The role of calcium (Ca) in the cycle of phosphorus in water environment depends on the speciation of Ca in sediments, and reliable Ca sequential extraction method is useful for obtaining information about Ca transport processes from sediment to water. Experiments have been carried out to develop a simple but robust Ca sequential extraction method for identification of Ca portioning in sediments. The sequential extraction protocol was MODIFIED for extractants, extracting time, concentration and pH of the reagents in the first three steps of TESSIER sequential PROCEDURE. With optimum conditions, there were 1:25 sediment to solution ratio and 3 h of extracting time shaken with NH4AC (1 mol L-1, pH 7.0) (exchangeable Ca fraction); 1:25 sediment to solution ratio and extracted with NH4AC (1 mol L-1, pH 5.0) for 5 h (carbonate-bound Ca fraction); and 1:30 sediment to solution ratio and extracted with NH2OH.HCl (0.5 mol L-1, pH 1.5) for 6 h (Fe and Mn oxides bound Ca fraction). The recovery for TESSIER PROCEDURE ranged form 35.6 to 71.1 %, while the recovery for the MODIFIED TESSIER PROCEDURE ranged form 46.1 to 86.9 %. These results revealed that TESSIER PROCEDURE underestimated the proportion of Ca in exchangeable fraction. In sediments, Ca was mainly exchangeable and carbonate bound, which was considered as the most liable fractions.

45 patients (40 male & 5 female) with recurrent anterior shoulder instability were operated from 1993 to 2001. The mean age was 27 years (18-46) and 95% were right handed and 5% left handed. Instability was on right side in 54.4% left side in 38.6% and bilateral in 6.9%. 15 pt’s were operated with classic Rowe PROCEDURE and 30 pt’s with using MODIFIED anchor screw, and follow up period was 37.6 mounths (12-110), Bankart lesion was found in 100% of cases. Subscapularis muscle lesion, Interval lesion and capsular laxity in 9.3%, 14.5% and 47.6% respectively. Glenoid fracture and loose body in 2.9 and 29% respectively. In 75% of pt’s Hill-Sachs lesion was found that was moderate to sever type in 88%. At follow up study, First group (with no MODIFIED screw), there was no apprehension sign in 53.3% and redislocation in one patient and full range of motion in all cases. In secound group (with screw), no apprehension in 79% and no redislocation was found and range of motion was full in 93%. The first group has little or no limitation at their function in 90% and secound group in 96%. According to rowe scores, results were 53.3% excellent, 26.6% good 13.3% fair and poor in one case for first group and 69% excellent, 15.5% good and 15.5% fair without poor result in sceound group. In conclusion, using MODIFIED anchor screw for bankart PROCEDURE is easy to do, needs less instruments, with low surgical trauma, shortoperation time, and low complication rate and over all good results.

Purpose: Open surgical reimplantation of ureters is a highly successful PROCEDURE, with reported correction rates of 95 to 99 percent regardless of the severity of vesicoureteral reflux (VUR). Leadbetter-Politano ureteroneocystostomy is one of the most preffered technique for open ureteroneocystostomy. The authors report the MODIFIED Politano-Leadbetter technique with extravesical mobilization and transection of the ureter at the level of ureterovesical junction and intravesical reimplantation. Materials and Methods: Fifty-seven children with unilateral VUR, underwent MODIFIED Leadbetter-Politano ureteral reimplantation with extravesical mobilization and transection of the ureter at the level of ureterovesical junction and intravesical reimplantation. Indications for open reimplantation were, persistence of VUR after endoscopic correction, breakthrough urinary infections, complications due to antibiotics, progressive renal scarring, and parental preference. Operations were done by two full-time pediatric surgeons. Operation time and hospital stay of the patients, reflux persistency, voiding dysfunction and complications were recorded. Results: No ipsilateral VUR was detected postoperatively. While mean operation time was 78. 42 min (± 7. 36 min; range, 70-86 min) Mean duration of the hospital stay is 82. 31 h (± 9. 48 h; range, 71-94 h) for classic Leadbetter-Politano PROCEDURE, mean operation time was 56. 54 min (± 8. 24 min; range, 52-67 min) and mean duration of the hospital stay is 62. 31 h (± 8. 35 h; range, 50-63 h) for MODIFIED technique. Postoperative gross hematuria was not seen in any patients. No voiding dysfunction and no late complications was encountered. Conclusion: MODIFIED Leadbetter-Politano technique is a good option to treat VUR with success rate up to 100% without any major complicatons such as viscus perforation and ureteral obstruction. It is a rather simple technique that require less operative time.

Background: Repairing the inguinal hernia with mesh using the Lichtenstein method is safe, with a high success rate and low recurrence. Still, there is a potential risk of damage and entrapment of the ilioinguinal and iliohypogastric sensory nerves. This study aimed to investigate the outcomes of the patients after MODIFIED Lichtenstein hernia repair surgery.Methods: This cross-sectional study was conducted on 35 male patients referred to Poursina Hospital with complaints of inguinal hernia who underwent a MODIFIED Lichtenstein hernia repair PROCEDURE. The demographical data, clinical characteristics, and the outcomes of the patients were recorded. A visual Analog Scale (VAS) evaluated pain scores after surgery, and the data was analyzed using SPSS version 24.Results: The mean age of the patients was 50.65±14.44 years. Surgery duration averaged 41.17±14.97 minutes, and most patients had indirect hernias (71.4%), with a 57.2% occurrence on the right side. No intraoperative complications occurred, and only one patient experienced postoperative complications. No hernia relapses were reported, and the mean pain score was 0.38±0.07, according to the VAS. Patients returned to work in an average of 2.90±0.98 days, with 45.7% returning after three days.Conclusion: Findings illustrated that the MODIFIED Lichtenstein surgery PROCEDURE can treat inguinal hernia due to its fewer postoperative complications.

Introduction: Midline cleft of mandible, classified as TESSIER 30 clefts is extremely rare, with less than 100 reported cases in the latest studies. Variations in severity and associated malformations have been reported before.Case Presentation: In this report, we present the first documented Iranian case of TESSIER 30 with median cleft of lower lip and bifid tongue concomitant with congenital heart defects.Conclusions: We explain embryologic origin, differential diagnosis, other associated anomalies and its treatment by reviewing literature.