Background: Osteoporosis is characterized by decreased bone strength and a higher fracture risk. Objectives: This study aimed to compare computed tomography (CT) scans and bone densitometry for diagnosing osteoporosis and osteopenia. Methods: A descriptive-analytical cross-sectional study was conducted on 322 kidney failure patients admitted to Baqiyatallah Hospital in 2021. Descriptive statistics (mean, standard deviation, frequency, minimum, and maximum) and logistic regression analysis were utilized. Data were collected and entered into SPSS software version 24, and descriptive and inferential statistics were applied. A significance level of 5% was established. Results: The data demonstrated a significant linear relationship between CT scan-based bone density of the L1 vertebra and spine bone density measurement (Pearson’s R = 0.58, P ≤ 0.001). Although a significant linear relationship was observed between L1 bone density via CT scan and femur bone density measurement (Pearson’s R = 0.44, P ≤ 0.001), this correlation was weaker than that of spine bone density measurements. Spearman’s rank correlation test revealed a marginally significant linear relationship between L1 bone density using CT scan and forearm bone density measurement (ρ = 0.20, P = 0.05). After categorizing the data into normal, osteopenia, and osteoporosis groups, Spearman’s test indicated a significant linear relationship between L1 bone density and femur bone density (ρ = 0.48, P ≤ 0.001). Similarly, when the data were grouped into these categories, a marginally significant linear relationship was observed between L1 bone density by CT scan and forearm bone density (Spearman’s ρ = 0.20, P = 0.05). Conclusions: The findings highlight a significant relationship between CT scan-based L1 bone density and bone density measurements of the spine, femur, and forearm, with the strongest correlation observed in spine measurements. Therefore, utilizing L1 bone density assessment via CT scans — a non-invasive method often performed for other clinical purposes — can serve as an opportunistic tool for osteoporosis and osteopenia screening. This approach not only reduces costs but also facilitates early detection of osteoporosis.

Background: Bladder cancer ranks second among urological cancers in Ivory Coast. In the sub-region, it also ranks second, but in Mali and the Maghreb, it is the first urological cancer. Its morbidity and mortality are high, with a significant social impact. Objectives: To report the factors promoting mortality of bladder tumors in Ivory Coast. Methods: A retrospective study of 74 cases of bladder cancer files collected in the urology department of the Cocody University Hospital Center over a period of 10 years (2013 to 2022). The mortality rate was calculated, and the factors influencing this mortality rate were studied with correlations using statistical tests (chi-square tests). Results: The mean age of the patients was 57 years, with extremes of 28 to 78 years. There was a male predominance with a sex ratio of 2.9. The main reason for consultation was hematuria, found in 70.8% of cases. The mortality rate was 46%. At cystoscopy, 83.3% of these cancers had a budding appearance. Tumors located on almost the entire bladder led to more deaths, with 32 cases out of 34 deaths. On ultrasound and CT scan, 74.1% of cancers were large (> 6 centimeters). Squamous cell carcinoma remained the dominant histological type, accounting for 71.4%. This histological type led to more deaths (20 cases out of 34 deaths). Patients with bladder cancer who experienced hemorrhagic postoperative complications all died. Conclusions: The mortality rate of bladder cancers is high in the Urology Department of the University Hospital Center (UHC) of Cocody. The poor prognostic factors identified were the budding aspect, large size greater than 6 centimeters, squamous cell type, and hemorrhagic postoperative period.

Background: Children with end-stage kidney disease (ESKD) require therapies such as hemodialysis (HD) and peritoneal dialysis (PD). These treatments can impact a child’s quality of life (QoL); however, research comparing the QoL between children undergoing HD and those undergoing chronic PD in developing countries is limited. Objectives: This study compared the QoL of children with ESKD undergoing PD versus HD. Methods: This study employed an analytic observational method with a cross-sectional design conducted from December 2023 to March 2024. Consecutive sampling was used for participant recruitment and data collection. The Pediatric QoL Inventory (PedsQL™) version 4.0 Questionnaire was utilized, and data were analyzed using the Mann-Whitney non-parametric test, with statistical significance set at P < 0.05. Results: The sample consisted of patients undergoing HD (n = 12, 48%) and PD (n = 13, 52%). Based on child and parent reports, the mean QoL score was significantly higher for PD patients compared to HD patients, although no significant differences were observed in certain aspects. The highest score was recorded in children’s reports regarding social aspects (91.53 ± 22.2). Conclusions: The QoL of pediatric patients on PD was better than that of patients on HD.

Background: Non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease characterized by a high risk of recurrence and progression. Clinicians have various surgical and therapeutic options available for managing NMIBC. Objectives: This evaluated the alignment of treatment practices at all hospitals in Urmia, a south-west province of Iran, with current guidelines for treating NMIBC. Methods: This cross-sectional study included 134 patients with NMIBC. Demographic data, medical history, perioperative intravesical therapy, imaging results, cytology findings, and surgical procedures were collected. Intravesical chemotherapy with mitomycin C, and post-surgical immunotherapy with Bacillus calmette-guérin (BCG) including induction and maintenance regimens and durations, were also recorded. Treatment protocols were compared to established guidelines using IBM SPSS statistics version 21. Results: The mean age of patients was 65 years, with 79.17% being male. Adherence to clinical guidelines was 45.5% for obtaining a separate sample from the tumor base, 40.3% for urinary cytology, 67.9% for performing re-transurethral resection of bladder tumors (TURBT), and 68.4% for performing re-TURBT within the appropriate timeframe. Among the patients indicated for re-TURBT, only 30% underwent the procedure. Mitomycin treatment was not used in 94.4% of low-risk patients. Induction treatment with BCG was compatible with guidelines in 86.6% of patients. Compliance with maintenance treatment was 69.8%, and adherence to the recommended duration was 55.2%. Only 55% of patients with indications received maintenance treatment. Overall treatment compliance with clinical guidelines was good in 19.4%, intermediate in 32.8%, and poor in 47.8%. Conclusions: Overall adherence to clinical guidelines for the management of NMIBC was found to be suboptimal, particularly among low-risk patients.

Background: The correct diagnosis of sexually transmitted infections (STIs) is the first step in the monitoring and management of these diseases. Objectives: This study was conducted to investigate the clinical and laboratory positive predictive value (PPV) of STI symptom management in Iran. Methods: This cross-sectional study was conducted on 5986 individuals (aged 18 to 50 years) from the general population of Marovdasht (Iran) in several stages: (1) self-reported symptoms of sexually transmitted diseases, (2) evaluation by a doctor, and (3) laboratory examination. Results: Among the population sample, 686 (17.68%) individuals reported at least one of the predefined symptoms. The clinical-based PPV of syndromes in men and women were 67.74 (62.34 - 73.14) and 85.36 (82.76 - 87.96), respectively. In men and women, the highest PPV was observed for abnormal discharge from the anus 32.35 (25.35 - 39.35) and abnormal secretions from the cervix 59.39 (56.39 - 62.39), respectively. The laboratory-based PPV for men and women was 0 and 5.04 (3.04 - 7.4), respectively. Conclusions: The clinical and laboratory-based PPV of STI symptoms in the general population is extremely low. Accordingly, a syndromic-based screening or monitoring approach for STIs is not a reliable tool for screening or monitoring in the Iranian general population. We suggest focusing on special (core) groups for monitoring STIs using laboratory-based methods.

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.

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.

Background: End-Stage Renal Disease (ESRD) is a severe nephrological condition that can lead to permanent kidney damage. Therefore, early disease diagnosis is key to preventing casualties. The gold standard method of diagnosis tends to evaluate changes in sodium, potassium, calcium, phosphorus, urea, creatinine, and parathormone hormones in blood after dialysis. However, serum evaluation is not always possible or easy for patients. Therefore, saliva evaluation has been proposed in recent years as an alternative. Objectives: The current article aims to evaluate metabolite in the saliva of ESRD patients. Methods: In this descriptive-analytical study, 29 ESRD patients undergoing hemodialysis treatment were selected. Their saliva and serum samples were taken. The number of biochemical factors, including sodium, potassium, calcium, phosphorus, urea, creatinine, and parathormone hormone, was measured with an autoanalyzer device and related kits. Finally, the correlation of parameters in serum and saliva was examined using the Pearson test. Results: The results showed a significant positive relationship between the levels of sodium, urea, and creatinine in serum and saliva samples (P < 0.05). On the other hand, there was no significant relationship between the serum and saliva levels of potassium, calcium, phosphorus, and PTH (P > 0.05). Conclusions: Due to the significant correlation between some prominent biochemical factors in saliva and serum after hemodialysis in ESRD patients, saliva could be considered a non-invasive diagnostic fluid for monitoring kidney disease in the future.

Introduction: Renal artery stenosis (RAS) is defined by a decrease in the internal diameter of one or both of the renal arteries. This can lead to renal insufficiency. RAS mostly occurs due to atherosclerosis; however, other conditions can cause this complication. Case Presentation: We present a 66-year-old man who was initially presented with abrupt bilateral lower limbs and scrotal edema in Shahid Beheshti Hospital of Qom. The patient had been regularly visiting the nephrology clinic for mild CKD. Due to the increased levels of creatinine (Cr) and urea in serum, he underwent angiography with suspicion of RAS, and 99% stenosis was confirmed in the left renal artery. Immediately after the diagnosis, we subjected the patient to angioplasty. After removing the arterial stenosis, the patient passed 8 liters of urine during one day, and his symptoms, including generalized edema, weight gain, and dyspnea, were improved gradually. The patient was discharged after 8 days of hospitalization with dramatically improved kidney function and relatively good general conditions. Conclusions: This patient had an uncommon presentation for a unilateral RAS and significant narrowing in the healthy renal artery. Angioplasty and stenting yielded a satisfactory result as a definite and effective treatment, and the patient enjoyed a relatively normal life with preserved kidney function during 4 years of follow-up.

Background: Acute kidney injury and proximal tubulopathy, resulting from Deferasirox administration, contribute significantly to acquired kidney failure. The role of antioxidants in preventing acute kidney injury remains inconclusive. Objectives: This study aimed to investigate the efficacy of vitamin E in preventing acute kidney injury and proximal tubulopathy in thalassemia major patients undergoing treatment with Deferasirox (Nanojade). Methods: This study employed a randomized controlled trial conducted at the thalassemia center of Amirkabir Hospital in Arak, Iran. Sixty patients with thalassemia major receiving Nanojade at 20 mg/kg were included. The vitamin E group (n = 30) received a daily dose of 400 IU for a month, while the control group (n = 30) did not receive any vitamin E. The primary outcome measure was Acute Kidney Injury (AKI), defined as a greater than 50% increase in serum creatinine levels after seven days of Deferasirox administration. Additionally, proximal tubulopathy was assessed using serum phosphate (P), Venous Blood Gas (VBG), and urinalysis (U/A) after one month. Also, the Glomerular Filtration Rate (GFR) and blood urea nitrogen to creatinine ratio (BUN/Cr) were compared between the two groups. Results: No AKI or proximal tubulopathy occurrences were observed in either group, thus limiting the investigation into the preventive effect of vitamin E in these conditions. However, several noteworthy findings emerged from our analysis. Regarding GFR and blood urea nitrogen to creatinine ratio (BUN/Cr), there was no significant difference between the vitamin E and control groups after one month (P = 0.985 and P = 0.063, respectively). The increase in serum creatinine levels during the first week was significantly lower in the vitamin E group than in the control group (P = 0.019). However, there was no difference after one month (P = 0.984). Notably, the vitamin E group exhibited a significantly lower decrease in serum bicarbonate (HCO3) and pH after a month (P = 0.013 and P = 0.003, respectively). The two groups had no significant differences regarding serum phosphate reduction (P = 0.391). Conclusions: Administering vitamin E for one week effectively prevents an increase in serum creatinine levels and prevents the decrease of Deferasirox-induced PH and HCO3 in thalassemia patients. However, it does not significantly affect the GFR.