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Effect of hydroalcoholic extract of Althaea officinalis root on improving chemotherapy-induced stomatitis: A randomized, double-blind, clinical trial
Get PDFBackground: Stomatitis is a common and serious side effect of chemotherapy. It is associated with multiple consequences such as pain, oral intake disorder, infection, bleeding, and failure of cancer treatments. Objectives: This study aimed to compare the improving effect of mouthwash containing hydroalcoholic extract of Althaea root and routine mouthwash on chemotherapy-induced stomatitis. Methods: This double-blind, randomized, controlled clinical trial was conducted on chemotherapy-induced stomatitis cases (n = 50) in the Oncology Department of Shahid Beheshti Hospital, Kashan, Iran, in 2016. Patients were assigned into two groups through permuted-block randomization. The control group was treated with 15 mL of routine mouthwash solution 4 times a day for 14 days whereas the experimental group was treated with a mixture of routine solution and Althaea root extract (50/50). The severity of stomatitis was assessed at baseline, 7th, and 14th days of intervention using the Worlds Health Organization's stomatitis evaluation checklist. Data analysis was conducted using the Chi-square and Fisher's exact tests and repeated measure analysis of variance. Results: At baseline, the mean score of stomatitis in the control group was 1.92 ± 0.70, which reduced to 0.96 ± 0.68 and 0.92 ± 0.64 on the 7th and 14th days after the intervention, respectively. In the experimental group, the mean score of stomatitis was 1.84 ± 0.74 at baseline, which reduced to 1.00 ± 0.82 and 0.44 ± 0.76 on the 7th and 14th days after the intervention, respectively (P = 0.015). Conclusion: Mouthwash solution containing Althaea officinalis root extract could improve stomatitis caused by chemotherapy more than the routine mouthwash solution. Thus, the mentioned herb has the potential to be used concurrently with chemotherapy agents to alleviate the occurrence of stomatitis. © 2018 Nursing and Midwifery Studies
Measurement of the photon and thermal neutron doses of contralateral breast surface in breast cancer radiotherapy
Get PDFIntroduction and purpose:During the radiation therapy of tumoral breast, the contralateral breast (CB) will receive scattered doses. In the present study, the photon and thermal neutron dose values received by CB surface during breast cancer radiation therapy were measured.Materials and methods:The right breast region of RANDO phantom was considered as CB, and the measurements of photon and thermal neutron dose values were carried out on this region surface. The phantom was irradiated with 18 MV photon beams, and the dose values were measured with thermoluminescent dosimeter (TLD-600 and TLD-700) chips for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes in the presence of physical and dynamic wedges.Results:The total dose values (photon + thermal neutron) received by the CB surface in the presence of physical wedge were 12·06, 15·75 and 33·40 of the prescribed dose, respectively, for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes. The corresponding dose values for dynamic wedge were 9·18, 12·92 and 29·26 of the prescribed dose, respectively. Moreover, the results showed that treatment field size and wedge type affect the received photon and thermal neutron doses at CB surface.Conclusion:According to our results, the total dose values received at CB surface during breast cancer radiotherapy with high-energy photon beams are remarkable. In addition, the dose values received at CB surface when using a physical wedge were greater than when using a dynamic wedge, especially for medial tangential fields. © Cambridge University Press 2019
The effects of curcumin on weight loss among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials
Get PDFBackground and objective: The current systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out to assess the influence of curcumin intake on weight among patients with metabolic syndrome and related disorders. Methods: We searched the following databases up until January 2018: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and evaluated for quality of the studies in accordance with the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95 confidence intervals (95 CI). Results: Eighteen articles (21 studies) that comprised a total of 1,604 individuals were finally included in the meta-analysis. Curcumin intake significantly reduced body mass index (BMI) (SMD �0.37; 95 CI, �0.61, �0.13; P < 0.01), weight (SMD �0.23; 95 CI, �0.39, �0.06; P < 0.01), waist-circumference (WC) (SMD �0.25; 95 CI, �0.44, �0.05; P = 0.01), leptin levels (SMD �0.97; 95 CI, �1.18, �0.75; P < 0.001) and increased adiponectin levels (SMD 1.05; 95 CI, 0.23, 1.87; P = 0.01). We found no significant effect of curcumin intake on hip ratio (HR) (SMD �0.17; 95 CI, �0.42, 0.08; P = 0.18). Conclusions: Overall, we have found that curcumin intake among patients with metabolic syndrome and related disorders was correlated with a significant reduction in BMI, weight, WC, and leptin, and a significant increase in adiponectin levels, but did not affect HR. Copyright © 2019 Akbari, Lankarani, Tabrizi, Ghayour-Mobarhan, Peymani, Ferns, Ghaderi and Asemi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms
Histological Survey of the Effect of Granulocyte-colony-stimulating Factor(G-CSF) on Bacterial Translocation and Wound Healing in Burned Mice
Get PDFBackground: Burn wound is an important cause of morbidity and mortality worldwide. Improving the host's immune system and removing the infection can be effective in healing wounds caused by burns. Granulocyte-colony-stimulating factor (G-CSF) stimulates both the bone marrow to produce granulocytes and the function of neutrophil precursors. The aim of this study was to examine the effect of G-CSF on removing infection and healing wound. Materials and Methods: A burn model was used to induce burns in 18 adult Balb/c mice, and their wounds were infected by Acinetobacter baumannii strains. Burned mice were divided into two groups (control and G-CSF) and treated daily by subcutaneous injections of normal saline (0.1 mL) and G-CSF (10 μg/kg). The wound healing process was evaluated by the morphological and histological assessments. Results: In morphological assay, the mean size of the wounds in the 3rd and 7th days of the treatment was significantly lower in the G-CSF treated group compared to the control group. Some of the histological parameters were evaluated, including the level of inflammation, re-epithelialization, angiogenesis, collagen deposition, the amount of granulation tissue, and fibroblast maturation. The results showed that inflammation was reduced in the G-CSF-treated group, and re-epithelialization and collagen deposition were increased insignificantly compared to the normal saline-treated group. Furthermore, bacterial translocation was reduced significantly in the G-CSF-treated group. Conclusion: G-CSF enhances wound closure and helps in wound healing by improving the immune system. It has also an anti-inflammatory role and reduces bacterial translocation
The prevalence of anxiety, stress, and depression with respect to coping strategies in caregivers of patients with head injuries
Get PDFContext: Psychological problems are very common in traumatic patients' caregivers necessitating usage of appropriate coping strategies to promote their mental health. Aim: The aim of this study was to assess anxiety, stress, and depression as well as coping strategies in caregivers of patients with head injuries. Settings and Design: In this cross-sectional study, 127 caregivers of traumatic patients referred to educational hospitals of Zabol city were selected by convenience sampling method. Subjects and Methods: The data were collected using a demographic questionnaire, as well as Depression, Anxiety and Stress Scale-21 and the Jalowiec coping strategies tools. The data were analyzed using descriptive statistics, one-way ANOVA, independent samples Student's t-test, and multivariate regression model. Results: Our findings showed that more than 70 of the caregivers of patients with head injuries suffered from severe and very severe stress and anxiety. The multivariate regression model demonstrated a negative and significant relationship between either stress (B = -0.81 P = 0.001) or depression (B = -1.23 P = 0.000) and problem-based coping strategies. Furthermore, stress (B = 0.64 P = 0.006) and anxiety (B = 0.74 P = 0.002) were negatively associated with emotional-based coping strategies. Conclusion: Considering the high rates of anxiety, stress, and depression in caregivers of patients with head injuries and significant associations observed between these variables and problem-based strategies, it is necessary to identify and obviate factors leading to anxiety and to educate coping strategies to these individuals
Patterns of road traffic fatalities in the six most populous provinces of Iran, 2011-2015
Get PDFBackground: The aim of this study was to compare the traffic safety condition as well as monthly pattern of fatalities in the six most populated provinces in Iran. Materials and Methods: This was a descriptive study. The data pertaining to fatalities and injuries during 2011-2015 were obtained from Iran Legal Medicine Organization. Results: Fatalities per 100,000 population in Kerman and Fars were significantly higher than the other four provinces, and Tehran had the lowest fatality rate per 100,000 population. To control for exposure, the number of fatalities per 100 injuries was calculated as an indicator of crash severity in the six provinces. The crashes were found to be more severe in Kerman (7.72 fatalities per 100 injuries) and Fars (5.97 fatalities per 100 injuries) compared to the other four provinces. Moreover, monthly pattern of fatalities was found to be significantly different among the six provinces. Conclusion: Results revealed several differences in the fatality patterns with the Kerman and Fars provinces having the most critical situation in the road safety among the six provinces. This could be due to the differences among these provinces in (1) quality and quantity of emergency and medical services, (2) road safety status, or (3) the share of vulnerable road user fatalities. Finally, our results suggest that to improve the efficiency and effectiveness of policies and countermeasure regarding traffic safety, policy-makers should consider the differences in the safety status and fatality patterns at provincial level
Tumor microenvironment: Interactions and therapy
No full textTumor microenvironment (TME) is a host for a complex network of heterogeneous stromal cells with overlapping or opposing functions depending on the dominant signals within this milieu. Reciprocal paracrine interactions between cancer cells with cells within the tumor stroma often reshape the TME in favor of the promotion of tumor. These complex interactions require more sophisticated approaches for cancer therapy, and, therefore, advancing knowledge about dominant drivers of cancer within the TME is critical for designing therapeutic schemes. This review will provide knowledge about TME architecture, multiple signaling, and cross communications between cells within this milieu, and its targeting for immunotherapy of cancer. © 2018 Wiley Periodicals, Inc
The effects of multidisciplinary education for nurses and physicians on the management of patients with multiple trauma
Get PDFBackground:Trauma is a leading cause of death and disability in developing countries. In-service training is a strategy for improving health-care providers' trauma-related knowledge and skills. Objectives: The purpose of this study was to evaluate the effects of multidisciplinary education for nurses and physicians on the management of patients with multiple trauma. Methods: This quasi-experimental study was conducted in 2017-2018 in Al Zahra hospital, Isfahan, Iran. Initially, the triage-related characteristics of 200 patients with multiple trauma were documented using specific checklist. Then, a multidisciplinary education program on the Emergency Service Index (ESI) triage and advanced trauma life support (ATLS)-based trauma management was implemented for emergency department (ED) staff, including 80 emergency nurses and 82 medical residents. After the intervention, the triage-related characteristics of another sample of 200 patients with multiple trauma were documented similarly. Data analyses were conducted using the Chi-square, Mann-Whitney and Wilcoxon tests. Results: The mean of waiting time for the first visit by emergency medicine specialists, the relative frequency of endotracheal intubation, and the length of stay in the ED significantly decreased from 19.45 ± 13.41 min, 12, and 7.55 ± 1.59 h at pretest to, respectively, 14.01 ± 1.81 min, 3, and 3.91 ± 0.71 h at posttest. Moreover, the relative frequency of patients who were transferred directly from the ED to the operating room significantly increased from 13 at pretest to 27 at posttest. Conclusion: Multidisciplinary education based on the ESI triage and ATLS can reduce the waiting time for specialized care services, facilitate patient transfer from the ED to the operating room, and shorten patient stay in the ED. It is also partially effective in alleviating overcrowding in the ED
Corrigendum: Does severity of Alzheimer's disease contribute to its responsiveness to modifying gut microbiota? A double blind clinical trial (Frontiers in Neurology (2018) 9 (662) DOI: 10.3389/fneur.2018.00662)
Get PDFIn the original article, there was an error. The term "normal people" was used instead of the term "cognitively intact people." Corrections of this term have been made throughout the text in the Materials and Methods, participants; the Results, Confirmation of Alzheimer's Disease in the Patients Based on the TYM Cognitive Test; Figure 2 and in the Discussion, paragraph one. Additionally, the determination of the sample size was incorrect. A correction has been made to the Materials and Methods, Participants: "This clinical study was performed as a randomized, double-blind, and placebo-controlled clinical trial. Participants included in this study were people with AD (65-90 years old) residing at Emam Ali (Tehran, Iran), Golabchi (Kashan, Iran), Miad (Kashan, Ravand, Iran), and Barekat (Aran and Bidgol, Iran) Welfare Organizations between June 2017 and August 2017. AD patients were diagnosed based on the NINDS-ADRDA criteria (22) and revised criteria from the National Institute on Aging-Alzheimer's Association (23). For further proof the AD patients were compared with the cognitively intact people based on the TYM cognitive test. Accordingly, the participants gaining TYM scores in level of AD (<45 out of 50 scores) were entered the study (see section "Results" for details). Patients with metabolic disorders, chronic infections and/or other clinically relevant disorders were excluded from the study. Standard formula for clinical trials was used to calculate sample size for the study. Based on a previous study (24), considering type one error (α) of 0.05 and type two error (β) of 0.20 (power = 80) we used 1.3 as SD and 1.1 as the difference in mean (d) of TYM as key variable. Accordingly, we needed 25 persons in each group. Assuming 5 dropouts in each group, the final sample size was determined to be 30 persons per group. Figure 1 explains flow of subject selection assigned as CON and PRO groups enrolled in the study." Furthermore, there was an error in the use of the term "underpowered." A correction has been made to the Discussion, Paragraph 10: "There were some limitations that influenced our study; importantly inclusion of people mostly in severe stage of AD, small number of subjects included in the study, the dosage and formulation of probiotic bacteria, and a sort supplement exposure time. Additionally, assessment of the impaired cognitive related inflammatory biomarkers, S100A12, and neopterin, are suggested in future investigations on AD patients." Lastly, there was a missing translation of the TYM test. A correction has been made to the Material and Methods, Outcome Evaluation: "The TYM test was used to evaluate the level of cognition in the patients and the TYM results were considered as the primary outcomes. However, the two questions in the semantic knowledge section of the TYM were substituted by questions familiar to Iranian people. In the first question the subjects were asked to name the Iranian president rather than the UK prime minister. Also the second question of semantic knowledge "In what year did the 1st World War start?" uncommon knowledge in Iran, was changed to "In what year did the war between Iran and Iraq?" As a secondary outcome the findings of the oxidative stress and inflammatory biomarkers were assessed." The authors apologize for these errors and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. Copyright © 2019 Agahi, Hamidi, Daneshvar, Hamdieh, Soheili, Alinaghipour, Taba and Salami
A Case of Knee Monoarthritis Caused by Mycobacterium Tuberculosis
Get PDFBACKGROUND Skeletal involvement is an uncommon form of extrapulmonary Mycobacterium tuberculosis (MTB) that occurs in 1-3 of the patients. Knee joints may be affected in 8 of cases. CASE REPORT We reported a case of TB knee arthritis in a 35-year-old Afghan male who was referred to Kashan Rheumatology Clinic for pain and swelling in the left knee. The patient had no history of fever, chills, weight loss, or anorexia. His chest radiography was normal. The synovial fluid culture was positive for M. tuberculosis. Magnetic resonance imaging (MRI) of the left knee demonstrated a marked joint effusion, chondromalacia in the lateral patellar facet, and edema in the origin of the gastrocnemius muscle. The histopathologic examination revealed multiple granulomas with foci of necrosis. CONCLUSIONS This case demonstrated that clinicians should pay particular attention to the possibility of TB as the cause of chronic monoarthritis even when pulmonary involvement is not documented