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Parameterizations for bottom shear stress are required to predict sediment resuspension from field observations and within numerical models that do not resolve flow within the viscous sublayer. This study assessed three observation‐based bottom shear stress (τb) parameterizations, including (a) the sum of surface wave stress and mean current (quadratic) stress (τb=τw+τc ${\tau }_{b}={{\tau }_{w}+\tau }_{c}$); (b) the log‐law (τb = τL); and (c) the turbulent kinetic energy (τb = τTKE); using 2 years of observations from a large shallow lake. For this system, the parameterization τb = τw + τc was sufficient to qualitatively predict resuspension, since bottom currents and surface wave orbitals were the two major processes found to resuspend bottom sediments. However, the τL and τTKE parameterizations also captured the development of a nepheloid layer within the hypolimnion associated with high‐frequency internal waves. Reynolds‐averaged Navier‐Stokes (RANS) equation models parameterize τb as the summation of modeled current‐induced bottom stress (τc,m) and modeled surface wave‐induced bottom stress (τw,m). The performance of different parameterizations for τw,m and τc,m in RANS models was assessed against the observations. The optimal parameterizations yielded root‐mean‐square errors of 0.031 and 0.025 Pa, respectively, when τw,m, and τc,m were set using a constant canonical drag coefficient. A RANS‐based τL parameterization was developed; however, the grid‐averaged modeled dissipation did not always match local observations, leading to O(10) errors in prediction of bottom stress. Turbulence‐based parameterizations should be further developed for application to flows with mean shear‐free boundary turbulence. Plain Language Summary: Bottom shear stress is the link between hydrodynamic motions and sediment resuspension, further relating to water quality in the lake. However, it is impractical to directly measure the bottom shear stress in the field. We assessed three observation‐based bottom shear stress parameterizations, using 2 years of observations from a large shallow lake, and found that the parameterization consisting of surface wave‐induced stress and bottom current‐induced stress is sufficient to capture major sediment resuspension events. In the numerical models, which averaged the turbulence dissipation, the parameterization based on modeled surface wave‐induced stress and bottom current‐induced stress was also assessed and compared against the values from observation‐based parameterizations. The usage of a constant, observed or literature‐based parameter in the model parameterization is recommended, and it should be calibrated to account for inaccuracies in modeled hydrodynamic variables (i.e., surface waves and bottom currents). Key Points: Three observation‐based bottom shear stress parameterizations were assessed in a large shallow lakeThe parameterizations of bottom shear stress in Reynolds‐averaged Navier‐Stokes equation models was assessed against the observations [ABSTRACT FROM AUTHOR]

In this study Astacus leptodactylus were tested for 8 week with three practical diets containing three crude protein (30, 35 and 40%) and isoenergetic level (370kcal/100 g) in fresh water and brackish water of Caspian Sea. In this test, 6 treatments were used with three replicates in 18 fiberglass tank (110 liter). Each tank had 5 narrow clawed Cray fish (mean (±SD) individual weight=17±2.3g) and totally 90 clawed Cray fish were stocking. Result indicates mean weight of Cray fish in fresh water and brackish water were 14.82 and 12.73, respectively, that were significantly different. The highest survival occurred in interaction between protein (30%) and salinity (0) (95.55%) and lowest survival occurred in protein 40 â salinity (12) that were significantly different. The highest specific growth rate (SGR), weight gain (WG), Protein Efficiency Ratio (PER), Net Protein Utilization (NPU) and lowest Feed Conversion Ratio (FCR), demonstrated that dietary (protein 30% and fresh water) which had no significantly differences. Result of this study showed that the highest protein of body composition were in practical diet containing 30% protein and 0 salinity (freshwater) that were significantly different with other treatment.

Introduction: Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common and challenging condition with no consensus on the best treatment. Also, based on a search in reputable scientific databases, it was found that so far, no study has been conducted to evaluate the response to treatment with concomitant use of tamsulosin, levofloxacin, and celecoxib in chronic pelvic pain syndrome in men., Methods: Ninety six male patients under 40 years of age with chronic pelvic pain syndrome who met the inclusion criteria and exclusion criteria were included in the study. Patients (there was only one group of patients in this study) were treated simultaneously with 3 drugs tamsulosin (0.4 mg), levofloxacin (500 mg), and celecoxib (200 mg) for 1 month and after 1 month of treatment response to treatment (pain relief) according to age factors. Weight, underlying disease, smoking, BMI, prostatitis family history, and education were recorded by the researcher in preprepared data collection forms. The results and information obtained were entered into statistical software and analyzed., Results: About 42.7% of patients experienced pain relief after treatment. Age, smoking, and family history of prostatitis showed significant relationships with pain reduction. Weight gain decreased the chances of pain reduction (OR = 0.303), while increased BMI (OR = 0.476) and smoking (OR = 0.801) also negatively influenced pain relief., Conclusions: The results of this study showed that the concomitant use of tamsulosin, levofloxacin and celecoxib in patients with chronic pelvic pain syndrome had acceptable results in reducing the symptoms of patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The water quality and resources of Lake Ontario's nearshore ecosystem undergo heightened stress, particularly along the northwest shoreline. Hydrodynamic processes linking the distinct nearshore and offshore trophic structures play a crucial role in transporting nutrient-loaded water along and across the shore. Despite the pivotal connection between algae growth and the development of nuisance proportions, the scales over which these processes operate remain poorly understood. This study delves into the exchange dynamics between nearshore and offshore areas of Lake Ontario throughout 2018, employing a validated three-dimensional numerical model. A virtual passive age tracer is utilized to discern horizontal mixing time scales between nearshore regions of the lake (water depth < 30 m) and offshore locations. The dispersal pattern, as revealed by a passive tracer released from eight points around the model lake's perimeter, indicates more extensive diffusion in late summer when lake-wide stratification is established, compared to the mixed period. Coastal upwelling events, leading to intrusions of hypolimnetic waters, significantly contribute to net cross-shore transport, with the most pronounced effects observed in May and June when the offshore thermocline is shallow. In the northern part of the lake, dispersal predominantly occurs alongshore, mirroring the prevailing cyclonic (counterclockwise) coastal circulation during the stratified season. This pattern is a consequence of a 45% increase in upwelling events compared to three decades ago. In the northwestern and southern sectors of the lake, elevated cross-shore mixing is attributed to geomorphology-induced cross-basin currents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Hlevca et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This systematic review investigates the probable effect of proton pump inhibitor (PPI) use on the severity of periodontal disease and peri-implantitis and implant survival. We conducted a literature search in PubMed, Scopus, and Cochrane Central Library up to April 2024. Two review authors independently screened the title and abstracts and then the full texts of retrieved studies. Observational and clinical trial studies that assessed the association between PPI use and periodontal disease severity and peri-implantitis or implant survival were included. Data extraction from the included studies was done by 2 reviewers independently. Of 940 studies initially retrieved from online searching, 7 met the inclusion criteria. Three studies examined periodontitis, whereas 4 focused on peri-implantitis and implant longevity. On the contrary, evidence regarding the impact of PPI use on peri-implantitis and implant survival is conflicting. Therefore, more well-designed randomized controlled trials are warranted to come to a definite conclusion. Because PPIs alter the gut microbiome and affect bone, plus that the pathogenesis and etiology of periodontal disease are affected by bacteria within the periodontal pocket, it is hypothesized that they may affect periodontal pathogenesis.

Introduction: Benign prostatic hyperplasia (BPH) mainly leads to lower urinary tract symptoms (LUTS) in aging men. The present study investigates the role of cholecalciferol, Silymarin, and their combined administration in patients with BPH suffering from LUTS., Methods: This double-blind, randomized, controlled trial enrolled 80 participants (50-80 years) diagnosed with BPH, from March 2019 to March 2020. Based on serum 25-(OH) vitamin D levels we formed subgroups, each receiving specific interventions. Measurements of International Prostate Symptom Score (IPSS), Maximal Urinary Flow Rate (Q-max), Prostate Volume (PV), Post-Void Residual (PVR), and Prostate-Specific Antigen (PSA) were recorded at baseline and following 3 months of follow-up., Results: Participants with serum concentration of 25-(OH) vitamin D below 20 ng/ml simultaneously received cholecalciferol and Silymarin that significantly improved IPSS, irritation, obstruction, PV, and PVR. In those with concentrations ⩾20 ng/ml, a single use of Silymarin significantly reduced IPSS, irritation, obstruction, and PVR. Adjustment of confounding variables revealed independent and significant effects of both cholecalciferol and Silymarin on PVR, IPSS, and obstruction. Cholecalciferol also improved irritation, while Silymarin reduced prostate volume. These findings highlight potential therapeutic benefits for BPH-associated LUTS, encouraging further exploration and clinical consideration., Conclusions: In this investigation, combination therapy with cholecalciferol at 50,000 IU/w for 8 weeks and Silymarin at a dosage of 480 mg for 3 months resulted in a notable improvement in the IPSS score, PV, and PVR, as well as both irritative and obstructive symptoms. However, the total PSA and free PSA amounts did not reach a significant difference., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Early childhood dental caries, or ECC, is a significant global oral health concern associated with various adverse outcomes. This systematic review and meta-analysis aimed to investigate the potential link between maternal smoking during pregnancy and the occurrence of dental caries in children., Method: Through a comprehensive search of PubMed, Scopus, and Google Scholar databases for studies examining the correlation between maternal smoking during pregnancy and childhood caries, we identified 609 relevant articles up to October 2023. Studies were selected, and data extraction was based on the pre-established eligibility criteria and items. Meta-analysis was executed utilizing Comprehensive Meta-analysis (CMA) with a random effects model, ensuring a robust synthesis of the gathered evidence., Result: 7 cohorts and five cross-sectional studies, totaling 12 studies, were included in our analysis. The combined results from the studies revealed a significant association between maternal smoking during pregnancy and an increased risk of dental caries in children (OR = 1.78, 95% CI = 1.55-2.05, I2 = 68.53). Sensitivity analyses confirmed the reliability of our results. However, there were indications of publication bias, as suggested by the funnel plot and Egger's test (P = 0.011) concerning the connection between prenatal smoking and childhood caries., Conclusion: This review underscores the association between maternal smoking during pregnancy and childhood dental caries. Nevertheless, confounding variables influence this link, necessitating more large-scale, longitudinal studies with adjusted factors. Additional randomized control trials are needed to validate these findings due to the observed heterogeneity. Future research should investigate the precise reasons behind this association. It is essential to raise awareness among pregnant women about the risks of smoking through educational programs., (© 2024. The Author(s).)

Introduction: Limited studies investigate bariatric surgery's role in improving UI status among Asians, specifically Middle Eastern Asian women. The aim of this study is to investigate the effect of bariatric surgery on the three most prevalent urine incontinence (UI).We also reviewed the current literature exploring the studies performed in Asian countries., Materials and Methods: A total of 77 women out of 200 who had UI and indications for bariatric surgery completed demographic information and the questionnaire (QUID) prior to surgery and 6 months after the surgery. For statistical analysis, the Mann-Whitney U test, Wilcoxon test, and Friedman test were utilized. We also performed a literature review with the aim of investigating studies performed in Asian countries., Results: Among the initial analysis of 200 participants, 50.5% reported UI symptoms before surgery. The average weight loss was 29 kg, with a standard deviation of 7 kg. The mean BMI dropped 11.2 kg/m 2 , and the standard deviation was 2.5 after weight loss. Post-surgery, significant reductions in UI scores were observed across all severity levels, with a notable 44% achieving complete symptom resolution, indicating a substantial decrease in urinary incontinence. Stress, urine incontinence, and mixed urine incontinence symptoms had improved in 75%, 71%, and 30% of women, respectively. Notably, age and gynecological history were identified as critical factors influencing the extent of UI improvement., Conclusion: This study reveals significant improvements in urinary incontinence scores, with age and gynecological history playing pivotal roles in UI improvement., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study aimed to evaluate the outcomes of laparoscopic pyelolithotomy, including its efficacy and feasibility in treatment of large renal stones. All patients who underwent laparoscopic pyelolithotomy operations in a referral center were enrolled from 2003 to 2020. The final analysis included 436 patients. The total stone free rate was 88.3% and the stone-free rate for staghorn/multiple stones versus other types of stones was 81% vs. 91% (P = 0.002). Likewise, the total operation duration was 158 ± 50 and the operation duration for staghorn/multiple stones versus other types of stones was 171 ± 51 min vs. 153 ± 49 min (P < 0.001). The operation duration (169 ± 51 vs. 155 ± 58 vs. 155 ± 42 min) and hospitalization (4.5 ± 2.3 vs. 4.0 ± 2.2 vs. 3.6 ± 1.8) decreased with increasing the surgeons' experience over time. The outcomes of laparoscopic pyelolithotomy for children versus adults versus geriatric patients and in patients with normal versus abnormal kidney anatomy did not reveal statistically significant differences. Laparoscopic pyelolithotomy could be employed as an alternative surgical approach for patients with large kidney stones of any age or with kidney abnormalities provided that appropriate expertise is available to carry out the procedure., (© 2024. The Author(s).)

The Sweepstakes, in Fathom Five National Marine Park, is Ontario's most iconic shipwreck with over 100,000 visitors each summer. Continued exposure to water currents has directly and indirectly affected the integrity of the wreck and resulted in management interventions including efforts to stabilize the wreck and control vessel activity (both duration and speed). Despite these efforts, a scour ring is present in the sediment around the Sweepstakes, raising concerns regarding the prolonged stability of the wreck. An extensive series of field measurements were made during the summer of 2015 with the aim of differentiating between natural hydrological processes present at this site and human-derived water movements during the summer visitor season. There is a high-degree of natural current variability from processes as diverse as wind-induced surface gravity waves, internal gravity waves, and diurnal flows due to differential heating. Our results show that summer circulation driven by internal gravity waves derived from upwelling, surface waves, and differential heating was insignificant with respect to sediment resuspension and thus unlikely to produce the observed scour around the shipwreck. Scour is most likely caused by energetic winter storms, which should be a focus of future studies. While vessel induced currents were detectable at the shipwreck, they were no larger than the normal summer hydrodynamic variability, thus suggesting that management efforts continue to protect the site generally., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Flood et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Invasive dreissenid mussels have reengineered many freshwater ecosystems in North America and Europe. However, few studies have directly linked their filter feeding activity with ecological effects except in laboratory tests or small-scale field enclosures. We investigated in situ grazing on lake seston by dreissenid mussels (mainly quagga mussel Dreissena rostriformis bugensis) using a 'control volume' approach in the nearshore of eastern Lake Erie in 2016. Flow conditions were measured using an acoustic Doppler current profiler, surrounded by three vertical sampling stations that were arranged in a triangular configuration to collect time-integrated water samples from five different depths. Seston variables, including chlorophyll a, phaeopigment, particulate organic carbon and nitrogen, and particulate phosphorus, along with stoichiometric ratios and water flow over mussel colonies, were considered when estimating grazing rates. We observed suboptimal flow velocity for mussel grazing, i.e., 0.028 m s -1 at 0.1 m above bottom (mab), and resuspension was deemed minimal. Water temperature (mean: 25.1 °C) and an unstratified water column were optimal for grazing. Concentration of seston was low (mean: 0.2 mg L -1 particulate organic carbon) and decreased from surface to lakebed where noticeable depletion was observed. Grazing rates calculated at discrete depths varied substantially among trials, with maximum rates occurring at 0.25 or 0.5 mab. Positive grazing rates were restricted to 0.5 mab and below, defining an effective grazing zone (0.1-0.5 mab) in which the flow velocity, seston concentration, and water depth were consistently and positively correlated with grazing rates of different lake seston variables. Horizontal changes in stoichiometric ratios of seston were strongly associated with grazing rates, revealing higher uptake of particulate phosphorus than nitrogen and carbon. Our study supports the nearshore phosphorus shunt hypothesis, which posits that dreissenid mussels retain phosphorus on the lake bottom and contribute to a wide range of ecological effects on freshwater ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Abstract: Suicide is a public health threat that leads to morbidity and mortality worldwide. In this study, we evaluated postmortem toxicological finding among forensic autopsies on suicidal deaths from 2010 to 2016 at the Legal Medicine Center of Zanjan Province (northwest of Iran). All suicide fatal cases were investigated to define the cause and manner of death. Toxicological analyses were performed using thin-layer chromatography, high-performance liquid chromatography, gas chromatography/mass spectrometry, headspace gas chromatography, and gas chromatography equipped with nitrogen phosphorus detector. Demographic data (age, sex, educational level, residential location, and marital status), cause of death, and postmortem toxicological findings were extracted from forensic reports and were entered into the designed questioners. During this period, a total of 181 cases of suicide deaths were investigated. Among them, 74% were male. The most often used suicide method was hanging, followed by self-poisoning in young people. Aluminum phosphide was the most frequent poison detected in the fatal suicidal cases (33 cases), followed by opioids. Hanging and self-poisoning were the frequent suicidal method in young male population. It seems that psychological and social supports in young people along with restriction to easy access to drugs and poisons should be considered by policy making and healthcare authorities., Competing Interests: The authors report no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

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.

Background: Cervical cancer is one of the major health problems and the third prevalent cancer in women all around the world. As a simple, inexpensive, and with no side-effects, Pap test is a reliable way to screen cervical cancer. This study aimed to investigate, the effects of educational intervention based on the Health Belief Model (HBM) on doing Pap smear tests among the rural women of the north of Iran., Methods: In a quasi-experimental study, 160 rural women were randomly divided into control and experimental groups to experience a three-session intervention. The experimental group received the usual educational programs of rural health center and educational programs based on the HBM constructs through personal consultation, asking/answering questions, and an educational pamphlet. The control group, received the usual educational programs of rural health center. The post-test data were collected 2 months after the intervention and analyzed in SPSS-18., Results: Before the intervention, there was no significant difference between the control and experimental groups regarding the mean score of knowledge, performance and constructs of the HBM. After the intervention, however, there was a significant difference in the mean scores of knowledge performance and all constructs of the HBM in two groups (p < 0.001). Rate of doing the Pap smear test in the experimental group increased from 18.7 to 78.7% in the intervention group., Conclusion: These findings support the effectiveness of cervical cancer prevention programs based on the HBM. Therefore, conducting similar programs in other regions is recommended.

Purpose: We investigated validation and optimization of ultrasound-assisted dispersive liquidliquid microextraction (UADLLME) as a preparation method for detection of methadone in saliva samples. Methods: We used blank and methadone-containing saliva samples and also standard methadone solution. Sodium hydroxide and chloroform were added to samples and they were held in ultrasonic bath. Then preparations were centrifuged and extracted analyte was analyzed by gas chromatography-mass spectrometry (GC-MS). Accuracy was measured by Intra and between-day mean relative errors (RE). Precision was assessed by coefficient of variation (CV). Recovery, specificity, linearity and limits of detection and quantification were also determined. Optimization was conducted for ultrasound duration, pH and extraction phase volume. Efficiency of dispersive liquid-liquid microextraction (DLLME) and UADLLME were compared. Results: Intra and between-day accuracies (2.3 -7.5%), recovery (89.4-115.5%) and precision (5.2-11.3%) were all acceptable. Calibration curve was linear in the concentration range of 150 ng/mL-10 µL/mL with R 2 >0.9995 and equation of y=86.901x-5342.5. Limits of detection and quantification were 50 and 150 ng/mL, respectively. Specificity was measured by comparing retention times of saliva samples (containing methadone metabolites and other commonly used drugs) during UADLLME/GC-MS analysis and no interference was observed. Recovery of UADLLME was 1.4 of DLLME. Solvent and sample volumes required for UADLLME were 1/200 and 1/20 of DLLME. The greatest efficiency obtained at pH of 10, with ultrasound treatment duration of 5 minutes and extraction phase volume of 1000 µL. Conclusion: Study found that UADLLME/GC-MS is a valid and efficient method for detection of methadone in oral fluid., (© 2020 The Authors.)

Purpose: The role of laparoscopic pyelolithotomy (LPL) in the management of renal stones is evolving. One of the challenges in LPL for renal stones is patients with intrarenal pelvis. Here we present our experience with laparoscopic pyelolithotomy for the management of renal stones with intrarenal pelvis anatomy., Materials and Methods: Patients candidate for laparoscopic pyelolithotomy from February 2014 to March 2015 were included. Intrarenal pelvis was defined as > 50% of the renal pelvis area contained inside renal parenchyma. Laparoscopic pyelolithotomy was done by transperitoneal approach. Residual stones were checked by computed tomography and/or intravenous pyelography and ultrasonography 6 weeks after the operation., Results: 28 patients were included in this study. The mean±SD of patients' age was 45.8±12.5 years. 19 patients (68%) were male. Stone locations were pelvis, multiple, and staghorn in 22, 3, and 3 patients respectively. The mean±SD of operation duration was 160±48 minutes. Residual stones were observed in 3 patients with multiple (n=2) or staghorn (n=1) stones. Urinary leak was observed in 3 patients and was managed conservatively in 2 patients. In one patient ureteral stent was inserted by cystoscopy. No conversion to open surgery or re-operation occurred., Conclusion: Laparoscopic pyelolithotomy is a feasible operation for patients with renal stones and intrarenal pelvis in centers with adequate experience in laparoscopy. However, the success of LPL decreases in patients with multiple stones and intrarenal pelvis.

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.

Escitalopram oxalate (EO) is considered as one of the extensively prescribed antidepressant drug in Turkey and some other countries, therefore this research was aimed to study the interaction of the drug with DNA and study of the substance effect on bacterial growth. The absorption value of the drug solution at 238 nm was increased when DNA was added gradually to it and it showed hyperchromism effect. The value obtained for DNA binding constant (Kb) was 0.035  M -1 . When we added the CuCl2 2H2O to the mixture, any breakage was not shown in double strand DNA in comparison with control DNA. In addition low concentration of EO couldn't protect DNA (0.5273 µmole bp) against Hydroxyl free radical (0.12 µmole) although it could protect the DNA when it was at the same or higher concentrations (0.5273, 5.273 and 252.73 µmole) than the DNA concentration. In addition, MIC of the drug for E.coli and Bacillus subtilis was almost 0.185 mM and 0.55 mM respectively. The E.coli strain was killed at concentrations 45, 15, 5 mM while the Bacillus subtilis was stable against all of the concentrations., Competing Interests: The authors don’t have any conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Previous radiological studies revealed that stones lodge more frequently in the ureterovesical junction (UVJ) as well as the proximal ureter. Factors that prevent stone passage from the proximal ureter are not well studied., Aim: To explore the site of the lodged stones in the proximal ureter with direct observation during laparoscopic ureterolithotomy., Materials and Methods: Between November 2014 and February 2015, we included 26 patients including 18 men and 8 women with stones larger than 10 millimeters in the proximal ureter who were candidate for laparoscopic ureterolithotomy. We prospectively recorded the site of the lodged stones in the ureter during laparoscopic ureterolithotomy in relation with the sites of ureteral stenosis as well as the gonadal vessels., Results: Among 26 patients with ureteral stone, in 19 cases stone was found close to the gonadal vein compared with seven cases that stone was in other locations of the ureter (p = 0.02). The characteristics of patients and stones were not different in cases that the stone was close to gonadal vessels compared with other locations., Conclusions: This study showed that most of the stones lodged in the proximal ureter were in close proximity with gonadal vessels. Gonadal vessels may be an extrinsic cause of ureteral narrowing.

Purpose: To evaluate the intraoperative pain score of patients who undergo percutaneous nephrolithotomy under spinal anesthesia and to evaluate surgeons' and patients' convenience with this type of anesthesia., Materials and Methods: PCNL cases who were performed by two endourology fellows under spinal anesthesia during June to July 2014 were included. Spinal anesthesia was performed using injection of 0.25mg/kg bupivacaine 0.5% in the intrathecal space. All procedures were performed with the patient in the prone position. Stone access was made by using ?uoroscopic guidance, and the tract was dilated using a single-stage technique. Visual analogue pain score was used to assess patients' pain during operation, immediately after, and 2 hours later., Results: 50 patients were enrolled during the study period. Visual analogue pain score of 10 and 8 were observed in 5 and three patients respectively. In two patients the operation was terminated because of patient anxiety and pain. In another patient a second access was not obtained to remove a staghorn stone because of patient's agitation. Gross agitation was observed in six patients. Apart from flank pain, intraoperative pain was felt in the flank, scapula, abdomen and/or chest., Conclusion: Spinal anesthesia does not provide enough analgesia for the patient in a limited frequency of percutaneous nephrolithotomy operations. We could not find statistically significant predictors of insufficient analgesiabased on patients' demographics, stone characteristics or access location.

Purpose: To present our experience with synchronous or metachronous laparoscopic pyelolithotomy and ureterolithotomy for patients with bilateral urolithiasis., Materials and Methods: The data of all patients who underwent laparoscopic pyelolithotomy (± ureterolithotomy) for bilateral renal and/or ureteral stones from November 2009 to July 2014 were included. Laparoscopic operations were performed through a transperitoneal approach., Results: 10 patients underwent laparoscopic operations for renal stones (19 kidney stones) and ureteral stones (1 ureteral stone). 4 patients underwent synchronous operations and 6 patients underwent metachronous operations. The mean ± SD of operation duration were 212 ± 51 minutes for synchronous operations and 166 ± 41 minutes for metachronous operations. Residual stone was observed 5 patients. No patient developed urinary leakage., Conclusion: Laparoscopic pyelolithotomy and/or ureterolithotomy for bilateral stones is a feasible option in centers with experience in laparoscopy.

Background: Using percutaneous nephrolitotomy (PCNL) with large adult instruments in treatment of pediatricurolithiasis is still in debate. This study was conducted to evaluate the efficacy and safety of PCNL with adult's instrument in treatment of patients less than 3 years old., Methods: Data on patient characteristics and outcomes for 261 consecutive children undergoing PCNL at a Labbafinejad University Hospital were collected prospectively from September 2006 to February 2016. Thirty-two children, with 34 renal units, who were treated with PCNL were enrolled in the study. All PCNL procedures were performed via subcostal approach with one access tract in all of them. Postoperative complications were evaluated according to the modified Clavien grading system., Results: The mean age of patients was 19.4 ± 6.2 months. Two patients had bilateral stones; thus, PCNL was performed on 34 kidney units. The mean size of the largest stone diameter was 17.5 ± 7.8 mm. The mean duration of procedures was 121.52 ± 29.05 minutes, ranging from 60 to 180 minutes. The most common complication was fever (n = 9, 26.4%), and hemorrhage that needs transfusion was the second one (n = 4, 11.7%). Seventeen patients with complications were in the first degree of Clavien complication system and five of them were in the second degree., Conclusions: Due to our experience, utilizing PCNL with adult-sized instruments in management of urolithiasis in less than 3 years old children appeared to be effective and relatively safe.

Objectives: To evaluate the success of ultrasonography directed renal access in entering the target calyx from proper entry site and in the direction of renal pelvis during percutaneous nephrolithotomy (PCNL)., Materials and Methods: PCNL cases who were operated on by one fellow from May-June 2014 were included in this study. A vertically placed ultrasound probe on the patient flank in prone position was used to identify the preselected target calyx. Needle was advanced through needle holder and fluoroscopy was used to document the entered calyx, site and angle of entry., Results: Successful entering to the target calyx was achieved in 43 cases (91%). Successful entry with appropriate entry site and angle was observed in 34 cases (72%). Reasons for failure were minimal hydronephrosis, upper pole access and high lying kidneys., Conclusions: Although it is feasible to access a preselected calyx by ultrasonography guidance during PCNL, but entry to the calyx from the appropriate site and direction is another problem and needs more experience. In cases of minimal hydronephrosis, superior pole access or high lying kidneys, ultrasonography is less successful and should be used with care., Competing Interests: Conflicts of Interest: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Aim. Sonography has been brought in percutaneous nephrolithotripsy (PCNL) as an adjunct to or substitute for X-ray to restrict radiation exposure. This study was designed to investigate the possible predictors for the success of the solo sonographically guided PCNL. Methods. 148 consecutive cases were prospectively enrolled. All steps of PCNL were performed solely with sonography guidance under spinal anesthesia. Residual stones were evaluated the day after surgery using sonography and plain radiography. Results. The mean age was 46 ± 15 years; 40% of kidneys had hydronephrosis. The mean stone burden was 504 ± 350 mm(2). The mean duration of surgery was 43 ± 21 minutes. The early stone-free rate was 92% in inferior or middle calyceal stones, 89.5% in single pelvic stones, 81.5% in partial staghorn stones, and 61.9% in staghorn stones. The mean residual stone size was 13 ± 8 mm. Logistic regression showed that a lower age and a larger stone burden significantly predicted positive residual stones. Fifteen percent of patients presented with grade I or II and six percent showed grade III complication based on Clavien classification. There was no cases of organ injury or death. Conclusion. Solo ultrasonographically guided PCNL under spinal anesthesia is feasible with an acceptable stone-free rate and complication rate.

Background: Premature ejaculation is one of the prevalent disorders in men; almost one out of three men between 18 and 59 years old have this disorder with its leading sequel such as lack of self-confidence, anxiety, depression and unsatisfactory intercourse in men and their partners. This study aimed to compare the length of penile mucosa in men with and without premature ejaculation., Method: Three hundred and eighty patients referring to our hospital from March 2009 to March 2010 were enrolled in the study. First group comprised 190 men with premature ejaculation and second group included 190 men without premature ejaculation as control group that were chosen randomly. A questionnaire was designed to collect data and was completed for both groups. Height, weight, body mass index (BMI), length of penile mucosa, length of penis and intravaginal ejaculation latency time (IELT) were measured., Results: The mean IELT in premature ejaculation group and control group were 47.58 ± 29.55 and 410.38 ± 190.2 s, respectively (p = 0.001). The mean penis length in premature ejaculation group and control group were 127.25 ± 16.23 and 127.03 ± 17.42 mm, respectively (p = 0.901, with nonsignificant difference); the mean penile mucosa in premature ejaculation group was 33.83 ± 11.54 mm and in control group was 31.40 ± 11.97 mm (p = 0.014, with significant difference)., Conclusion: Longer penile mucosa can be one of the factors in causing premature ejaculation.

The geometry, electronic structure, and catalytic properties of nitrogen- and phosphorus-doped graphene (N-/P-graphene) are investigated by density functional theory calculations. The reaction between adsorbed O2 and CO molecules on N- and P-graphene is comparably studied via Langmuir-Hinshelwood (LH) and Eley-Rideal (ER) mechanisms. The results indicate that a two-step process can occur, namely, CO+O2 →CO2 +Oads and CO+Oads →CO2 . The calculated energy barriers of the first step are 15.8 and 12.4 kcal mol(-1) for N- and P-graphene, respectively. The second step of the oxidation reaction on N-graphene proceeds with an energy barrier of about 4 kcal mol(-1) . It is noteworthy that this reaction step was not observed on P-graphene because of the strong binding of Oads species on the P atoms. Thus, it can be concluded that low-cost N-graphene can be used as a promising green catalyst for low-temperature CO oxidation., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Primary adenocarcinoma of the urethra is rarely reported. We report a case of a 47-year-old male with symptoms of urinary obstruction started 2 years before diagnosis. Video-assisted urethrocystoscopy revealed a papillary mass almost obstructing the entire lumen with bleeding. Pathology report was consistent with primary adenocarcinoma of the urethra.

Purpose: This study was conducted to compare safety, efficacy and cosmetic outcome between standard laparoscopic live donor nephrectomy (sLDN) and mini-laparoscopic donor nephrectomy (mLDN) in a randomized clinical trial., Materials and Methods: From March 2012 to June 2013, 100 consecutive kidney donors were randomly assigned to two equal groups for laparoscopic donor nephrectomy. mLDN: Six to eight centimeters Pfannenstiel incision was made slightly above pubis symphysis and 11 millimeters trocar was fixed through exposed fascia using open technique. Five mm port was placed under direct vision at the umbilicus for camera insertion and two 3.5 mm ports were placed in subxiphoid and paraumbilical area. sLDN: Ten mm port was placed at umbilicus using open access technique for camera insertion. Five mm trocar for grasping and 11 mm trocar for vascular clipping were placed at subxiphoid and paraumbilical areas under direct vision, respectively. The second 5 mm trocar was placed in suprapubic area. Cosmetic appearance was assessed three months after surgery by using the Patient Scar Assessment Questionnaire (PSAQ)., Results: Demographic data of the patients was not significantly different between two groups. Total operative time and ischemic time was nearly similar in both groups (104 ± 21 vs. 114 ± 24 min; P = .327 and 4.03 vs. 4.07 min; P = .592). There were no cases of conversion to open surgery. Mean hospital stay was similar between the two groups [2.1 (2-5) vs. 2.4 (2-5) days; P = .346]. Kidney graft function assessed by serum creatinine val­ues (mg/dL) of recipients, was equivalent in both groups (1.58 vs. 1.86: P = .206). Mean appearance score (34 vs. 29) and consciousness score (22 vs. 18) in PSAQ showed significantly better results in the mLDN group., Conclusion: Our experience in this study revealed that peri- and post-operative findings were comparable between sLDN and mLDN, but mLDN has significant better cosmetic appearance than standard laparoscopic approach.

Purpose: To compare efficacy and safety of holmium:YAG laser and pneumatic lithotripter in the management of ureteral stones., Materials and Methods: One hundred and twelve patients with 1 to 2 cm ureteral calculi were selected for pneumatic or holmium:YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and plain abdominal x-ray were performed for all the patients before the operation. The pneumatic lithoclast was Swiss LithoClast, while in laser lithotripsy, holmium:YAG laser frequency was used, which was usually set between 5 and 10 Hz at a power of 10 to 15 Watt. Intravenous urography was performed for all the patients at 3 months to assess functional status and to delineate the ureteral anatomy., Results: The mean patients' age and stones' size were the same in both groups, and there were no statistical differences. Mean duration of lithotripsy was 13.7 ± 12.6 minutes in laser group and 7.9 ± 4.2 minutes in pneumatic lithotripsy group. Immediate stone-free rate was 100% and 82.1% in the laser and pneumatic groups, respectively (P = .001). Stone pushing back occurred only in 10 (17.9%) patients in pneumatic group. In terms of complications, such as perforation, mucosal injury, and bleeding, there were no differences between the two groups. No intravenous pyelography related complication was seen at 3-month follow-up., Conclusion: Laser lithotripsy is a superior approach for the management of upper ureteral stones of 1 to 2 cm in size due to its higher rate of stone clearance.

Aim: To assess frequency of urodynamic abnormalities in young men with chronic lower urinary tract symptoms (LUTS)., Materials and Methods: We assessed 456 men (18-40 years old) with chronic LUTS. Those with the history of urogenital malignancies, neurological disease, urethral stricture or trauma, acute UTI, congenital urological disease, and diabetes mellitus were excluded. Patients were classified by special urodynamic diagnosis., Results: Mean patient age was 25.8  ±  5.9 years old and the mean symptom duration was 12.3 ±  3.2 months. Urodynamic studies showed bladder neck dysfunction in 96 of cases (21%), dysfunctional voiding in 69 (15.1%), detrusor overactivity in 62 (13.6%), small cystometric capacity in 49 (10.7%), and acontractile detrusor in 48 (10.5%), underactive detrusor in 11 (2.4%), low compliance in 18 (3.9%), detrusor overactivity plus acontractile detrusor in 6 (1.3%), low compliance plus small cystometric capacity in 5 (1.0%), detrusor overactivity plus small cystometric capacity together with low compliance in 4 (0.8%), low compliance plus Underactive detrusor in 3 (0.6%) and normal urodynamics in 85 (18.6%). Mean Q(max) in patients with bladder neck dysfunction, dysfunctional voiding, underactive detrusor, acontractile detrusor, underactive detrusor plus low compliance, and acontractile detrusor plus detrusor overactivity were lower than those of the other groups. Mean postvoid residues in patients with underactive detrusor, and underactive detrusor plus low compliance, were higher than those in the remaining groups. Positive four-glass test in patient with normal urodynamic was greater than those in the remaining groups., Conclusion: A few clinical symptoms or noninvasive tests were useful in young men with chronic LUTS; hence, urodynamics are advised to make the correct diagnosis in this regard., (Copyright © 2011 Wiley Periodicals, Inc.)