Low-Level Laser Therapy in the Treatment of Autoimmune Thyroiditis

Autoimmune thyroiditis is an autoimmune disorder which characterized by thyroid gland dysfunction. Low Level Laser Therapy(LLLT) is a safe and non-invasive intervention that gained much attention in many clinical applications including pain relief, regenerative medicine, and autoimmune. In the present review, we discuss the effects of LLLT on the treatment of autoimmune thyroiditis

Self-assessment of clinical competence on sexual health by Iranian medical interns: a framework for curriculum revision

Background: The sexual medicine education in medical faculties has been a challenging issue worldwide in recent decades. Most of medical students are dissatisfied for their sexual health education which indicates an emergent need for curriculum revision. The nobility of the study was to reveal medical students' competency gaps on sexual medicine.Methods: This cross-sectional study was conducted at a large, public medical school, topped the national ranking for its excellence in education. The target population was medical interns in their 6th and 7th year of their course. With a census sampling approach, all eligible students were included. To develop the questionnaire, the framework of ESSM (European Society for Sexual Medicine) syllabus of sexual medicine 2012 was employed after being examined by an expert panel to meet the criteria of content coverage. Recruiting 10 participants, a pilot was conducted to assess the criterions of validity and reliability. Finally a 35 item questionnaire was developed including three domains; "male sexual problems", "female sexual problems" and "common to both sexes sexual problems” with 17, 9, and 9 items, respectively. Students were asked to answer each item in a five-level Likert scale. The total score was standardized to convert scores to a range of 0-100 making it easy to interpret. In addition, a single question on the general competency was asked. Analytical statistics were used appropriate to data type and distribution (t test, one-way ANOVA). Study protocol was approved by research executive and ethics board of the institution.Results: 152 of 260 eligible students participated, with mean age of 25.0 (SD=2.3), of whom 54% were females. The standardized total competency score was 22.3 (95% CI: 20.4-24.2). Regarding to not only total but also different domains scores, there was no significant difference in different grades (PV>0.05). The female students' competency was significantly higher in the domain of "female sexual problems" and "common sexual problems, but not in the domain of "male sexual problems". None of the interns believed that they are competent enough to manage patients with sexual problems by themselves.Conclusions: We magnificently attained that medical students' clinical competency on sexual medicine is poor. Medical education system of Iran would not be able to deal with this challenge unless it provides with a comprehensive curriculum revision

Cell Therapy and Tissue Engineering in Bone Defect Reconstruction; A Review

Background: Extensive research on bone tissue engineering as a novel therapeutic approach to design and fabricate suitable scaffolds is in progress to overcome the limitations of conventional bone repair techniques. In recent years, tissue engineering and remedial medicine have come up with the strategy of designing, fabricating, and optimizing synthetic and natural scaffolds containing cells and growth factors to facilitate the direct and indirect mechanisms of bone tissue repair in the body. Based on many studies, cellular source, cell medium condition, and biological scaffolds are critical factors in bone defect repair in the field of tissue engineering.Aim: In this review, we focus on the combination of mesenchymal cells derived from the human adipose tissue, stem cell-to-bone differentiation medium, and biocompatible polyvinyl alcohol-graphene oxide scaffolds in bone lesion repair to gain a better understanding of each factor. This would, in turn, help us design and develop optimal therapeutic approaches for bone repair and regeneration. Conclusion: The combination of mesenchymal cells and biocompatible scaffolds proved promising in the process of bone lesion repair

Exosome Therapy in Spinal Cord Injury: A Review

Background: Injuries to the spinal cord (SCI) are one of the most detrimental central nervous system (CNS) injuries in developing countries. Today, treatment is one of the major issues facing the medical profession, and to date, there is no known promising treatment capable of fully healing injuries. There are various methods to repair and improve SCI, including the use of stem cells particularly mesenchymal stem cells (MSCs). Various studies have been performed on applying these cells in the treatment of SCI, whose results have confirmed the efficacy of using these cells specifically due to the paracrine secretion of these cells including growth factors, chemokines, cytokines, and small extracellular vesicles. Interestingly, among these paracrine molecules, exosomes may have the maximum therapeutic value and as such is widely investigated by researchers.Aim: to fully focus on the usage of stem cell-derived extracellular vesicles on the healing of SCI in animal models.Conclusion: Taken together, the extracellular nanovesicles have promising therapeutic potentials and their use in the treatment of SCI has been rapidly growing. In this review, we elucidated the effect of exosomes derived from bone marrow MSCs in SCI

Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis

ObjectivesThe aim of this study was to estimate the extra risk of second primary cancer among breast cancer patients.Methods and materialsThis is a systematic review. A comprehensive search of literature was performed in PubMed, Web of Science, Cochrane library, and Scopus. The search included all published studies up to October 2022. This systematic review included studies published in the English language that reported the risk of second primary non-breast cancer [i.e., standardized incidence ratio (SIR)] among breast cancer patients older than 15 years. After evaluating the methodological quality of the selected studies, SIRs were pooled with consideration of heterogeneity among studies. The estimates were pooled by age and time since the diagnosis of primary breast cancer for both sexes (male and female). Age was categorized based on before 50 years and after 50 years, and time was categorized as duration of less than and more than 10 years, respectively.ResultsFrom 2,484 articles, 30 articles were eligible for inclusion in the systematic review and meta-analysis. The studies varied in terms of population, number of cases, study design, setting, and year of implementation of the research. The estimated SIR for men and women was 1.28 (95% CI: 1.18, 1.38) and 1.27 (95% CI: 1.15, 1.39), respectively. Women diagnosed with breast cancer before menopause [SIR: 1.52 (95% CI: 1.34, 1.71) vs. 1.21 (95% CI: 1.08, 1.34)] as well as women after 10 years since their breast cancer diagnosis [1.33 (95% CI: 1.22, 1.431) vs. 1.24 (95% CI: 1.10, 1.37)] were at a higher risk of developing second primary cancer. Among men, while there were no differences in risk based on age, with the increase of time, the risk of second primary cancer was reduced [SIR: 1.22 (95% CI: 1.12, 1.33) vs. 1.00 (95% CI: 0.79, 1.22)].ConclusionThere is an extra risk of second primary cancer among breast cancer patients. The extra risk should be considered for further screening and preventive measures among this population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062, identifier (CRD42022336062)

The The Role of Low-Level Laser Therapy in the Treatment of Multiple Sclerosis: A Review Study: Low-Level Laser Therapy and Multiple Sclerosis

Introduction: Multiple sclerosis (MS) is an autoimmune disease. Inflammatory cells, cytokines, and chemokines play a major role in the pathogenesis of the disease. Low-level laser therapy (LLLT) as a photobiostimulation approach could affect a wide range of cellular responses. LLLT inhibits the inflammatory signaling pathway, improves cell viability, inhibits apoptosis, modulates immune responses, and induces the production of growth factors.Methods: In this review, we discuss the effect of LLLT on cellular responses and its application in the treatment of MS. Such keywords as “low-level laser therapy”, “photobiomodulation” and “multiple sclerosis” were used to find studies related to laser therapy in MS in Google scholar, PubMed, and Medline databases.Results: LLLT reduced the inflammatory immune cells and mediators. It also enhanced the regeneration of neurons.Conclusion: Investigations showed that besides current treatment strategies, LLLT could be a promising therapeutic approach for the treatment of MS. DOI:10.34172/jlms.2021.8

Low-Level Laser Therapy for Rheumatoid Arthritis: A Review of Experimental Approaches: Low-Level Laser Therapy as a Complementary Treatment for Rheumatoid Arthritis

Introduction: Rheumatoid arthritis (RA) is an inflammatory and autoimmune disorder that is characterized by joint inflammation, pain, physical disability, and morning stiffness. In the present study, the effect of low-level laser therapy (LLLT) on RA was reviewed.Methods: “Low-level laser therapy”, “rheumatoid arthritis disease”, and “photobiomodulation” keywords were searched in Google Scholar, PubMed, and Medline.Results: A literature survey led to a discussion about the immunology of the RA, laser therapy, mechanism of LLLT action, and anti-inflammatory and immunomodulatory properties of LLLT.Conclusion: It was concluded that LLLT could improve RA patients’ quality of life, reduce pain, and enhance physical movement

Unveiling Therapeutic Potential: A Systematic Review of Photobiomodulation Therapy and Biological Dressings for Diabetic Foot Ulcers: Therapeutic potential of photobiomodulation therapy and biological dressings

Introduction: Diabetes poses a global health challenge, giving rise to various complications, including diabetic foot ulcers (DFUs). DFUs, marked by ischemic ulcers susceptible to infection and amputation, underscore the urgency for innovative treatments. This study investigated the impact of photobiomodulation therapy (PBT) and autologous platelet gel (APG) on DFUs recovery.Methods: We systematically searched Web of Science, EMBASE, MEDLINE, Cochrane Library, Scopus, and Google Scholar (2015-2023) by using pertinent terms like “photobiomodulation therapy,” “low level light therapy,” and “platelet gel.” After meticulous data extraction and review, 57 articles were chosen and categorized. Among these, three randomized controlled trials involving 186 participants were selected for APG analysis.Results: Findings demonstrate that APG application carries minimal risk and offers promising improvements in healing time, grade, pain reduction, and granulation tissue formation. Similarly, diverse PBT modalities involving distinct probes and wavelengths exhibit the potential to enhance tissue perfusion, expedite healing, and impede wound progression, reducing the need for invasive interventions.Conclusion: PBT and APG emerge as valuable tools to augment wound healing, mitigate inflammation, and avert amputation, representing compelling therapeutic options for DFUs

Determinants of survival of common childhood cancers in Iran

Background: Cancer is the second most common cause of morbidity and mortality in children. This study aimed to epidemiologically and demographically assess common cancers in children in Iran. Materials and Methods: This cohort study was conducted on children registered in Mahak Hospital and Rehabilitation Complex (which is a non-governmental organizations (NGO)-related hospital for only malignant diseases). A total of 2232 questionnaires were filled out for cancer patients between 2007 and 2016. The factors including age, gender, race, family history, type of treatment, and type of cancer were entered into Cox regression model to examine their effect on mortality of children diagnosed with cancer. Results: The Cox regression model showed that age, race, type of cancer, family history of cancer, and type of treatment had a significant effect on mortality of children diagnosed with cancer (P < 0.05). The hazard ratio (HR) of mortality in 10–15 years old was higher than that of 1–5 years old (P = 0.03, HR = 1.3). The HR of mortality in patients with brain tumor (P < 0.01, HR = 2.24), sarcoma (P < 0.01, HR = 2.32), and neuroblastoma (P < 0.01, HR = 2.56) was twice the value in patients with leukemia. The HR of mortality in patients who had a family history of cancer was higher than that of patients without it (P < 0.01, HR = 1.33). Patients who had undergone chemotherapy along with surgery and radiotherapy (P = 0.02, HR = 0.68) and patients who received chemotherapy along with surgery (P = 0.01, HR = 0.67) had a lower HR of mortality compared to the chemotherapy group. Conclusion: Young age, multidisciplinary approach, and absence of family history were associated with lower hazard of death in children diagnosed with cancer; brain tumor, leukemia, and sarcoma had higher hazard of mortality compared to leukemia. Children with a family history of cancer should be under regular follow-up. Treatment should be multidisciplinary and comprehensive