Vesicovaginal fistula (VVF) may be caused by prolonged obstructed labor, gynecologic, urologic, or other pelvic surgery, malignancy, radiation, infection and trauma. Here we report a case of VVF caused by nail penetrating trauma in a young woman with genital bleeding after first intercourse. This is a rare etiology of VVF. We also explain the operative technique used to repair the fistula.

· AIM: We describe visual improvement after phacoemulsification with intraocular lens (IOL) implantation in 7 eyes with anterior lenticonus secondary to Alport syndrome.· METHODS: 7 eyes from 4 patients with Alport syndrome underwent phacoemulsification with IOL implantation due to anterior lenticonus.· RESULTS: All of the patients resumed excellent visual acuity after surgery.· CONCLUSION: We recommend the phacoemulsification with IOL implantation as a safe procedure in anterior lenticonus due to Alport syndrome.

Background: Neuro-Behcet’s disease (NBD) is similar to multiple sclerosis (MS) in multiple aspects. This study was conducted to investigate the sensitivity, specificity, accuracy, positive and negative predictive values for the 2005 revised McDonald MRI criteria for the diagnosis of MS and NBD. Methods: This study enrolled 28 consecutive patients with a diagnosis of NBD and 48 patients with a diagnosis of clinically definite MS, who were referred to the Nemazee Hospital, Shiraz University of Medical Sciences, between March 2009 and March 2010. Brain and spinal cord magnetic resonance imaging (MRI) were obtained. Two Radiologists, blinded to clinical diagnosis, reviewed the MRI. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of the 2005 revision of the McDonald criteria for dissemination in space for the diagnosis of MS and NBD. Results: There were a total of 10 men and 38 women with a mean age of 32.76±7.5 years, with a diagnosis of MS, and 18 men and 10 women with a mean age of 26.8±5.9 years with a diagnosis of parenchymal NBD. The interobserver agreement for the diagnosis of MS using the 2005 revision of the McDonald criteria for dissemination in space with the use of the Cohen kappa scores was 0.82. The sensitivity, specificity, accuracy, and positive and negative predictive values were 80%, 61%, 71.5%, 77% and 64%, respectively. Conclusion: The accuracy and specificity of the McDonald criteria for dissemination in space for the differentiation of MS and NBD are not optimal.

PURPOSE: Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer. METHODS: This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013. RESULTS: Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival. CONCLUSION: Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colorectal Neoplasms* ; Disease-Free Survival ; Hospitals, University ; Humans ; Mucins* ; Multivariate Analysis ; Prognosis ; Rectal Neoplasms ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Vesicovaginal fistula (VVF) may be caused by prolonged obstructed labor, gynecologic, urologic, or other pelvic surgery, malignancy, radiation, infection and trauma. Here we report a case of VVF caused by nail penetrating trauma in a young woman with genital bleeding after first intercourse. This is a rare etiology of VVF. We also explain the operative technique used to repair the fistula.
Female ; Humans ; Nails ; Vesicovaginal Fistula ; etiology ; therapy ; Wounds, Penetrating ; etiology ; therapy

BACKGROUND: Healthcare workers' practices regarding hepatitis B have an important effect on the control of this problem in workplaces. METHODS: A questionnaire-based cross-sectional study was used to investigate the role of knowledge, cues to action, and risk perceptions as predictors of preventive behavioral intentions for hepatitis B among healthcare works in Broujen, Iran (n = 150). History of hepatitis B vaccination, hepatitis B surface antigen test, and demographic characteristics were investigated. The psychometric properties of the questionnaire were established. RESULTS: Those who had a history of hepatitis B surface antigen test had a statistically significant higher level of risk perceptions (30.89 +/- 4.08 vs. 28.41 +/- 3.93, p < 0.01) and preventive behavioral intentions (5.05 +/- 1.43 vs. 4.45 +/- 1.29, p < 0.01). The mean score of cues to action was significantly correlated with age and work history (r = 0.20, p = 0.02 and r = 0.19, p = 0.02). Preventive behavioral intentions were significantly correlated with cues to action and risk perceptions but not with knowledge level. Cognitional factors were responsible for a 17% change in observed variance of preventive behavioral intentions, which was statistically significant. CONCLUSION: Risk perceptions were the most important determinant of preventive behavioral intentions for hepatitis B among health personnel; thus, emphasizing risk perceptions is recommended in educational programs aimed at increasing health personnel's practices regarding hepatitis B.
Cross-Sectional Studies ; Cues ; Delivery of Health Care* ; Health Personnel ; Hepatitis B Surface Antigens ; Hepatitis B* ; Humans ; Intention* ; Iran ; Occupational Exposure ; Psychometrics ; Surveys and Questionnaires ; Vaccination

Objective: Uropathogenic Escherichia coli is known to cause urinary tract infections, and the endotoxin (lipopolysaccharide [LPS]) of this bacterium may cause deficiencies of sperm quality and morphology. In the present study, the effects of LPS on mouse sperm were studied, and the levels of interleukin (IL)-17A and possible changes in testis tissue were evaluated. Methods: LPS of uropathogenic E. coli was extracted using the methanol-chloroform method, followed confirmation using sodium dodecyl sulfate-polyacrylamide electrophoresis. Purified LPS (100 µg/kg) or phosphate-buffered saline was injected intraperitoneally into BALB/c mice for 7 days consecutively in the test and control groups, Mice were sacrificed on days 3, 7, and 42 after the first injection. Blood was tested for levels of IL-17A using the enzyme-linked immunosorbent assay method. Testis tissue and sperm were collected from each mouse and were studied according to standard protocols. Results: The mean sperm count and motility significantly decreased (p=0.03) at 3, 7, and 42 days after the injections. The level of IL-17A in the test groups increased, but not significantly (p=0.8, p=0.11, and p=0.15, respectively). Microscopic studies showed no obvious changes in the morphology of the testis tissue; however, significant changes were observed in the cellular parenchyma on day 42. Conclusion LPS can stimulate the immune system to produce pro-inflammatory cytokines, resulting in an immune response in the testis and ultimately leading to deficiency in sperm parameters and testis tissue damage. In addition, the presence of LPS could significantly impair sperm parameters, as shown by the finding of decreased motility.

Objective: Uropathogenic Escherichia coli is known to cause urinary tract infections, and the endotoxin (lipopolysaccharide [LPS]) of this bacterium may cause deficiencies of sperm quality and morphology. In the present study, the effects of LPS on mouse sperm were studied, and the levels of interleukin (IL)-17A and possible changes in testis tissue were evaluated. Methods: LPS of uropathogenic E. coli was extracted using the methanol-chloroform method, followed confirmation using sodium dodecyl sulfate-polyacrylamide electrophoresis. Purified LPS (100 µg/kg) or phosphate-buffered saline was injected intraperitoneally into BALB/c mice for 7 days consecutively in the test and control groups, Mice were sacrificed on days 3, 7, and 42 after the first injection. Blood was tested for levels of IL-17A using the enzyme-linked immunosorbent assay method. Testis tissue and sperm were collected from each mouse and were studied according to standard protocols. Results: The mean sperm count and motility significantly decreased (p=0.03) at 3, 7, and 42 days after the injections. The level of IL-17A in the test groups increased, but not significantly (p=0.8, p=0.11, and p=0.15, respectively). Microscopic studies showed no obvious changes in the morphology of the testis tissue; however, significant changes were observed in the cellular parenchyma on day 42. Conclusion LPS can stimulate the immune system to produce pro-inflammatory cytokines, resulting in an immune response in the testis and ultimately leading to deficiency in sperm parameters and testis tissue damage. In addition, the presence of LPS could significantly impair sperm parameters, as shown by the finding of decreased motility.

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

Ovarian aging is related to the reduction of oocyte quality and ovarian follicles reservation leading to infertility. Vitamin C is a natural antioxidant which may counteract with adverse effects of aging in the ovary. The aim of this study was to evaluate the possible effect of vitamin C on NMRI mice ovarian aging according to the stereological study. In this experimental study, 36 adult female mice (25–30 g) were divided into two groups: control and vitamin C. Vitamin C (150 mg/kg/day) were administered by oral gavage for 33 weeks. Six animals of each group were sacrificed on week 8, 12, and 33, and right ovary samples were extracted for stereology analysis. Our data showed that the total volume of ovary, cortex, medulla and corpus luteum were significantly increased in vitamin C group in comparison to the control groups (P≤0.05). In addition, the total number of primordial, primary, secondary, and antral follicles as well as granulosa cells were improved in vitamin C group in compared to the control groups (P≤0.05). No significant difference was observed in total volume of oocytes in antral follicles between control and vitamin C groups. Our data showed that vitamin C could notably compensate undesirable effects of ovarian aging in a mouse model.
Adult ; Aging ; Animals ; Ascorbic Acid ; Corpus Luteum ; Female ; Granulosa Cells ; Humans ; Infertility ; Mice ; Oocytes ; Ovarian Follicle ; Ovary ; Vitamins