Tehran University Medical Journal

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Some factors such as: aging, obesity, hypoactivity, stress, urbanization, hyperlipidemia, hypertension, multiple pregnancies, smoking and so forth, are important factors that are always argued whether in disease production or in increasing morbidity and mortality in diabetic patients. In a descriptive, cross-sectional and correlational study, we looked for some important risk factors in 780 diabetic patients in Yazd city. The main objective in this study was to identifying the at risk cases. In this study, 54% of understudied patients were obese, 52.3% hypoactive, 80.7% urbanized, 21.5% smokers and approximately 11% were continiously or occasional alcohol users. 85% of all patients had no habit to sport, and the mean of their last fast blood sugar was significantly upper than those who had continiously physical exercises (P=0.01). Majority of understudied women (65.3%) had experienced 6 or more pregnancies during their life, and the last mean blood sugar in these patients was significantly upper than those with <6 pregnancies (P=0.0004). The age of majority of patients in either males or females was 50-70 years, and duration of disease in majority of them was <10 years. Increasing of the last mean blood sugar was significantly compatible with increasing of disease duration (P=0.00003). Regardless the type of diabetes, the disease in every generation was more frequent in female gender and totally, the mean of last fast blood sugar in the patients was 216 mg/dl which is not a controlled sugar. We have suggested the mean of last fast blood sugar in all of the referal cases as a performance indicator during evaluation of center of diabetic patients control

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There are now several tests available that can assess fetal status. A series of 164 cases of high risk pregnancies were studied in order to assess predictive value of a nonstress test. The majority (36%) of patients complained about postdate pregnancy. A nonreactive test was identified in 24 of the patients (14.6%). Fetal distress, low Apgar score in 1 and 10 minutes after birth and mean of Apgar score in 5 minutes, cesarean section due to fetal distress, congenital anomalies, need of neonatal care, IUGR, abnormal presentation and perinatal death were much more common in the group of pregnancies with a nonreactive NST than in the group with reactive test. The difference was statistically significant. A reactive test was found to be a good predictor of the healthy fetus. Negative predictive value and specifity of the test were found 80% and 91.9%, respectively. The nonreactive test could identify a population at risk but it was not helpful as a stand alone modality in decision making, because of the low sensitivity and positive predictive value rates (33.3% and 58%).

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Despite improvement of mechanical ventilation devices for infants, lung injury still causes morbidity and mortality in many cases. To determine the effect of high frequency oscillatory ventilation (HFOV) in infants with severe respiratory failure, 10 neonates were evaluated prospectively. Mean gestational age of these patients was 35 weeks and alveolar-arterial oxygen gradient (A-aDo2) and the ratio of arterial to alveolar oxygen pressure (a/A) immediately before HFO were 610 torr and 0.072 respectively. These neonates were received inspired oxygen concentration of >95% with a mean airway pressure of 12 cm H2O by conventional mechanical ventilation. The A-aDo2 and a/A after 6 and 24 hrs on HFO was not significant in those infants with survived compared with those who died. Comparison of 3 alive neonates with 7 deaths, demonstrate that pulmonary hypoplasia, HMD accompanied with asphyxia, congestive heart failure with pneumonia are associated with poor outcome. The mean a/A ratio during 24hrs of HFO in the alived HMD group was 0.75 compared with 0.25 in those who died. It is possible that we can use this as a prognostic factor in survival. In this study, the positive effect of HFOV was demonstrated in those with no predisposing factors such as pulmonary hypoplasia, congestive heart failure, pneumonia and asphyxia.

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In order to determine the frequency rate of urinary stress incontinence (S.I) after delivery and related factors a longitudinal study carried on primiparous women in Arash Hospital in 1379. Through a non probability sampling, 400 eligible women were recruited from available population. Patient with complain of urinary stress incontinence on third day after delivery, were examined and undergone for required diagnostic tests. After stabilizing the diagnosis of urinary stress incontinence, they were followed on 6th week, 3th month and the first year after delivery. The mean of maternal age was 23.5±4.3 years and the mean of gestational age was 37.9±2.1 weeks. The vaginal delivery and cesarean section rates were 83.7 percent and 16.3 percent respectively. From the cases, 50 women (12.5 percent) had S.I on third day after delivery, which 28 of them had this problem from their pregnancy (grup A), and in 22 patients (5.5 percent), S.I were began after delivery (group B). On first year after delivery, only 6 patients (1.5 percent) had complaint of S.I, totally. All patients with S.I had a vaginal delivery and no cases of S.I had found in cesarean section group (65 women). This difference was significant (P=0.019). Comparison of 3 groups A, B and C (including 285 women without S.I after vaginal delivery) had represented that the mean of maternal age and gestational age were significantly higher in group B than other two groups (P=0.0001 and P=0.0009 respectively).

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Background and Aim: This study was conducted to evaluate the safety and efficacy of Tension-free Tape for the surgical treatment of female stress urinary incontinence.

Materials and Methods: In a prospective open study for pre and post operative, we followed 36 patients at least 1.5 years after surgery (18-28 months) all patients underwent the operation under local anesthesia, allowing the surgeon to check intra-operatively that continence has been obtained.

Results: Mean operation time was 36 minutes (range 20-45 minutes). 32(89%) of the patients was cured according to the protocol, another 3(8.3%) were significantly improved and there was 1(2.7%) failure. Mast of patients (about 91%) were operated on a one day-care basis, which implies that they were released from the hospital the day after the procedure, and no post operative catheterization, defect healing and tape rejection occurred. Pain free recovery time without any analgesic was another benefit. Five patients needed an indwelling catheter for 3 days and two uncomplicated hematoma occurred.

Conclusion: Based on the results, we conclude that Tension-free Vaginal Tape is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence, which allows the majority of the women to be discharged from the clinic the day after the procedure and start their works in the second week.

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Background: The most frequently used test for evaluation of fetal health is the Non Stress Test (NST). Unfortunately it has a high incidence of false positive results. The combination of vibroacoustic stimulation with the NTS has been shown to reduce non reactive results.
Methods: A tests assessment method was chosen with a simple randomized sampling. 40 pregnant women with non reactive NST in the first 20 minutes who received VAS in one of Tehran University's Hospitals were compared with BPP scores. A vibroacoustic stimulation was applied for a 3 seconds on the maternal abdomen and fallowed within 10 minutes.Data collection tools were NST, sonography instruments ,NST result paper, tooth brusher, watch, demographic questioner and check list. Data analysis was made by descriptive static and by using the Fisher's Exact Test (with level of significant at p<0/05). All statistical analysis were performed using an spss/win.
Results: After VAS, 70% of non reactive tracing became reactive. All cases with fetal reactivity response after a VAS had a subsequent BPP score of 8 (negative predictive value of 100%). False positivity of VAS was lower than NST.
Conclusion: VAS offers benefits, by decreasing the incidence of non reactive test and reducing test time. VAS lowers the rate of false positive NST. VAS is safe and allows more efficient of prenatal services. This test could be used as a rapid antepartum test to predict fetal well-being.

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Background: Many studies have shown the efficacy of cognitive – behavioral therapy and psychological debriefing in treatment of post traumatic stress disorder (PTSD) and a few evidences are available for using these techniques in large scale disasters. This study aimed to asses the effect of some psychological interventions in reducing PTSD symptoms after Bam earthquake in different age groups.
Methods: In a before-after quasi experimental clinical trial, we compared the efficacy of one session of psychological debriefing and three sessions of group cognitive-behavioral therapy in bam earthquake PTSD symptoms in different age groups. We evaluated PTSD symptoms before and immediately and three months after interventions by CASP scaling system and analyzed data.
Results: one hundred and thirty persons entered in the study and 51 persons excluded during interventions because of migration. Interventions were showed to be effective only in short term period. The means of PTSD symptoms frequency and severity of avoidance symptoms were reduced during three months period of study which were statistically significant P<0.05. Interventions showed no efficacy for recall symptoms in long term and hyper arousal symptoms in short term and long term periods. There was no statistically significant difference among age groups.
Conclusion: Psychosocial supportive interventions may be effective on some of the PTSD symptoms but there is no difference in different age groups.

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Background: Psychosocial stressors and the quality of the support system are important factors in attempted suicide. This research has studied these stressors and the condition of the support system in suicide attempt cases in Karaj, Iran. Methods: This is a part of the Iranian section of the widest multisite study on suicide prevention (SUPRE-MISS) proposed and directed by the WHO in eight countries, including Iran. Here we present data obtained from 632 suicide attempters presenting in emergency centers over a period of ten months.
Results: According to the time lapse from the stressor to the suicide attempt, proximal stressors are considered to be precipitating while distal stressors are considered to be perpetuating factors. Although, family conflicts were found to increase the risk of suicide one year after the conflict, conflicts with family (25%) and spouse (35%) were the most frequent stressors one month before the attempt, acting as proximal factors. Conflict with spouse was more prominent for people who had been married less than seven years. Conflict with family was the most important stressors for 15-25 year-old attempters. Though it is not clear which areas of conflict are more crucial in a suicide attempt, especially considering gender differences, educational and financial problems were more prominent one year before the suicide attempt. The support system was more crucial for female attempters: Although they received more practical support than males, females complained more of deficiencies in support.
Conclusions: The roles of different psychological stressors in attempted suicide vary according to the time lapse from the stressor until the suicide. Family and marital conflicts can be precipitating and perpetuating factors, while educational and financial problems appear to be perpetuating factors. Family is considered to be an important support system for a great number of attempted suicide cases, especially since it offers practical support. Support systems are crucial in preventive programs for suicide, especially among women.

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Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with several factors that contribute to its manifestation and continuation. One of the factors that initiate RA is emotional stress, which is in direct relationship with the sufficiency or insufficiency of the neuro-endocrine axis. Therefore, any stress that is not resolved in the neuro-endocrine axis might lead to RA and, as the stress continues, it causes the continuation of the disease. The aim of this study is to determine the effect of stress on continuation of RA and to find curative methods and, ultimately, the best method for treatment.

Methods: One hundred rheumatoid arthritic patients (80 females and 20 males), having a final diagnosis of RA based on the guidelines of the American College of Rheumatology and onset of disease within the last 12-36 months, were studied as case and control subjects. Data was collected using interviews and questionnaires that reflected their life events with stress as a serious factor in their disease. The patients were divided into two groups: group A with stable stress and group B with unstable stress. The same treatment method was given to both groups. The results of the treatment were evaluated and compared after two years of follow up. Results: There was significant improvement in the patients in group B with unstable stress over that of the patients in group A with stable stress (P<0.0001). Conclusion: The present study shows that a considerable number of RA patients suffer from serious stress that affects their clinical path and improvement, and is quite visible in the health indexes and continuity of the disease. The results further showed that stress can play an important role in the initiation and continuation of RA. Therefore, by identifying and making efforts to remove the stress factors using anti-anxiety drugs, the disease can be better controlled.

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Background: Ureteral obstruction, leading to urinary stasis and elevated pressure in the proximal part of urinary tract, causes progressive renal dysfunction. This study was designed to evaluate the status of oxidative stress and metabolic defect in acute unilateral ureteral obstruction (UUO).

Methods: Experiments were performed on three groups of male Sprague-Dawley rats (n=10 in each group). In the UUO group, rats were lightly anesthetized by ether and the left ureter was occluded by means of a sterile surgical procedure. Twenty-four hours after UUO-induction, both kidneys were removed and stored at -70 °C. In the sham group, anesthesia and surgery were performed without ureteral occlusion, and the control group received no surgical procedure. The kidney samples were assessed to measure the levels of ATP and ADP by the luciferin-luciferase method for determining metabolic status. In addition, the levels of malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) of the kidneys were measured to evaluate the redox state. Data are expressed as means ±SEM per gram of kidney weight (gKW). The comparisons were performed using paired t-test for intra-group analysis, and ANOVA followed by Duncan's post-hoc test and then LSD test for inter-group analysis. Significance was taken at p<0.05.

Results: The comparisons between the UUO and sham groups indicated that 24 hours of UUO increased levels of MDA (51.42±1.86 vs. 38.64±1.02 nmol/gKW, respectively p<0.001) and ADP (0.67±0.04 vs. 0.47±0.045 µmol/gKW, respectively p<0.01), but decreased levels of FRAP (2.44±0.18 vs. 4.28±0.27 µmol/gKW, respectively), ATP (1.09±0.10 vs. 2.26±0.19 µmol/gKW, respectively) and ATP/ADP ratio (1.64±0.14 vs. 5.11±0.56, respectively) in the obstructed kidneys, all p<0.001. In the non-obstructed kidneys, the levels of ATP and ADP were higher (p<0.01 and p<0.001, respectively), while the levels of MDA and ATP/ADP ratio were equal to those of the sham group.

Conclusion: Twenty-four hours of acute UUO induces oxidative stress and reduces the aerobic metabolism in obstructed kidneys, whereas non-obstructed kidneys with a normal redox state show the higher levels of metabolism.

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Background: The most common methods for screening of patients with probable ischemic heart disease are stress test and in special conditions are perfusion scan, so that their positive results was important indication of coronary angiography. Although, predictive value of perfusion scan has been considered, with regard to the impact of technical and specialized factors and according to the spread of this technique that has wrongly replaced the stress test, it is necessary to compare predictive value of this method with stress test in our country.

Methods: In a cross-sectional study, patients referred to Tehran Heart Center from all centers of country between January 2004 and January 2005 for coronary angiography was included. Demographic characteristics of patients were collected by interview and clinical tests and analyzed in two genders. Then, positive predictive value (PPV) of both techniques was calculated and compared.

Results: The total number of positive perfusion scan and stress test were 2178 and 2581, respectively. It was not significant difference between PPV of perfusion scan and stress test in men (86.9% vs 86.6%, P=0.814). PPV of perfusion scan was higher than stress test only in women more than 60 years old (P=0.0002).

Conclusions: According to the results of this study and with regard to high cost of perfusion scan, it seems that in case the possibility of stress test, the use of perfusion scan had no advantages with the condition of our scan centers and especially in women, predictive value of these techniques were similar. However, it is necessary to consider the causes of this unusual finding according to the role of drugs, instruments, and specialists in the future.

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Background: Musculoskeletal disorders (MSDs) are one of the major problems, encountering work force today. Many researches have revealed the disadvantages and inconveniences that such problems have caused. Some kinds of careers are traditional and complex and are more probable to cause disorders. Carpet restoration is one of these jobs causing musculoskeletal disorders in the work force. The nature of this job puts a lot of pressure on the worker’s body. The postures are most of the time problematic and are in need of some ergonomic actions to be taken in order to prevent from diseases and disorders of musculoskeletal system.
Methods: In a cross- sectional survey, 144 male carpet restoration workers enrolled. NORDIC and PLIBEL checklists were used to assess the musculoskeletal stress factors with injury effects. Another checklist was employed to address demographic characteristics of the population under study.
Results: The results showed that 82% of these workers suffered from some forms of musculoskeletal disorders mostly from knee and lower back discomfort. The more they had job experience, the more they suffered from MSDs. Disorders of neck and upper back had significant relationship with the duration of work experience. Also badly designed tools and awkward posture were of main risk factors. PLIBEL checklist successfully showed the main threatening risk factors of all body parts.
Conclusion: The survey revealed that the incidence of MSDs in these workers is high and there are several risk factors affecting their body during work unsuitable design of tools, incorrect work height and bending position of the body during work were the most risk factors, which observed.

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Background: The risk of atherosclerosis and cancer is high in hemodialysis (HD) patients. There is evidence that HD causes oxidative stress. However, the causative factors of oxidative stress are unknown. It has been suggested that HD imposes an additional oxidative stress on patients with chronic renal failure by activation of granulocytes on dialyzer membranes resulting in an imbalance between oxidants and antioxidants. In this regard, a number of reports, either measuring specific analytes or enzymes, or estimating the total antioxidant activity of the plasma have given contradictory and inconclusive results. To investigate the oxidative stress status in Iranian HD patients, in this study, we evaluated GSH and FRAP levels along with Ca and pH in the blood of these patients.

Methods: Along with 20 healthy age and gender matched control subjects, 24 patients underwent dialysis, three times per week, for four hours in each session. Before and after dialysis, blood was taken for biochemical and liver function tests and to evaluate oxidative stress markers and measure Ca and pH levels.

Results: There was a significant decrease in FRAP and GSH levels after dialysis compared to those before treatment. Dialysis caused an increase in pH and Ca levels compared to levels in control subjects after dialysis.

Conclusion: In general, before dialysis, there is a balance between oxidants and antioxidants however, due to higher levels of oxidants as well as the possible binding of antioxidants to the dialyzer membrane during dialysis, an imbalance occurs. The instability in the balance of oxidants and antioxidants may be the major cause of cellular oxidative damage found in HD patients. This study indicates that there is a significant level of oxidative stress in renal chronic patients and this stress is augmented by dialysis. Antioxidant therapy should be considered in these patients.

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Background: The presence of increased numbers of nucleated red blood cell (NRBC) in the umbilical cord blood has been associated with states of relative hypoxia. Nucleated red blood cell counts are a potentially useful tool in estimating the degree and timing of intrauterine hypoxia. This may have important implication in determining causality in case of compromised infant. Cord blood NRBC counts may be obtained noninvasively from an otherwise discarded specimen and analyzed by personnel on equipment readily available in most hospital laboratories. Since the aim of monitoring of fetal heart is early diagnosis of hypoxia, we studied the relationship between abnormal fetal heart rate with the number of nucleated red blood cells (NRBC) in the umbilical cord blood.

Methods: We performed this research at Hazrat Zeynab Hospital on 130 full-term newborns (65 cases of fetal distress and 65 normal cases) between July 2005 and July 2006. The NRBC counts of newborns with abnormal fetal heart rate were compared with those of normal newborns and correlations with other parameters including Apgar score, hemoglobin level, condition of newborns in the first 24 hours of the birth and birth weight.

Results: The mean NRBC count in the fetal distress group was 9.45 ± 8.75 and that of the normal group was 9.17 ± 8.76 per 100 white cells (p=0.89). The mean duration between diagnosis of fetal distress to birth was equal to 1.2± 0.77 hours. Furthermore, there was no meaningful correlation between number of NRBC and Apgar score, hemoglobin, birth weight and condition of newborns in the first 24 hours.

Conclusion: If the fetus is born a short time after the diagnosis of distress with no risk factors for hypoxia, the NRBC count for cord blood is not elevated.

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Background: The relationship between coping styles and psychological adaptation during the recovery process was investigated in a sample of coronary heart disease (CHD) patients.

Methods: One hundred and fifty patients from Shahid Rajaee Heart Center, Tehran, Iran, were included in this study at intake and forty five patients (27 men, 18 women) participated in the follow-up study. All participants were asked to complete the Tehran Coping Styles Scale (TCSS) and Mental Health Inventory (MHI). The Recovery Process Questionnaire (RPQ) was completed using each patient's medical file and clinical examinations by cardiologists. Styles of coping with stress were categorized as problem-focused, positive emotional-focused and negative emotional-focused. Psychological adaptation included psychological well-being and psychological distress.

Results: Objective recovery status showed no significant correlation with either coping styles or psychological adaptation. Perceived recovery revealed a significant positive association with negative emotional-focused coping (p<0.05), but no significant correlation with other coping and psychological adaptation variables. Perceived recovery revealed a significant negative association with psychological distress (p<0.05), but showed no significant correlation with psychological well-being.

Conclusions: Perceived recovery in CHD patients is positively influenced by negative emotional-focused coping styles. Results and implications are discussed specifically in terms of the possible reasons for the positive relationship between perceived recovery and negative emotional-focused coping.

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Background: Obstructive nephropathy has been associated with disorders in metabolism state and oxidative balance of kidney. Stress oxidative play a key role in the pathophysiological processes of renal diseases. The objective of this study was to investigate effects of vitamin-E, as a powerful antioxidant, on renal oxidative stress and metabolism defect induced by 24-hr unilateral ureteral obstruction (UUO).

Methods: Anesthetized male Sprague-Dawley rats (n=10 in each group) were sterilely operated to occlude the left ureter. In UUO+NS, we had a single dose normal saline injection and in UUO+VitE and UUO+OO groups, D-α-tocopherol (50 mg/kg), the main component of vitamin-E, and its vehicle (Olive Oil), respectively, were twicely infused I.P. before and after UUO-induction. There were also sham-operated and control groups. 24-hr after of UUO-induction, both kidneys were removed and stored in -70°C. To determine metabolism condition, the levels of ATP and ADP and to evaluate redox state, the levels of malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) of kidneys were assessed.

Results: The comparisons between UUO+NS and sham groups indicated that UUO increased MDA (p<0.001) and ADP (p<0.05), but decreased FRAP, and ATP/ADP ratio in obstructed kidney (all p<0.001). In UUO+VitE group, MDA and FRAP were equal to their levels in sham group, while ATP, ADP and ATP/ADP ratio were not different from those of UUO+NS group in obstructed kidney.

Conclusion: Twenty four hour of UUO caused renal reduction in oxidative metabolism and elevations in reactive oxygen species and administration of vitamin-E, although considerably ameliorated the oxidative stress, could not improve the defected metabolism.

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Background: Tumor cells need food and oxygen supply for growth and division. Therefore one of the most promising areas of cancer therapy focuses on using agents that inhibit tumor angiogenesis. Inhibition of angiogenesis prevents cell growth, division and metastasis. Previous studies showed that plasminogen related Protein-B has an anti-tumor activity in mice. This protein has a high level of homology with preactivation Peptide (PAP) of human plasminogen. According to this high homology, antiangiogeneic activity of PAP was investigated in an in vitro angiogenesis model.

Methods: PAP encoding region of human plasminogen gene was isolated by Polymerase Chain Reaction and ‎cloned in pGEX-2T vector. This plasmid was expressed in Escherichia coli as a fusion protein (GST-PAP). ‎GST-PAP was expressed as inclusion body and purified by affinity chromatography on GSH-sepharose ‎resin after refolding. antiangiogenic effects of purified protein were surveyed with Matrigel assay‏.‏‎ ‎

Results: The GST-PAP was expressed and purified and its accuracy was confirmed by SDS-PAGE analysis ‎and immunoblotting. Microscopic studies showed that GST-PAP inhibited angiogenesis in Matrigel system ‎which is shown by shrinking the length of capillary like structures and a decrease in the number of tubule. ‎While applying concentarations of 25μg/ml of GST-PAP and concentrations above that, antiangiogenic ‎activity of GST-PAP was significant comparing to the controls. ‎

Conclusion: Finding shows that GST-PAP can inhibit network formation in Matrigel system. This findings ‎support the theory that PAP is a potent angiogenesis inhibitor.‎

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress incontinence is the most common type of urinary incontinence which has been treated by different surgical techniques. The objectives of our study were to compare the laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic, I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was determined by no urinary leakage during stress and were analyzed urodynamic evaluation was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the result of both groups before and after surgery and showed that the improvement in Urgency was significant in TOT in compare to Burch (p=0.04). I-QOL score significantly increased in both groups after six months of operation (p<0.05). But the differences were not statistically significant.
Conclusion: Based on our results subjective and objective cure rate were not significantly different between TOT and laparoscopic Burch colposuspension.

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Background: Ureteral obstruction has been shown to induce renal oxidative stress, suppressed energy metabolism and defected acid excretion. This study was aimed to examine the improving effects of L-carnitine, a facilitating cofactor for mitochondrial oxidation of fatty-acids as well as a scavenger of free-radicals, and -tocopherol as the most potent antioxidant on these renal disorders at early hours following release of unilateral ureteral obstruction.
Methods: The left ureter was ligated in 60 anaesthetised rats, L-carnitine, -tocopherol, or their vehicles (normal saline and olive oil, respectively) were injected (i.p.) in four groups. Each rat was re-anesthetized and cannulated, and ureteral legation was released at exactly 24h after UUO-induction. A 30-min clearance period performed to separately collect urine from both kidneys. The collected urine and arterial blood samples were given to pH-gas analyzer and autoanalyzer, and malondialdehyde (MDA), ATP and ADP levels were assessed in preserved kidneys. There were also sham and control groups (n=8-10 in each).
Results: In the post-obstructed kidney of vehicle-treated groups with respect to the equivalent kidney of sham group, there were increases in MDA (p<0.001), ADP (p<0.01), urinary pH (p<0.001), absolute (p<0.05) and fractional bicarbonate excretions (p<0.01), but decreases in ATP, ATP/ADP (both p<0.001), and urinary PCO2 (p<0.01). -tocopherol could normalize MDA level but did not affect the altered amounts of energy metabolic indices and acid-base excretions, while L-carnitine improved all of them except of decreased urinary PCO2.
Conclusions: Increased bicarbonate-excretion in post-obstructed kidney is due to defected acid-secretion at collecting duct, which is not related to ureteral obstruction-induced renal oxidative stress and suppressed energy metabolism.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress urinary incontinence is a major confounding factor which impairs health quality in women. Some procedures cannot resolve it&aposs impact on life quality. This study aims to assess a less common and newly method use of transobturator tension- free vaginal tapes (TOT) in regard to short- term and long-term morbidity and impact on patient&aposs quality of life (QOL).

Methods: Fifty four patients diagnosed with urinary stress incontinence, underwent a transobturator tension free vaginal tape procedure with or whitout prolapse surgery. Pre and post operative quality of life assessed with Incontinence- specific Quality of Life questionnaire (I-QOL), and objective and subjective cure rate according to patients signs and symptoms before operation, early and late surgical complications like hemorrhage, Injury and/ or perforation of bladder, intestine, urethra and infection were mentioned.

Results: The overall intraoperative and early post-operative complication rates were 5.5% and 3.7%, respectively. No case of hematoma, bladder or bowel injury was seen.   I-QOL scores were significantly higher after surgery. The mean I-QOL score were 23.6 and 64 before and after surgery respectively (p<0.0001). This improvement was independent of the concomitant pelvic floor repair surgery, menopause, underlying diseases, number of parity, body mass index (BMI) and age. The global rate of objective cure was 94.4% (p<0.0001). The majority of women were satisfied with the outcome. (subjective cure was 90.7%- p<0.001).

Conclusions: This study demonstrates that the TOT approach in the treatment of stress urinary incontinence is a safe and effective procedure which promotes health quality of life.