than in the CHIT group. Immunohistochemistry showed that the locations of reaction to S-100 were clearly more positive in the CHIT/T3 group than in the CHIT group.

Conclusions: The response to local treatment showed that thyroid hormone influenced and improved the functional recovery of peripheral nerve regeneration.
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http://dx.doi.org/10.1016/j.joms.2013.03.010DOI Listing
October 2013

Metabolic syndrome and health-related quality of life in Iranian population.

J Res Med Sci 2011 Mar;16(3):254-61

Professor of Medicine, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: To investigate the association between Metabolic syndrome (MetS) and Health related quality of life (QoL) in Iranian population.

Methods: We used data from the post-intervention phase of Isfahan Healthy Heart Program (IHHP), a community trial for cardiovascular disease (CVD) prevention and control. We recruited 9570 healthy adults, aged ≥ 19 years who were randomly selected using multistage random sampling method. World Health Organization QoL questionnaire (WHOQOL-BREF) which contains 26 items was used to assess QoL. It assesses four domains of QoL; Physical health, Psychological health, Social relationship and Environmental issues. MetS was defined based on ATP III criteria.

Results: The mean age of participants was 38.8±15.6 years (mean ± SD) and the prevalence of MetS was 22.5%. From all participant 18.2% were illiterate and 13.2% had university educational level. Two way multivariate analyses of covariance (MANCOVA) test after adjusting age showed significant difference between women with and without Mets in regard to physical health and social relations domains, while none of QoL domains was different in men with Mets in comparison to men without it.

Conclusions: After adjusting the role of socio-demographic factors as components of QoL score, no association was observed between QoL domains and MetS in men, while only social relations and physical health scores were higher in women with Mets compared to those without Mets. Other variety of health-related QoL assessment tools or definitions of MetS may show different relationship in the Iranian socio-cultural context.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214330PMC
March 2011

Stress and Personal Well-being among a Sample of Iranian Disabled Veteran's Wives.

Iran J Psychiatry 2010 ;5(2):66-73

Payam-e- Noor University,Tehran, Iran.

Objective: The aim of this study was to compare overall life satisfaction, subjective well-being, family stress, and stress symptoms of wives of three groups of Iranian disabled veterans.

Method: Participants included 97 wives of three groups of disabled veterans (Group 1with 25-49% disability; Group 2 with 50-69% disability; and Group 3 with larger or equal to 70% disability). The participants were selected randomly by computers of Iranian Martyrs and Veterans Foundations. Personal Well-being Index-Adult, Family Inventory of Life Events and Changes and Stress-related Symptoms Inventory were used to measure overall life satisfaction, family resources of stress and stress symptoms. Data were analyzed by ANOVA and linear multivariate regression analysis.

Results: Results showed that there are no differences in stress symptoms among the 3 groups. However, the wives of group 2 showed less stress and more global life satisfaction and subjective well-being; whereas, wives of group 3 showed more family stress and less global life satisfaction and subjective well-being. However, the wives of group 1 showed less global life satisfaction, subjective well-being and less family stress.

Conclusion: Based on other studies, the results of group 1 is abnormal. This abnormality in results is due to two reasons: first, the participants tried to show poorer quality of life. Second, these women have not received enough facilities and services. Therefore, they lost their natural homeostasis. It seems that the last reason is more real because of equality in stress symptoms between the 3 groups.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430497PMC
September 2012

Personal Well-being and Stress Symptoms in Wives of Iranian Martyrs, Prisoners of wars and Disabled Veterans.

Iran J Psychiatry 2010 ;5(1):28-34

Assistant professor of Payame Noor University, Qom, Iran.

Objective: This study was conducted to compare the personal well-being among the wives of Iranian veterans living in the city of Qom.

Method: A sample of 300 was randomly selected from a database containing the addresses of veteran's families at Iran's Veterans Foundation in Qom (Bonyad-e-Shahid va Omoore Isargaran). The veterans' wives were divided into three groups: wives of martyrs (killed veterans), wives of prisoners of war, and wives of disabled veterans. The Persian translation of Personal Well-being Index and Stress Symptoms Checklist (SSC) were administered for data collection. Four women chose not to respond to Personal Well-being Index. Data were then analyzed using linear multivariate regression (stepwise method), analysis of variance, and by computing the correlation between variables.

Results: Results showed a negative correlation between well-being and stress symptoms. However, each group demonstrated different levels of stress symptoms. Furthermore, multivariate linear regression in the 3 groups showed that overall satisfaction of life and personal well-being (total score and its domains) could be predicted by different symptoms.

Conclusion: Each group experienced different challenges and thus different stress symptoms. Therefore, although they all need help, each group needs to be helped in a different way.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430407PMC
September 2012

Ultrasonography-guided percutaneous nephrolithotomy.

J Endourol 2009 Apr;23(4):603-7

Endourology Division, Department of Urology, Nephrology-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrolithotomy (PCNL).

Patients And Methods: Between August 2003 and December 2007, 47 patients were treated, 29 men and 18 women, with a mean age of 33.4 years (range 21-67 yrs) and a mean stone size of 31.5 mm (range 24-46 mm). All stones were located in the renal pelvis with mild to moderate hydronephrosis seen on intravenous urography. A ureteral stent was inserted cystoscopically, and saline was injected for more localization of the pelvicaliceal system (PCS), if needed. Puncture of the PCS was performed with an 18-gauge nephrostomy needle through the lower pole calyx, and all the stages, including dilatation, were performed under ultrasonography guidance.

Results: Thirty-nine patients were stone free in the kidneys, ureters, and bladder the day after the operation. Five patients had multiple fragments that measured about 4 to 5 mm, which passed in 4 weeks (total stone-free rate: 93.61%); failure occurred in two patients, and fluoroscopy was needed; two patients who had residual fragments that measured 10 and 12 mm underwent shockwave lithotripsy; and in one patient, a fragment that measured 7 to 8 mm migrated into the ureter--it fragmented and was removed with a ureteroscope 2 days after the operation.

Conclusion: PCNL using sonography is a good alternative to the fluoroscopic method. It is performed without radiation exposure to the surgeon and patient; however, more experience is needed.
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http://dx.doi.org/10.1089/end.2007.0213DOI Listing
April 2009