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The use of honey and curcumin for episiotomy pain relief and wound healing: A three-group double-blind randomized clinical trial
Get PDFBackground: Episiotomy is the most common surgical procedure in obstetrics. It may be associated with wound infection and delayed wound healing. Objectives: This study aimed to compare the effects of honey and curcumin on episiotomy pain and wound healing. Methods:This double-blind three-group randomized controlled trial was done on 120 women admitted for vaginal delivery to Shahid Yahyanejad hospital, Babol, Iran. Participants were randomly assigned to three groups of 40 subjects and were taught to apply honey, curcumin, or placebo creams on their own episiotomy wound twice daily for 10 successive days after birth. Pain and wound healing were assessed 2 h, 5 days, and 10 days after birth via a visual analog scale and the Redness, Edema, Ecchymosis, Discharge, and Approximation scale. The primary outcomes of the study were episiotomy wound healing and pain intensity. The Chi-square test as well as the one-way analysis of variance and the repeated measures analyses of variance were conducted for data analysis. Results: The study was completed with 30 women in each of the honey and the curcumin groups and 29 in the placebo group. There were no statistically significant differences among the groups respecting the variations of pain intensity and wound healing mean scores across the three measurement time points. However, based on the complete pain relief on the 10th day and compared with the placebo group, number-to-treat values in the curcumin and the honey groups were around 6 and 5, respectively. Moreover, compared with the placebo group, number-needed-to-treat values for complete wound healing on the 10th day in the curcumin and the honey groups were 6 and 8, respectively. Conclusion: Curcumin and honey creams have almost the same effects on episiotomy wound healing and pain intensity
NADPH oxidase as a target for modulation of radiation response; implications to carcinogenesis and radiotherapy
Get PDFBackground: Radiotherapy is a treatment modality for cancer. For better therapeutic efficiency, it could be used in combination with surgery, chemotherapy or immunotherapy. In addition to its beneficial therapeutic effects, exposure to radiation leads to several toxic effects on normal tissues. Also, it may induce some changes in genomic expression of tumor cells, thereby increasing the resistance of tumor cells. These changes lead to the appearance of some acute reactions in irradiated organs, increased risk of carcinogenesis, and reduction in the therapeutic effect of radiotherapy. Discussion: So far, several studies have proposed different targets such as cyclooxygenase-2 (COX-2), some toll-like receptors (TLRs), mitogen-activated protein kinases (MAPKs) etc., for the amelioration of radiation toxicity and enhancing tumor response. NADPH oxidase includes five NOX and two dual oxidases (DUOX1 and DUOX2) subfamilies that through the production of superoxide and hydrogen peroxide, play key roles in oxidative stress and several signaling pathways involved in early and late effects of ionizing radiation. Chronic ROS production by NOX enzymes can induce genomic instability, thereby increasing the risk of carcinogenesis. Also, these enzymes are able to induce cell death, especially through apoptosis and senescence that may affect tissue function. ROS-derived NADPH oxidase causes apoptosis in some organs such as intestine and tongue, which mediate inflammation. Furthermore, continuous ROS production stimulates fibrosis via stimulation of fibroblast differentiation and collagen deposition. Evidence has shown that in contrast to normal tissues, the NOX system induces tumor resistance to radiotherapy through some mechanisms such as induction of hypoxia, stimulation of proliferation, and activation of macrophages. However, there are some contradictory results. Inhibition of NADPH oxidase in experimental studies has shown promising results for both normal tissue protection and tumor sensitization to ionizing radiation. Conclusion: In this article, we aimed to review the role of different subfamilies of NADPH oxidase in radiation-induced early and late normal tissue toxicities in different organs. © 2019 Bentham Science Publishers
Psychometric testing of the Persian version of the conditions of work effectiveness Questionnaire-II (CWEQ-II-PV)
No full textStructural empowerment (SE) is an effective method of advancing work environments and has previously been widely discussed in Western countries. Due to the lack of culturally and academically accepted scales in Iran for measuring SE, localization of a foreign scale in this field is necessary. OBJECTIVES: This study aimed at investigating the validity and reliability of the Persian Version of the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II-PV) among Iranian nurses. METHODS: The present cross-sectional methodological research was conducted during 2017-2018. Participants were 230 nurses working in four teaching hospitals affiliated to Kashan University of Medical Sciences in Kashan, Iran, who were selected using quota sampling. A standard forward-backward translation procedure according to Wild et al. (2005) was used to translate the English Version of the CWEQ-II to Persian. The psychometric evaluation processes were achieved by face, content, and construct validity (confirmatory factor analysis CFA). Reliability was examined using test-retest and Cronbach's alpha for internal consistency reliability. RESULTS: The CWEQ-II-PV showed good content validity (the mean content validity scores for relevancy, clarity, and simplicity were 94%, 96%, and 94%, respectively). In the CFA, the original six-factor version with 19 items was confirmed. The original model was presented and incorporated in the CFA, indicating an acceptable fit for the model (root mean square error of approximation = 0.06, comparative fit index = 0.92, goodness of fit index (GFI) = 0.94, and adjusted GFI = 0.91). Cronbach's alpha coefficient for the total scale was 0.84 and for each component ranged from 0.71 to 0.87, indicating good internal consistency, and the test-retest Spearman and intraclass correlation coefficients were 0.93 and 0.87, respectively, showing good test-retest reliability. CONCLUSIONS: Evidence was found to support the reliability and validity of the CWEQ-II-PV scale that measures the quality of the work environment for nurses from a SE perspective. © 2019 Journal of Education and Health Promotion Published by Wolters Kluwer - Medknow
The effects of mobile health interventions on lipid profiles among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials
Get PDFObjective: The current systematic review and meta-analysis of randomized controlled trials (RCTs)was conducted to summarize the effect of mobile health (m-health)interventions on lipid profiles among patients with metabolic syndrome and related disorders. Methods: Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched to indentify the relevant randomized clinical trials published up April 30 th , 2018. Two reviewers examined study eligibility, extracted data, and assessed risk of bias of included clinical trials, individually. Heterogeneity was measured using I-square (I 2 )statistic and Cochran's Q test. Data were pooled the standardized mean difference (SMD)effect size by the random-effect model. Results: 18 trials of 1681 citations were identified to be appropriate for the current meta-analysis. Findings random-effects model indicated that m-health interventions significantly decreased total- (SMD �0.54; 95 CI, �1.05, �0.03)and LDL-cholesterol levels (SMD �0.66; 95 CI, �1.18, -0.15). M-health interventions had no significant effect on triglycerides (SMD �0.14; 95 CI, �0.56, 0.28)and HDL-cholesterol levels (SMD �0.35; 95 CI, �0.81, 0.11). Conclusion: Overall, the current meta-analysis demonstrated that m-health interventions resulted in an improvement in total- and LDL-cholesterol, but did not affect triglycerides and HDL-cholesterol levels. © 2019 Diabetes Indi
The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes
Get PDFBackground: Diabetes is the most common medical condition in pregnant women and its complications affect both mother and fetus. The beneficial effects of vitamin D on gestational diabetes have been shown, though data on the effects of co-administration of vitamin D with other nutrients on pregnancy outcomes in gestational diabetes (GDM) are scarce. This study was aimed to determine the effects of magnesium-zinc-calcium-vitamin D co-supplementation on parameters of inflammation and oxidative stress, and pregnancy outcomes among women with GDM. Methods: This randomized, double-blinded, placebo-controlled trial was conducted on 60 women with GDM not taking oral hypoglycemic agents. Patients were randomly assigned to take magnesium-zinc-calcium-vitamin D supplements (n = 30) or placebo (n = 30) for 6 weeks. Fasting blood samples were collected from participants at baseline and after the 6-week intervention to measure related biomarkers. Results: Magnesium-zinc-calcium-vitamin D co-supplementation resulted in a significant reduction in serum high-sensitivity C-reactive protein (- 1.2 ± 3.5 vs. + 0.8 ± 2.0 mg/L, P = 0.01) and plasma malondialdehyde concentrations (- 0.3 ± 0.3 vs. + 0.3 ± 1.1 μmol/L, P = 0.003), as well as a significant increase in total antioxidant capacity levels (+ 38.2 ± 76.5 vs. -16.3 ± 93.5 mmol/L, P = 0.01), compared to placebo. We found a decreasing trend in newborns' weight (3089.8 ± 519.9 vs. 3346.3 ± 411.1 g, P = 0.05) and the rate of macrosomia (3.3 vs. 16.7, P = 0.08) in the magnesium-zinc-calcium-vitamin D supplemented women. Conclusions: Overall, the findings of this study have demonstrated that magnesium-zinc-calcium-vitamin D co-supplementation for 6 weeks to women with GDM may reduce biomarkers of inflammation and oxidative stress. This study was retrospectively registered on 25 April 2017 in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT201704225623N109). © 2019 The Author(s)
Vitamin D status in women with pelvic floor disorders: A meta-analysis of observational studies
No full textThe current evidence regarding the association between vitamin D status and pelvic floor disorder (PFD) are inconclusive. This meta-analysis was aimed to summarize existing data demonstrating the association between Vitamin D status and PFD using published observational studies. All national and international databases including Web of Science, PubMed, Google Scholar, and Scopus were searched up until January 30, 2018, and related published studies retrieved for meta-analysis. The effect sizes of Vitamin D status were presented as standardized mean difference (SMD) with 95 confidence interval (CI), using random-effect models and inverse variance method. The Cochran Q statistic and I2 tests were used to evaluate the heterogeneity across included studies. Seven studies with 3219 women were included our meta-analysis. There was heterogeneity existing among included studies (I2 = 96.4, P < 0.001), so a random-effect model was used. The findings of this meta-analysis revealed that the mean serum Vitamin D levels in women with PFD were significantly lower than healthy women (SMD -0.60; 95 CI, -1.06, -0.13; P = 0.01). This meta-analysis demonstrates lower levels of serum Vitamin D in women with PFD rather than healthy women. Additional prospective studies regarding the association between Vitamin D status and PFD are required to confirm our findings. © 2019 Journal of Mid-life Health
CDX2 Protein Expression in Colorectal Cancer and ItsCorrelation with Clinical and Pathological Characteristics, Prognosis, and Survival Rate of Patients
Get PDFPurpose: Caudal-type homeobox transcription factor 2 (CDX2) is expressed in the nucleus of the intestinal epithelial cells and is essential for embryonic formation and differentiation of the intestine, whose reduced expression can result in metastatic tumors. This study was to investigate the association of CDX2 expression level in colorectal cancer (CRC) with age, gender, microscopic histopathology, tumor staging, tumor grading, 3-year survival rate, and prognosis. Methods: After preparing paraffin tissue blocks, CDX2 protein expression was assayed by immunohistochemistry in 82 CRC patients. Hematoxylin and eosin staining was used to detect tumor histology, tumor grading, tumor staging, and blood-lymphatic, and neural invasion. The collected data includes age, gender, tumor site, and 3-year survival rate of patients after diagnosis. Results: The CDX2 expression was significantly higher in men than in women, and it was significantly lower in right-sided tumors as in transverse colon and left-sided tumors. Also, the CDX2 expression was significantly higher in adenocarcinoma than in mucinous. In addition, a significant correlation was found between downregulated CDX2 and lymph node involvement. In tumor grading, there was a significant correlation between CDX2 downregulation and high-grade tumor. Moreover, there was a significant correlation between downregulated CDX2 expression and overall pathological staging. Conclusion: The downregulated CDX2 expression is associated with female gender, right-sided tumors, mucinous tumors, lymph node involvement, high-grade tumor, and advanced overall pathological staging and can be considered as a possible prognostic factor for patients follow-up. However, our study is a preliminary study and further studies with larger sample sizes in different ethnic groups are required. © 2019, Springer Science+Business Media, LLC, part of Springer Nature
Enhancing Asthma Patients' Self-Management through Smartphone-Based Application: Design, Usability Evaluation, and Educational Intervention
No full textObjective The aim of this study was to design and evaluate a smartphone-based application for improving self-management in patients with asthma and evaluate its effects on their knowledge. Methods In this applied research, based on the Clinical Practice Guideline and a systematic review, a questionnaire was designed to determine the application information content and functionality requirements by 15 pediatric and adult asthma and allergy specialist. Then the application was designed and developed using Adobe Air software on the Android operating system. Usability evaluation of the mobile application was performed using the standard questionnaire for user interaction satisfaction (QUIS), which completed by 30 patients with asthma, 8 information technology (IT) specialists, and 2 asthma and allergy specialists. Self-management knowledge of 30 asthma patients was measured using a researcher-made questionnaire before and after using the application. Results The number of specialists in the both Delphi rounds was 15 and the mean work experiences were 17.6 years. The most important elements for asthma self-management were avoiding exposure to allergen and triggers (96), drug treatment (94.6), and how to use the therapeutic tools (92.4), and the most important functionalities were alerting the patients when they did not control asthma (92), setting reminders for timely drug use (85.4) and therapeutic tools (82.6), recording prescription drugs (82.6), and peak flow meter values (82). Usability evaluation showed that 30 patients with asthma, 8 IT specialists, and 2 physicians evaluated the application at a good level. The mean score of the patients' knowledge before intervention was 2.43 ± 0.95 which after intervention was significantly increased to 4.3 ± 0.56 (p < 0.001). Conclusion Considering the desirable outcomes of application evaluation and a positive impact of this educational intervention on asthma patients' knowledge, it is possible to use mobile-based self-management programs to help these patients to manage illness and gain knowledge and self-management skills. © 2019 Georg Thieme Verlag KG Stuttgart New York
Satureja khuzestanica essential oil against quorum sensing of pseudomonas aeroginosa using RT-PCR
Get PDFComparative study of lactobacilli and bifidobacteria in vaginal tract of individual with bacterial vaginosis and healthy control by quantitative PCR
Get PDFBackground:Bacterial vaginosis is characterized by a disequilibrium in vaginal microflora with the distinguishing feature of decrease in lactobacilli. The current study aimed to study lactobacilli and bifidobacteria in the vaginal tract of individual with bacterial vaginosis.Methods:For this purpose, vaginal swabs of 108 women, including 92 patients with clinical symptoms of bacterial vaginosis and 16 healthy cases were collected. After extraction of DNA from vaginal samples, quantitative PCR was performed for detect the bacterial load and 16SrRNA gene. PCR was performed for the detection of microorganisms related to sexually transmitted infections, which all samples harboring any of such microorganisms was excluded from study.Results:There was a positive link between the quantitation of Lactobacillus spp. and Bifidobacterium spp. among patients with bacterial vaginosis and healthy group. Quantitative PCR analysis illustrates that the frequency of Lactobacillus spp. and Bifidobacterium spp. are significantly lower in patients with bacterial vaginosis compared with healthy individuals.Conclusion:The current study promotes our understanding about the vaginal Lactobacillus spp. and Bifidobacterium spp. among patients and healthy individuals in Iran. Confirming the link between the frequency of lactobacilli and bacterial vaginosis could help us develop new prebiotics and probiotics for this disorder. © 2019 Wolters Kluwer Health, Inc. All rights reserved