Evaluating the Efficiency of Low Level Laser Therapy (LLLT) in Combination With Intravenous Laser Therapy (IVL) on Diabetic Foot Ulcer, Added to Conventional Therapy

INTRODUCTION:: Low level laser therapy (LLLT) is gaining acceptance in clinical applications. For example, it is used as therapeutic modality in the repair of diabetic foot ulcer when conventional therapy was not effective, separately. The aim of this study is to determine the effect of local and travenous LLLT for the healing of diabetic foot ulcer.METHODS: This study contains 74 diabetic foot-ulcers which were prone to resistance to conventional therapy. Different stages of diabetic foot are included in this study. The wounds irradiation are performed by the combination therapy of 650 nm and 860 nm laser, with the total energy density of 3.6 J/cm² plus intravenous laser therapy (IVL) with 2.5 MW, 650 nm laser used for 30 minutes. All wounds have been photographed from equal distance, before and after treatments, and all the wounds were staged by a surgeon who was disinterested and neutral about the effects of the laser therapy. Her judgments were based on the visual assessments of the wounds. All the mathematical and statistical analysis is based on the descriptive statistics which, is done by the SPSS 16.RESULTS: in the result of this study; 62.2% (Forty-six out of the 74 ulcers) completely healed, 12.2% (Nine in numbers) healed more than 50%, 8.1% (Six in numbers) healed less than 50%, 5.4% (Four in numbers) not healed,12.2% (Nine in numbers) did not continue their treatment (less than 5 sessions of Laser therapy). Excluding, the wounds in stage 5, more than 80% of each stage’s wound, completely healed more than 50%, with in 2 months duration. In this study, we definitely can express that, all the Patients received some degrees of healing, during their laser receiving treatments.CONCLUSION:  The combined local and intravenous LLLT promote the tissue repair process of diabetic foot ulcer. In this multi-disciplinary method, we achieved a remarkably shorter mean healing time of two months, compared with other reported studies with healing time of three to six months

Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestational diabetes mellitus: A prospective cohort study

There exist currently in production an immense number of applications that are considered safety critical, meaning that the execution of them is directly related to issues concerning the well being of people. A domain where these applications are particularly present is in the aeronautics industry. A piece of critical software that’s embedded into an airplane’s calculator cannot, under any circumstance, fail while the aircraft is in-flight. And this restriction becomes more and more severe when the priority of the application escalates. This situation also poses an inconvenient at the moment of testing software. Since for applications to be tested on their real environment (flight test) it is necessary to have certain guarantees that it won’t fail, other methods such as unitary tests and simulations have to be used. But none of these methods are sound, meaning that if some particular case is unintentionally left out of the executions, then the behavior of the program in such scenario is not contemplated in the performed analysis. But when we are talking about safety critical applications, these small cases could mean a very big difference. This is why more and more companies that produce this kind of software are starting to include in their verification process sound techniques to validate the absence of run-time errors on their programs. Particularly Airbus, one of the main aircraft manufacturers of the world, uses AstréeA, a static analyzer based on abstract interpretation, to prove that the programs embedded in their calculators cannot possibly fail. In the following report an investigation will be presented were AstréeA was used at Airbus to prove the absence of run-time errors on the ATSU. The introductory chapter presents a description of the software analyzed, an explanation of the objectives set for the project and its scope. Then, on chapter 2 all the necessary theoretical concepts will be presented. Sections 2.1 - 2.3 give an overview of the basics of abstract interpretation, while section 2.4 presents the analyzer used. Then chapters 3 and 4 describe in depth the solution given and how the investigation was carried out. Finally chapters 5 and 6 enter into the presentation and analysis of the results obtained in the period of study and the current state of the solution

Evaluating the Effect of the Different Diabetic Control’s Methods Including Tight Control on the Healing Response of Diabetic Foot Ulcer Treated with Low Level Laser Therapy (LLLT)

INTRODUCTION: Low-level laser therapy (LLLT) is shown effective in healing diabetic foot ulcer when combined with conventional therapy. Since; Diabetes mellitus is a leading cause of impaired wound healing. The aim of this study is to determine the effect of different diabetic control’s methods on the healing response of diabetic foot ulcer in those patients treated with Low level laser therapy (LLLT), added to conventional therapy.METHODS: This study contains 74 diabetic foot-ulcers which most of them prone to resistance to conventional therapy. Different stages of diabetic foot ulcers and ways of controlling blood glucose level are included in this study. There were 3 response groups; Group 1-Insulin receiving patients, most of them had a very tight blood glyceamic level profile controlling. Group 2- Non-insulin receiving or drug dependent patients, had a periodical blood glyceamic level profile with flatuance. Group 3- Mixed methods. Most of the patients in this group had tight blood glyceamic level profile controlling. The way to control blood glucose level should be according to the internist`s consult. The wounds irradiation are performed by the combination of infra-red and red, (860 nm and 650 nm) laser, with the total energy density of 3.6 J/cm² in addition of intravenous laser therapy (IVL) with 2.5 MW, 650 nm (red) laser used for 30 minutes. All wounds have been photographed from equal distance, before and after treatments, and all the wounds were staged by a surgeon who was neutral about the effects of the laser therapy. The surgeon’s judgment was established only by the visual assessments of the wounds. All the mathematical and statistical analysis is based on the descriptive statistics using the software package SPSS16.CONCLUSION: LLLT promote the tissue repair process of diabetic foot ulcer. Healing response of the patients was not dependent on methods of controlling blood glucose level. Previously it was reported that tight control of diabetes containing continuous subcutaneous insulin infusion and others on split mixed doses promotes healing of diabetic foot lesions. In this study; we found interruption of LLLT in the treatment of diabetic wound; can give a very acceptable result even in the absence of tight controlling of glucose level. When the quantity presentations value of the mean blood glucose level distribution was on the range of 144- 275 mg/dl. In this multi-disciplinary method we achieved a remarkably shorter mean healing time of two months, compared with other reported studies with healing time of three to six months.

Admission Dysnatremia in Citically ill Children

Introduction: Many causes of admission to the pediatric intensive care unit (PICU) may potentially induce hyponatremia. This study was aimed at evaluating the incidence of admission dysnatremia in the PICU and its relationship with the underlying disease and demographic factors.Materials and Methods: This observational prospective study was conducted in a 12-bed medical PICU in a tertiary governmental teaching hospital for six months. The study group comprised patients aged 1 month to 18 years. Patients who received intravenous fluid within 24 hours before admission were excluded. Serum sodium was checked on admission and concentrations below 135 and above 145 mEq/L were considered hyponatremia and hypernatremia, respectively.Results: One hundred and ninety-five patients (117 males, 60%) were included in the study. The mean serum sodium level was 137.8 mEq/L ± 5.2. Forty-two patients (20.5%) were hyponatremic and 10 (5.1%) werehypernatremic. The most prevalent diagnosis in hyponatremic patientswas pulmonary diseases followed by renal diseases, central nervoussystem (CNS) diseases, diabetic ketoacidosis (DKA), gastrointestinal (GI)diseases, and cardiovascular and hematologic-oncologic diseases. Fiftypercent of nephrologic patients were hyponatremic. Hyponatremia wasfound in 26.5%, 23.5%, 20%, 16.6%, and 14.2%of the children with lungdiseases, DKA, hematologic-oncologic diseases, cardiovascular diseases,and CNS and GI diseases, respectively. Moreover, 20%, 16.6%, 11.7%,7.1%, and 2.9%of the patients with infectious diseases, cardiovasculardiseases, DKA, CNS diseases, and pulmonary diseases hadhypernatremia, respectively.Conclusions: Hyponatremia is frequent in our PICU. Patients suffering from renal diseases, pulmonary problems, DKA, and hematologic-oncologic diseases have a higher chance of hyponatremia (≥20%).Keywords: Sodium; Hyponatremia; Fluid Therapy; Children; Intensive Care

Nrf1 and Nrf2 Knockdown Effect in Anxiety-related Behavior and Mitochondrial Function

Introduction:  Nuclear factor, erythroid-derived 2, -like2 (Nrf2) and Nuclear erythroid 2-related factor 1 (Nrf1) stand as two important regulators of antioxidant defense system. Materials and Methods: Small interfering RNA (siRNA) targeting Nrf1 and Nrf2 (Nrf1&2) was injected in dorsal third ventricle of adult male albino Wistar rats. Anxiety-related behaviors and protein level of mitochondrial biogenesis, apoptotic marker factors and also electron transport chain (ETC), Citrate synthase (CS) and Malate dehydrogenase (MDH) enzymes activity in three brain regions: hippocampus, prefrontal cortex, and amygdala were evaluated. Results: Nrf1&2-silenced rats induced anxiety-like behaviors compared to the control group. The level of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1a) protein increased in those three regions. Although Nrf1&2-silencing decreased MDH activity in hippocampus and prefrontal cortex, the activity of CS was increased in all three mentioned areas. However, Nrf1&2 silencing had no effect in complex I and II-III activity, but complex IV activity was increased, particularly in amygdala. Furthermore, Bax/Bcl2 ratio and cleavage of caspase-3 was increased in all mentioned areas of the brain in Nrf1&2-silenced group. Conclusion: In conclusion, the presented data evaluated the complexity of mitochondrial functions and Nrf1 and Nrf2 in rat’s brain and points to mitochondrial crucial role in oxidative stress, energy metabolism, and behavior. &nbsp

Transgenerational influence of parental morphine exposure on pain perception, anxiety-like behavior and passive avoidance memory among male and female offspring of Wistar rats

Accumulating evidence suggests that epigenetic mechanisms play an important role in the formation and maintenance of memory within the brain. Moreover, the effect of parental drug-exposure before gestation on behavioral state of offspring has been little studied. The main objective of the current study is to evaluate the effect of parental morphine exposure on avoidance memory, morphine preference and anxiety-like behavior of offspring. The total of 32 males and 32 females were used for mating. The animals were treated with morphine. The offspring according to their parental morphine treatment was divided into four groups (n=16) including paternally treated, maternally treated, both of parents treated and naïve animals. The pain perception, anxiety-like behavior, and avoidance memory were evaluated in the offspring. In the current study, the total of 256 offspring was used for the experiments (4 tasks × 4 groups of offspring × 8 female offspring × 8 male offspring). The finding revealed that the avoidance memory and visceral pain were reduced significantly in male and female offspring with at least one morphine-treated parent. Moreover, anxiety-like behavior was reduced significantly in the male offspring with at least one morphine-treated parent. While anxiety-like behavior was increased significantly in female offspring that were treated by morphine either maternally or both of parents. The data revealed that the endogenous opioid system may be altered in the offspring of morphine-treated parent(s), and epigenetic role could be important. However, analysis of variance signified the important role of maternal inheritance

Introduction to Neurocircuitry and Neurobiology of Anxiety

Context: Nowadays, experiencing occasional anxiety is a common part of each person’s life. The number of anxious people has increased in this modern life style. This study aimed to review some researches as to accelerate searching for new anxiolytic treatments. Evidence Acquisition: Related articles were extracted from databases including PubMed, Google Scholar, Springer, Science Direct and Wiley. Forty-eight articles were chosen. The articles were carefully considered, and after extracting information, they were categorized and integrated in the appropriate sequences to meet the needs of this study. Results: This review mentions the important brain regions involved in anxiety; it then continues with encapsulating some of the neurotransmitters’ and neuropeptides’ functions that cope with anxiety-like behaviors. Conclusion: With regard to the results, it is suggested that anxiety can be caused by change in the brains’ neurotransmitters level but more studies are needed to identify its exact mechanism

Enter evaluation of mitral inflow velocity profile: optimal through plane location for mitral inflow assessment with cardiac magnetic resonance

Diastology is usually assessed using transthoracic echocardiography (TTE). Velocity‐encoded phase‐contrast imaging permits evaluation with cardiac magnetic resonance (CMR). Heterogeneous contour locations have been used to measure mitral (MV) inflow velocities and the optimal contour location is uncertain. We evaluated CMR MV inflow velocities against TTE to identify the optimal location

Tramadol Treatment Induces Change in Phospho-Cyclic Adenosine Monophosphate Response Element-Binding Protein and Delta and Mu Opioid Receptors within Hippocampus and Amygdala Areas of Rat Brain

Background: Tramadol induces its unique effects through opioid pathways, but the exact mechanism is not known. The study aims to evaluate changes in the level of mu-opioid receptor (μOR), delta-opioid receptor (δOR), and phosphorylated cyclic adenosine monophosphate (cAMP) response element-binding protein (p-CREB) in the hippocampus (HPC) and amygdala (AL) areas of tramadol-treated rats.Methods: For this purpose, a total of 36 male rats were divided into two main groups for chronic or acute tramadol exposure. The animals were then exposed to 5 mg.kg-1 of tramadol, 10 mg.kg-1 of tramadol, and normal saline. The HPC and AL areas of the animals were dissected upon completion of the period. The levels of p-CREB and μOR were quantified using the western blotting technique. The data were subjected to analysis of variance (ANOVA) followed by Tukey’s post-hoc analysis. The differences with the P-value lower than 0.05 were considered as significant.Findings: In the HPC and AL areas of the brain, the level of μOR was decreased by acute tramadol exposure, while no significant difference was observed by chronic tramadol exposure. Moreover, results showed that the level of p-CREB dose-dependently increased by acute and chronic tramadol exposure.Conclusion: HPC and AL are essential in the control of tramadol abuse. Tramadol abuse affects gene expression and transcription factors such as CREB. With acute drug tramadol treatments, the level of cAMP response element-binding protein (CREB) rapidly increases, while by chronic tramadol treatment, “peak and trough pattern is observing”. The activation of the rewarding mechanism is a precise instance of addictive behavior in tramadol-treated individuals