Pevlic splenosis is a very rare condition, particularly when the condition is diagnosed during a hematuria workup. Hematuria can be caused by genitourinary system infection, urolithiasis, neoplasm, or trauma. Hematuria can be seen in patients with symptoms or without symptoms. The standard work-up for hematuria includes a computed tomography (CT) scan which can sometimes have incident findings that can make diagnosis difficult. We report a rare case of a 44-year-old patient with painless gross hematuria and the CT scan revealed a pelvic mass that was eventually confirmed to be a pelvic splenosis by a nuclear liver–spleen sulfur colloid scan.

Congenital anorchia represents a rare form of testicular disorder. It classically refers to the absence of unilateral or bilateral testes in an otherwise normal genetic male. It is usually diagnosed in infancy due to the absence of testes with or without evidence of micropenis during routine health screening of the child. However, it can be identified at late stages while the person is being evaluated for delayed puberty and primary hypogonadism. Early identification and differentiation from cryptorchidism are essential from a therapeutic point of view. Apart from imaging studies, hormonal evaluation plays a crucial role in establishing the diagnosis.

Background: Infections of urinary tract were considered as the most common hospital-acquired infections in hospitalized patients. Area-specific monitoring studies aimed to assess the prevalence of causative organisms of urinary tract infections (UTIs) and their responsiveness to different available antimicrobials in a sample of Arab children, which may help the clinician to choose the correct empirical treatment. We aimed to study the type of urinary pathogens isolated from hospitalized patients with first-episode UTI in our locality and its antibiotic susceptibility pattern. Materials and Methods: Urine samples were collected from 320 clinically suspected cases of UTI from inpatient wards and outpatient clinic of Pediatric Department of Tanta University Hospital during the period from June 2016 to June 2017. The samples were tested microbiologically by standard procedures. Antibiotic susceptibility of the isolated pathogens was tested for commonly used antibiotics by disc diffusion method according to hospital policy. Results: Significant bacteriuria was present in 75% of the samples, 16.25% were sterile, and 8.75% showed insignificant bacteriuria. The most common pathogens were Escherichia coli (55%), Klebsiella spp. (26.6%), and Proteus mirabilis (14.2%). The mean susceptibility was high for amikacin (85%), ceftriaxone (82%), cefotaxime (80%), nitrofurantoin (80%), and nalidixic acid (78%) but low for ampicillin (21%), cephalexin (30%), and sulfamethoxazole + trimethoprim (37%). Conclusions: The antibiotics which are commonely used in UTIs such as trimethoprim/sulphamethoxazole,ampicillin and cephalexin are not appropriate for embrical treatment of common UTIs.This may be attributed to high rate of bacterial resistance .Regular monitering of these patients is recommended to establish reliable information about patterns of urinary pathogens aiming optimal embrical therapy for children with UTI.

Background and Objectives: Nephrotic syndrome (NS) is a well-known risk factor for arterial or venous thromboembolism (TE). There is a higher risk of TE in steroid-resistant nephrotic syndrome (SRNS) than in steroid-sensitive NS (SSNS). The aim of this study was to investigate serum level of von Willebrand factor-cleaving protease activity which is known as vWF-CP in children with idiopathic NS (INS) and its correlation with clinical and laboratory parameters. Patients and Methods: This study was conducted on 120 children with INS, including 40 SSNS, 40 SRNS, and 40 healthy controls. All subjects are investigated by complete blood count, 24 h collected urine analysis for urine volume, urinary proteins, total serum protein and serum albumin, total serum cholesterol, prothrombin time, partial thromboblastin time (PTT), and serum vWF-CP activity. Results: There was a highly significant decrease in serum vWF-CP activity in SSNS and SRNS groups when compared to control group while there was no significant difference in serum vWF-CP activity between SSNS and SRNS groups. Conclusions: Serum vWF-CP activity is a biomarker for endothelial dysfunction and hypercoagulable state. The decreased vWF-CP activity in different extent of nephrotic patients (SSNS and SRNS) may be one of the pathogenesis of thrombosis as a common complication of NS. Regular follow-up of nephrotic patients and estimation of serum vWF-CP level as its decreased level is a risk factor of thrombosis.

Background and Objectives: It is important to distinguish steroid sensitive nephrotic syndrome (SSNS) from steroid resistant nephrotic syndrome (SRNS) to avoid initial full dose steroid therapy in the latter. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury (AKI) even on top of chronic kidney disease (CKD). The aim is to determine urinary NGAL level in children with idiopathic nephrotic syndrome (INS) as a prognostic factor for INS, it can predict steroid resistance early in the course of INS. Subjects and Methods: The present study was carried out on ninety children with INS who were admitted in Pediatric Nephrology Unit of Tanta University Hospital. Thirty healthy children of the same age and sex served as control group. The subjects were subdivided into three groups: Group 1 (SSNS), Group 2 (SRNS), and Group 3 (controls). Patients and controls were subjected to clinical evaluation, laboratory investigations which included 24 h urinary collection for urinary volume and protein, complete blood count, serum cholesterol, serum albumin, blood urea, serum creatinine, and urinary NGAL measurement by enzyme-linked immunosorbent assay. Results: There was a significant increase in uNGAL levels in SRNS when compared with SSNS or controls. There was no significant difference in uNGAL levels between Group 1 and Group 3. ROC curve of uNGAL to predict SRNS had cutoff value >315 at the area under the curve 0.9, sensitivity 86.7%, and specificity 93.3%. There was a significant positive correlation between urinary NGAL level and age of patients and disease duration and serum creatinine level. Conclusions: Urinary NGAL can predict SRNS in INS in children.

This review aims to discuss the current evidence about the role of two biomarkers in pediatric acute kidney injury (AKI)-uromodulin (UMOD) and YKL-40 (a glycoprotein whose name is derived from the three N-terminal amino acids present on the secreted form and its molecular size of 40 kDa). Several novel biomarkers have been used in the diagnostic and prognostic evaluation of AKI. UMOD and YKL-40 or chitinase 3-like protein 1 have recently attracted scientific interest as potential biomarkers in the disease. Although UMOD has long been recognized as a marker of tubular health, it was only in the recent past that its functional role in health and disease began to be understood. The finding of low levels of the biomarker in AKI supports the recent discovery that it plays a protective rather than an instigatory role in the disease. Evidence synthesized from the reviewed studies suggests that urine UMOD levels are negatively correlated with AKI risk. Moreover, increased serum UMOD may also be used as a prognostic biomarker for recovery from AKI. On the other hand, YKL-40 (although a multidisease biomarker) has been shown to play a predictive and prognostic role in AKI, its levels being positively correlated with disease risk. Large prospective studies are however required to confirm these results and to assess the clinical utility of estimating UMOD and YKL-40 levels as well as the therapeutic implications of their altered levels.

Intravesical foreign bodies are rarely encountered in the practice of urology; they are the exception rather than the rule. Radiological imaging plays an important role in the diagnosis and management as it helps to determine the size, shape, number of foreign bodies as well as the possible complications. Treatment should aim to the removal of the foreign bodies and avoid complications whether by endoscopic or open approaches. Here, we present a case of a female child presented with chronic urinary symptoms found to have intravesical foreign with encrustation.

Multilocular cystic renal neoplasm of low malignant potential, formerly known as multilocular cystic renal cell carcinoma, is a relatively uncommon renal neoplasm. The peculiarity of this neoplasm lies in the absence of expansile solid nodules. We report a case of this uncommon neoplasm with a focal micropapillary pattern, which is a very rare feature. To the best of our knowledge, there are no case reports emphasizing on the micropapillary pattern in case of multilocular cystic renal neoplasm of low malignant potential. We report a case of a 57-year-old female patient who presented with pain abdomen. Ultrasound and computerized tomography of abdomen revealed a multilocular cystic renal mass. The patient underwent right nephrectomy and the specimen was sent for histopathological examination. Grossly, the enlarged lower pole on cutting open showed multiloculated fluid-filled cyst with smooth inner walls. Microscopically, the tumor was composed of cysts lined by cells with clear cytoplasm and of Fuhrman nuclear Grade 1. A rare feature seen was the disposition of tumor cells in micropapillary pattern. The case was reported as multilocular cystic renal neoplasm of low malignant potential. This neoplasm needs special consideration due to its good prognosis and potential amenability to cure by nephron-sparing surgery. Also to be noted is that a multilocular cystic renal neoplasm of low malignant potential can have a micropapillary pattern too.

Background: In chronic kidney disease, systemic inflammation may contribute to the endothelial dysfunction and accelerated thrombosis. Vascular access thromboembolism is the most common cardiovascular complication of children with end-stage renal disease (ESRD). Recently, a disintegrate-like and metalloproteinase with thrombospondin type 1 repeats 13 (ADAMTS13) is suspected to be involved as a specific von Willebrand factor cleaving protease. Objectives: To evaluate serum ADAMTS13 level in children with ESRD on regular hemodialysis (HD) and its correlation to thrombotic episode in HD patients. Materials and Methods: The present study was carried out on forty children with ESRD on regular HD in Pediatric Department of Tanta and Aswan University hospitals and forty healthy age- and sex-matched children were serving as controls. All patients and controls were subjected to thorough history taking, especially history concerning vascular access thrombosis, clinical examination including anthropometric measurements, and routine laboratory assessment measuring complete blood count (CBC), blood urea, serum creatinine, parathormone, prothrombin time, partial thromboplastin time, bleeding time, clotting time, blood electrolytes, and urine analysis. Laboratory investigations also included serum ADAMTS 13 level in this study. Results: There was a positive history of thrombi formation in patients more than controls, especially in the vascular access, and there was a significant decrease in ADAMTS13 level in patients when compared to controls. Conclusions: Diminished serum ADAMTS13 level is an early biomarker for hypercoagulability and thrombotic tendency. Children with ESRD under regular HD have lower levels of serum ADAMTS 13 than controls which increases the risk for thrombosis.

Objectives: To explore possible link between intradialytic hypotension (IDH) with serum fibroblast growth factor 23 (FGF23) and serum soluble klotho (sKl) in maintenance hemodialysis (MHD) patients in a single dialysis center. Materials and Methods: Cross-sectional data were collected from MHD patients. Intradialytic blood pressure was recorded continuously in a 1-month period. According to the dialysis records, MHD patients were divided into IDH group and non-IDH group. Fast sera of the MHD patients were obtained for FGF23 and sKl assay at the end of IDH record month, and other routing laboratory results were analyzed statistically for comparison between the two groups. Results: A total of eighty MHD patients with complete laboratory data were enrolled into the study. The occurrence rate of IDH was 77.5%. The significant differences in serum ferritin (P = 0.046), serum triglyceride (P = 0.045), parathyroid hormone (P = 0.042), calcium-phosphorus product (P = 0.047), and serum FGF23 (P < 0.001) were found between the two groups, but the difference in sKl between the two groups was marginal (P = 0.747). Furthermore, the serum FGF23 was positively correlated with the occurrence of IDH (r = 0.807, P< 0.001). Conclusions: The present study indicated a positive correlation between serum FGF23 and IDH in MHD patients, which suggested the FGF23 could be a potential biomarker for incidence of IDH in the hemodialysis population.

Erectile dysfunction (ED) is the most frequently treated sexual dysfunction in men and affects 70% of men over 70. Recently, numerous studies have focused on the pathogenesis of ED and found many causes and several key molecular changes. However, the understanding of the ED mechanism is still limited. MicroRNAs (miRNAs) are small, noncoding RNA molecules. They regulate many physiological and pathological processes, including ED. In this review, we summarize the expression and regulation mechanisms of miRNAs in ED. In ED rats and patients, many miRNAs were found increased or decreased in corpus cavernosum tissues or blood. MiRNAs can regulate erectile function by regulating many processes related to erection, such as regulating nitric oxide synthase activation, endothelial function, smooth muscle cells, and androgen function. In summary, we found that miRNAs play a critical role in ED development. However, there is inadequate direct evidence to reveal the regulatory mechanism. Further studies are required to meet the scientific needs.

The thiazide-sensitive sodium-chloride cotransporter (NCC) is exclusively expressed in the apical membrane of the renal distal convoluted tubule (DCT), and it is important for maintaining fluid and salt balance. NCC is responsible for electroneutral NaCl reabsorption, and its activity is determined by phosphorylation, which was reported to be regulated by WNK-stimulated Ste20-type kinases, Ste20-related proline alanine-rich kinase, and oxidative stress response 1 kinase. WNK kinases have chloride-binding sites, and WNK4 has the highest sensitivity to intracellular chloride concentration ([Cl⁻]_i) compared with WNK1 and WNK3. NCC dysfunction often comes together with abnormal urinary potassium excretion, which is not only highlighted by Mendelian disorders such as familial hyperkalemic hypertension (FHHt) and Gitelman syndrome but also presented more frequently by long-term usage of thiazides, specific inhibitors of NCC. Recent studies have shown that extracellular potassium (K⁺) can modulate DCT cell membrane voltage and in turn intracellular Cl⁻, which regulates phosphorylation of WNK kinases. Additional Cl⁻ independent mechanisms were also reported by several groups. This paper is a brief review of the recent discoveries on mechanisms of NCC regulation by extracellular potassium.

Primary renal malignant fibrous histiocytoma (MFH) is a rare tumor indistinguishable from renal cell carcinoma clinically and radiologically which can be differentiated only by histological and immunohistochemical studies. We report a case of primary renal MFH in a 40-year-old female who presented with left flank pain. Abdominal ultrasonography and computerized tomography revealed a well-defined renal mass. The contralateral kidney and renal functions were normal. Preoperative diagnosis was renal cell carcinoma and nephrectomy was performed. Histological examination and immunohistochemistry revealed MFH.

Atypical hemolytic uremic syndrome (aHUS) is a rare disease of uncontrolled alternative pathway complement activation and pregnancy-associated aHUS (P-aHUS) is a more rare but life-threatening disorder. Besides gene screening, ADAMTS-13 detection and renal biopsy is helpful to establish diagnosis and prognosis assessment when kidney is involved. Combined liver-kidney transplant and eculizumab therapy has generally been the initial approach to this disease management besides therapeutic plasma exchange and plasma infusion. Though transplant and eculizumab therapy may be more effective than traditional therapy, it is much more expensive and not easily available. Herein we report a case of P-aHUS and our case indicates that plasma exchange and hemodialysis may be effective to P-aHUS for those not suitable/available for eculizumab treatment or transplant.

Myelolipomas are a rare benign variant of adipose tissue tumors with additional hematopoietic elements. In general, these tumors were discovered accidentally on autopsy with a low incidence. Adrenal gland is the most common site for myelolipoma. We reported a case of giant adrenal myelolipoma (>18 cm) which presented with vague, nonspecific pain which is worth mentioning because of its rarity and huge size.

Purpose: The aim of the study was to identify correlation between DNA damage marker 8-hydroxy 2-deoxy guanosine (8-OHdG) and other prognostic factors such as Gleason's score, serum prostate-specific antigen (PSA), and stage in carcinoma prostate and to assess a probability-correlation between DNA damage and benign prostatic hyperplasia (BPH) and control. Materials and Methods: A study has been carried out prospectively. Forty patients of carcinoma prostate, 34 BPH, and 14 healthy controls were included in the study between the period of July 2010 to July 2012. Serum 8-OHdG level was measured in all subjects as a marker of DNA damage. Results: Serum 8-OHdG level was significantly raised in patient with prostate cancer (313.39 ± 69.48 ng/mL) as compared with BPH patients (204.42 ± 40.97 ng/mL) and control group (198.94 ± 15.74 ng/mL) with P< 0.001. Serum 8-OHdG level in BPH patients was higher than the controls, but the mean difference was statistically insignificant (P = 1.000). The patients with serum PSA >20 ng/mL, Gleason's score >6 had higher mean 8-OHdG levels as compared to serum PSA ≤20 and Gleason score ≤6, as P< 0.05. There was also direct association found between prostate volume and stage of the tumor though it was not significant. Conclusions: These findings suggest that oxidative stress level was significantly raised in prostate cancer patients. It was also observed that a significant direct association exists between oxidative stress and certain clinicopathologic factors, including serum PSA, Gleason score, and metastasis which show that with progression of disease, there was increase in oxidative stress level.

Objectives: The objective of this study was to assess the clinical presentations of perianal warts in boys and to evaluate the possible relationship between the presence of perianal warts and the sexual abuse as mode of transmission. Materials and Methods: In a prospective clinical study, it conducted on 16 boys with clinically evident perianal warts at the Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Upper Egypt, between September 2012 and March 2016. A detailed history from the child and his family was taken. All boys underwent full clinical general and local examinations including (1) site, number, size, and the shape of warts in perianal region, (2) physical signs of sexual abuse, (3) warts in other body areas, and (4) signs of other sexually transmitted diseases. Results: The age of boys ranged from 4 to 10 years, with a mean ± standard deviation of 6.4 ± 1.9 years. Fourteen boys (87.5%) presented with multiple moist papules. Eleven boys (68.75%) had a progressive course. Fourteen boys (87.5%) had no symptoms (incidentally discovered) and 2 boys (12.5%) had perianal itching and pain. Thirteen boys (81.25%) had confirmed history of sexual abuse. Fourteen boys (87.5%) had no physical signs of sexual abuse and 2 boys (12.5%) had perianal fissures. Conclusion: Our results suggested that sexual abuse should be considered in every case of boys with perianal warts.

Introduction: Success of renal transplantation, besides other factors, depends on the total number of nephrons in the transplanted kidney. The aim of our study was to investigate the effect of ratio of donor kidney weight (DKW) to recipient body weight (RBW) on renal allograft function. Materials and Methods: We conducted a retrospective study at our hospital on 245 patients who underwent live-related kidney transplant. Patients were divided into three groups depending on the ratio of DKW in grams to RBW in kilograms. Results: Mean age of the recipients was 40.19 ± 11.86 years (15–68 years) and donor was 46.18 ± 10.98 years (22–75 years). Male:female ratio for recipients and donors was 205:40 and 163:82, respectively. The decrease in mean creatinine level was more rapid in Group 3 patients as compared with Group 2 and Group 1 patients at 7 days and the trend continued till 3 years. Conclusion: The higher DKW/RBW ratio is an important factor for early function and late function of grafts. Extreme mismatch between the DKW and RBW should be kept in mind, and the DKW/RBW ratio can help us prognosticate patients' renal allograft function.

Urinary tract infection (UTI) is one of the common causes of hospital visit in infants and children. Vesicoureteral reflux (VUR) predisposes to UTI and renal scarring. VUR is usually diagnosed after an episode of UTI. VUR is the most common underlying etiology responsible for febrile UTIs or pyelonephritis in children. Along with the morbidity of pyelonephritis, long-term sequelae of recurrent renal infections include renal scarring, proteinuria, and hypertension. Treatment is directed toward the prevention of recurrent infection through the use of continuous antibiotic prophylaxis during a period of observation for spontaneous resolution or by surgical correction. In children, bowel and bladder dysfunction (BBD) plays a significant role in the occurrence of UTI and the rate of VUR resolution. Effective treatment of BBD leads to higher rates of spontaneous resolution and decreased risk of UTI.

Allergic reactions happened during hemodialysis (HD) on polysulfone membrane in a 59-year-old female patient who was being treated with an angiotensin II receptor antagonist, olmesartan, for aggravated hypertension. Anaphylactic reactions including itching, hypoxemia, and facial swelling appeared 1 h after starting the 6^th session of HD and lasted for 30 min. When we changed dialyzer and stopped olmesartan for 4 days, the reactions disappeared.

Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disorder characterized by crescentic glomerulonephritis, pulmonary hemorrhage, and the presence of circulating anti-GBM antibodies which bind to the α3 chain of Type IV collagen found in the GBM. IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. The simultaneous occurrence of atypical anti-GBM disease and IgAN has not been reported previously. We report here two female patients who presented with oliguria, hypertension, and renal failure. Renal biopsy revealed crescentic glomerulonephritis and bright linear IgG staining along glomerular capillary walls and mesangial IgA (3+) deposits in immunofluorescence. Serology was negative for anti-GBM antibodies both by ELISA and immunoblot assays. Hence, a diagnosis of atypical anti-GBM disease with superimposed IgAN was made. Both patients were treated with hemodialysis, intravenous steroids, and cyclophosphamide with the improvement of renal function in one patient and the other progressed to end-stage renal disease.

Background and Objectives: The prevalence of nondiabetic renal disease (NDRD) in those with type 2 diabetes mellitus (T2DM) is common worldwide; however, data from India are limited. Materials and Methods: This study included participants with T2DM who underwent renal biopsy with suspicion of NDRD from September 2009 to August 2016. Results: Seventy-one participants (males: 47 [66.2%] and females: 24 [33.8%]) of T2DM with mean age and standard deviation of 52.93 ± 12.56 years were included in the study. The indications for renal biopsy included acute on chronic renal failure in 35.2% (25), nephrotic syndrome in 31% (22), acute renal failure in 14.1% (10), nephritic syndrome in 14.1% (10), and others in 5.6% (4) of participants. The prevalence rates of NDRD, diabetic nephropathy (DN), and DN with NDRD were 50.71% (36), 28.16% (20), and 21.13% (15), respectively. Among the participants with NDRD, 69.44% (25) had primary glomerular diseases (PGDs), 16.67% (6) had tubulointerstitial diseases (TIDs), and 13.89% (5) had secondary glomerular diseases (SGDs). IgA nephropathy was the most common of PGDs affecting 28% (7), followed by postinfective glomerulonephritis (PIGN) in 20% (5), membranous nephropathy in 16% (4), focal segmental glomerulosclerosis in 12% (3), and miscellaneous lesions in 24% (10). Acute interstitial nephritis and primary amyloidosis were the most common of TIDs and SGDs, respectively. Among the patients with combination of DN with NDRD, 53.33% (8) were TIDs and 46.67% (7) had glomerular diseases. Acute tubular injury/necrosis and PIGN were the most common of TIDs and glomerular disease, respectively. The figures in brackets representing number of patients. Conclusions: The majority of the participants with T2DM had NDRD either alone or in combination with DN in the study, underlining the utility of renal biopsy for their diagnoses in those with appropriate indication. Wide spectrum of PGDs, TIDs, and SGDs was found in the study.

Background and Objectives: Tubular ectasia is a rare, pathologically benign condition which initially may present as tiny cyst. Knowledge of typical ultrasound features of this condition helps to differentiate it from other malignant lesions of testis. This study was conducted to find out ultrasound spectrum of tubular ectasia of rete testis and epididymis. Methods: Patients undergoing scrotal ultrasound and doppler for various indications including scrotal pain, infertility, postvasectomy and prior to recanalisation of vas were studied. The history, clinical examination, semen analysis and ultrasound features were analyzed. Our emphasis was on early detection of this rare but benign entity involving testis and epididymis. Results: Scrotal ultrasound with colour doppler in these patients revealed the abnormalities ranging from early changes like specked appearance and tiny cysts to more severe forms involving rete testis and epididymis. Associated abnormalities like epididymal cyst, hydrocele and spermatocele were also found in addition to tubular ectasia in some cases. Conclusion: Tubular ectasia is a pathologically benign condition which can be reliably diagnosed on ultrasound and colour doppler. Familiarity with the ultrasound and doppler features of tubular ectasia will definitely help in early diagnosis which in turn will help in reducing patients' anxiety and prevent unnecessary interventions.

Objectives: The objective of this study was to explore the values of prostate-specific antigen (PSA) before and after transurethral prostatic resection (TURP) surgery and the corresponding correlation with the resection extent through short and long-term changes of benign prostatic hyperplasia (BPH) of patient's serum PSA after TURP. Materials and Methods: Data were abstracted from a retrospective sampling study of 209 cases of BPH patients. The values of serum PSA level were measured preoperatively and at specified periods after TURP surgery; 5 days, 1 month, 3 months, and 6 months. These periods were correlated with the resection extent. Results: Quantitative PSA values were collected before and after the surgical procedure at the time periods. The decrease of PSA value was observed 5 days after surgery when compared with preoperative PSA value, which is about 4.42 ± 8.78 ng/mL while 35% decrease was reported following a month after surgery. Moreover, PSA levels in these five periods were significantly different (P < 0.01), and the value of PSA >4 ng/mL group is still higher than the group of PSA ≤4 ng/mL after the decrease. Resection extent of TURP: The mean differences between real removal quality and the quality, according to the prostate ultrasonography, should be removed, which is expressed in ± standard deviations. The value of the total sample is −0.941 ± 9.56 ng/mL. Values in the group of PSA ≤4 ng/mL and PSA >4 ng/mL are 0.13 ± 10.53 and −3.83 ± 5.41, respectively. There appears to be a positive correlation between the variations of PSA and the resection extent (P < 0.01, R = 0.91). In addition, a positive correlation was confirmed between the variations of PSA and the resection extent in the group of PSA ≤4 ng/mL and PSA >4 ng/mL (P < 0.01, R 1 = 0.986, R 2 = 0.924). Conclusion: A downward trend is demonstrated here in PSA after TURP. The PSA value lowered to a normal level in about 1 month. The interesting point is that there is an inverse relationship between the larger size of the resection and the decrease in PSA values. Thus, missed and misdiagnoses of prostate cancer could be reduced with the long-term follow-up of BPH patients' postoperative levels of serum after TURP. In regards to patients whose preoperative PSA >4 ng/mL, monitoring standards should be taken according to their postoperative PSA baseline when measuring their results of prostate needle biopsies and the diagnosis of prostatic cancer.

Chronic kidney disease (CKD) is characterized by progressive loss of renal function. Although the burden of CKD in India cannot be assessed accurately, its approximate prevalence is believed to be 800 per million populations (pmp), and the incidence of end-stage renal disease (ESRD) is 150–200 pmp. Diabetic nephropathy is a leading cause of ESRD worldwide. Another cause of ESRD is dyslipidemia, which is one of the most common quantitative lipid abnormalities in patients with CKD. In diabetes, the total cholesterol and triglyceride levels rise as the albumin excretion rate increases, leading to renal injury. Oxidative stress generated by hyperglycemia increases reactive oxygen species production, which causes cellular dysfunction and damage, and ultimately results in diabetic micro- and macro-vascular complications. Therefore, lipids may represent a useful clinical tool for not only identifying patients at a high risk of developing CVD but also assessing the development and progression of renal disease. In this review, we summarize the effects of lipid abnormalities and oxidative stress in patients with diabetes and nephropathy.