Pub Date : 2024-07-21DOI: 10.5812/numonthly-145972
F. Moeinzadeh, Ali Kabiri, Amirmohammad Bavandipour, A. Atapour, Mina Rezaei, Masoud Mahmoudi
Background: Zinc deficiency is a common finding among ESRD and dialysis patients and may affect their quality of life. Objectives: This study aimed to evaluate the serum level of zinc and its correlation with the quality-of-life score in dialysis patients. Methods: A cross-sectional study was conducted in 2018 on dialysis patients. Patients’ information and clinical data, their serum zinc levels, and quality of life assessed by the SF-36 questionnaire were collected. The Spearman correlation test was used to assess the correlation between serum zinc levels and the Physical (PCS) and Mental (MCS) Component Summary scores of the SF-36 questionnaire in general and in different subgroups. P-values less than 0.05 were considered significant. Results: In the HD group, PCS and MCS scores were significantly correlated (P = 0.0001), while this correlation was not observed in the PD group. Additionally, there was a positive correlation between zinc levels and PCS and MCS scores in the HD group but not in the PD group (P = 0.0001). In the PD group, only age negatively correlated with the PCS score (P = 0.03), without any other significant correlations with other study variables. Multivariate analysis revealed that zinc level was an independent predictor of PCS and MCS scores in the HD group (P < 0.001). In the PD group, age (P = 0.02) and zinc level (P = 0.03) were independent predictors of PCS score but not MCS score. Conclusions: There is a positive correlation between serum zinc levels and both the physical and mental aspects of quality of life in dialysis patients.
{"title":"Does The Serum Zinc Level Affect the Quality of Life in Dialysis Patients? A Report from Iran","authors":"F. Moeinzadeh, Ali Kabiri, Amirmohammad Bavandipour, A. Atapour, Mina Rezaei, Masoud Mahmoudi","doi":"10.5812/numonthly-145972","DOIUrl":"https://doi.org/10.5812/numonthly-145972","url":null,"abstract":"Background: Zinc deficiency is a common finding among ESRD and dialysis patients and may affect their quality of life. Objectives: This study aimed to evaluate the serum level of zinc and its correlation with the quality-of-life score in dialysis patients. Methods: A cross-sectional study was conducted in 2018 on dialysis patients. Patients’ information and clinical data, their serum zinc levels, and quality of life assessed by the SF-36 questionnaire were collected. The Spearman correlation test was used to assess the correlation between serum zinc levels and the Physical (PCS) and Mental (MCS) Component Summary scores of the SF-36 questionnaire in general and in different subgroups. P-values less than 0.05 were considered significant. Results: In the HD group, PCS and MCS scores were significantly correlated (P = 0.0001), while this correlation was not observed in the PD group. Additionally, there was a positive correlation between zinc levels and PCS and MCS scores in the HD group but not in the PD group (P = 0.0001). In the PD group, only age negatively correlated with the PCS score (P = 0.03), without any other significant correlations with other study variables. Multivariate analysis revealed that zinc level was an independent predictor of PCS and MCS scores in the HD group (P < 0.001). In the PD group, age (P = 0.02) and zinc level (P = 0.03) were independent predictors of PCS score but not MCS score. Conclusions: There is a positive correlation between serum zinc levels and both the physical and mental aspects of quality of life in dialysis patients.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"52 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.5812/numonthly-146347
Amir Alinejad Khorram, Zahra Razzaghi, Hossein Rahnama, F. Allameh
Background: Erectile dysfunction (ED) in men is a significant issue that can profoundly impact personal relationships, mood, and overall quality of life. The nocturnal penile tumescence (NPT) test is a valuable tool for distinguishing between psychological and physiological causes of ED. The normal values of the NPT test are a subject of debate across various racial groups. Therefore, there is a need to conduct a study in the Middle East region to establish standard norms for NPT. Objectives: The aim of this study is to investigate the results of the NPT test in sexually healthy Iranian men. Methods: This descriptive study involved the examination of 30 sexually healthy Iranian volunteers using the iranian erection analyzer over a period of two nights. In this study, a NPT episode was defined as radial rigidity exceeding 70%. The frequency and duration of these episodes were documented and subjected to analysis. Results: The average number of tumescence episodes per participant on the first and second nights was observed to be 1.73 ± 0.82 and 1.9 ± 0.66 episodes, respectively. The average duration of each tumescence episode on the first and second nights was found to be 16.04 ± 7.7 and 22.08 ± 6.85 minutes, respectively. A statistically significant difference in tumescence duration was noted between the two nights (P < 0.001), with the second night showing higher values. Furthermore, it was determined that 83.4% of sexually healthy men experienced 1 to 2 episodes of tumescence during the night. Conclusions: The findings of this study indicate that the majority of sexually healthy Iranian men experience 1 to 2 episodes of NPT with rigidity surpassing 70% overnight, with an average duration of 16 to 22 minutes per episode. Additionally, the study suggests that relying on a single-night NPT test may be inadequate for an accurate assessment.
{"title":"Normal Variations in Episodes and Duration of Nocturnal Penile Tumescence Among Iranian Men: A Descriptive Analytical Study","authors":"Amir Alinejad Khorram, Zahra Razzaghi, Hossein Rahnama, F. Allameh","doi":"10.5812/numonthly-146347","DOIUrl":"https://doi.org/10.5812/numonthly-146347","url":null,"abstract":"Background: Erectile dysfunction (ED) in men is a significant issue that can profoundly impact personal relationships, mood, and overall quality of life. The nocturnal penile tumescence (NPT) test is a valuable tool for distinguishing between psychological and physiological causes of ED. The normal values of the NPT test are a subject of debate across various racial groups. Therefore, there is a need to conduct a study in the Middle East region to establish standard norms for NPT. Objectives: The aim of this study is to investigate the results of the NPT test in sexually healthy Iranian men. Methods: This descriptive study involved the examination of 30 sexually healthy Iranian volunteers using the iranian erection analyzer over a period of two nights. In this study, a NPT episode was defined as radial rigidity exceeding 70%. The frequency and duration of these episodes were documented and subjected to analysis. Results: The average number of tumescence episodes per participant on the first and second nights was observed to be 1.73 ± 0.82 and 1.9 ± 0.66 episodes, respectively. The average duration of each tumescence episode on the first and second nights was found to be 16.04 ± 7.7 and 22.08 ± 6.85 minutes, respectively. A statistically significant difference in tumescence duration was noted between the two nights (P < 0.001), with the second night showing higher values. Furthermore, it was determined that 83.4% of sexually healthy men experienced 1 to 2 episodes of tumescence during the night. Conclusions: The findings of this study indicate that the majority of sexually healthy Iranian men experience 1 to 2 episodes of NPT with rigidity surpassing 70% overnight, with an average duration of 16 to 22 minutes per episode. Additionally, the study suggests that relying on a single-night NPT test may be inadequate for an accurate assessment.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"33 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-07DOI: 10.5812/numonthly-147546
Tuan Bui Van, Chung Dang Thanh, Kien Nguyen Trung, Khoa Le Ha, Hanh Vu Le Phuoc, Hai Nguyen Thi Thu, Nam Nguyen Giang, Thang Le Viet
Background: Iron overload in MHD patients is associated with many factors, including inflammation. Objectives: We conducted this study to determine the ratio of iron overload and its relationship with elevated plasma C-reactive protein (CRP) concentration in maintenance hemodialysis (MHD) patients with anemia. Methods: A cross-sectional observational study was conducted on 103 MHD patients with anemia. Plasma iron, ferritin, total iron-binding capacity (TIBC), and CRP concentrations were measured in all patients. Transferrin saturation (TSAT) was calculated based on plasma ferritin and TIBC concentrations. Patients with plasma ferritin > 800 ng/mL and/or TSAT > 50% were determined to have iron overload. Results: The proportion of iron overload was 51.5% (53/103 patients). The median CRP concentration in the iron overload group was 3.15 (1.66 - 6.67) mg/L, higher than that of the non-iron overload group [1.5 (0.78 - 3.24) mg/L], P < 0.001. Plasma CRP was an independent factor associated with iron overload (P = 0.003). It was also a valuable predictor for iron overload in MHD patients with anemia (AUC = 0.703; P < 0.001). Conclusions: Plasma CRP was a good predictor of iron overload in maintenance hemodialysis patients with anemia.
{"title":"Elevated Plasma C-reactive Protein Related to Iron Overload in Maintenance Hemodialysis Patients with Anemia: A Cross-Sectional Observational Study in Vietnam","authors":"Tuan Bui Van, Chung Dang Thanh, Kien Nguyen Trung, Khoa Le Ha, Hanh Vu Le Phuoc, Hai Nguyen Thi Thu, Nam Nguyen Giang, Thang Le Viet","doi":"10.5812/numonthly-147546","DOIUrl":"https://doi.org/10.5812/numonthly-147546","url":null,"abstract":"Background: Iron overload in MHD patients is associated with many factors, including inflammation. Objectives: We conducted this study to determine the ratio of iron overload and its relationship with elevated plasma C-reactive protein (CRP) concentration in maintenance hemodialysis (MHD) patients with anemia. Methods: A cross-sectional observational study was conducted on 103 MHD patients with anemia. Plasma iron, ferritin, total iron-binding capacity (TIBC), and CRP concentrations were measured in all patients. Transferrin saturation (TSAT) was calculated based on plasma ferritin and TIBC concentrations. Patients with plasma ferritin > 800 ng/mL and/or TSAT > 50% were determined to have iron overload. Results: The proportion of iron overload was 51.5% (53/103 patients). The median CRP concentration in the iron overload group was 3.15 (1.66 - 6.67) mg/L, higher than that of the non-iron overload group [1.5 (0.78 - 3.24) mg/L], P < 0.001. Plasma CRP was an independent factor associated with iron overload (P = 0.003). It was also a valuable predictor for iron overload in MHD patients with anemia (AUC = 0.703; P < 0.001). Conclusions: Plasma CRP was a good predictor of iron overload in maintenance hemodialysis patients with anemia.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-07DOI: 10.5812/numonthly-147361
Shirin Shamel, M. Zarkesh
Introduction: One of the most preferred cutdown access sites in neonates is the femoral vein; however, the medical staff should be aware of the associated complications. In this study, we present a case where the displacement of the catheter tip after femoral vein cutdown resulted in a scrotal hematoma. Case Presentation: A neonate with a gestational age of 39 weeks and a birth weight of 3740 grams was born in an academic hospital in Tehran, Iran, in 2022. The newborn gradually showed symptoms of respiratory distress and was immediately transferred to the neonatal intensive care unit (NICU). Within the first minutes of NICU admission, the newborn developed acute respiratory distress, and a chest X-ray revealed congenital pneumonia. The patient was promptly intubated, and endotracheal surfactant was administered. Simultaneously, peripheral vascular access was established. On day 3, the vascular access failed, and multiple attempts at percutaneous venipuncture were unsuccessful. A consultation with an expert pediatric surgeon led to the decision to perform a surgical venous cutdown. A 22-gauge catheter was inserted into the external iliac vein through the right femoral access to initiate intravenous fluid and antibiotics. Within the next four hours, the neonate developed right scrotal edema, discoloration, localized erythema, and clear fluid leakage from the right scrotum. Intravenous infusion was urgently clamped. The pediatric surgeon recommended catheter removal, suspecting displacement of the catheter. A sonography examination revealed a hypoechoic 11 × 10 × 4 mm region, indicating a hematoma at the inferior pole of the right testis. The neonate was placed under serial follow-up to monitor vital signs and local manifestations. The patient was managed with conservative treatment and discharged in good condition on the 10th day of NICU admission. Conclusions: The presented case demonstrated scrotal damage following femoral cutdown catheterization. This unexpected complication was effectively managed by the immediate removal of the catheter, close monitoring, conservative therapy, and serial follow-ups, which prevented the progression of local signs. NICU staff should be aware of the potential for testicular injuries in such cases.
{"title":"The Scrotal Displacement of the Catheter After Femoral Venous Cutdown: A Neonatal Case Report from Iran","authors":"Shirin Shamel, M. Zarkesh","doi":"10.5812/numonthly-147361","DOIUrl":"https://doi.org/10.5812/numonthly-147361","url":null,"abstract":"Introduction: One of the most preferred cutdown access sites in neonates is the femoral vein; however, the medical staff should be aware of the associated complications. In this study, we present a case where the displacement of the catheter tip after femoral vein cutdown resulted in a scrotal hematoma. Case Presentation: A neonate with a gestational age of 39 weeks and a birth weight of 3740 grams was born in an academic hospital in Tehran, Iran, in 2022. The newborn gradually showed symptoms of respiratory distress and was immediately transferred to the neonatal intensive care unit (NICU). Within the first minutes of NICU admission, the newborn developed acute respiratory distress, and a chest X-ray revealed congenital pneumonia. The patient was promptly intubated, and endotracheal surfactant was administered. Simultaneously, peripheral vascular access was established. On day 3, the vascular access failed, and multiple attempts at percutaneous venipuncture were unsuccessful. A consultation with an expert pediatric surgeon led to the decision to perform a surgical venous cutdown. A 22-gauge catheter was inserted into the external iliac vein through the right femoral access to initiate intravenous fluid and antibiotics. Within the next four hours, the neonate developed right scrotal edema, discoloration, localized erythema, and clear fluid leakage from the right scrotum. Intravenous infusion was urgently clamped. The pediatric surgeon recommended catheter removal, suspecting displacement of the catheter. A sonography examination revealed a hypoechoic 11 × 10 × 4 mm region, indicating a hematoma at the inferior pole of the right testis. The neonate was placed under serial follow-up to monitor vital signs and local manifestations. The patient was managed with conservative treatment and discharged in good condition on the 10th day of NICU admission. Conclusions: The presented case demonstrated scrotal damage following femoral cutdown catheterization. This unexpected complication was effectively managed by the immediate removal of the catheter, close monitoring, conservative therapy, and serial follow-ups, which prevented the progression of local signs. NICU staff should be aware of the potential for testicular injuries in such cases.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" 54","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-07DOI: 10.5812/numonthly-146785
Ahmad Sulaiman Lubis, Ahmad Zulfan Hendri, Dhirajaya Dharma Kadar, Pradipta Haydan Aldiosta, Wildan Chanieful Wajiih, Fadhli Rizal Makarim
: Renal stone disease is one of the most common conditions in urology. For renal stones larger than two centimeters, percutaneous nephrolithotomy (PCNL) is the primary treatment choice. Percutaneous nephrolithotomy provides the best stone-free rate compared to other modalities. However, PCNL can be challenging, especially in cases involving thick renal parenchyma, which may lead to internal organ bleeding. Additionally, PCNL requires highly advanced instruments, which may not always be available nationwide. Laparoscopic nephrolithotomy is a widely available surgical option that may offer similar benefits to PCNL. However, laparoscopic nephrolithotomy carries a higher risk of intraoperative bleeding compared to PCNL and open nephrolithotomy. A 45-year-old male presented to the emergency department with colic pain in the right flank persisting for over a year. Nephrolithiasis was diagnosed based on a KUB X-Ray and an abdominal CT scan. Laparoscopic nephrolithotomy with a small incision was performed, utilizing a hypotensive technique by anesthesia to reduce intraoperative bleeding. There were no perioperative complications, and 300 cc of blood loss was recorded intraoperatively. Laparoscopic nephrolithotomy proved to be a safe and effective treatment for renal stones in patients with thick renal parenchyma.
{"title":"Low Intraoperative Bleeding During Laparoscopic Nephrolithotomy: A Case Report","authors":"Ahmad Sulaiman Lubis, Ahmad Zulfan Hendri, Dhirajaya Dharma Kadar, Pradipta Haydan Aldiosta, Wildan Chanieful Wajiih, Fadhli Rizal Makarim","doi":"10.5812/numonthly-146785","DOIUrl":"https://doi.org/10.5812/numonthly-146785","url":null,"abstract":": Renal stone disease is one of the most common conditions in urology. For renal stones larger than two centimeters, percutaneous nephrolithotomy (PCNL) is the primary treatment choice. Percutaneous nephrolithotomy provides the best stone-free rate compared to other modalities. However, PCNL can be challenging, especially in cases involving thick renal parenchyma, which may lead to internal organ bleeding. Additionally, PCNL requires highly advanced instruments, which may not always be available nationwide. Laparoscopic nephrolithotomy is a widely available surgical option that may offer similar benefits to PCNL. However, laparoscopic nephrolithotomy carries a higher risk of intraoperative bleeding compared to PCNL and open nephrolithotomy. A 45-year-old male presented to the emergency department with colic pain in the right flank persisting for over a year. Nephrolithiasis was diagnosed based on a KUB X-Ray and an abdominal CT scan. Laparoscopic nephrolithotomy with a small incision was performed, utilizing a hypotensive technique by anesthesia to reduce intraoperative bleeding. There were no perioperative complications, and 300 cc of blood loss was recorded intraoperatively. Laparoscopic nephrolithotomy proved to be a safe and effective treatment for renal stones in patients with thick renal parenchyma.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.5812/numonthly-141425
Anahita Ansari Djafari, B. Javanmard, AmirHossein Eslami, Esmat Ghanei, Zahra Davoudi, Seyyed Ali Hojjati, Mahboobeh Freidoon
Background: Typically, patients with decreased renal function exhibit elevated levels of certain tumor markers. Prostate-specific antigen (PSA), a glycoprotein antigen produced by the prostate gland's epithelial cells and a member of the tissue kallikrein family, is among them. Objectives: This study aimed to investigate the potential relationship between free and total PSA levels, glomerular filtration rate (GFR), and Body Mass Index (BMI) in patients with chronic kidney disease (CKD). Methods: This cross-sectional investigation included 152 male CKD patients who met the inclusion criteria. Following the initial patient visits and enrollment, levels of free and total PSA, serum creatinine, and serum total protein were measured. Subsequently, GFR was calculated for all patients using Cockcroft's formula. Statistical analysis was performed using SPSS software. Results: The mean age of the participants was 58.5 ± 17.6 years. Furthermore, there were inverse relationships observed between the mean levels of free and total PSA with GFR, BMI, and serum creatinine clearance. Conclusions: The study's findings reveal inverse relationships between free and total PSA levels and GFR and BMI. Therefore, renal dysfunction can significantly influence PSA levels.
{"title":"Is It a Necessity to Revise Normal Level of Prostate-Specific Antigen in Patients with Chronic Kidney Disease?","authors":"Anahita Ansari Djafari, B. Javanmard, AmirHossein Eslami, Esmat Ghanei, Zahra Davoudi, Seyyed Ali Hojjati, Mahboobeh Freidoon","doi":"10.5812/numonthly-141425","DOIUrl":"https://doi.org/10.5812/numonthly-141425","url":null,"abstract":"Background: Typically, patients with decreased renal function exhibit elevated levels of certain tumor markers. Prostate-specific antigen (PSA), a glycoprotein antigen produced by the prostate gland's epithelial cells and a member of the tissue kallikrein family, is among them. Objectives: This study aimed to investigate the potential relationship between free and total PSA levels, glomerular filtration rate (GFR), and Body Mass Index (BMI) in patients with chronic kidney disease (CKD). Methods: This cross-sectional investigation included 152 male CKD patients who met the inclusion criteria. Following the initial patient visits and enrollment, levels of free and total PSA, serum creatinine, and serum total protein were measured. Subsequently, GFR was calculated for all patients using Cockcroft's formula. Statistical analysis was performed using SPSS software. Results: The mean age of the participants was 58.5 ± 17.6 years. Furthermore, there were inverse relationships observed between the mean levels of free and total PSA with GFR, BMI, and serum creatinine clearance. Conclusions: The study's findings reveal inverse relationships between free and total PSA levels and GFR and BMI. Therefore, renal dysfunction can significantly influence PSA levels.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-18DOI: 10.5812/numonthly-145130
Reza Shahrokhi Damavand, Ardalan Akhavan Tavakoli, S. Esmaeili, Shahab Aali, E. Kazemnezhad, Samira Kazemi, Amirhossein Abasi
Background: The reason for elevated serum prostate-specific antigen (PSA) levels in patients undergoing urethral catheterization due to acute urinary retention (AUR) remains a significant and controversial issue. Objectives: To assess the serum PSA level in men with AUR and its changes after catheterization. Methods: This prospective quasi-experimental study (reviewer 1 - comment 7) was conducted on 43 patients who underwent transurethral catheterization following AUR caused by benign prostatic hyperplasia (BPH). Total PSA levels and free/total PSA ratios were measured before catheterization and one and three days after catheter insertion. Additionally, prostate volume and urine output after catheterization (UOAC) were recorded. Results: The mean age, prostate volume, and UOAC of the patients were 69.05 ± 9.45 years, 60.51 ± 26.35 g, and 844.04 ± 341.66 mL, respectively. The mean and median baseline total PSA levels were 12.59 ± 17.71 ng/mL and 6.30 ng/mL, respectively. These values changed to 13.73 ± 19.83 ng/mL (median = 4.80 ng/mL) and 11.57 ± 17.70 ng/mL (median = 4.40 ng/mL) after 1 and 3 days of catheterization, respectively. The changes in total PSA and free/total PSA levels during the study period were not statistically significant (P > 0.05). Moreover, the PSA levels showed no statistically significant difference before, 1 day, and 3 days after catheterization in groups with total PSA ≤ 4 and total PSA > 4 (P = 0.37; 0.22, respectively). Conclusions: Our results suggest an initial elevation in PSA levels in patients with AUR before urethral catheterization. Both PSA and free/total PSA ratios showed no statistically significant differences before and after urethral catheter insertion, and initial PSA levels did not affect their changes post-catheterization (reviewer 1 - comment 1).
{"title":"Is the Serum Prostate-Specific Antigen Level Affected by Urethral Catheterization in Patients with Acute Urinary Retention?","authors":"Reza Shahrokhi Damavand, Ardalan Akhavan Tavakoli, S. Esmaeili, Shahab Aali, E. Kazemnezhad, Samira Kazemi, Amirhossein Abasi","doi":"10.5812/numonthly-145130","DOIUrl":"https://doi.org/10.5812/numonthly-145130","url":null,"abstract":"Background: The reason for elevated serum prostate-specific antigen (PSA) levels in patients undergoing urethral catheterization due to acute urinary retention (AUR) remains a significant and controversial issue. Objectives: To assess the serum PSA level in men with AUR and its changes after catheterization. Methods: This prospective quasi-experimental study (reviewer 1 - comment 7) was conducted on 43 patients who underwent transurethral catheterization following AUR caused by benign prostatic hyperplasia (BPH). Total PSA levels and free/total PSA ratios were measured before catheterization and one and three days after catheter insertion. Additionally, prostate volume and urine output after catheterization (UOAC) were recorded. Results: The mean age, prostate volume, and UOAC of the patients were 69.05 ± 9.45 years, 60.51 ± 26.35 g, and 844.04 ± 341.66 mL, respectively. The mean and median baseline total PSA levels were 12.59 ± 17.71 ng/mL and 6.30 ng/mL, respectively. These values changed to 13.73 ± 19.83 ng/mL (median = 4.80 ng/mL) and 11.57 ± 17.70 ng/mL (median = 4.40 ng/mL) after 1 and 3 days of catheterization, respectively. The changes in total PSA and free/total PSA levels during the study period were not statistically significant (P > 0.05). Moreover, the PSA levels showed no statistically significant difference before, 1 day, and 3 days after catheterization in groups with total PSA ≤ 4 and total PSA > 4 (P = 0.37; 0.22, respectively). Conclusions: Our results suggest an initial elevation in PSA levels in patients with AUR before urethral catheterization. Both PSA and free/total PSA ratios showed no statistically significant differences before and after urethral catheter insertion, and initial PSA levels did not affect their changes post-catheterization (reviewer 1 - comment 1).","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"102 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-18DOI: 10.5812/numonthly-138699
Morteza Haghighi Enayat, H. Azami, Leili Tapak, S. Borzou, M. Gholyaf
Background: Standard hemodialysis sessions pose challenges for patients due to fluctuations in blood pressure. Alternative strategies, such as ultrafiltration profiling, have been proposed as potentially more effective treatments. Objectives: This study aimed to evaluate the effects of ultrafiltration profiling compared to the conventional method on blood pressure regulation among hemodialysis patients. Methods: This study employed a pre-test and post-test design, involving a single group of 30 hemodialysis patients undergoing treatment at Shahid Beheshti Hospital in Hamadan in 2022. The sampling method used was simple random sampling. The intervention consisted of three sessions using the routine method, followed by three sessions utilizing the ultrafiltration profile method, which employed an interval with a negative slope. Demographic and clinical information about the patients was recorded on a checklist. Systolic and diastolic blood pressure measurements were taken before the commencement of hemodialysis, at 1-, 2-, and 3-hour intervals post-treatment initiation, and again 15 minutes after completing hemodialysis. Results: The mean blood pressure changes observed during dialysis stages increased with both methods; however, there was a significant difference between the methods (P < 0.001). Specifically, patients receiving the ultrafiltration profile method experienced significantly lower increases in blood pressure compared to those receiving the routine method. Conclusions: Based on the research results, integrating ultrafiltration profiling into hemodialysis can be regarded as an effective and viable strategy for enhancing blood pressure regulation in patients undergoing hemodialysis treatment. Therefore, it is recommended that this approach be considered in hemodialysis programs as well.
{"title":"Impact of Ultrafiltration Profiling Compared to Conventional Methods on Blood Pressure Regulation Among Hemodialysis Patients","authors":"Morteza Haghighi Enayat, H. Azami, Leili Tapak, S. Borzou, M. Gholyaf","doi":"10.5812/numonthly-138699","DOIUrl":"https://doi.org/10.5812/numonthly-138699","url":null,"abstract":"Background: Standard hemodialysis sessions pose challenges for patients due to fluctuations in blood pressure. Alternative strategies, such as ultrafiltration profiling, have been proposed as potentially more effective treatments. Objectives: This study aimed to evaluate the effects of ultrafiltration profiling compared to the conventional method on blood pressure regulation among hemodialysis patients. Methods: This study employed a pre-test and post-test design, involving a single group of 30 hemodialysis patients undergoing treatment at Shahid Beheshti Hospital in Hamadan in 2022. The sampling method used was simple random sampling. The intervention consisted of three sessions using the routine method, followed by three sessions utilizing the ultrafiltration profile method, which employed an interval with a negative slope. Demographic and clinical information about the patients was recorded on a checklist. Systolic and diastolic blood pressure measurements were taken before the commencement of hemodialysis, at 1-, 2-, and 3-hour intervals post-treatment initiation, and again 15 minutes after completing hemodialysis. Results: The mean blood pressure changes observed during dialysis stages increased with both methods; however, there was a significant difference between the methods (P < 0.001). Specifically, patients receiving the ultrafiltration profile method experienced significantly lower increases in blood pressure compared to those receiving the routine method. Conclusions: Based on the research results, integrating ultrafiltration profiling into hemodialysis can be regarded as an effective and viable strategy for enhancing blood pressure regulation in patients undergoing hemodialysis treatment. Therefore, it is recommended that this approach be considered in hemodialysis programs as well.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"118 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141125213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Coronavirus disease 2019 (COVID-19) manifestations are highly diverse, potentially affecting nearly all organ systems during or after infection. Given the importance of a thorough assessment of COVID-19. Objectives: Our study aimed to investigate any new onset or worsening lower urinary tract symptoms (LUTS) in patients infected with COVID-19. Methods: In this cross-sectional study, 88 COVID-19 patients completed the International Consultation on Incontinence Questionnaire-Overactive Bladder and the Overactive Bladder Symptom Score Questionnaires (OABSS). The patients assessed stress urinary incontinence (SUI) and difficulty voiding. Results: Our study revealed that urinary symptoms were the only initial symptom for 28 (31.8%) of the patients or part of the initial symptoms. Furthermore, new onset of OAB symptoms was noted in 35 (39.8%) patients; worsening of pre-diagnosed OAB symptoms was noted in 4 (4.5%) patients; new onset SUI was reported in 17 (32.7%) women, and voiding dysfunction was reported in one woman and two men. There was no significant difference in demographic characteristics, laboratory tests, and lung involvement between patients with and without LUTS (P > 0.05). However, new onset or worsening LUTS significantly (P < 0.001) affected the quality of life. Conclusions: This study demonstrated that LUTS could be the only symptom or one of the initial symptoms of COVID-19. Therefore, physicians should consider COVID-19 as a differential diagnosis in patients presenting with these symptoms.
{"title":"The Onset or Worsening of Lower Urinary Tract Symptoms in Patients Infected with COVID-19","authors":"Nasim Shokouhi, S. Najafizadeh, Parastoo Daneshpajoo, Pershang Nazemi, Nafiseh Saedi, Elham Feizabad","doi":"10.5812/numonthly-141210","DOIUrl":"https://doi.org/10.5812/numonthly-141210","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) manifestations are highly diverse, potentially affecting nearly all organ systems during or after infection. Given the importance of a thorough assessment of COVID-19. Objectives: Our study aimed to investigate any new onset or worsening lower urinary tract symptoms (LUTS) in patients infected with COVID-19. Methods: In this cross-sectional study, 88 COVID-19 patients completed the International Consultation on Incontinence Questionnaire-Overactive Bladder and the Overactive Bladder Symptom Score Questionnaires (OABSS). The patients assessed stress urinary incontinence (SUI) and difficulty voiding. Results: Our study revealed that urinary symptoms were the only initial symptom for 28 (31.8%) of the patients or part of the initial symptoms. Furthermore, new onset of OAB symptoms was noted in 35 (39.8%) patients; worsening of pre-diagnosed OAB symptoms was noted in 4 (4.5%) patients; new onset SUI was reported in 17 (32.7%) women, and voiding dysfunction was reported in one woman and two men. There was no significant difference in demographic characteristics, laboratory tests, and lung involvement between patients with and without LUTS (P > 0.05). However, new onset or worsening LUTS significantly (P < 0.001) affected the quality of life. Conclusions: This study demonstrated that LUTS could be the only symptom or one of the initial symptoms of COVID-19. Therefore, physicians should consider COVID-19 as a differential diagnosis in patients presenting with these symptoms.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"115 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141125726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-30DOI: 10.5812/numonthly-143378
Tushar A Dighe, Tushar Kalekar, Rajesh Kuber, Debapriya Saha, N. Shinde, Pavan S Wakhare, C. Bale, A. Sajgure
Background: Cerebral small vessel disease (CSVD) is a chronic disorder affecting small vessels within the brain, increasing the risk of stroke in patients with chronic kidney disease (CKD). Diffusion tensor imaging (DTI) is a newer quantitative method for diagnosing CSVD at an early stage of pathogenesis. Objectives: This study compares various DTI parameters in multiple white matter tracts of the brain in CKD patients undergoing maintenance hemodialysis with normal controls in the Indian population using the volume of interest (VOI) method. Additionally, it correlates these DTI parameters with each other at different locations to gain insights into the pathogenesis of CSVD. Methods: After obtaining institutional ethics approval, a cross-sectional study was conducted at a tertiary care hospital over one year (June 2022 to May 2023). The study comprised seventy-five patients in the hemodialysis group and twenty-five controls. All participants underwent MRI brain examinations on a 3 Tesla MRI scanner, and the four DTI parameters - fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) - were reviewed for nine white matter tracts to evaluate statistical differences and correlations. Results: Fractional anisotropy was significantly decreased at anterior locations – corpus callosum genu (P = 0. 357 × 10-7), right anterior corona radiata (P = 0.001), and left anterior corona radiata (P = 0.45 × 10-5). In these locations, FA negatively correlated with RD (R = -0.7904, P < 0.00001), and RD was also significantly increased. Axial diffusivity was significantly increased at posterior locations in the corpus callosum splenium (P = 0.108 × 10-5) and left posterior corona radiata (P = 0.244 × 10-5). However, none of the four DTI parameters showed significant differences between hemodialysis patients and the control group for the subset of patients with normal routine brain MRI features. The intraclass correlation coefficients (ICCs) were high for all four DTI parameters for both patients (0.78 to 0.85) and controls (0.82 to 0.89). Conclusions: This study on CKD patients undergoing maintenance hemodialysis reveals significant differences in some DTI parameters in widespread white matter tracts of the brain using the VOI method, with acceptable to excellent interobserver agreement.
{"title":"A Cross-Sectional Study Was Conducted to Evaluate Diffusion Tensor Imaging Findings of the Brain in End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis Using the Volume of Interest Method","authors":"Tushar A Dighe, Tushar Kalekar, Rajesh Kuber, Debapriya Saha, N. Shinde, Pavan S Wakhare, C. Bale, A. Sajgure","doi":"10.5812/numonthly-143378","DOIUrl":"https://doi.org/10.5812/numonthly-143378","url":null,"abstract":"Background: Cerebral small vessel disease (CSVD) is a chronic disorder affecting small vessels within the brain, increasing the risk of stroke in patients with chronic kidney disease (CKD). Diffusion tensor imaging (DTI) is a newer quantitative method for diagnosing CSVD at an early stage of pathogenesis. Objectives: This study compares various DTI parameters in multiple white matter tracts of the brain in CKD patients undergoing maintenance hemodialysis with normal controls in the Indian population using the volume of interest (VOI) method. Additionally, it correlates these DTI parameters with each other at different locations to gain insights into the pathogenesis of CSVD. Methods: After obtaining institutional ethics approval, a cross-sectional study was conducted at a tertiary care hospital over one year (June 2022 to May 2023). The study comprised seventy-five patients in the hemodialysis group and twenty-five controls. All participants underwent MRI brain examinations on a 3 Tesla MRI scanner, and the four DTI parameters - fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) - were reviewed for nine white matter tracts to evaluate statistical differences and correlations. Results: Fractional anisotropy was significantly decreased at anterior locations – corpus callosum genu (P = 0. 357 × 10-7), right anterior corona radiata (P = 0.001), and left anterior corona radiata (P = 0.45 × 10-5). In these locations, FA negatively correlated with RD (R = -0.7904, P < 0.00001), and RD was also significantly increased. Axial diffusivity was significantly increased at posterior locations in the corpus callosum splenium (P = 0.108 × 10-5) and left posterior corona radiata (P = 0.244 × 10-5). However, none of the four DTI parameters showed significant differences between hemodialysis patients and the control group for the subset of patients with normal routine brain MRI features. The intraclass correlation coefficients (ICCs) were high for all four DTI parameters for both patients (0.78 to 0.85) and controls (0.82 to 0.89). Conclusions: This study on CKD patients undergoing maintenance hemodialysis reveals significant differences in some DTI parameters in widespread white matter tracts of the brain using the VOI method, with acceptable to excellent interobserver agreement.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"37 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140364065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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