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Objectives: To evaluate the safety and efficacy of transperitoneal laparoscopic pyelolithotomy in renal stone cases with previous renal surgeries.Patients and methods: In this prospective study, 190 consecutive patients with renal stones, who were candidates for transperitoneal laparoscopic pyelolithotomy, were enrolled. The patients were divided into two groups. In group A, 163 patients without a history of renal surgery underwent standard laparoscopic pyelolithotomy, whereas in group B laparoscopic pyelolithotomy was performed in 27 patients with a history of kidney stone surgery including percutaneous nephrolithotomy or open stone surgery. All intraoperative data including the operating time and complications such as bleeding requiring transfusion were recorded. Postoperative data such as length of hospitalization, hemoglobin level alteration, and other complications were also recorded.Results: There was no significant difference in the preoperative data such as stone size, stone site, age, sex, and stone side between the two groups. There was no significant difference in the stone-free rate between the two groups (p = 0.4). There was no significant difference between the two study groups regarding the operating time, hospital stay, stone-free rate, complications, and transfusion rate.Conclusion: Laparoscopic pyelolithotomy can be used as a safe and feasible treatment modality in the setting of previous renal surgery. The complications and stone-free rate of laparoscopic pyelolithotomy in patients with history of renal surgery are acceptable.

Introduction: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone.Methods: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter.Results: The mean age was 108 ± 53 months (range, 14–180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred.Conclusion: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.

AbstractObjectiveHealth diplomacy has increasingly become a crucial element in forging political neutrality and conflict resolution and the World Health Organization has strongly encouraged its use. Global turmoil has heightened, especially in the Middle East, and with it, political, religious, and cultural differences have become major reasons to incite crises.MethodsThe authors cite the example of the human stampede and the deaths of over 2000 pilgrims during the 2015 annual Haj pilgrimage in Mecca.ResultsThe resulting political conflict between Iran and Saudi Arabia had the potential to escalate into a more severe political and military crisis had it not been for the ministers of health from both countries successfully exercising “soft power” options.ConclusionGlobal health security demands critical health diplomacy skills and training for all health providers. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)

We evaluated the relationship between dietary regimen and the incidence of urolithiasis in various regions.