PURPOSE: Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. RESULTS: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. CONCLUSIONS: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.
Anesthesia, General ; Coma ; Hemiplegia ; Humans ; Iran ; Medical Records ; Nephrostomy, Percutaneous ; Neurologic Manifestations ; Paraplegia ; Prone Position ; Retrospective Studies

BACKGROUND: Bone marrow-derived mesenchymal stem cells (BM-MSCs) have potential of differentiation and they secrete anti-inflammatory cytokines and growth factors which make them appropriate for cell therapy. AIM OF THE WORK: Were to evaluate the healing effect of BM-MSCs transplantation on germinal cells of busulfan-induced azoospermic hamsters. MATERIAL AND METHODS: In the present experimental case control study, BM-MSCs were isolated from bone marrow of donor albino hamsters. Five mature male recipient hamsters received two doses of 10 mg/kg of busulfan with 21 days interval to stop endogenous spermatogenesis. After induction of azoospermia, right testis of hamsters was injected with 106 BM-MSCs via efferent duct and the left one remained as azoospermia control testis. Five normal mature hamsters were selected as normal intact control. After 35 days, testes and epididymis of three groups were removed for histological evaluation. RESULTS: Histomorphological analyses of BM-MSCs treated testes and epididymis showed the epithelial tissue of seminiferous tubules had normal morphology and spermatozoa were present in epididymis tubes. Spermatogenesis was observed in most cell-treated seminiferous tubules. The untreated seminiferous tubules were empty. CONCLUSION: Transplanted BM-MSCs could successfully induce spermatogenesis in seminiferous tubules of azoospermic hamster. Therefore, BM-MSCs can be an attractive candidate in cell transplantation of azoospermia.
Animals ; Azoospermia* ; Bone Marrow ; Busulfan ; Case-Control Studies ; Cell Transplantation ; Cell- and Tissue-Based Therapy ; Cricetinae* ; Cytokines ; Epididymis ; Humans ; Intercellular Signaling Peptides and Proteins ; Male ; Mesenchymal Stromal Cells* ; Seminiferous Tubules ; Spermatogenesis* ; Spermatozoa ; Testis ; Tissue Donors ; Transplants

OBJECTIVETo determine the effects of environmental characteristics of larval habitats on distribution and abundance of anopheline mosquitoes in Bashagard county, a malarious area in southeast of Iran.

METHODSLarvae were collected monthly using the standard dipping method and identified using a morphological-based key. Environmental characteristics of the larval habitats were recorded. Water samples were taken from habitats during larval collection for physico-chemical characterization. Statistical analyses were performed.

RESULTSIn total 5 150 anopheline larvae from 36 larval habitats were collected and identified. They comprised of six species: Anopheles culicifacies (29.36%), Anopheles moghulensis (25.20%), Anopheles dthali (18.02%), Anopheles superpictus (17.24%), Anopheles turkhudi (5.17%) and Anopheles stephensi (5.01%). The most common larval habitats were natural and clear water bodies such as riverbeds with sandy substrates and still water. Furthermore, the anopheline larvae were abundant in permanent and full sunlight habitats without vegetation and algae. Larval density was positively correlated with water temperature. Chemical characteristics including conductivity, total alkalinity, sulphate and chloride had significant effects on distribution and abundance of anopheline species.

CONCLUSIONSThe result of this study indicates a correlation between some environmental characteristics and anopheline larvae abundance which can be considered for effective planning and implementing malaria elimination program in Iran.

PROPOSE: In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion. METHODS: All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP. RESULTS: In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the Group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the Group P (p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the Group PP (p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the Group PP. CONCLUSION We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.
COVID-19 ; Contusions/diagnostic imaging* ; Humans ; Lead ; Lung/diagnostic imaging* ; Lung Injury/etiology* ; Retrospective Studies ; SARS-CoV-2 ; Tomography, X-Ray Computed/methods*