To provide data on the distribution of intraocular pressure (IOP) in an Iranian population. Through a population based, cross sectional study, 4565 Tehran citizens were studied in the Tehran Eye Study. The findings from the participants (n = 3834) aged 10 years and older free of glaucoma diagnosis or suspicion who had undergone applanation tonometry examination are presented. All participants received a standardised protocol including applanation tonometry, fundus examination, demographic data, and an interview. IOP measurement was used to evaluate its distribution by age, sex, and some eye parameters. Mean (SD) IOP was 14.5 (2.6) mm Hg in the total population, 14.4 (2.7) in men, and 14.5 (2.5) in women. Mean (SD) IOP in people > or =40 years was 15.1 (2.9) mm Hg. IOP increased significantly with age and cup:disc ratio except for a fall in old age. This relation was also observed when individuals without diabetes or hypertension history were analysed. IOP increased with darker eye pigmentation except for blue/grey eyes. There was a non-linear increase in IOP from emmetropic to high myopic eyes. Age, iris colour, and cup:disc ratio were related to IOP but not to sex. The distribution of IOP in this study was different from various other studies in different geographical regions and it seems advisable to employ a geographical approach to normal IOP interpretation.

Comprehensive sequencing of the coding exons of the calcium-sensing receptor gene (CASR) was performed in a group of Iranian recurrent calcium kidney stone-formers and the results were compared with a control group. Serum and urine parameters were evaluated in 99 males aged between 30 and 55 years old with idiopathic recurrent calcium urolithiasis and in 107 men as a control group. Products of polymerase chain reaction were sequenced using forward primer until a mutation was found in that exon. Then, other cases were analysed by single-strand conformation polymorphism. Four polymorphisms were detected in CASR exons, all in the coding region of exon 7. These polymorphisms and their minor allele frequency were P748P (100%), A986S (1%), R990G (3%) and E1011Q (98%). There was a significantly higher count of 986S (p = 0.006), 990G (p = 0.006) and E1011 (p = 0.02) alleles in patients. The odds ratio (95% confidence interval) was 2.55 (1.31-4.96) in those at risk of stone disease for the 986S allele and 8.06 (1.80-35.9) for the 990G allele. Men with the RR genotype at R990G showed a significantly higher serum ionized calcium than the RG or GG group (p = 0.03). A significantly lower serum total calcium was found in subjects with the QQ than the EQ genotype with respect to the 1011 locus (p = 0.005). Furthermore, the 1011Q allele was marginally associated with hypercalciuria (p = 0.05). The 986S, 990G and 1011Q alleles were associated with a recurrent calcium kidney stone-forming state. 986S and 1011Q alleles, but not 986S, were associated with hypercalcaemia.

Objectives: To review the current literature on the presence of COVID-19 virus in the urine of infected patientsand to explore the clinical features that can predict the presence of COVID-19 in urine.Materials and Methods: A systematic review of published literature between 30th December 2019 and 21st June2020 was conducted on Pubmed, Google Scholar, Ovid, Scopus, and ISI web of science. Studies investigatingurinary viral shedding of COVID-19 in infected patients were included. Two reviewers selected relative studiesand performed quality assessment of individual studies. Meta-analysis was performed on the pooled case reportsand cohort with a sample size of ≥ 9.Results: Thirty-nine studies were finally included in the systematic review; 12 case reports, 26 case series, andone cohort study. Urinary samples from 533 patients were investigated. Fourteen studies reported the presenceof COVID-19 in the urinary samples from 24 patients. The crude overall rate of COVID-19 detection in urinarysamples was 4.5%. Considering case series and cohorts with a sample size of ≥ 9, the estimated viral sheddingfrequency was 1.18 % (CI 95%: 0.14 – 2.87) in the meta-analysis. Urinary viral load in most reports were lowerthan rectal or oropharyngeal samples. In adult patients, urinary shedding of COVID-19 was commonly detectedin patients with moderate to severe disease (16 adult patients with moderate or severe disease versus two adultpatients with mild disease). In children, urinary viral shedding of COVID-19 was reported in 4 children who allsuffered from mild disease. Urinary viral shedding of COVID-19 was detected from day 1 to day 52 after diseaseonset. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one studywhile another study failed to reveal replication of isolated viral RNA in cell cultures. Urinary symptoms were notattributed to urinary viral shedding.Conclusion: While COVID-19 is rarely detected in urine of infected individuals, infection transmission throughurine still remains possible. In adult patients, infected urine is more likely in the presence of moderate or severedisease. Therefore, caution should be exerted when dealing with COVID-19 infected patients during medical interventionslike endoscopy and urethral catheterization especially in symptomatic adult patients while in childrencaution should be exerted regardless of symptoms.

Purpose: To evaluate the safety and cost-effectiveness of Hem-o-lok and metallic titanium clips for both renal arterial and venous control in laparoscopic nephrectomies. Patients and Methods: All patients who underwent laparoscopic nephrectomy from June 2000 to March 2011 in our center were included. Before July 2005, we used three medium-large titanium clips for safe control of renal vessels. After July 2005, we used two clips for renal artery control (one 10 mm Hem-o-lok clip and one medium-large titanium clip) and two clips for renal vein control (12 mm and 10 mm Hem-o-lok clips) in all cases. To prevent possible complications, we placed vascular clips 2 to 3 mm away from the aortic root of the renal artery underneath lumbar vessels. Episodes of clip failure were defined as intraoperative or postoperative hemorrhage or exploration because of clip failure. Results: This study included 1834 laparoscopic nephrectomies (1423 donor nephrectomies, 214 simple nephrectomies, and 197 radical nephrectomies). All arteries and renal veins were controlled by titanium and Hem-o-lok clips. One complication that was probably related to vascular clips (titanium and Hem-o-lok), however, involved a delayed hemorrhage from a pseudoaneurysm at the aortic root of the renal artery, which was repaired at exploration. No complication was clearly related to vascular clips. Using Hem-o-lok and titanium clips instead of vascular staplers resulted in $670 savings per operation. Conclusions: Hem-o-lok and metallic vascular clips applied properly by trained surgeons according to published safety measures provide a safe and considerable cost-saving option for vascular control in laparoscopic nephrectomy.