Some physiotherapy treatments may relieve menstrual pain in women with primary dysmenorrhea: a systematic review

Question: In women with primary dysmenorrhoea, what is the effect of physiotherapeutic interventions compared to control (either no treatment or placebo/sham) on pain and quality of life? Design: Systematic review of randomised trials with meta-analysis. Participants: Women with primary dysmenorrhea. Intervention: Any form of physiotherapy treatment. Outcome measures: The primary outcome was menstrual pain intensity and the secondary outcome was quality of life. Results: The search yielded 222 citations. Of these, 11 were eligible randomised trials and were included in the review. Meta-analysis revealed statistically significant reductions in pain severity on a 0–10 scale from acupuncture (weighted mean difference 2.3, 95% CI 1.6 to 2.9) and acupressure (weighted mean difference 1.4, 95% CI 0.8 to 1.9), when compared to a control group receiving no treatment. However, these are likely to be placebo effects because when the control groups in acupuncture/acupressure trials received a sham instead of no treatment, pain severity did not significantly differ between the groups. Significant reductions in pain intensity on a 0–10 scale were noted in individual trials of heat (by 1.8, 95% CI 0.9 to 2.7), transcutaneous electrical nerve stimulation (2.3, 95% CI 0.03 to 4.2), and yoga (3.2, 95% CI 2.2 to 4.2). Meta-analysis of two trials of spinal manipulation showed no significant reduction in pain. None of the included studies measured quality of life. Conclusion: Physiotherapists could consider using heat, transcutaneous electrical nerve stimulation, and yoga in the management of primary dysmenorrhea. While benefits were also identified for acupuncture and acupressure in no-treatment controlled trials, the absence of significant effects in sham-controlled trials suggests these effects are mainly attributable to placebo effects

Toxic effect of Pb, Cd, Ni and Zn on Azolla filiculoides in the International Anzali Wetland

The limitation of plant growth in the polluted mediums can be used as a factor to determine of plant tolerance and the toxic effect of these mediums. In this work, the effect of Pb2+, Cd2+, Ni2+ and Zn2+ (individually) on Azolla filiculoides growth in the aqueous solution and using this method to water post treatment were studied. During 15 days the biomass the fresh Azolla with initial mass of 20 g was grown on the nutrient solution containing these metal ions, each in a concentration 4 mg/l. The presence of these ions, caused about 25%, 42%, 31% and 17% inhibition of biomass growth, respectively, in comparison to Azolla control weight which had not heavy metals. The water salinity of 1, 2 and 4 g. NaCl/l decreased the removal of these heavy metals about 4-7%, 20-24% and 40-55%, respectively. The addition of total dissolved solids (TDS) from 50 to 300 ppm. (as CaCO3) into the samples of containing heavy metals increased Azolla growth, but decreased the control Azolla growth