Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: A randomized clinical trial

Objective: The purpose of this study was to explore the effect of Lavandula angustifolia (lavender) inhalation on the symptoms of dysmenorrhea and the amount of menstrual bleeding in female students with primary dysmenorrhea. Design: This study is an experimental clinical trial. The subjects were 96 female students residing in dormitory at Tehran University of Medical Sciences in 2011 and suffering from level two or three dysmenorrhea according to the verbal multi-dimensional scoring system. The inclusion criteria were as: being single, suffering from primary dysmenorrhea, having no genital organs disorder, having no systemic disease, having regular menstrual cycles, using no contraceptives, etc. The follow-up time was 4 menstrual cycles. Interventions: The subjects were randomized into two groups: experimental (n = 48) who inhaled lavender based on sesame oil, and placebo (n = 48) who inhaled sesame oil only. Main outcome measures: The severity of dysmenorrhea symptoms was measured through a questionnaire, and the amount of menstrual bleeding was measured by sanitary towel usage. Methods: Ordinal logistic regression and generalized estimating equation (GEE) were used to analyze the data. Results: The symptoms of dysmenorrhea were significantly lowered in the lavender group compared to the placebo group (p < 0.001). The amount of menstrual bleeding in the lavender group was reduced in comparison to the placebo group but the difference was not statistically significant (p = 0.25). No significant difference was observed for blood clot among the students (p = 0.666). Conclusions: This study showed that lavender inhalation was effective in alleviating dysmenorrhea symptoms, suggesting that it could be applied by midwives in a safe manner because of no side effects, simplicity and cost-effectiveness for all patients. (C) 2014 Elsevier Ltd. All rights reserved

The effect of infant massage on the frequency and duration of breast feeding- A randomized clinical trial

زمینه و هدف: شیر مادر بهترین تغذیه برای نوزاد است، زیرا فواید سلامتی بی شماری را برای مادر و نوزاد فراهم می کند. ماساژ به عنوان بخش روتینی از مراقبت شیرخواران در بسیاری از فرهنگ ها استفاده می گردد. هدف از این مطالعه بررسی تاثیر ماساژ توسط مادر بر دفعات و مدت زمان شیرخوردن شیرخوار بود. روش بررسی: این مطالعه کارآزمایی بالینی بر روی 80 شیرخوار از زنان نخست زای مراجعه کننده به مراکز بهداشتی درمانی منتخب دانشگاه علوم پزشکی شهرکرد در سال 1389 انجام یافته است. شیرخواران به طور تصادفی به دو گروه 40 نفره تقسیم شدند. درگروه آزمون ماساژ توسط مادر 2 نوبت در روز (صبح و عصر) و به مدت 8 هفته، هر بار به مدت 15 دقیقه انجام گرفت؛ در حالی که گروه کنترل تنها مراقبت های معمول را دریافت نمودند. ابزار جمع‌آوری اطلاعات فرم ثبت خاطرات روزانه والدین شیرخوار در خصوص دفعات و مدت زمان شیرخوردن شیرخوار بود که در ابتدای مطالعه و انتهای هفته-های چهارم و هشتم مطالعه توسط مادر تکمیل ‌گردید. یافته ها: یافته های مطالعه نشان داد که مدت و دفعات شیرخوردن در هفته های چهارم و هشتم پس از مداخله در گروه آزمون به طور معناداری بیشتر از گروه کنترل بود (05/0>P). نتیجه گیری: به طور کلی نتایج حاصل از این پژوهش نشان داد که ماساژ بر دفعات و مدت شیر خوردن شیر خواران موثر بوده و آن را ارتقاء بخشیده است. از آنجا که ماساژ یکی از عوامل مهم در موفقیت شیردهی با شیر مادر می باشد؛ لذا تأکید بر اهمیت ماساژ در هر زمان ممکن، با هر طول مدتی پس از تولد توصیه می گردد

The effect of massage with oils on the growth of term infants: a randomized controlled trial

Background and Aims: Infant massage could potentially benefit both physiological and psychological health. This study aims to determine the effect of massage with oils on the growth of full-term infants, which is given by their mothers. Study Design: This is a double-blind randomized controlled trial which was conducted on full term infants visited in the nine Public Health Centers of Shahrekord, Iran in 2010. Material and Methods: This study included 217 infants. Inclusion criteria for the infants were age scale between 10 to 15 days, full term gestation, birth weight of 2500 grams at least, Apgar score of 7 or above, no resuscitation after the birth, exclusive breastfeeding during the study, medically stable condition without any need for drugs, nulliparous. The infants were randomized into four groups: massage with sunflower oil, massage with sesame oil, massage without oil, and no massage (control group). Massage was given by mothers twice a day for 4 weeks, starting from the 10 - 15th day of life. Weight and height were measured weekly. At last, Repeated Measures Analysis of Covariance was employed to analyze the data. Birth weight (height) as well as mean frequency of breastfeeding during the study was deemed as covariates. Results: The findings showed that the mean of weight and height was significantly different between groups over time, respectively (P = 0.005, P < 0.001). The infants’ mean weight in sunflower oil massage group increased significantly compared with other three groups (P = 0.005). In addition, infants’ height gain in sunflower and sesame oil massage group were significantly higher than message-only and control groups (p < 0.001). Conclusions: Massage with oil, especially sunflower oil is an inexpensive, simple, and effective intervention which improved weight and height gain in selected samples. Further studies are needed to evaluate the serious adverse effects, if any, to notify midwives and health care staff

Early postoperative pain as a risk factor of shoulder stiffness after arthroscopic rotator cuff repair

Background: The role of postoperative pain in incidence of shoulder stiffness (SS) after shoulder arthroscopy has not been thoroughly investigated. The present study was conducted to assess the effects of early postoperative pain (EPOP) on onset of SS after arthroscopic rotator cuff (RC) repair. Materials and methods: In a retrospective analysis of a prospectively collected database, 335 patients who underwent arthroscopic RC repair were evaluated. RC tendons were sutured to the bone using the double-row technique. EPOP was evaluated 1 week after surgery using the visual analog scale (VAS). SS was assessed 3 months after surgery and was categorized into moderate or severe based on shoulder range of motion (ROM). Each type of complication including SS was identified and recorded. Results: Postoperative shoulder stiffness (POSS) was identified in 121 patients (36.2) that was moderate in 86 patients (70.1) and severe in 35 patients (28.9). After 1 week, VAS pain score was equal to 7.7 ± 3.1 and 4.5 ± 2.1 in the patients with and without stiffness, respectively (p < 0.001). Diabetes and traumatic tear were found to be associated with postoperative stiffness (p = 0.046 and p < 0.001, respectively). Similar associations were found on multivariate analysis of data. VAS pain score was higher in the patients with severe stiffness compared with those with moderate stiffness (p < 0.001). Conclusions: Our findings revealed that EPOP is associated with shoulder stiffness after arthroscopic RC repair. Therefore, strategies to ameliorate EPOP could be opted to decrease rate of POSS. Level of evidence: Level IV © 2021, The Author(s)

The role of alimentary and biliopancreatic limb length in outcomes of Roux-en-Y gastric bypass

Introduction: Roux-en-Y gastric bypass (RYGB) is one of the safe and easily reproducible bariatric procedures. Aim: To evaluate the effect of biliopancreatic limb (BPL) and alimentary limb (AL) length on weight loss outcomes after RYGB. Material and methods: This retrospective cohort study included 313 morbidly obese patients who underwent primary laparoscopic RYGB 2009-2015. Patients' BPL and AL lengths were categorized into three groups: Group 1 (BPL: 50 cm and AL: 150 cm), group 2 (BPL: 150 cm and AL: 50 cm), and group 3 (BPL: 100 cm and AL: 100 cm). Data were provided from the Iranian National Obesity Surgery Database. The generalized estimating equations method was used to assess the effect of limbs length on excess weight loss (EWL). Results: Mean ± standard deviation age and body mass index (BMI) of 252 patients were 38.55 ±10.24 years and 45.8 ±4.77 kg/m2, respectively. Totally, 172 (68.3, BMI of 46 ±5 kg/m2), 48 (19, BMI of 45.12 ±4.26 kg/m2), and 32 (12.7, BMI of 45.43 ±4.23 kg/m2) were in group 1, 2, and 3, respectively (p = 0.44). The results showed that the choice of different limb lengths had no significant effect on EWL over 12 months follow-up (p = 0.625) adjusted for baseline BMI (p = 0.25). Mean EWL in the patients with longer BPL and shorter AL was 5.43 (1.91, 8.95) higher in comparison to the patients with shorter BPL and longer AL during 36 months postoperatively adjusted for baseline BMI (p = 0.002). Conclusions: During 12 months after RYGB, EWL was not associated with BPL or AL length. However, during 36 months postoperatively, the patients with longer BPL had a significantly higher EWL in comparison to the patients with shorter BPL. © 2020 Termedia Publishing House Ltd.. All rights reserved

Relapse, mortality, and the associated factors in children with acute lymphoblastic leukemia; a competing risks analysis

Background: Acute lymphoblastic leukemia (ALL) is the most frequent form of malignant neoplasia diagnosed in ages 0 to 14 years old. Efforts have not yet converted into a better prospect. Bone marrow relapse is still the leading cause of person-year of life lost in this malignancy. Objectives: This study aimed at identifying the associated risk factors for relapse and mortality for pediatric patients with ALL in standard and high-risk groups. Methods: This study included a cohort of pediatric (0-16 years old) patients with ALL referred to Sheikh Hospital, Mashhad, Iran from 2007 to 2016. The demographic, clinical, and laboratory information were considered. Hazard ration (HR) with 95 highest posterior density region was obtained, using a Bayesian competing risks model. Results: Of 424 patients with a mean age of 5.56 ± 3.75 years, 172 (40) were female. Median follow-up time was 43.29 months, 10.6 had a relapse, and 17.2 had mortality related to ALL. Relapse-free survival rates at 1, 3, and 5 years were 97, 91, and 88, respectively. Overall survival rates were 86, 83, and 82, respectively. In the standard-risk group, tumor lysis syndrome (TLS) significantly increased either the relapse risk HR: 13.47 (2.05-67.54) or mortality risk HR: 19.57 (2.24-32.18). In the high-risk group, the higher level of hemoglobin, platelet, and lactic acid dehydrogenase was significantly associated with higher relapse risk. TLS was associated with a higher risk of mortality in high-risk groups. Conclusions: It was suggested that TLS was a predictor for the disease relapse as well as mortality in pediatric patients with ALL. However, further evaluation on the larger population of patients is demanded to ascertain the precision of such parameters in leukemic management strategies. © 2021, Author(s)

The association between melasma and iron profile: A case-control study

Background ' Melasma is a chronic acquired localized hypermelanosis, causing aesthetic problem for women and impairing their quality of life. Evidence has suggested that hyperpigmentation can occur as a result of iron deficiency anemia and vitamin B12 deficiency. Aim ' We aimed to evaluate the serum parameters of iron profile in melasma patients. Material and Methods ' This case-control study investigated 51 adult non pregnant women with melasma, compared with 51 controls, from patients referred to the Hospital, Tehran, Iran, 2017-2018. Melasma was diagnosed clinically according to the melasma area and severity index (MASI) score was calculated and recorded by the physician. The groups were compared in terms of vitamin B12, folate, serum iron, hemoglobin (Hb), mean corpuscular volume (MCV), total iron binding capacity (TIBC), and ferritin. Results ' The mean and standard deviation of the women's age was 36.89±8.88 years, significantly higher in the group of patients with melasma. Comparing the serum parameters between the groups indicated no statistically significant difference in terms of mean levels of ferritin, Hb, MCV, iron, vitamin B12, TIBC, and folate. The women in melasma group had a higher frequency in below normal range of ferritin and serum iron compared to the control group. None of the serum parameters were correlated with MASI. Conclusion ' The higher frequency of below normal range of ferritin and serum iron levels in women with melasma compared to the control group showed a possible association between these serum parameters and melasma. © 2020, LLC Science and Innovations, Saratov, Russi

The first experience of ex-vivo lung perfusion (EVLP) in Iran: An effective method to increase suitable lung for transplantation

Background: Although lung transplantation is a well-accepted treatment for end-stage lung diseases patients, only 15-20 of the brain-dead donors' lungs are usable for transplantation. This results in high mortality of candidates on waiting lists. Ex-vivo lung perfusion (EVLP) is a novel method for better evaluation of a potential lung for transplantation. Objective: To report the first experience of EVLP in Iran. Methods: The study included a pig in Vienna Medical University, Vienna, Austria, and 4 humans in Masih Daneshvari Hospital, Tehran, Iran. All brain-dead donors from 2013 to 2015 in Tehran were evaluated for EVLP. Donors without signs of severe chest trauma or pneumonia, with poor oxygenation were included. Results: An increasing trend in difference between the pulmonary arterial pO2 and left atrial pO2, an increasing pattern in dynamic lung compliance, and a decreasing trend in the pulmonary vascular resistance, were observed. Conclusion: The initial experience of EVLP in Iran was successful in terms of important/critical parameters. The results emphasize on some important considerations such as precisely following standard lung harvesting and monitoring temperature and pressure. EVLP technique may not be a cost-effective option for low-income countries at first glance. However, because this is the only therapeutic treatment for end-stage lung disease, it is advisable to continue working on this method to find alternatives with lesser costs

The first experience of ex-vivo lung perfusion (EVLP) in Iran: An effective method to increase suitable lung for transplantation

Background: Although lung transplantation is a well-accepted treatment for end-stage lung diseases patients, only 15-20 of the brain-dead donors' lungs are usable for transplantation. This results in high mortality of candidates on waiting lists. Ex-vivo lung perfusion (EVLP) is a novel method for better evaluation of a potential lung for transplantation. Objective: To report the first experience of EVLP in Iran. Methods: The study included a pig in Vienna Medical University, Vienna, Austria, and 4 humans in Masih Daneshvari Hospital, Tehran, Iran. All brain-dead donors from 2013 to 2015 in Tehran were evaluated for EVLP. Donors without signs of severe chest trauma or pneumonia, with poor oxygenation were included. Results: An increasing trend in difference between the pulmonary arterial pO2 and left atrial pO2, an increasing pattern in dynamic lung compliance, and a decreasing trend in the pulmonary vascular resistance, were observed. Conclusion: The initial experience of EVLP in Iran was successful in terms of important/critical parameters. The results emphasize on some important considerations such as precisely following standard lung harvesting and monitoring temperature and pressure. EVLP technique may not be a cost-effective option for low-income countries at first glance. However, because this is the only therapeutic treatment for end-stage lung disease, it is advisable to continue working on this method to find alternatives with lesser costs

An improper form of Weibull distribution for competing risks analysis with Bayesian approach

In survival analysis, individuals may fail due to multiple causes of failure called competing risks setting. Parametric models such as Weibull model are not improper that ignore the assumption of multiple failure times. In this study, a novel extension of Weibull distribution is proposed which is improper and then can incorporate to the competing risks framework. This model includes the original Weibull model before a pre-specified time point and an exponential form for the tail of the time axis. A Bayesian approach is used for parameter estimation. A simulation study is performed to evaluate the proposed model. The conducted simulation study showed identifiability and appropriate convergence of the proposed model. The proposed model and the 3-parameter Gompertz model, another improper parametric distribution, are fitted to the acute lymphoblastic leukemia dataset. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group