PCNL in supine position is safe, effective and suitable for the patients. It offers the potential advantages of better urethral access, less patient handling, needing drape only once, ability to perform simultaneous PCNL and ureteroscopic procedures, better control of the airway during procedures, thus reducing over-all operative time compared to traditional prone position and performing PCNL while the surgeon is sitting. It may be considered for most patients requiring PCNL.

One-shot dilation was proved to be safe and effective like metal telescopic dilation even in patients with a history of ipsilateral open renal surgery. In this procedure, X-ray exposure is lower.

PCNL in patients who previously underwent open renal surgery is effective and safe. We found no difference in results between the two groups based on the number of stones and the number of accesses. The step 1 of dilatation was the only difference between the two groups.

Context: Leptospirosis is a worldwide zoonotic infection which appears to be a re-emerging health problem. The clinical features of the disease are broad ranging, but are often similar to those of other infections. As a result, the accuracy of a clinical diagnosis of leptospirosis is low and confirmation requires the use of laboratory tests. Evidence Acquisition: The disease is usually diagnosed in the laboratory by different methods such as direct microscopy, culture, serological methods and molecular methods. The microscopic agglutination test (MAT) is considered the reference test among the several serological methods for leptospirosis diagnosis. However, isolation and identification of the microorganism allows for definitive diagnosis, and provides for epidemiological and prophylactic studies of this disease. Therefore, culture is a golden standard method. Polymerase chain reaction is a rapid, sensitive and specific means of detecting leptospiral infection, in contrast to serology tests. Further benefit is the ability to identify early infection especially during the first few days of the disease even before antibodies are detectable. Conclusions: Choice of test for diagnosis of leptospirosis depends on the stage of the disease. An ideal test will need to discriminate between leptospirosis and a broad spectrum of diseases that cause acute febrile illness and have overlapping clinical presentations. Although detection of antibodies is by itself no proof of a current infection, serological methods (such as MAT and ELISA) are often the most appropriate diagnostic methods.

During last decades, diphtheria has remained as a serious disease that still outbreaks and can occur worldwide. Recently, new vaccine delivery systems have been developed by using the biodegradable and biocompatible polymers such as alginate. Alginate nanoparticles as a carrier with adjuvant and prolong release properties that enhance the immunogenicity of vaccines. In this study diphtheria toxoid loaded nanoparticles were prepared by ionic gelation technique and characterized with respect to size, zeta potential, morphology, encapsulation efficiency, release profile, and immunogenicity. Appropriate parameters (calcium chloride and sodium alginate concentration, homogenization rate and homogenization time) redounded to the formation of suitable nanoparticles with a mean diameter of 70±0.5 nm. The loading studies of the nanoparticles resulted in high loading capacities (>90%) and subsequent release studies showed prolong profile. The stability and antigenicity of toxoid were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and ouchterlony test and proved that the encapsulation process did not affect the antigenic integrity and activity. Guinea pigs immunized with the diphtheria toxoid-loaded alginate nanoparticles showed highest humoral immune response than conventional vaccine. It is concluded that, with regard to the desirable properties of nanoparticles and high immunogenicity, alginate nanoparticles could be considered as a new promising vaccine delivery and adjuvant system.