Application of autologous platelet-rich plasma (PRP) on wound healing after caesarean section in high-risk patients

Background: Platelet-rich plasma (PRP) is ahumanplasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties. Objectives: The aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections. Patients and Methods: In this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women�s hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance. Results: At the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5 reduction in the PRP group; 72 in the control group) (P < 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VANscore, beginning on the fifth day after the cesarean section (-0.7, 38 reduction in PRP group;-0.8, 33 in control group) (P < 0.001), and this trend was stable at the end of the eighth week (-0.6, 54 reduction in PRP group;-0.3, 18 in control group). Furthermore, patients treated with PRP experienced a 93 reduction in the VAS score at the end of follow-up, but the control group only observed a 79 reduction (P < 0.001). Conclusions: It seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors. © 2016, Iranian Red Crescent Medical Journal

Investigation of the Relationship between Serum Leptin levels and Nausea and Vomiting of Pregnancy

Background: Worldwide, half of women suffer from nausea and vomiting in early pregnancy which generally continues to the 20th week of pregnancy. Although pathogeneses of nausea and vomiting of pregnancy as well as hyperemesis gravid arum are still unknown, some believe that nausea and vomiting of pregnancy is likely related to maternal serum leptin level. Objectives: This study aimed to examine the relationship between leptin and pregnancy nausea and vomiting. Methods: In this case-control study, 45 pregnant women at first and second trimesters were selected through convenient sampling. Mothers’ blood samples were taken in the 6th, 12th, 15th, and 20th weeks of pregnancy. The participants were devised into healthy, without nausea, (24) and with nausea and vomiting groups (21). The relationship among the variables was analyzed using independent t-test, Pearson correlation, regression tests, and Lambda statistic (P value <0.05). Results: The mean age of the participants was 27.47±5.55 years, and Body Mass Index (BMI) was found to be 5.458±26.57. There was no significant difference between groups in this regard. Based on results, changes in maternal serum leptin had significant correlation with nausea and vomiting of pregnancy (p<0.04), meaning that the mean of leptin changes in patients with nausea and vomiting was significantly lower. Moreover, serum leptin at first and second trimesters of pregnancy did not have significant correlation with nausea and vomiting (p=0.5 and 0.3, respectively). Conclusion: With regard to leptin peak level at second trimester of pregnancy, leptin changes at first and second trimesters can be a good index to predict the nausea and vomiting of pregnancy. Thus, further domestic studies are required in this respect

Not Quite Right: Representations of Eastern Europeans in ECJ Discourse

Although the increasing responsiveness of the Court of Justice of the European Union (the ‘ECJ’) jurisprudence to western Member States’ concerns regarding Central and Eastern European (‘CEE’) nationals’ mobility has garnered academic attention, ECJ discourse has not been scrutinised for how it approaches the CEE region or CEE movers. Applying postcolonial theory, this article seeks to fill this gap and to explore whether there are any indications that ECJ discourse is in line with the historical western-centric inferiorisation of the CEE region. A critical discourse analysis of a set of ECJ judgments and corresponding Advocate General opinions pertaining to CEE nationals illustrates not only how the ECJ adopts numerous discursive strategies to maintain its authority, but also how it tends to prioritise values of the western Member States, while overlooking interests of CEE movers. Its one-sided approach is further reinforced by referring to irrelevant facts and negative assumptions to create an image of CEE nationals as socially and economically inferior to westerners, as not belonging to the proper EU polity and as not quite deserving of EU law’s protections. By silencing CEE nationals’ voices, while disregarding the background of east/west socio-economic and political power differentials and precariousness experienced by many CEE workers in the west, such racialising discourse normalises ethnicity- and class-based stereotypes. These findings also help to contextualise both EU and western policies targeting CEE movers and evidence of their unequal outcomes in the west, and are in line with today’s nuanced expressions of racisms. By illustrating the ECJ’s role in addressing values pertinent to mobile CEE individuals, this study facilitates a fuller appreciation of the ECJ’s power in shaping and reflecting western-centric EU identity and policies. Engaging with such issues will not only allow us to better appreciate—and question—the ECJ’s legitimacy, but might also facilitate a better understanding of power dynamics within the EU. This study also makes significant theoretical and methodological contributions. It expands (and complicates) the application of postcolonial theory to contemporary intra-EU processes, while illustrating the usefulness of applying critical discourse analysis to exploring differentiation, exclusion, subordination and power within legal language

LONG TERM ORAL ETOPOSIDE AS SECOND LINE THERAPY IN RECURRENT EPITHELIAL CARCINOMA OF THE OVARY

There is a continuing need to identify new agents that are active in ovarian cancer. Etoposide is a derivative of the plant alkaloid epipodophyllotoxin. The availability of etoposide in oral preparation allows prolonged administration by the oral route. In this study, activity and toxicity of etoposide in women with recurrent ovarian cancer are described from a case series of women with recurrent ovarian cancer who had measurable disease. All patients had prior platinum-based chemotherapy and developed progressive disease. Oral etoposide was given as 50 mg/day for 21 days every 4 weeks until progression of disease or prohibitive toxicity. From December 1999 to January 2004, 32 patients were enrolled in this study. Thirty patients received a total of 133 cycles of etoposide. Median age of patients was 49 years (range, 19 to 75). The median number of etoposide cycles was 4 (range, 1 to 12). There were 5 partial responses (16.6%). The mean response duration was 4.8 months (range, 3.5 to 6); median progression-free interval was 7 months (range, 3 to 13) and median survival time was 12.5 months (range, 1.3 to 36). The major toxicity was leukopenia. One patient required red blood cell transfusions and the main non-hematologic toxicity was nausea and vomiting. There were no treatment-related mortalities. Although etoposide appears to exhibit modest activity in recurrent ovarian cancer after platinum-based therapy, response and survival durations are short