Low-Level Laser Therapy Effects on Reducing Surgical Complications and Wound Infection after Cesarean Section

Background:One of the main problems in cesarean section cases is represented by postoperative pain that can cause delay in recovery and intense complications for patients. Therefore, the present study evaluates the effect and quality of treating infectious tissue and surgical complications using low-level lasers after cesarean section. Methods:In this clinical study, 240 candidates for the same type of surgery using the spinal anesthesia technique, were randomly divided into a laser treatment group and a control group. Finally, the surgical incision in the laser group was irradiated by laser (810 nm). Furthermore, the same method was used for the control group. The first request for analgesia, total analgesic consumption and severity of postoperative pain by visual analogue scale (VAS) were monitored in all patients for 24 hours. Findings: The 240 participants in the present study were equally allocated (1:1 ratio) to the case and control groups. There was a significant difference in average age (P=0.013) between subjects of the two study groups, with controls having a lower average age than participants in the case group based on the obtained results. However, the body mass index did not significantly differ between the two groups (p=0.1). The average use of painkillers (a painkiller is a pill or other form of drug that reduces or stops physical pain), suture removal time, and postoperative pain on days 3, 7, 14, and six weeks after surgery were lower in the case group than in the control group. The obtained difference was statistically significant (p<0.001). Conclusion:According to the findings of this study, using low-level laser therapy with cluster current (wavelength 810 nm and power 300 mW and power density for low-level laser 4 W/cm2) can help reduce postoperative pain and the need for painkillers.

Protective Effect of Ursodeoxycholic Acid on Liver Function in Pediatric Patients with Seizure Treated with Phenobarbital

BackgroundEpilepsy is a common and devastating neurological disease. Its treatment, especially when using phenobarbital, causes liver complications, and it is therefore essential to identify a way to reduce liver complications. This study aimed to investigate the protective effect of ursodeoxycholic acid on liver function in pediatric patients with seizure treated with phenobarbital. Materials and methods:Materials and methods: The present study was conducted on 80 patients (40 in the placebo group and 40 in the ursodeoxycholic acid group). To assess the effect of intervention, liver enzyme levels after five weeks of treatment were recorded. Independent t-test and ANOVA repeated measures were used to compare the means. Conclusions:The study results showed that the administration of ursodeoxycholic acid had a relative effect in improving liver function in patients with liver injury caused by phenobarbital.

Evaluation of The Relationship between Cell-Free DNA Fetal Fraction of The Circulatory System and Fetal and Maternal Pregnancy Prognosis: A Prospective Study

BACKGROUND

Non-invasive prenatal testing (NIPT), sometimes called noninvasive prenatal screening (NIPS), is a non-invasive prenatal genetic test using cell-free DNA in maternal blood. This method is used to diagnose fetal aneuploidy disorders such as Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13), which causes disability disorders or significant postpartum defects. The aim of this study was to investigate the relationship between high and low fetal fraction (FF) and prognosis of maternal pregnancy.

MATERIALS AND METHODS

In this prospective study, after obtaining informed consent, 10 ml of blood was collected from 450 mothers with singleton pregnancies with gestational age above 11 weeks (11-16) at the request of NIPT for cell-free DNA BCT test. After obtaining the test results, maternal and embryonic results were evaluated based on the amount of non-cellular DNA FF. Data analysis was performed by using SPSS software version 21 and independent t test, chi-square statistical tests.

RESULTS

Based on test results, 20.5% of women were nulli par. The mean FF index in the studied women was 8.3% with a standard deviation of 4.6. The minimum and maximum values were 0 and 27, respectively. The frequency of normal, low and high FFs was 73.2, 17.3 and 9.5%, respectively.

CONCLUSION

High FF has fewer risks to the mother and fetus than low FF. The use of FF level (high or low) can help us determining the prognosis of pregnancy and using it to better manage the pregnancy.

The effect of yoga on uterine artery Doppler indices, maternal and fetal complications in pregnant women: A quasi-experimental study

BACKGROUND

Today, the effect of yoga has been examined on various physical and psychological dimensions of pregnant women. However, there are still sparse studies on the effect of yoga on the uterine artery indices as well as maternal and fetal complications.

OBJECTIVE

The aim was to determine the effect of yoga on uterine artery Doppler indices, maternal and fetal Complications.

MATERIALS AND METHODS

This quasi-experiential study was conducted, on 100 pregnant women. The participants were assigned to yoga and control groups. In the yoga group, the participants exercised yoga for 1 h. On the other hand, the control group received routine care.

RESULTS

The results showed that in the yoga group, the functional indices of the uterine artery (S/D, PI, RI, and DN) improved more significantly compared to the control (p = 0.01). The results also showed that in the yoga group, maternal complications (diabetes and preeclampsia), as well as fetal complications (SAG, IUGR), were significantly lower compared to the control (p = 0.01).

CONCLUSION

This study revealed the positive effects of yoga on improving fetal development indices and reducing maternal and fetal complications following pregnancy. It can be used as a Complementary therapy alongside other treatments for mothers.

Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis

Objective:

Postoperative nausea and vomiting (PONV) is a daily phenomenon, to which less attention has been paid in a variety of surgeries. Despite the individual studies, there is no comprehensive study on the prevalence of PONV. The aim of this study was to determine the global prevalence of PONV.

Materials and Methods:

In this systematic and meta-analysis study, descriptive studies of four databases (PubMed, Web of Science, Scopus, and Google Scholar) were searched for relevant texts from the time they were created until 31 December 2018. The random effects model was used for meta-analysis of studies included. All the steps were carried out by two individuals. Hoy et al.'s tool was used to evaluate its risk bias.

Results:

A total of 23 studies that were performed on 22,683 people from 11 countries were entered into the final phase. The prevalence of PONV, nausea, and vomiting was 27.7%, 31.4%, and 16.8%, respectively. The prevalence of PONV was higher during the first 24 h in European countries.

Conclusion:

Considering the high prevalence of PONV and our goal to better control it, it is necessary to use high cost-effective approaches and recommendations and to educate health caregivers and patients.

Prevalence of gestational diabetes mellitus in Eastern Mediterranean region: a systematic review and meta-analysis

PURPOSE

Gestational diabetes mellitus (GDM) is one of the costly challenges in the health field. Despite the individual studies in the Eastern Mediterranean, there is no comprehensive study in this regard. The aim of this study was to determine the prevalence of GDM in the Eastern Mediterranean region.

METHODS

In this meta-analysis and systematic review, three international databases (PubMed, Web of science and Scopus) were searched from inception until 30 December 2018. The Hui tool was used to assess the quality of the included studies.

RESULTS

Thirty-three studies performed on 887166 participants were included in the meta-analysis. Based on the results of random effect method, the overall prevalence of GDM was 11.7%. Between six country with have three or more study, pooled prevalence for Saudi Arabi it was 3.6 times more than Israel (17.6 vs. 4.9%), and for Pakistan, Qatar, Bahrain and Iran were 15.3%, 14.7%, 12.2%, and 8.6%, respectively.

CONCLUSION

Despite the high diversity of methods, the results of the present study indicate a high prevalence of GDM in the Eastern Mediterranean region, indicating more policymakers' interest in timely screening and proper management.

Surgical site infections in Eastern Mediterranean region: a systematic review and meta-analysis

Background: Surgical site infections (SSIs) are the most common and costly type of hospital-acquired infections (HAIs) worldwide. Despite individual studies, there is also no clear statistics on the SSI prevalence rate in the East Mediterranean region. The aim of this study was to investigate the prevalence of SSI in the Eastern Mediterranean region. Methods: This systematic review and meta-analysis were performed by searching three international databases (Web of Science, PubMed and Scopus) from 1 January 2001 to 31 December 2018. The keywords used included 'Prevalence' OR 'incidence' OR 'surgical site infection' OR 'wound infection' OR 'Postoperative Wound Infections' and 'Middle east'. The Hoy et al.'s tool was used to evaluate the quality of the articles. Result: Out of 889 initial studies, 40 studies from 12 countries of the Eastern Mediterranean region were included in the final stage of the study. Based on the results of random effect method, the overall prevalence of SSI in 137,452 patients was 7.9% (95% Confidence Interval (CI): 7.1, 8.8; I²=96.7%). The prevalence of SSI in cardiac surgery and general surgery wards was 10 and 9.2%, respectively. The prevalence of SSI was lower in women than in males, although this difference was related to caesarean section. Conclusions: Considering the high prevalence of SSI in the Eastern Mediterranean region, timely diagnosis, proper prevention and postoperative control are necessary in the region using the same international guides in all countries.

The Role of Ionizing Radiation in Cellular Signaling Pathways, Mutagenesis, and Carcinogenesis

One of the negative effects of ionizing radiation is the alteration of cellular signaling pathways which lead to carcinogenesis and tumorigenesis. In this review, we discussed the impacts of ionizing radiation on cells and cellular signaling pathways. In this regard, exposure to radiation can directly or indirectly alter cellular signaling pathways. Remarkably, irradiated cells release special mediators into cellular matrix, aberrating cell-cell and cell-environment interactions. Most notably, these mediators include nitric oxide (NO), reactive oxygen species (ROS), and cell growth factors which contribute to cellular interactions between irradiated cells and their neighbor cells, a phenomenon known as radiation-induced bystander effect. DNA molecule is the most important cellular compartment damaged by ionizing radiation. On the other hand, the ability of irradiated cells to repair the damaged DNA is very low. Therefore, DNA alternations are passed to the next generations, and ultimately lead to carcinogenesis. The study of ionizing radiations and their impacts on biological systems is of remarkable importance to divulge their impacts on cellular signaling pathways.

Relationship between Ultrasonic Marker of Fetal Lung Maturity and Lamellar Body Count

BACKGROUND

The aim of this study was prediction the fetal lung maturity by ultrasonic markers and comparison by lamellar body count and fetal outcome.

METHODS

A prospective Longitudinal study Department of perinatology of performed Emam Khomeini hospital and Mirza Kochak Khan Hospital in Tehran, Iran from March 2013 to January 2014. 100 pregnant women (37-40 weeks of gestation) who were admitted for elective cesarean section and referred for an obstetric ultrasound scan at the same day of their elective cesarean section were included. Scanning with linear ultrasound with convex transducer frequency of 3.5 MHZ was utilized to measure the biparietal diameter, Amniotic fluid vernix and placental grading. Statistical analysis was performed using Spss version 20. Validity of the indicators compared with lamellar body count and fetal outcome.

RESULTS

In this study, from 100 patients under study, 8 cases were hospitalized in NICU (neonatal intensive care unit) which all of them had LAMELAR BODY COUNT < 14000 (10000-14000). There were 6 boys and 2 girls. In this study, there was no perinatal mortality.

CONCLUSIONS

In study we used ultrasonic marker of fetal lung maturity and related this to lamellar body count and neo natal outcome. The ultrasonic marker of fetal lung maturity can reduce mortality and morbidity in neonate.

Perinatal outcome after diagnosis of oligohydramnious at term

Background:

Oligohydramnious is threatening condition to fetal health for which some treatment are available and some are under evaluation. Oligohydramnious, is associated with increased pregnancy complication, congenital anomalies and perinatal mortality. There is an inverse relationship between the amniotic fluid index (AFI) and the adverse perinatal outcome. Oligo hydramnlious is clinical condition characteries by amniotic fluid index (AFI) of 5cm or less. Its incidence is 3-5 % of all the pregnancies an accurate and reproducible method of determining abnormality in amniotic fluid volume (AFI) is sonographic asessment of amniotic fluid index (AFI). It often increase the risk of small for gestational age (SGA) and also the incidence of cesarean section, meconium stained, low apgar score and Neonatal intensive care (NICU) admission.

Objectives:

The aim of study was to analyze the fetal out come in low risk pregnant women with oligohydramnious at term. This is a prospective, descriptive study.

Materials and Methods:

The study was conducted at Amiralmomenin hospital in Zabol for a period of 8 months from 2012/Mar/27 to 2012/Nov/5.It included 100 pregnant women diagnosed with the AFI of or less than 5cm at term. Control group included 300 pregnant women with AFI more than 8cm. Comparison was done between the study group and the control group. Regarding the fetal and pregnancy outcome using chi square and p value, detail were recorded in terms of fetal weight, apgar score at 1 and 5 minutes.

Results:

Mode of delivery, NICU admission neonatal death and induction of labour. Oligohydramnious is associated with a high rate of pregnancy complication and increased preinatal morbidity and mortality. Women with oligohydramnious usually have low birth babies.

Conclusions:

However, it can expect a safe and good outcome for which proper fetal surveillance and regular antenatal care visits are required.

Randomized comparison of nylon versus absorbing polyglactin 910 for fascial closure in caesarean section

Background:

Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material.

Objectives:

The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean.

Patients and Methods:

This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ≤ 0.05 was considered as statistically significant.

Results:

One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically significant difference in wound stitch and incision hernia was demonstrated between the suture groups.

Conclusions:

The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.