As acupressure decreases pain, acupuncture may improve some aspects of quality of life for women with primary dysmenorrhea: a systematic review with meta-analysis

AbstractPrimary dysmenorrhea is the most common gynecological symptom reported by women and constitutes a high health, social, and economic burden. Chemotherapies, along with their side effects, have not yielded satisfactory outcomes. Alternative nonpharmacological interventions, including acupuncture and acupressure, have been advocated, but evidence regarding their beneficial effect is inconclusive. This study sought to obtain evidence on the effectiveness of acupuncture and acupressure interventions. Twelve electronic databases were searched by using menstrual pain intensity and quality of life as primary and secondary outcomes, respectively, with the PEDro guideline for quality appraisal. Data unsuitable for a meta-analysis were reported as descriptive data. The search yielded 38 citations, from which eight studies were systematically reviewed, four of the eight being eligible for meta-analysis. The systematic review showed moderate methodological quality with a mean of 6.1 out of 10 on the PEDro quality scale. Acupressure showed evidence of pain relief while acupuncture improved both the mental and the physical components of quality of life. In conclusion, physiotherapists should consider using acupuncture and acupressure to treat primary dysmenorrhea, but a need exists for higher quality, randomized, blinded, sham-controlled trials with adequate sample sizes to establish clearly the effects of these modalities

Assessment of Patient Radiation Dose in Interventional Procedures at Shahid Madani Heart Center in Khorramabad, Iran

Introduction: Coronary angiography is the most common angiographic procedure for diagnosis and treatment of the heart diseases. Herein, we aimed to evaluate the entrance surface dose (ESD), dose area product (DAP), as well as cancer risk in interventional cardiology procedures. Materials and Methods: This study was conducted during July-December 2015 at Shahid Madani Heart Center in Khorramabad, Iran. A total of 225 adult patients including 122 females and 103 males regardless of the risk factors for coronary diseases were participated. Of them, 199 and 26 patients underwent diagnostic coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), respectively. Each patient underwent CA or PTCA separately. All the procedures were carried out using Siemens angiography system with the pulsed fluoroscopy of 10-30 pulses/s and cine frame rate of 15 frames/s. DAP, ESD, fluoroscopy time (FT), as well as the number of sequences and frames per sequence were collected for each 199 CA and 26 PTCA procedures. Results: The median values of DAP were 19.77±14.88 and 57.11±33.36 Gy.cm2 in CA and PTCA, respectively. In addition, the median values of ESD were 323.12±245.39 and 1145.22±594.42 mGy in CA and PTCA, respectively. FTs were 114.59±74.33 s in CA and 424.15±292.93 s in PTCA. Conclusion: The average patient dose and cancer risk estimates in both CA and PTCA were consistent with the reference levels. However, in agreement with other interventional procedures, dose levels in the interventional cardiology are influenced by staff and clinical protocols, as well as the type of equipment

Optimization of thermal field parameters of the High Intensity Focused Ultrasound: HIFU simulator

Background: The High intensity focused ultrasound (HIFU) is a noninvasive and effective technique for tumor ablation. Frequency and acoustic power are effective parameters for temperature distribution and the extent of tissue damage. Objective: The aim of this study was to optimize the frequency and acoustic power and to achieve appropriate temperature and thermal fields. Methods: This analytical study was conducted in Kermanshah, 2014. Computer simulation was performed using MATLAB software (HIFU simulator toolbox). The KZK nonlinear wave equation was used to model sound propagation. The Bio heat equation was used to calculate the transient temperature in the liver tissue. Extracorporeal transducer was assessed over a frequency range of 2,3 and 4 MHz and a power range of 50, 100 and 150 W. Findings: In 2 MHz frequency, the temperature in the focal point reached to 44.5°C, 55°C and 75°C for 50, 100 and 150-W power, respectively. In 3 MHz frequency and the mentioned powers, the temperature reached to 47.5°C, 67°C and 94°C, respectively. The temperature reached to 45.5°C, 55 °C and 67 °C in 4 MHz frequency, respectively. 2, 3 and 4 MHz frequencies with 150- W power and 3 MHz frequency with 100-W power induced considerable extent of thermal dose. Conclusion: 2-MHz frequency and 150W power can lead to more thermal dose in the same exposure time. These parameters can reduce treatment period and complications in larger tumors ablation. Keywords: High Intensity Focused Ultrasound, Temperature, Neoplasm

Numerical Study for Optimizing Parameters of High-Intensity Focused Ultrasound-Induced Thermal Field during Liver Tumor Ablation: HIFU Simulator

Introduction High intensity focused ultrasound (HIFU) is considered a noninvasive and effective technique for tumor ablation. Frequency and acoustic power are the most effective parameters for temperature distribution and the extent of tissue damage. The aim of this study was to optimize the operating transducer parameters such as frequency and input power in order to acquire suitable temperature and thermal dose distribution in the course of a numerical assessment. Materials and Methods To model the sound propagation, the Khokhlov-Zabolotskava-Kuznetsov (KZK) nonlinear wave equation was used and simulation was carried out using MATLAB HIFU toolbox. Bioheat equation was applied to calculate the transient temperature in the liver tissue. Frequency ranges of 2, 3, 4, and 5 MHz and power levels of 50 and 100 W were applied using an extracorporeal transducer. Results Using a frequency of 2 MHz, the maximum temperatures reached 53°C and 90°C in the focal point for power levels of 50 W and 100 W, respectively. With the same powers and using a frequency of 3 MHz, the temperature reached to 71°C and 170°C, respectively. In addition, for these power levels at the frequency of 4 MHz, the temperature reached to 72°C and 145°C, respectively. However, at the 5 MHz frequency, the temperature in the focal spot was either 57°C or 79°C. Conclusion Use of frequency of 2 MHz and power of 100 W led to higher thermal dose distribution, and subsequently, reduction of the treatment duration and complications at the same exposure time in ablation of large tumors

Health Risk Assessment of Natural Background Radiation in Residents of Khorramabad, Iran

Introduction Radioactive materials naturally exist in the world. Indeed, approximately 82% of human-absorbed radiation doses, which are out of human control, arise from natural sources of radiation including cosmic, terrestrial, and exposure through inhalation or ingestion. Thus, the aim of the present study was to estimate health risk, as well as the effective and organ doses from naturally occurring background radiation in residents living in the vicinity of Khorramabad, Iran. Materials and Methods This cross-sectional study was carried out in Khorramabad, Iran. The measurements were performed using Geiger-Muller detector (RDS-110) during daylight from April to June, 2015. The natural gamma radiation measurements were made both indoor and outdoor across five regions of Khorramabad (north, south, west, east, and center). Results The estimated mean absorbed dose rate in outdoor and indoor zones were 0.09±0.024 and 0.117±0.032 mSvy-1, respectively. Additionally, the mean annual effective dose was calculated as 0.69±0.19 mSvy-1, while the estimated health risk probability was 0.0345%. Conclusion The average annual effective dose arising from gamma background radiation was higher than global values. Therefore, more studies are required to examine the relationship between radiation-induced effects and the natural background radiation level in Khorramabad