BackgroundEarly predictive biomarkers for acute kidney injury (AKI) such as neutrophil elatinase-associated lipocalin (NGAL) could identify patients who may benefit from early initiation of treatment.ObjectivesWe aimed to obtain a cut off point for AKI prediction by urine NGAL in kidney transplantation.Patients and MethodsIn a prospective cohort study, 64 adult who underwent kidney transplantation from living or deceased donors at Baqiyatallah transplant center between April 2009 and January 2010 were included. Patients divided into two groups based on the presence or absence of graft dysfunction. In this study, early graft dysfunction (post transplantation AKI) was defined as Cr level more than 1.5 mg/dL on the second postoperative day.ResultsPost-transplant AKI was observed in 31 recipients. Mean urinary NGAL level was greater in recipients with AKI (P = 0.024). In linear regression model, AKI was only factor affected on urinary NGAL level (B = 299.8, P = 0.009). The best sensitivity and specificity for AKI detection by urinary NGAL observed at 2 hour after operation with cut-off point 204 ng/mL.ConclusionsOur study showed in those who developed early post transplantation graft dysfunction the best AUC-ROC for urine NGAL observed at a cut-off value of 204 ng/mL after 2 hour post transplantation.

A 22-year-old female, was referred with a history of a headache and elevated blood pressure without family history of hypertension or familial dyslipidemia. Initially, a spiral computed tomographic angiography of the renal arteries was conducted, demonstrating completely abnormal left renal artery at the medial portion of the vessel with suspicious stenosis, which was supposed to be due to fibromuscular dysplasia (FMD). Subsequently, the patient underwent selective renal angiography and balloon angioplasty. Severe stenosis was observed on the left side and moderate stenosis on the right side in the medial and proximal part of the vessels, respectively. After the diagnosis of FMD, the left side was treated by balloon and finally, the patient was discharged with good control of blood pressure by losartan/amlodipine treatment.

We report the case of a 24-year-old man admitted to the emergency room with a history of headache exacerbated. At the emergency room, he was unresponsive to drug or alcohol consumption. At this time, computed tomography (CT) did not detect the brain and abdomen lesions. At the intensive care unit (ICU), 6h later, he suddenly developed shallow respirations, followed by loss of consciousness, hypotension, and blurred vision. He was intubated immediately and underwent mechanical ventilation. Arterial blood gases and biochemical analyses indicated intense metabolic acidosis (Day1: pH 7.25, PCO2 49 mmHg, PO2 65 mmHg, HCO3 15 mmol/L and day 2, pH 7.32, PCO2 45 mmHg, PO2 60 mmHg, and HCO3=19 mmol/L) and elevated liver enzymes. The clinical diagnosis of toxic alcohol ingestion was based on the history, arterial blood gases results, and significant biochemical changes. In ICU, the patient underwent ethanol infusion and hemodialysis and the impression of methanol intoxication. He underwent redialysis with a minimal dose of heparin (5000 IU/mL). A second CT scan revealed basal ganglia ischemia, and an MRI scan exhibited clear abrasion and basal ganglia necrosis. Finally, he died due to severe methanol intoxication, but the probability of cerebral hemorrhage may be the cause of the patient death associated with heparin ©CIKD Publishing Received

Introduction:  A routine treatment of ureteral stones is using ureteroscopic lithotripsy, a common problem of which is retropulsion of the stone to the renal pelvis and calyces that reduces the rate of lithotripsy’s success. In this study, we aim to investigate the safety and success of using wire basket to hold the stones along with pneumatic lithotripstic probe in endoscopic lithotripsy of ureteral stones. Methods: Patients with ureteral stone were randomly divided to groups A and B. Group A (control) undergone lithotripsy without basket and group B (case) with wire basket along with pneumatic lithotripsy. In addition to demographic and clinical data, rate of success, retropulsion and residual stone with a size of greater than 3 mm were collected, before, during and after lithotripsy. Additionally, the total duration of lithotripsy and ureteral traumatic side effects was also recorded in both groups. All the patients were followed up until their discharge. Data was analyzed using SPPSS ve. 20.  Results: There was no significant difference between groups by the point of demographic data. When compared together, there was no significant difference between the location, side and size of the stone and duration of the lithotripsy in both groups. The rate of lithotripsy success was significantly higher in the case group. The incidence of retropulsion and need for a secondary intervention was significantly higher in the control group.  We didn’t have any ureteral trauma in neither control nor case group. Conclusion: Based on the results of this study, using wire basked as an anti retropulsion device increases the stone free rate in addition to it’s easy applicability, So it can be useful in treatment of ureteral stone.

Background and Objectives: One of the effective methods for preventing infectious diseases, especially in children, is vaccination; if children are not fully, correctly and timely immunized, infectious diseases will threaten their lives. The present study aims to evaluate the effect of an educational intervention based on the health belief model (HBM) on timely vaccination of children in Qom, Iran Methods: This is an interventional study that was conducted on 100 mothers referred to comprehensive health centers in Qom, Iran for the 2-month and 4-month vaccination of their children with a delay of more than 10 days. After dividing them into two groups of intervention and control by the block randomization method (4 blocks), questionnaires were completed by both groups. Then, the intervention group received the online educational materials for two months. Two months later, the questionnaires were completed by both groups again and the time of their visit was checked. Results: The mean score of practice in both groups increased after two months, which was higher in the intervention group and this difference was significant (P<0.001). Conclusion: HBM-based educational programs can be used to increase immunization coverage of children in Qom, Iran.