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Aim Urinary catheterization contributes significantly to hospital-acquired infections. Adhering to CDC guidelines is vital to prevent inappropriate use and reduce infection rates. This study evaluated compliance with these guidelines in hospitalized patients at a tertiary hospital in 2024. Methodology A cross-sectional study assessed compliance with CDC guidelines for preventing catheter-associated urinary tract infections (CAUTIs) in hospitalized patients at Al-Zahra Hospital, Isfahan. Data were gathered through patient observation and chart reviews, evaluating demographics, catheter indications, retention duration, and guideline adherence. Department-specific compliance rates were also analyzed. Standardized checklists ensured consistent data recording. Results Of 1262 patients evaluated, 477 (37.8%) underwent urinary catheterization, with a 57.3% adherence rate to CDC guidelines. The most common appropriate indication was acute urinary retention (15.4%), followed by urine output monitoring in critically ill patients (14.5%) and intraoperative monitoring (11.1%). Adherence was highest in cardiology and urology, while gynecology, rheumatology, plastic surgery, and vascular surgery had the lowest rates. The emergency department showed only 27.8% adherence. Conclusion The findings highlight a suboptimal adherence rate to CDC guidelines in urinary catheterization, emphasizing the need for targeted interventions to improve compliance. Strategic interventions can enhance adherence and subsequently reduce catheter-associated urinary tract infections. Clinical trial number Not applicable.

Idiopathic oligoasthenoteratozoospermia (iOAT) treatment still poses significant challenges. This study aims to compare the therapeutic efficacy of probiotics on sperm parameters of iOAT patients with placebo and antioxidants. In this triple-blind, randomized controlled trial, 110 men with iOAT were assigned to receive either a probiotic (Familact ), an antioxidant (Sperigen ), or a placebo daily for 3 months, in two academic centers in Iran (Isfahan and Yazd). The study was conducted from July 2021 to April 2022. Sperm parameters were analyzed using computer-assisted semen analysis. The main measured outcomes included semen volume and sperm features, including motility, morphology, and concentration. Changes in semen parameters were assessed using linear mixed-effects models with fixed effects for time, group, and their interaction. Estimated marginal means were compared across groups using Bonferroni-adjusted pairwise tests. Overall, 110 men (mean age of 34.3±4.5 years) were included in the final analysis. Significant Time×Group interactions were found for sperm concentration (P=0.003), motility (P<0.001), and morphology (P<0.001), but not for semen volume (P=0.71). After 3 months, the probiotic group showed significantly greater improvements in sperm concentration (10.42±1.11×10 /mL, P=0.007), motility (46.65±3.73%, P=0.001), and morphology (4.31±0.21%, P<0.001) compared to the placebo group. Additionally, probiotics outperformed antioxidants in morphology (P<0.001) and motility (P=0.009). This study is the first to directly compare probiotics and antioxidants in treating iOAT. Probiotics showed superior performance in sperm motility and morphology compared to antioxidants, although drawing a strong conclusion requires further robust studies IRCT20150420021869N5.

BackgroundThe combination of MRI-guided targeted biopsy (MRGB) with systematic biopsy (SB) provides the highest accuracy in detecting prostate cancer. There is a controversy over the superiority of fusion targeted biopsy (fus-MRGB) over cognitive targeted biopsy (cog-MRGB). The present head-to-head randomized controlled trial was performed to compare diagnostic yield of fus-MRGB in combination with SB with cog-MRGB in combination with SB.MethodsBiopsy-naive patients with a prostate-specific antigen level between 2 and 10 ng/dL who were candidates for prostate biopsy were included in the study. Multiparametric MRI was performed on all patients and patients with suspicious lesions with Prostate Imaging Reporting and Data System score of 3 or more were randomized into two groups. In the cog-MRGB group, a targeted cognitive biopsy was performed followed by a 12-core SB. Similarly, in the fus-MRGB group, first targeted fusion biopsy and then SBs were performed. The overall and clinically significant prostate cancer detection rates between the two study groups were compared by the Pearson χ2 test. McNemar test was used to compare detection rates yielded by SB and targeted biopsy in each study group.ResultsOne-hundred men in the cog-MRGB group and 99 men in the fus-MRGB group were compared. The baseline characteristics of patients including age, PSA level, prostate volume, PSA density, and clinical stage were similar in the two groups (p > 0.05). Both the overall and clinically significant prostate cancer detection rates in the fus-MRGB group (44.4% and 33.3%, respectively) were significantly higher than cog-MRGB group (31.0% and 19.0%, respectively) (p = 0.035 and p = 0.016, respectively).ConclusionThe accuracy of identifying overall and clinically significant prostate cancer by fus-MRGB in biopsy-naive patients with PSA levels between 2 and 10 ng/dL is significantly higher than cog-MRGB and if available, we recommend using fus-MRGB over cog-MRGB in these patients.

Labial adhesion (LA) is a rare clinical entity in postmenopausal women. Estrogen deficiency and lack of sexual activity are probable contributing causes. Voiding dysfunction due to LA is even rarer in postmenopausal women, and only a few studies have previously reported such occurrence. A 62-year-old virgin postmenopausal woman presented to the Al-Zahra Hospital (Isfahan, Iran) with a 5-year history of voiding dysfunction and recurrent urinary tract infection. Despite multiple medical visits, no genital examination was ever performed by a medical practitioner, mainly due to the patient’s refusal to be examined by a male physician. On physical examination, we observed extensive LA with only a small opening. Surgical separation of the labia was performed and subsequently, the urinary tract symptoms were completely resolved. Herein, we present a case of LA causing urinary problems in a virgin postmenopausal woman. The case underlines the importance of the genital examination of female patients with urinary tract symptoms.

Transurethral resection of the prostate (TURP) is the gold standard surgical treatment for benign prostatic hyperplasia (BPH). Despite its widespread use, monopolar TURP carries a risk of significant complications, particularly transurethral resection (TUR) syndrome leading to hyponatremia and fluid overload. The study evaluates whether prophylactic furosemide prevents hyponatremia and TUR syndrome in monopolar TURP. This study was a triple-blind randomized clinical trial conducted in Al-Zahra and Khorshid educational hospitals of Isfahan, Iran, in 2022-2023. Patients undergoing monopolar TURP, were divided into two groups: those receiving preoperative furosemide and a control group. The primary outcomes were changes in serum sodium levels and the incidence of hyponatremia. Secondary outcomes included fluid balance, complication rates, and recovery times. Continuous data were analyzed using test/Mann-Whitney U, categorical data with Fisher's exact test, and time-based changes with repeated measures ANOVA. Normality was checked via Kolmogorov-Smirnov, and power analysis determined sample size. The furosemide group demonstrated a significantly lower incidence of hyponatremia than the control group (P=0.008). Additionally, serum sodium levels were significantly higher in the furosemide group after surgery (P=0.011), while potassium levels were lower (P=0.003). Mild hypokalemia was observed as a manageable side effect, primarily in patients with baseline potassium levels below 4.1 mmol/L. Preoperative administration of furosemide effectively reduces the risk of TUR syndrome during monopolar TURP. Furosemide effectively reduces hyponatremia but may increase hypokalemia in some cases, limiting its clinical utility during monopolar TURP. Patient-specific assessment and further research are needed to ensure its safe and effective use. IRCT20211208053328N2.

Labial adhesion (LA) is a rare clinical entity in postmenopausal women. Estrogen deficiency and lack of sexual activity are probable contributing causes. Voiding dysfunction due to LA is even rarer in postmenopausal women, and only a few studies have previously reported such occurrence. A 62-year-old virgin postmenopausal woman presented to the Al-Zahra Hospital (Isfahan, Iran) with a 5-year history of voiding dysfunction and recurrent urinary tract infection. Despite multiple medical visits, no genital examination was ever performed by a medical practitioner, mainly due to the patient's refusal to be examined by a male physician. On physical examination, we observed extensive LA with only a small opening. Surgical separation of the labia was performed and subsequently, the urinary tract symptoms were completely resolved. Herein, we present a case of LA causing urinary problems in a virgin postmenopausal woman. The case underlines the importance of the genital examination of female patients with urinary tract symptoms.

Introduction and hypothesis Abdominal Sacral Colpopexy (ASC) is one of the best surgical methods to repair apical or uterine prolapse. We aimed to evaluate the short-term results of a triple-compartment open ASC strategy using polyvinylidene fluoride (PVDF) mesh in the treatment of patients with severe apical or uterine prolapse. Methods Women with high-grade uterine or apical prolapse with or without cysto-rectocele were prospectively enrolled in the study from April 2015 to June 2021. We performed all-compartment repair using a tailored PVDF mesh for ASC. We assessed the severity of pelvic organ prolapse (POP) using the Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and 12 months after the operation. The patients completed the International Continence Society Questionnaire Vaginal Symptom (ICIQ-VS) questionnaire at baseline, 3, 6, and 12 months postoperatively. Results Thirty-five women with a mean age of 59.8±10.0 years were included in the final analysis. Stage III and stage IV prolapse was evident in 12 and 25 patients, respectively. After 12 months, the median POP-Q stage was significantly lower compared to the baseline (4 vs 0, p=<0.0001). Vaginal symptoms score was also reduced significantly at 3-month (7.5±3.5), 6-month (7.3±3.6), and 12-month (7.2±3.1) compared to the baseline (39.5±6.7) (p values < 0.0001). We did not observe any mesh extrusion or high-grade complications. Six (16.7%) patients had cystocele recurrence during the 12-month follow-up, and two of them needed reoperation. Conclusions Our short-term follow-up showed that using an open ASC technique with PVDF mesh in treating high-grade apical or uterine prolapse is associated with a high rate of procedural success and low rates of complication.

In this work, we present a novel silicon-on-insulator (SOI) laterally diffused metal–oxide–semiconductor (LDMOS) using β-Ga 2 O 3 material (β-SOI-LDMOS) as a wide-bandgap material for enhancing breakdown voltage. Because of the embedded gallium oxide in the drift side, the distribution of the electric field of the β-SOI-LDMOS is altered, and the depletion region changes. The properties of β-SOI-LDMOS including breakdown voltage (BV), ON-resistance ( R ON ), figure of merit, and floating body and self-heating effects are compared with a conventional SOI-LDMOS (C-SOI-LDMOS). The primary goal in this work is to use an ultra-wide-bandgap material between the gate and drain area on the critical side. The proposed structure shows promising results compared to the C-SOI-LDMOS, and the BV of the β-SOI-LDMOS is increased to 1202 V as compared with 73 V for the conventional LDMOS structure. The proposed β-Ga 2 O 3 MOSFET exhibits saturation drain current of 37 mA/mm, with low specific R ON of 4.7 mΩ cm 2 and a figure of merit ( V BR 2 / R ON ) of 30.7 MW/cm 2 .

Introduction and hypothesisTo study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT).MethodsBetween 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively.ResultsOne hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%).ConclusionOur findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.