Background Vitiligo is a chronic depigmentary skin disorder caused by destruction of epidermal melanocytes. Various cytokines play an important role in its pathogenesis. Interleukin-22 (IL-22) is one of the cytokines produced by multiple immune cells such as lymphocytes and natural killer cells. It has a role in the proinflammatory process, and also it can induce production of C-reactive protein (CRP). The role of IL-22 has been studied and evaluated in many chronic inflammatory diseases such as psoriasis, rheumatoid arthritis, and inflammatory bowel diseases. Aim This study was planned to study the effect of serum IL-22 and CRP in patients with vitiligo and to correlate their level with the severity of the disease using vitiligo area severity index, vitiligo extent score, and vitiligo disease activity score. Patients and methods A prospective case–control study was conducted on 35 patients with vitiligo and 35 age-matched and sex-matched healthy volunteers. Both disease severity and disease activity were estimated using vitiligo area severity index and vitiligo disease activity score, respectively. All participants were subjected to measurement of serum IL-22 by enzyme-linked immunosorbent assay technique and measurement of serum CRP level by rate nephelometry. Results We found that the most common type of vitiligo was the generalized type (88.6%), followed by segmental vitiligo (5.7%) and focal vitiligo (5.7%). We found that both IL-22 and CRP are significantly higher in patients with vitiligo compared with healthy participants (P=0.001), with a positive correlation with the disease activity. Conclusion Both IL-22 and CRP have a role in vitiligo pathogenesis as their presence intensifies the severity of the disease. They could be considered useful tools for evaluating the disease activity. Keywords: C-reactive protein, cytokines, interleukin-22, vitiligo

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Objectives: To compare the efficacy, complications, and costs of percutaneous nephrolithotomy (PNL) and extracorporeal shock wave lithotripsy (SWL) in the treatment of a 20 to 30 mm single renal pelvic stone with a density ≤1000 HU. Patients and Methods: Eighty patients were prospectively randomized to receive either PNL or SWL during May 2017 to April 2019. The relevant demographic and clinical characteristics were compared. Results: The mean age in the PNL and SWL groups was 43.25 ± 15.16 and 44.18 ± 12.08 years, respectively. The mean stone sizes were 25.2 ± 3.9 and 24.6 ± 2.3 mm, respectively. The stone-free rate (SFR) was significantly different after the primary procedures (92.5% vs 37.5%, respectively; p  0.04), but it was comparable after 3 months (97.5% vs 90%, respectively; p = 0.723), with a higher rate of auxiliary procedures after SWL (p = 0.017). On multivariate analysis, stone density was the only significant variable for the SFR in the SWL group (p = 0.004). Complications occurred in 27.5% and 22.5% of cases, respectively (p = 0.796). The mean costs of SWL (650.23 ± 424.74 United States Dollars [US$]) were significantly lower than those of PNL (1137.65 ± 224.43 US$; p  0.0001). Conclusions: The SFRs for PNL and SWL were not significantly different after 3 months in the treatment of a 20 to 30 mm single renal pelvic stone with ≤1000 HU, although PNL provided a significantly higher rate after its primary procedure. SWL was significantly less costly, but it mandated a significantly higher number of auxiliary procedures than PNL.

Background and Objectives: Non-operative managements have been increasingly favored for high-grade renal traumas. Our aim was to compare the outcomes of conservative and interventional managements of Grades 3-5 renal traumas. Materials and Methods: Prospective studying of the patients who presented to our hospital with Grades 3-5 renal trauma between October 2015 and March 2017. They were classified into Group A for conservative management and Group B for interventional management with comparisons for the demographic and clinical variables and outcomes. Results: A total of 63 patients presented with Grades 3-5 renal trauma within the duration of the study. Group A and B included 49 and 14 patients, respectively, with comparable demographic characteristics. Blunt trauma was mainly due to motor vehicle accidents (39.7%) and represented >87% of all cases. Distribution of the grades of renal trauma was represented in Group A and B as Grade-3 in 17 and 1 patient(s), Grade-4 in 17 and 7 patients, and Grade-5 in 15 and 6 patients, respectively. Conservative management was successful in 43 cases (87.8%), while it failed in six cases which indicated surgical interventions up to nephrectomy. In Group B, interventions included nephrectomy, renorrhaphy, angioembolization for persistent hemorrhage, JJ stent insertion, and combined JJ stent with nephrostomy tube insertion for the drainage of collection in 6 (42.9%), 3 (21.4%), 2 (14.3%), 2 (14.3%), and 1 (7.1%) patient(s), respectively. Blood transfusion rate was significantly higher in Group B (0.57 ± 0.89 vs. 2.07 ± 1.00; P = 0.000), while hospital stay was insignificantly longer in Group A (P = 0.066). Conclusions: Conservative management could be applied successfully for significant proportions of high Grades 3-5 renal trauma in the hemodynamically stable patients with significant reduction of the rate of nephrectomy. However, surgical interventions are still warranted for certain indications with relatively high possibilities of nephrectomy.

Background and Objectives: Non-operative managements have been increasingly favored for high-grade renal traumas. Our aim was to compare the outcomes of conservative and interventional managements of Grades 3-5 renal traumas. Materials and Methods: Prospective studying of the patients who presented to our hospital with Grades 3-5 renal trauma between October 2015 and March 2017. They were classified into Group A for conservative management and Group B for interventional management with comparisons for the demographic and clinical variables and outcomes. Results: A total of 63 patients presented with Grades 3-5 renal trauma within the duration of the study. Group A and B included 49 and 14 patients, respectively, with comparable demographic characteristics. Blunt trauma was mainly due to motor vehicle accidents (39.7%) and represented >87% of all cases. Distribution of the grades of renal trauma was represented in Group A and B as Grade-3 in 17 and 1 patient(s), Grade-4 in 17 and 7 patients, and Grade-5 in 15 and 6 patients, respectively. Conservative management was successful in 43 cases (87.8%), while it failed in six cases which indicated surgical interventions up to nephrectomy. In Group B, interventions included nephrectomy, renorrhaphy, angioembolization for persistent hemorrhage, JJ stent insertion, and combined JJ stent with nephrostomy tube insertion for the drainage of collection in 6 (42.9%), 3 (21.4%), 2 (14.3%), 2 (14.3%), and 1 (7.1%) patient(s), respectively. Blood transfusion rate was significantly higher in Group B (0.57 ± 0.89 vs. 2.07 ± 1.00; P = 0.000), while hospital stay was insignificantly longer in Group A (P = 0.066). Conclusions: Conservative management could be applied successfully for significant proportions of high Grades 3-5 renal trauma in the hemodynamically stable patients with significant reduction of the rate of nephrectomy. However, surgical interventions are still warranted for certain indications with relatively high possibilities of nephrectomy.

Background and Objectives: Non-operative managements have been increasingly favored for high-grade renal traumas. Our aim was to compare the outcomes of conservative and interventional managements of Grades 3-5 renal traumas. Materials and Methods: Prospective studying of the patients who presented to our hospital with Grades 3-5 renal trauma between October 2015 and March 2017. They were classified into Group A for conservative management and Group B for interventional management with comparisons for the demographic and clinical variables and outcomes. Results: A total of 63 patients presented with Grades 3-5 renal trauma within the duration of the study. Group A and B included 49 and 14 patients, respectively, with comparable demographic characteristics. Blunt trauma was mainly due to motor vehicle accidents (39.7%) and represented >87% of all cases. Distribution of the grades of renal trauma was represented in Group A and B as Grade-3 in 17 and 1 patient(s), Grade-4 in 17 and 7 patients, and Grade-5 in 15 and 6 patients, respectively. Conservative management was successful in 43 cases (87.8%), while it failed in six cases which indicated surgical interventions up to nephrectomy. In Group B, interventions included nephrectomy, renorrhaphy, angioembolization for persistent hemorrhage, JJ stent insertion, and combined JJ stent with nephrostomy tube insertion for the drainage of collection in 6 (42.9%), 3 (21.4%), 2 (14.3%), 2 (14.3%), and 1 (7.1%) patient(s), respectively. Blood transfusion rate was significantly higher in Group B (0.57 ± 0.89 vs. 2.07 ± 1.00; P = 0.000), while hospital stay was insignificantly longer in Group A (P = 0.066). Conclusions: Conservative management could be applied successfully for significant proportions of high Grades 3-5 renal trauma in the hemodynamically stable patients with significant reduction of the rate of nephrectomy. However, surgical interventions are still warranted for certain indications with relatively high possibilities of nephrectomy.

Background and Objectives: Non-operative managements have been increasingly favored for high-grade renal traumas. Our aim was to compare the outcomes of conservative and interventional managements of Grades 3-5 renal traumas. Materials and Methods: Prospective studying of the patients who presented to our hospital with Grades 3-5 renal trauma between October 2015 and March 2017. They were classified into Group A for conservative management and Group B for interventional management with comparisons for the demographic and clinical variables and outcomes. Results: A total of 63 patients presented with Grades 3-5 renal trauma within the duration of the study. Group A and B included 49 and 14 patients, respectively, with comparable demographic characteristics. Blunt trauma was mainly due to motor vehicle accidents (39.7%) and represented >87% of all cases. Distribution of the grades of renal trauma was represented in Group A and B as Grade-3 in 17 and 1 patient(s), Grade-4 in 17 and 7 patients, and Grade-5 in 15 and 6 patients, respectively. Conservative management was successful in 43 cases (87.8%), while it failed in six cases which indicated surgical interventions up to nephrectomy. In Group B, interventions included nephrectomy, renorrhaphy, angioembolization for persistent hemorrhage, JJ stent insertion, and combined JJ stent with nephrostomy tube insertion for the drainage of collection in 6 (42.9%), 3 (21.4%), 2 (14.3%), 2 (14.3%), and 1 (7.1%) patient(s), respectively. Blood transfusion rate was significantly higher in Group B (0.57 ± 0.89 vs. 2.07 ± 1.00; P = 0.000), while hospital stay was insignificantly longer in Group A (P = 0.066). Conclusions: Conservative management could be applied successfully for significant proportions of high Grades 3-5 renal trauma in the hemodynamically stable patients with significant reduction of the rate of nephrectomy. However, surgical interventions are still warranted for certain indications with relatively high possibilities of nephrectomy.