Evaluation of the Effects of Low Level Laser Therapy on the Healing Process After Skin Graft Surgery in Burned Patients (A Randomized Clinical Trial)

Background: Skin graft is standard therapeutic technique in patients with deep ulcers but as every surgical procedure has complications. Although several modern dressings are available to enhance comfort of donor site, using techniques that accelerate wound healing may enhance patient’s satisfaction.Low Level Laser Therapy (LLLT) has been used in several medical fields, especially for wound healing but for treating large ulcers, it may last several months to heal completely.Materials and Methods: The protocols and informed consent were reviewed according to Medical Ethics Board of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1394.363) and Iranian Registry of Clinical Trials (IRCT2016020226069N2). Nine patients with bilateral similar grade 3 burn ulcer in both hands or both feet, candidate for Split Thickness Skin Graft (STSG) were selected. One side was selected for laser irradiation and the other side as control, randomly. Laser area was irradiated by red, 655 nm laser light, 150 mW, 2 J/Cm2 for the bed of the ulcer and infra red 808 nm laser light, 200 mW for the margins, every day for 7 days.Results: The rate of wound dehiscence after skin graft surgery was significantly lower in laser treated group in comparison to control group which received only classic dressing (P=0.019).Discussion: In the present study for the first time we evaluate the effects of LLLT on the healing process of skin grafted area in burn patients. The results showed LLLT is a safe effective method which improves graft survival and wound healing process and decreases the rate of wound dehiscence in patients with deep burn ulcer

Holmium-YAG Laser Ureteroscopic Lithotripsy in a Patient with Ectopic Malrotated Kidney

The incidence of stone disease among patients with congenital renal anomalies including malrotated kidney is more than in normal population due to poor urine drainage and stasis (1). Various minimally invasive options have been used for the management. Ureteroscopy and Holmium:YAG laser lithotripsy have been reported with favorable outcomes (2). We report a 30-year-old male who presented to our hospital having a right side malrotated kidney with a large stone in it. He underwent two session of ureteroscopy and Holmium:YAG laser lithotrips

Retrograde Holmium- YAG Laser Endopyelotomy

Endourologic pyeloplasty is being a substitute of open pyeloplasty in management of ureteropelvic junction obstruction. This procedure can be done in different manners like balloon dilation, cold knife and electrosurgical endoureterotomy, accucise and lasers.A 47 year old woman referred with history of previous open pyeloplasty. Hydronephrosis of right kidney with unremarkable T ½ was found in DTPA scan. A full-thickness lateral incision was done with holmium:YAG laser just below the right UPJ and carried through the stenotic segment until the renal pelvis was reached. Half-time of radioisotope excretion was 13 min for the right kidney in diuretic renogram 3 months following operatio

Cut-off Value for Stenosis Ratio and Zung Depression Scale in Successful Prediction of Posterior Spinal Fusion surgery

Background: The aim of this study was to investigate effect of some clinical attributes in prediction of satisfaction with posterior spinal fusion (PSF) surgery in patients with lumbar disc herniation (LDH) and lumbar spinal canal stenosis (LSCS) and determine a cut-off point for these attributes.Methods: The attributes such as stenosis ratio (SR) values (described by Lurencin), Japanese Orthopaedic Association (JOA), The Zung depression scale (ZDS), duration of symptoms (in months), were investigated for 329 patients with LSCS and 151 patients with LDH separately. Patient satisfaction was recorded based on the international standard questionnaire Swiss Spinal Stenosis Score (SSS). The sensitivity and specificity values and the optimal cut-off points were calculated for SR, JOA, ZDS and duration of symptoms using receiver operating characteristic (ROC) analysis.Results: One hundred fifty-one patients with LDH (39 male, 112 female; mean age 50.24 ± 9.21 years) and 329 patients with LSCS (111 male, 218 female; mean age 53.28 ±7.81 years) were followed–up for 6 months. Post-surgical satisfaction was 73.86% in patients with LSCS and 85.43% in patients with LDH. The cut-off point of SR for prediction of besting surgical outcome was estimated more than 0.46 with asymptotic significance less than 0.05, 60% sensitivity and 75% specificity in LSCS patients (AUC-0.705, 95% CI, 0.644–0.766; P < 0.001).Conclusion: The findings show that the SR with a cut off value of 0.46 cross sectional area, in patients with LSCS may be superior to JOA, duration of symptoms and ZDS for prediction of satisfaction with PSF surgery

A trend of Medical Negligence in Laser Therapy in the Capital City: A Nine-Year Survey

Background: the purpose of the present study is to investigate the common causes of injuries, claims, and decisions related to laser therapy medical malpractice during a nine-year survey. Study design: This study is a retrospective descriptive study. Methods: The legal documents in the coroner’s Office of Forensic Medicine were investigated in a national database from 2012 to 2020 in Tehran, Iran. The frequency and nature of the cases, including the year of litigation, the location and certificate of the provider, the injury sustained, the cause of legal action and judgment were collected. Results: Three hundred and eighty-three cases related to injury from laser therapy were registered in the coroner’s Office of Forensic Medicine during the study period. The incidence of litigation related to laser surgery showed an increasing trend, with a peak occurrence in 2020. Laser hair removal was the most common (51.2%) litigated procedure. General practice operators (48%) recorded the highest rate of laser-related medical complaints. lack of skill was the most common reason for failure. Among 383 cases with public decisions, 62.4% of them were fault liability in paid judgment. Conclusions: Medical claims related to laser application are increasing. However, as it is clear, the growth of laser technology and the increasing demand for lasers in medical science require more surveillance to avoid probable injuries and improve patient safety, especially surveillance of the physicians who work outside the scope of their specialty.&nbsp

Effect of KTP Laser on Surgically Resected Adenomas of Prostate

INTRODUCTION: Palmoplantar psoriasis could hardly be differentiated from chronic tylotic eczema both clinically and histologically. The most commonly used therapeutic options for palmoplantar psoriasis are long-term therapy with topical corticosteroids and local PUVA. Frequently, it is a recalcitrant disease. We investigated the efficacy and tolerability of the combination of topical calcipotriol with local UVA radiation in comparison with local PUVA therapy.METHODS:In a total of 43 patients with palmoplantar psoriasis, 33 were given 15 sessions of local UVA radiation and topical calcipotriol and the remainder received 15 sessions of local PUVA (psoralen + UVA radiation).RESULTS:The statistical analyses of the results showed that the effect and tolerability of both therapeutic modalities are comparable.CONCLUSION: Combination of topical calcipotriol and local UVA radiation is an optional corticosteroid-free therapeutic modality for palmoplantar  psoriasis. It has a comparable effectiveness and tolerability with local PUVA

Laser Application in Iran Urology: A Narrative Review

The usage of laser in medicine is not recent, and its history in urology goes back to 40 years ago. For the last 2 decades, common uses of laser have been treatments of subjects with urolithiasis, bladder tumors, benign prostatic enlargement, lesions of the genitalia and urinary tract strictures. To evaluate laser application in urology in Iran, we reviewed all of the Iranian literature on the topic. This study was designed to retrieve all studies on laser application in urology in Iran, regardless of publication status or language, covering years 1990–2017. Twenty-six articles were identified: 12 about urolithiasis, 8 about benign prostatic hyperplasia (BPH), 2 case reports, 1 paper about prostate cancer, 1 on female urethral stricture, 1 review and 1 basic sciences study. We conclude that the use of this technology has not yet found its position in Iran, especially in the field of urology. The main causes for it are the difficult accessibility and disturb of laser devices and its accessories, as well as the lack of adequate knowledge of the medical community about this modality

Cultural affordance of products: coverage within industrial design education

Products are regarded as possessing not only physical properties but also subjective qualities such as culturally-based user preferences. To communicate these cultural aspects, products must "afford" conversation with their intended users using some type of language. Being initiators of product creation, industrial designers are supposed to facilitate the communication of the products' physical and non-physical attributes to users in a self-explanatory way. In this paper, the authors argue that if the cultural affordance of products is deemed to be important, then industrial design education must accordingly cover this topic in the curricula. To that effect, we examined the courses of study for industrial design from 39 universities worldwide, to determine if the relationship between culture and design is convincingly addressed within the training of designers. It is found that the majority of industrial design curricula suffer from a relative lack of subjects related to the links between culture and design. This paper concludes with propositions to integrate and enhance cultural affordance within the curricular structure of industrial design degree programs

Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?

INTRODUCTION: Our aim was compare of two types of lithotripter include holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for the management of ureteral calculi ≥1 cm.METHODS: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images.RESULTS: Success rate was 85.7% in pneumatic group and 100% in holmium: YAG laser group (p =0.003). Stone migration up in the pelvicalyceal system was observed only in 8 cases of pneumatic group. No statically differences were observed in terms of patient’s age, hospital stay, and complications between two groups.CONCLUSION: According to our experience, for ureteral stone larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication