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

Introduction:Diagnosis of renal cortical lesions by radioisotopes in nuclear medicine is one of the most common techniques and procedures can be performed by different radiotracer. However, all these materials are accurate in determining kidney function, but there are differences between them in the field. The purpose of this study was to evaluate the effectiveness of EC scans compared with DMSA scan in the detection of cortical lesions and DRF.Methods:65 cases, which have been referred for various reasons, for DMSA scans were enrolled. Patients 1 week after DMSA scan with the previous consent of the EC being scanned. The results were compared in terms of convergence as well as sensitivity, specificity, positive and negative predictive value of EC with respect to the results of DMSA scan.Results:PPV of EC was 100%, negative predictive value of EC was 68.75%, sensitivity of EC was 90.74% and specificity of EC was 100% in the detection of cortical lesions. DMSA scan and EC convergence rates result in cortical lesions in our study was high.Discussion:We suggest EC scan as an alternative to reduce the cost of therapy and radiation, but considering the benefits of DMSA scan, it could remain the gold standard method of diagnosis.

Objective:The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy (ESWL).Materials and Methods:A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi (diameter ≤2 cm) were enrolled from February 2010 to September 2010. ESWL protocol was performed by 2,500 shocks per session. The patients were randomized into two groups: (1) 26 patients who were given 25 mg hydrochlorothiazide twice daily; and (2) 26 patients who received placebo. The stone-free rate was defined as residual calculus size ≤4 mm in controlled ultrasound on 2nd week, 1 month and 3 months after ESWL.Results:19 (78%) of the first group and 9 (42.9%) of the second group were stone-free after one session of ESWL (P = 0.02). 88% of the group 1 and 47.8% of the group 2 were stone-free on 1 month after ESWL (P = 0.003); however, this effect of hydrochlorothiazide was not related to the patients' body mass index, age and gender. The accessory treatment procedures were applied in 24% of the group 1 compared with 19% of the group 2 during 3 months (P = 0.68). All patients in both groups were stone-free on 3 months following lithotripsy.Conclusions:Hydrochlorothiazide did not impact on the stone-free rate and using accessory procedure within 3 months; however, it decreased duration of stone-free status and number of ESWL sessions.

Given the predictive role of serum cystatin C in kidney function, the poor financial status of patients with chronic kidney diseases and the high cost of this test, it should be considered only in high risk patients with high probability of transplantation rejection. Taghizadeh Introduction: Serum cystatin C is not routinely used in the evaluation of renal function and this may be due to its high cost, lack of adequate studies to approve the use of cystatin C and lack of accessibility and reliability. Many kidney transplanted patients encounter with decreased performance before creatinine rising and go toward rejection without certain actions. Certainly, the early detection of renal function reduction can prevent spiritual and physical damage among patients. Objectives: This study was aimed to determine the predictive value of serum cystatin C and creatinine in the assessment of allograft function in the early period after kidney transplantation in Urmia city, Iran. Patients and Methods: In this prospective study, serum creatinine, cystatin C and glomerular filtration rate (GFR) of 49 kidney transplanted patients in the 3rd, 8th and 14th day were measured and compared together. The correlation of creatinine and cystatin C was examined using Spearman's correlation. ROC curves were used to investigate sensitivity and specificity. Results: In this study, there was a statistically significant relationship between serum levels of creatinine and serum levels of cystatin C in 3rd, 8th and 14th day. The sensitivity and specificity of cystatin C in 14th day were 76% and 91.2%, respectively and for creatinine were 72% and 75% respectively, indicating cystatin C is a more sensitive indicator compared to creatinine on the 14th day in the presence of loss of GFR below 60 mL/cc. Conclusion: Serum cystatin C as a valuable marker can be an effective predictor marker of renal function reduction beside creatinine. Due to high cost of measuring kits of serum cystatin C, it is not possible to use this marker in all transplanted patients in the world. Therefore, we can use this marker in high-risk patients with probability of transplantation rejection. Please cite this paper as:

Backgrounds: Kidney transplantation has become a preferred surgical treatment for several renal disorders. To obtain information on acute transplant rejection and its complications, it is important to determine rejection prevalence and its potential causes. Methods: In this retrospective, 37-year study, 2,250 patients underwent conventional kidney transplantation. Patients who experienced graft loss, who underwent nephrectomy of the transplanted kidney during the first month after transplantation, or who died were enrolled the study. All required data were recorded in a designed questionnaire. Results: Of the 2,557 patients who underwent kidney transplantation, 86 (3.36%) experienced acute graft loss during the first month after transplantation; of these, 43 (50%) were men and 43 (50%) were women. The mean age of the patients who experienced acute graft loss was 40.09 ± 14.09 years. The most common underlying causes of acute graft loss were as follows: acute rejection of transplanted kidney%), renal vein thrombosis (17.5%), heart infarction (13.9%), and idiopathy (6.9%). Of these 86 patients, 33 underwent nephrectomy after rejection; however, 53 responded well to medical treatment. In addition, 33 patients (38.4%) underwent acute nephrectomy during the first month after transplantation, which constituted in 33 patients (1.2%) of the total graft losses. Conclusion: In our study, renal vein thrombosis was the most common underlying cause of graft loss in kidney transplantation patients that can be prevented using anticoagulants or other drugs to help prevent such outcomes., and graft rejection occurred most commonly in the first week after transplantation.