THE RELATIONSHIP BETWEEN UTERINE TEMPERAMENT AND VAGINITIS FROM IRANIAN TRADITIONAL MEDICINE POINT OF VIEW

Iranian traditional medicine is based on the concept of Mizaj (Temperament). Mizaj is the overall quality of body and any of its organs in terms of the amount and the proportion of combination of each of four elements, i.e. warmness, coldness, wetness, and dryness in it. If an organ or the whole body gets out of their natural temperament, a disease will be developed. Uterine infections are caused by the wet dys-temperament (Su'e Mizaj) of the uterus, from this perspective. This study was carried out to investigate the relationship between uterine temperament and vaginitis. This case-control study was conducted on 223 women aged 20-40 years living in Tehran who referred to two clinics affiliated with Shahid Beheshti University of Medical Sciences by matching the age and contraceptive method. In the case group (n=112) one kind of vaginitis was detected and the control group (n=111) were healthy in this regard. The data were analyzed using chi-square test, independent t-test, or Mann-Whitney test and logistic regression. Uterine compound temperament was cold-wet in most patients (62.5%). Uterine singular temperament was cold in 73.7% of the patient in terms of coldness and hotness and was wet in 74.6% of the patients in terms of dryness and wetness. There was a significant relationship between uterine singular and compound temperament and risk of vaginitis. It can be said that uterine dis-temperament is a predisposing factor to develop vaginitis and this finding validates the theory claimed in traditional medicine literature. Keywords: Temperament; Vaginitis; Iranian traditional medicine; Uterin

Potassium Alum Vaginal Suppository: Irritation Assessment in Rabbit

Background and objective: Potassium alum, called “Zaj-e-abyaz” in Iranian traditional medicine, is used vaginally in traditional clinics as an astringent agent for uterine fibroids. Before evaluating its efficacy, it is necessary to prepare a suitable dosage form and assess the possible irritation in animal model which was the aim of the current research. Methods: Vaginal suppositories were prepared using 400 mg potassium alum, 200 mg honey and different proportions of poly ethylene glycol (PEG) 600, 1000 and 4000 in each suppository. The best formulation was used for evaluation of possible irritation in rabbit. The suppositories were used in rabbit’s perineum daily for 5 consecutive days in 3 albino rabbits and the appearance of the vaginal opening and perineum for signs of erythema and edema were recorded every day. The final results were calculated as a primary irritation index (PII). Results: The best formulation contained potassium alum 20%, honey 10%, PEG 600 18%, PEG 1000 12%, PEG 4000 30% and water 10%. According to the animal test, the irritation of the vaginal mucus membrane was considered moderate in rabbits. Conclusion: Regarding the results, potassium alum could not be used in form of suppository in PEG vehicle and other formulations should be prepared for acquiring the least irritation

Evaluation of Patient Satisfaction Referred to Health Center Traditional Medicine in Shahid Beheshti University of Medical Sciences in 2016

زمینه و هدف: رضایتمندی از خدمات سلامت یک معیار مهم برای سنجش کیفیت مراقبت‌های بهداشتی شناخته شده است و تاکنون بررسی از نظر میزان رضایتمندی بیماران مراجعه‌کننده به سلامتکده‌های طب سنتی انجام نشده است، لذا در این مطالعه برای نخستین‌بار به سنجش کیفیت خدمات در سلامتکده طب سنتی دانشگاه شهید بهشتی پرداخته شد. مواد و روش‌ها: مطالعه حاضر یک مطالعه توصیفی ـ مقطعی (Cross–Sectional) است که جهت سنجش رضایت بیماران، از 150 بیمار مراجعه‌کننده به سلامتکده طب سنتی دانشگاه شهید بهشتی در سال 1395 انجام شد. نمونه‌ها از طریق نمونه‌گیری در دسترس، پس از اخذ رضایت‌نامه، با پرسشنامه رضایتمندی محقق‌ساخته بررسی شدند، سپس اطلاعات جمع‌آوری‌شده توسط نرم‌افزار SPSS 20 و شاخص‌های آماری توصیفی و استنباطی مورد تجزیه و تحلیل قرار گرفت. ملاحظات اخلاقی: این پژوهش حاصل طرح تحقیقاتی مصوب معاونت پژوهش دانشگاه علوم پزشکی شهید بهشتی با کد IR.SBMU.RETECH.REC.1395.487 می‌باشد و کلیه اطلاعات بیماران به صورت محرمانه حفظ شد. یافته‫ها: میزان رضایتمندی بیماران نسبت به عملکرد کلی سلامتکده خوب (میانگین 4/54) گزارش شد. میانگین امتیاز رضایتمندی در ابعاد مختلف، شامل وضعیت برخورد پزشکان با بیماران 4/73، وضعیت برخورد دستیاران با بیماران 4/69، وضعیت فضا و امکانات بهداشتی 4/66، وضعیت خدمات تشخیصی 4/74، وضعیت خدمات درمانی 4/50، نحوه وقت‌دهی و برخورد پرسنل 4/59، رضایت از داروخانه 4/62 که نشان‌دهنده طیف نسبتاً راضی به سمت کاملاً راضی بوده است. میانگین بیشترین میزان رضایت در بین بخش‌های مختلف تخصصی، از نظر وضعیت برخورد پزشکان با بیماران مربوط به بخش گوارش 4/82 می‌باشد. بیشترین میزان رضایت مراجعه‌کنندگان در بین بخش‌های مختلف تخصصی از نظر وضعیت خدمات تشخیصی (بخش مفاصل، زنان، گوارش و اعصاب و روان) مربوط به بخش اعصاب و روان بود (P=0/039). نتیجه‌گیری: رضایت بیماران از ارائه خدمات سلامتکده مورد مطالعه در سطح مطلوبی قرار داشت، اما در جهت ارائه خدمات با کیفیت بالاتر به بیماران انجام برنامه‌ریزی دقیق‌تر ضروری به نظر می‌رسد.Background and Aim: Satisfaction from health services is an important criterion for measuring the quality of health care and so far, there has been no study on the satisfaction of patients referring to traditional medicine health centers. Therefore, in this study, for the first time, the quality of services in the traditional medicine health center of Shahid Beheshti University was assessed. Materials and Methods: The present study is a cross-sectional study, in order to measure patients satisfaction, out of 150 patients referred to Shahid Beheshti University Traditional Medicine Health Center, it was performed in 2016. Samples were examined through available sampling, after obtaining consent, with the researcher-made satisfaction questionnaire. Data were analyzed by SPSS 20 software and descriptive and inferential statistical indices. Ethical Considerations: This research is the result of a research project approved by the Research Vice Chancellor of Shahid Beheshti University of Medical Sciences with the code IR.SBMU.RETECH.REC.1395.487 and all patient information was kept confidential. Findings: Patients' satisfaction with good general health center performance was reported (Mean 4/54). Mean of satisfaction in different dimensions, including The situation of doctors with patients was 4/73, the situation of patients with patients 4/69, the condition of space and health facilities 4/66, the status of diagnostic services, 4/74, the state of health care 4/40, the manner of staffing and staffing 4/59, satisfaction from the pharmacy 4/62 that this range represents a fairly pleasingly satisfactory range. The average of the highest satisfaction among different specialized departments, in terms of the situation of doctors, with patient’s gastrointestinal tract are 4/82. The highest satisfaction rate was observed in the diagnostic services status in the various specialized departments, which is related to the neurology and psychiatry is significant (P=0/039). Conclusion: Patients' satisfaction from the health services provided by the study center was at a desirable level .In order to provide higher quality services, patients need to be more accurately planned.   Please cite this article as: Tansaz M, Adhami S, Choopani R, Mokaberinejad R, Movahhed M, Ghasemi E, Ilkhani R. Evaluation of Patient Satisfaction Referred to Health Center Traditional Medicine in Shahid Beheshti University of Medical Sciences in 2016. Med Hist J 2020; 12(43): 61-72

Soja-Protein-basierte Biomaterialien für Weichgewebezüchtung und Wundversorgung

Biomaterials have been utilized in tissue engineering and regenerative medicine as synthetic or natural derived scaffolds to support cells in order to promote tissue regeneration and to restore the function of injured tissue. Different biomaterials chosen for scaffold fabrication may contain however some unfavorable properties. In order to bypass some of the limitations of synthetic polymers such as having undesirable degradation products and being inactive or, moreover, to tackle potential biocompatibility issues with animal derived proteins like immunogenicity, this project investigated soy protein isolate (SPI) as a green and abundant plant derived protein in a variety of structures for soft tissue engineering and wound dressing applications. Composite SPI films containing bioactive glasses (BG) showed hemostatic capability which is important for wound healing applications. Moreover, cell culture study results confirmed attachment, spreading and proliferation of mouse embryonic fibroblast (MEF) cells on these composite films, particularly for SPI films containing 13-93 BG that could be due to the smoother surface morphology of this film in comparison to other composite films fabricated with other BG composition. In order to suggest SPI based hydrogels for other types of wounds like diabetic ulcers or burn wounds, SPI was combined with alginate which is a well-known hydrogel that has been used for decades as wound dressing material. Alginate (Alg) has some drawbacks such as slow and uncontrolled degradation and poor cell adhesion properties which was solved in the present study by blending with SPI. Cytocompatibilty results of 2D cell culture on Alg/SPI hydrogels showed better cell attachment and proliferation for both human umbilical vein endothelial cells (HUVEC) and normal human dermal fibroblast (NHDF) cells compared to pure alginate hydrogel films. The addition of BG also promoted cell attachment and proliferation which might be due to changes in the surface morphology of the hydrogels and ionic dissolution products of BG. Nano indentation outcomes on Alg/SPI hydrogel films indicated higher effective Young’s modulus in comparison to pure Alg hydrogel films. As a 3D model, encapsulated human adipose-derived mesenchymal stem cells (hADSCs) in Alg/SPI hydrogel microcapsules indicated migration and proliferation of these cells compared to pure alginate microcapsules, which were found to be enhanced by increasing SPI content. Higher degradation profile of different compositions of Alg/SPI microcapsules compared to Alg microcapsules could be the reason for cell elongation and cell proliferation. In this research project two different techniques were considered to produce 3D SPI based scaffolds: electrospinning and bioplotting. The parameters for electrospinning SPI based fibrous scaffold were optimized and then scaffolds were characterized in terms of pore size, fiber diameter, porosity and mechanical properties. The effect of relative humidity on the fibers morphology was investigated. A preliminary cell biology study was carried out to assess the viability of MEF cells in contact with electrospun fibrous scaffolds. The results indicated no toxic effect compared to the control and these fibrous scaffolds were shown to support cell proliferation. Biofabrication of Alg/SPI hydrogels containing MEF cells was investigated to obtain 3D Alg/SPI constructs. Cell viability results were equivalent to the results obtained with capsules. Overall, the outcomes of these studies make the developed materials as promising candidates for applications in soft tissue engineering and wound healing applications and warrant further in vitro and in vivo investigations.Biomaterialien, synthetischen oder natürlichen Ursprungs, werden bei der Gewebezüchtung für die regenerativen Medizin als sog. Stützstrukturen für Zellen eingesetzt, um das Wachstum und das Differenzieren von Stammzellen zu unterstützen und um letztlich die Funktion des verletzten Gewebes wiederherzustellen. Verschiedene Biomaterialien, die bereits als Stützstrukturen eingesetzt wurden, zeigten jedoch nachteilige Eigenschaften wie fehlende Biokompatibität oder unzureichende Abbaubarkeit. Mit dem Ziel einige diese Nachteile zu überwinden, wie beispielsweise unerwünschte Degradationsprodukte, Inaktivität, oder vielmehr potentielle Biokompatibilitätsprobleme bei Proteinen tierischen Ursprungs, welche Immunogenizität hervorrufen können -, wurde Soja Protein Isolat (SPI) als ein reichlich vorhandenes Protein natürlichen Ursprungs in unterschiedlichen Strukturen für die Weichgewebezüchtung und als Wundversorgung untersucht. Kompositfilme aus SPI und bioaktiven Glass (BG), zeigten hämostatisches Potenzial, welches wichtig für die Anwendung in der Wundversorgung ist. Des Weiteren bestätigten in vitro Studien, das die Adhäsion, Spreitung und Proliferation von embrionalen Maus Fibroblasten (MEF) auf den Kompositfilmen, speziell für SPI Filme, welche 13-93 BG beinhalteten ansteigt. Dies kann u.a. auf die Oberflächenmorphologie dieser Filme zurückgeführt werden. Um SPI basierte Hydrogele für andere Wundtypen, wie z.B. auf Diabetis verursachte Geschwüre oder auf Verbrennungswunden anwenden zu können, wurde SPI mit Alginat kombiniert Alginat (Alg) , welches seit Jahrzehnten ein bekanntes Hydrogel in der Wundversorgung ist, weist einige Nachteile auf, wie eine langsame und nicht kontrollierbare Degradationsrate sowie geringe Zelladhäsionseigenschaften, welche in der vorliegenden Studie durch die Beimischung von SPI gelöst wurden. Zytokompatibilitätuntersuchungen auf Alg/SPI Hydrogelen in 2D zeigten eine verbesserte Zelladhäsion und Proliferation sowohl von humanen Endothelzellen aus der Nabelschnurvene (HUVEC) als auch von humanen dermalen Fibroblasten (NHDF) im Vergleich zu puren Alginat Hydrogelfilmen. Die Zugabe von BG förderte ebenfalls die Zelladhäsion und Proliferation, die auf Veränderungen in der Oberflächenmorphologie der Hydrogele und ionischen Lösungsprodukten des BG zurückzuführen sein könnten. Untersuchungen mittels Nanoindentierung zeigten einen höheren effektiven Elastizitätsmodul von Alg/SPI-Hydrogel-Filmen im Vergleich zu reinen Alg-Hydrogel-Filmen. Humane mesenchymale Stammzellen adipösen Ursprungs (hADSCs), welche in Alg/SPI-Hydrogel-Mikrokapseln als 3D-Zellkulturmodell immobilisiert wurde, zeigten eine erhöhte Migration und Proliferation im Vergleich zu den immobilisierten Zellen in reinen Alg-Mikrokapseln. Dieses Verhalten der Zellen wurde durch eine Erhöhung des SPI Anteils noch verstärkt. Eine höhere Degradationsrate von Alg/SPI-Mikrokapseln im Vergleich zu Alg-Mikrokapseln, könnte eine Erklärung für die Zunahme der Zellausdehnung und Zellproliferation sein. In dieser Arbeit wurden zwei verschiedene Techniken eingesetzt, um 3D SPI-basierte Konstrukte herzustellen: Elektrospinning und Bioplotting. Die Parameter für das Elektrospinnen von SPI-basierten Fasergerüsten wurden hinsichtlich Porengröße, Faserdurchmesser, Porosität und mechanischen Eigenschaften evaluiert. Zusätzlich wurde die Wirkung von relativer Feuchtigkeit auf die Fasermorphologie untersucht. Eine erste zellbiologische Studie wurde durchgeführt, um die Lebensfähigkeit von MEF-Zellen in Kontakt mit elektrogesponnenen Fasergerüsten zu beurteilen. Diese Ergebnisse zeigten keine toxische Wirkung der Scaffolds auf die Zellen im Vergleich zur Kontrollgruppe und es wurde gezeigt, dass die fibrösen Stützstrukturen die Zellproliferation unterstützen. Die Biofabrikation von Alg/SPI-Hydrogelen, welche MEF-Zellen enthielten wurde untersucht, um 3D Alg/SPI Konstrukte zu erhalten. Die Ergebnisse der Zellvitalitätsuntersuchungen waren identisch zu den Ergebnissen aus der Zellverkapselung. Insgesamt, die Resultate dieser Studien zeigen, dass die entwickelten Materialien vielversprechende Kandidaten für Anwendungen in der Weichgewebezüchtung sowie der Wundversorgung sind und rechtfertigen somit weitere in vitro und in vivo Untersuchungen

Soy Protein-Based Composite Hydrogels: Physico-Chemical Characterization and In Vitro Cytocompatibility

Novel composite hydrogels based on the combination of alginate (Alg), soy protein isolate (SPI) and bioactive glass (BG) nanoparticles were developed for soft tissue engineering. Human umbilical vein endothelial cells (HUVEC) and normal human dermal fibroblasts were cultivated on hydrogels for 7, 14 and 21 days. Cell morphology was visualized using fluorescent staining at Days 7 and 14 for fibroblast cells and Days 14 and 21 for HUVEC. Metabolic activity of cells was analyzed using a colorimetric assay (water soluble tetrazolium (WST) assay). Compared to pure Alg, Alg/SPI and Alg/SPI/BG provided superior surfaces for both types of cells, supporting their attachment, growth, spreading and metabolic activity. Fibroblasts showed better colonization and growth on Alg/SPI/BG hydrogels compared to Alg/SPI hydrogels. The results indicate that such novel composite hydrogels might find applications in soft tissue regeneration