Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine / 中西医结合学报

Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains-which are similar to moxibustion usages-have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended. Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; 21(4):354-360.

The effect of Teach-back method education on the control of asthma and family care pressure of patients in Iran / El efecto de la educación del método Teach-back en el control del asma y la carga del cuidado familiar de los pacientes en Irán / O efeito da educação do método Teach-back no controle da asma e a carga do cuidado familiar dos pacientes no Irã

Objective. To investigate the effect of teach-back education on patient asthma control and family care pressure of patients with asthma. Methods. The present study is a clinical trial and the study population was patients referred to Shahid Faghihi and Shahid Motahhari clinics in Shiraz, Iran. 58 patients with asthma and their caregivers were randomly assigned to the intervention and control groups, for a total of 29 subjects in each group. In the intervention group: the teach-back method was delivered individually to the patient and his or her primary caregiver in three sessions of approximately 60 minutes at one-day intervals. each session included presentations, practical techniques and a booklet. In this study, patients and caregivers in the control group were not trained. Before the intervention, 4 and 8 weeks after the intervention, asthma control test and spirometry test were performed to evaluate asthma control; Also, before the intervention and 8 weeks after the intervention, Zarit test was performed to evaluate the care burden. Results. The findings of repeated measures tests showed that, compared to the control group, the intervention group obtained a greater increase in the vital capacity index (p=0.028) and in the disease control score (p=0.001), as well as a reduction in the burden of care on family members (p<0.001). Conclusion. The present study showed that teaching asthma related topics to the patient and her caregiver along with the follow-up and supervision of the nurse improves the asthma control of the patient and also reduces the caregiver pressure.

Objetivo. Investigar el efecto de la educación con el método teach-back sobre el control del asma y la carga del cuidado familiar de estos pacientes. Métodos. Ensayo clínico cuya población de estudio fueron los pacientes remitidos a las clínicas Shahid Faghihi y Shahid Motahhari en Shiraz, Irán. Se asignaron aleatoriamente 58 pacientes con asma y sus cuidadores a los grupos de intervención y control, con un total de 29 díadas en cada grupo. Las personas del grupo de intervención recibieron formación con el método teach-back que se impartió individualmente al paciente y a su cuidador principal en tres sesiones de aproximadamente 60 minutos en tres días consecutivos. Cada sesión incluía presentaciones, técnicas prácticas y un folleto. Los pacientes y cuidadores del grupo de control no recibieron formación. Antes de la intervención y a las 4 y 8 semanas después de la misma, se aplicaron las escalas de control del asma y la de Zarit para evaluación de la carga del cuidado y, además se practicó una espirometría. Resultados. Las pruebas de medidas repetidas entre los grupos de estudio mostraron que, comparando con el grupo control, el grupo de intervención obtuvo mayor aumento del índice de capacidad vital (p=0.028) y del puntaje de control de la enfermedad (p=0.001), además, se redujo la carga del cuidado en los familiares (p<0.001). Conclusión. El presente estudio mostró que con la enseñanza de temas relacionados con el asma al paciente y a su cuidador, junto con el seguimiento y la supervisión de la enfermera, se mejora el control del asma en el paciente y también se reduce la carga del cuidador.

Objetivo. Investigar o efeito da educação com o método teach-back sobre o controle da asma e a carga do cuidado familiar destes pacientes. Métodos. Ensaio clínico no qual a população de estudo foram os pacientes enviados às clínicas Shahid Faghihi e Shahid Motahhari em Shiraz, Irã. 58 pacientes com asma e seus cuidadores foram designados aleatoriamente aos grupos de intervenção e controle, com um total de 29 díade em cada grupo. As pessoas do grupo da intervenção receberam formação com o método teach-back que se transmitiu individualmente ao paciente e ao seu cuidador principal em três sessões de aproximadamente 60 minutos em três dias consecutivos. Cada sessão incluía apresentações, técnicas práticas e um folheto. Os pacientes e cuidadores do grupo de controle não receberam formação. Antes da intervenção e às 4 e 8 semanas depois dela, se aplicaram as escalas de controle da asma e a de Zarit para avaliação da carga do cuidado e, além disso se praticou uma espirometria. Resultados. As provas de medidas repetidas entre os grupos de estudo mostraram que, comparando com o grupo de controle, o grupo de intervenção obteve maior aumento do índice de capacidade vital (p=0.028) e da pontuação de controle da doença (p=0.001), ademais de que se reduziu a carga do cuidado nos familiares (p<0.001). Conclusão. O presente estudo mostrou que o ensino de temas relacionados com a asma ao paciente e ao seu cuidador, junto com o seguimento e a supervisão da enfermeira, se melhora o controle da asma no paciente e também se reduz a carga do cuidador.

Treatment of Trans-Sphincteric Fistula-In-Ano with Combined Therapy of Laser and Kshara Sutra

Fistula-in-ano is most infectious disease among all the ano-rectal disorders since ancient times. Over the past few decades, various techniques are being evaluated in terms to prevent its recurrence and complications; it is still a challenging surgical disease. The sign and symptoms of fistula in ano resembles with Bhagandar described in Ayurvedic classics. Kshara sutra therapy (medicated thread) practiced in Ayurveda Since ancient time for the management of Naadi Vrana and Bhagandar. Kshara sutra therapy has revolutionized the treatment of fistula-in-ano, as it treat the main culprit of fistula that is cryptoglandular origin but the drawback of Kshara sutra therapy are as it takes more number of hospital visit, long anxiety period and discomfort. In present time LASER therapy is used in various medical surgery and also in proctology like in fistula as FILAC, DLPL etc. Diode LASER 980nm (Radial Fibre) burns unhealthy granulation tissues in 360° manner with less or minimal pain, LASER act as photo evaporation effect and leads to the shrinkage of the fistula tract. But if we do LASER in internal opening of fistula it provides a bare area for microbes and creates a chance to re-infects the crypts and anal glands, which further leads recurrent fistula formation. Therefore a novel technique for sphincter preserving surgery proposed as combined therapy of Kshara sutra ligation for main culprit that is cryptoglandular infection as SMAK (Sub Mucosal Application of Kshara Sutra) and LASER, shrink the remaining fistula tract instantly

A Systematic Literature Review of Current Therapeutic Approaches for COVID-19 Patients

Background:In December 2019, the pneumonia outbreak reported in Wuhan, Hubei Province, China. WHO introduced a novel coronavirus and the virus named Severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) in January 2020. There are not any specific antiviral agents for coronavirus disease 19 (COVID‐19). Objective:Our review aimed to discuss treatment options and the efficacy of currently prescribed drugs and supportive care in COVID‐19 patients. Study Design:A literature review of the articles in the Web of Science, PubMed, Scopus and EMBASE conducted. Results: Lopinavir/ritonavir combination was the most frequently used drug, followed by Arbidol and Oseltamivir and Methylprednisolone. Lopinavir/Ritonavir outcome showed the fever and respiratory infection improve in day two and day eight, respectively. Also, negative PCR of SARS‐CoV‐2 in days six and 7day was seen and finally these patients discharged in 10 days. Conclusions: Lopinavir/Ritonavir was the most improving administrated antiviral combination, which might be a good option for COVID-19 due to its availability. Although supportive care such as O2supplementary and IV fluid therapy has improved outcomes. There are not evidence forsuggesting a new treatment or a new drug, which mean the necessity of further investigations for drug research in a clinical trial for a conclusion about the optimum treatment

Validation of an Ultrashort Persian Version of Oral Health Impact Profile (OHIP-5) Questionnaire

Abstract Objective: To validate the ultrashort (5-item) Persian version of OHIP by investigating its psychometric properties. Material and Methods: Construct validity was assessed by examining the correlation between OHIP-5 scores and self-reported oral health status, judgment for dental treatment needs and the number of natural teeth. Reliability was calculated using Cronbach's alpha and corrected item-total correlation. Effect size (ES) and Standardized Response Mean (SRM) were calculated for the responsiveness of the scale and factor analysis was done by measuring Kaiser-Meyer-Olkin (KMO), Bartlett's sphericity test and scree plot. Results: In 430 subjects (mean age 41.56+/-11.35 years, 56% female) the correlations between OHIP-5 scores and mentioned items were significant (p<0.01) indicating sufficient construct validity. The reliability coefficient (Cronbach's alpha) of the OHIP-5 was above the recommended 0.7 thresholds (0.809) and considered well. For evaluation of responsiveness, the ES was measured to be 5.604 and the SRM was 1.5. Moreover, in the confirmatory factor analysis, the unidimensional model for OHIP5 approved by indices (KMO=0.81, p<0.001 for Bartlett sphericity). Conclusion: The Persian version of OHIP-5 is a precise, valid, reliable and unidimensional instrument for assessing oral health-related quality of life among the general adult population.

An overview of biotechnological production of propionic acid: from upstream to downstream processes

The increasing demand for propionic acid (PA) production and its wide applications in several industries, especially the food industry (as a preservative and satiety inducer), have led to studies on the low-cost biosynthesis of this acid. This paper gives an overview of the biotechnological aspects of PA production and introduces Propionibacterium as the most popular organism for PA production. Moreover, all process variables influencing the production yield, different simple and complex carbon sources, the metabolic pathway of production, engineered mutants with increased productivity, and modified tolerance against high concentrations of acid have been described. Furthermore, possible methods of extraction and analysis of this organic acid, several applied bioreactors, and different culture systems and substrates are introduced. It can be concluded that maximum biomass and PA production may be achieved using metabolically engineered microorganisms and analyzing the most significant factors influencing yield. To date, the maximum reported yield for PA production is 0.973 g·g-1, obtained from Propionibacterium acidipropionici in a three-electrode amperometric culture system in medium containing 0.4 mM cobalt sepulchrate. In addition, the best promising substrate for PA bioproduction may be achieved using glycerol as a carbon source in an extractive continuous fermentation. Simultaneous production of PA and vitamin B12 is suggested, and finally, the limitations of and strategies for competitive microbial production with respect to chemical process from an economical point of view are proposed and presented. Finally, some future trends for bioproduction of PA are suggested.

Using beta-cyclodextrin and Arabic gum as wall materials for encapsulation of saffron essential oil

Saffron essential oil has a pleasant aroma and medicinal activities. However, it is sensible into the environmental condition. Therefore, it should be protected against unwanted changes during storage or processing. Encapsulation is introduced as a process by which liable materials are protected from unwanted changes. In the present study, different ratios [0:100, 25:75, 50:50, 75:25, and 100:0] of beta-cyclodextrin [beta-CD] and arabic gum [GA] were used as wall martial for encapsulation saffron essential oil. In order to calculate of loading capacity [LC] and encapsulation efficiency [EE], and release [RE], safranal was determined as indicator of saffron essential oil using GC. According to the results, the highest LC and EE were related to the mixture of beta-CD/GA at a 75:25 ratio. In contrast, the lowest encapsulate hygroscopicity [EH] and RE were observed when only beta-CD was applied as wall material [P

Viability of probiotic bacteria and some chemical and sensory characteristics in cornelian cherry juice during cold storage

Background: Increased popularity of vegetarianism, lactose intolerance, and the high cholesterol content in dairy products, are all factors that have recently increased the demand for nondairy probiotic products. The objective of this study is to evaluate the effect of refrigeration on the viability of probiotics and asses some of the chemical and sensory characteristics in cornelian cherry juice. Results: The Iranian native probiotic strain (L. casei T4) showed greater viability compared to industrial types (viable count of 8.67 log cfu/mL versus <6.0 log cfu/mL at d 28). However, this most tolerant Iranian strain, could not withstand the conditions of 'Natural juice' at pH 2.6 for more than 7 d. Following a pH adjusted treatment (to pH ~3.5), the viability of the strain was improved to 28 d with some evidence of increased growth of the probiotic. However, the level of antioxidant activity, anthocyanin and phenolic compounds, revealed a slight decrease during cold storage. The changes in the chemical profile of the sample containing L. casei T4 indicated fermentation activity during cold storage. Sensory evaluation results showed significant differences between samples containing L. casei TD4 and other samples in taste, odor and overall acceptance in a complimentary way. Conclusion: The results showed that low pH and presence of inhibitor phenolic compounds of cornelian cherry juice have negative effect on viability of probiotics, especially industrial strains during refrigerated storage.

validity of pulse wave tissue doppler imaging in predicting elevated left ventricular end diastolic pressure in patients with coronary artery disease

Background: Elevated left ventricular filling pressures are the main physiological consequence of diastolic dysfunction and carry a prognostic significance in different cardiovascular diseases including coronary artery diseases, and cardiomyopathies. Filling pressures are considered elevated when the mean pulmonary capillary wedge pressure is >12mmHg or when the left ventricular end diastolic pressure is >/= 16 mm Hg. a reliable noninvasive method for the estimation of LVEDP is needed

Objective: The aim of this study was to evaluate the correlation between the Tissue Doppler Imaging derived E/e ratio, and Left Ventricular End Diastolic Pressure [measured during left ventricular catheterization] in patients with significant Coronary artery Disease, and to identify the optimal cutoff value of the E/e ratio to predict elevated LVEDP

Patients and Methods: This study included 87 patients scheduled for elective coronary angiography at Ibn-Albitar Hospital catheterization laboratory between December 2012 and April 2013.Transthoracic echocardiography was performed to all patients within 2 hours before left heart catheterization, using Philips echocardiography system and S5-1 probe. Mitral valve inflow velocities were assessed by Pulsed-wave Doppler performed in the apical 4-chamber view. Ejection fraction [EF] was measured with biplane Simpson's method from the apical 4-chamber view. PW TDI was performed in the apical 4-chamber view to measure mitral annular velocities from the medial and lateral mitral annuli

Results: The mitral inflow velocities [E, and A] were not correlated to LVEDP while the E/A ratio had a weak positive and the DT of the E wave had a weak negative correlations with LVEDP. E/e ratio showed intermediate to good positive correlation with LVEDP especially those derived from the medial mitral annulus. The correlation between E/e ratio and LVEDP was similar in the patients with or without significant CAD. The ROC curve showed that the cutoff point of E/ e ratio for predicting LVEDP higher than 15mm Hg was from medial mitral annulus > 15 [sensitivity 77.5 %, specificity 84.6%; P<0.001] and from lateral mitral annulus >10 [sensitivity 79 %, specificity 80.3 %; P < 0.001]. On subgroup classification according to EFs, the E/e medial showed significant but weaker correlation with LVEDP in patients with EF >/= 50%, as compared to patients with EF < 50 %. E/e lateral and E/e average had poor correlation with LVEDP in patients with EF >/= 50 %, while they have intermediately significant correlation in patients with EF < 50%

Conclusion: The TDI derived E/e ratio is better than mitral inflow doppler velocities and intervals for predicting elevated LVEDP in patients with or without significant CAD, especially in patients with reduced EF. The E/e medial > 15 and E/e lateral > 10, predict LVEDP > 15 mm Hg with good sensitivity and specificity

Fenugreek: potential applications as a functional food and nutraceutical

Fenugreek [Trigonella foenum graecum] native to southern Europe and Asia, is an annual herb with white flowers and hard, yellowish brown and angular seeds, known from ancient times, for nutritional value beside of its medicinal effects. Fenugreek seeds are rich source of gum, fiber, alkaloids, flavonoids, saponins and volatile content. Due to its high content of fiber, fenugreek could be used as food stabilizer, adhesive and emulsifying agent to change food texture for some special purposes. Some evidence suggests that fenugreek may also be regarded as antidiabetic, anticarcinogenic, antioxidant, antibacterial agent, antianorexia agent, and gastric stimulant, as well as remedy for hypocholesterolemia and hypoglycemia. The present article is aimed to review the potential applications of fenugreek as a functional food and nutraceutical agent

Influence of heat shock temperatures and fast freezing on viability of probiotic sporeformers and the issue of spore plate count versus true numbers

Background and Objectives: The purpose of the present study was to investigate effects of various heat shock conditions and fast freezing and subsequent thawing on the viability and recovery of Bacillus coagulans and Bacillus subtilis as probiotic Sporeformers, and also to compare spore plate and microscopic counts

Materials and Methods: After preparing the final suspensions of B. coagulans and Bacillus suhtilis subsp. Natto spores, they were spread-plated before and after fast freezing treatment [-70°C for about 1 min]. Heat shock treatments of the spores were carried out at 68°C for 15, 20, and 30 min as well as at 80°C for 10 and 15 min. Concentrations of the examined probiotic Sporeformers were determined simultaneously by plate enumerations and microscopically determined counts. Student's t-test and one-way analysis of variance [ANOVA] of SPSS were used for statistical analysis of the data. Analysis of DoE results was carried out using Minitab

Results: The results presented here show that the highest recovery rates for B. coagulans [14.75 log CFU/mL] and B. subtilis spores [14.80 log CFU/mL] were under a heat shock condition of 68°C for 20 min in nutrient agar [p<0.05]

In addition, the survival rates of B. coagulans and B. subtilis spores under the fast freezing and subsequent thawing condition were about 90% and 88%, respectively. Plate counts differed significantly from counts determined microscopically, with differences of almost 0.5 and 0.8 log for B. coagulans and B. subtilis spores, respectively [p<0.05]

In addition, DoE results of the study revealed that both factors of spore count method and only freezing factor in fast freezing treatment have a significant effect on concentrations of the spores examined [p<0.05]

Conclusions: Heat shock conditions, freezing and subsequent thawing circumstances, and plate counts or enumerations determined microscopically have significant influences on the viability of probiotic Sporeformers and should be considered in determining of their accurate concentrations

Sleep quality in long haul truck drivers: A study on Iranian national data / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors.</p><p><b>METHODS</b>2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality.</p><p><b>RESULTS</b>Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality.</p><p><b>CONCLUSION</b>Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.</p>

Thyroid metastasis of bladder transitional cell carcinoma

The thyroid gland is a rare site for cancer metastasis. We report a 75-year-old man who was referred with a history of hematuria and generalized bone pain for the past few months. He had a past history of partial left lobe thyroidectomy for follicular adenoma. Subsequently he was referred for a thyroid mass and a subtotal thyroidectomy showed a poorly-differentiated carcinoma. On the latest admission, the patient underwent resection of a bladder tumour with malignant histology and an immunohistochemical profile of CK7+/CK20+/34 Beta E12+/CEA-/PSA-. Re-examination of thyroid sections with immunohistochemical stains revealed the malignant cells to be CK7+/CK20+/34 Beta E12+/CEA-/TTF1-. The findings were compatible with metastasis of the bladder transitional cell carcinoma to the thyroid gland.Scans revealed multiple liver and bone metastases. The patient died 2 months after the diagnosis.

Long term effect of permenant right ventricular pacing on left ventricular systolic function

Background: Right ventricular apical pacing is associated with alterations of left ventricular contraction sequence and dilatation and may have a deleterious effect on left ventricular function

Objective: The study investigates the correlation between left ventricular function and long term right ventricular pacing

Methods: In this study, 80 patients with permanent right ventricular apical [VDD and DDD] randomized to assess left ventricular systolic function particular LVEF%. primary end point was LVEF% after 1 year of pacing

Results: In this study, the mean LVEF% was reduced after hear of right ventricular pacing from [67.47 +/- 2.94 to 55.89 +/- 8.41, p value 0.0001], with absolute reduction of about 12%. Patients with LV systolic dysfunction [EF% less than or equal to 45%] which constitute 10 patients [12.5%] have mean baseline LVEF% [66.70 +/- 4.03 reduced to 3.50=6.38, P value 0.0001]. Cumulative percentage of RV pacing and duration are predictors of LVEF% reduction

Conclusion: Conventional right ventricular apical pacing resulted in a significant reduction in the left ventricular ejection fraction, particularly in patients with high percentage of right ventricular pacing and should be suspected in any patients after long term pacing of right ventricular. Functional rather than topographic criterion should be considered for optimal pacing

morphological study of atypical uterine bleeding

To find out the Histopathological pattern of Endomyometrium in atypical uterine bleeding [AUB], also to study organic causes of AUB. A prospective, descriptive study. This study was conducted at the Departments of Pathology and Gynaecology and Obstetrics, Bolan Medical College Complex Hospital Quetta from January 2011 to January 2013. Specimens were received as endometrial curettage and hysterectomy specimens from patients hospitalized in the dept. of Gynaecology and Obstetrics of BMC Complex Hospital Quetta. This study included 300 women's presenting with AUB, irrespective of age and parity. A detailed clinical history followed by physical examination was also carried out in each patients to exclude systemic causes like psychological upsets and early pregnancy states and also exclude general physical abnormalities. After grossing and H and E staining all the sections were studied by group of pathologists. A Total 300 cases were studied, including 100 endometrial curetting's and 200 uteri in patients of atypical uterine bleeding at Bolan Medical Complex Hospital Quetta. The ages of these patients ranged from 20-69 years. Maximum numbers of cases were in age groups 40-49 years. Chronic endometritis [7 out of 100] 7% and the cystic hyperplasia [9 out of 100] 9% were the most important causes of atypical uterine bleeding in endometrial curetting's. No case of endometrial carcinoma was diagnosed in this series. The histological study of hysterectomy specimen revealed multiple leiomyoma's [135 out of 200] 67.5% and adenomyosis [38 out of 200] 19% as the commonest causes of atypical uterine bleeding. [2 out of 200] 1% case of leiomyosarcoma and [1 out of 200] 0.5% case of choriocarcinoma were diagnosed suggesting a lower frequency of uterine malignancy in our study. In conclusion leiomyoma's and adenomyosis are most important causes of AUB after 3[rd] decade of life. Fortunately the frequency of uterine malignancy [excluding cervix] including endometrial carcinoma is much low in our setup as compared to western studies

[Comparisons between three different skin closure methods on incisions repair]

Background and Objectives: Various studies have proven the effect of closure technique on the repair outcome. But there are few studies to investigate the functional and cosmetic outcomes related to different closure techniques. As regards to method of wound and ruptures closure has effects on healing process and choosing the best technique by physician has the priority, the aim of this study is to compare three different suture techniques

Materials and Methods: In this study, sixty patients with anterior cruciate ligament rupture were studied. After subcutaneous tissue closure, skin incision was sutured by three different methods includings: Simple technique, vertical mattress or semisubcuticular suture techniques. To evaluate the cosmetic outcomes visual analogue scale was used. During the study wounds were observed for inflammation, infection or discharges

Results: In semisubcuticular method there was kr167 with p<0.001 between second and third observer, k=0.35 [p-A.001] between first and second observer and kA.22 [p4].001] between first and third observer. In simple technique group the result of second and third observer there was k=0.61 [p=0.01] and kappa results of first and second observer and first and third observer of 0.19 and 0.17 [p-A.002] respectively. The maximum calculated kappa for vertical mattress technique was k=0.54 [p<0.001] between second and third observer. All sutures were free of infection and dehiscence

Conclusion: It seems that semisubcuticular technique has better cosmetic results to other two techniques. So, using this closure technique may increase the patients' satisfaction from operation

Sentinel node mapping for intra-thoracic malignancies: systematic review of the best available evidence

Introduction: Sentinel node mapping is a new technique of lymph nodal staging in solid tumors, which can decrease the morbidity of regional lymph node dissection considerably. Intra-thoracic tumors including non-small cell lung cancer [NSCLC] and esophageal carcinoma [EC] are among the solid tumors in which sentinel node [SN] mapping has been applied. In the current systematic review, we gathered the best available evidence [systematic reviews] in this regard and presented the results in a systematic review format

Material and methods: We searched MEDLINE and SCOPUS since the inception till 13 December 2014 using the following keywords: [lung OR esophagus OR esophageal] AND sentinel AND [systematic review OR meta-analysis OR metaanalysis]. No language limit was imposed on the search strategy. Systematic reviews and meta-analyses on SN mapping in EC or NSCLC were included in the current study. Narrative review articles were excluded from the study

Results: Overall five systematic review were included. One of the included studies was on SN mapping in NSCLC and four were on EC. Overall detection rate and sensitivity for EC and NSCLC were high and both were related to mapping technique, pathological involvement of the mediastinal nodes, size and location of the tumors

Conclusion: SN mapping is feasible and highly accurate in EC and NSCLC. Attention to the technique [using radiotracers, peri-tumoral injection] and restriction of the patients to less advanced cases [cN0 and T1, 2] would ensure the best results with high detection rate and sensitivity

Effect of Process Variables on Survival of Bacteria in Probiotics Enriched Pomegranate Juice.

Aims: The consumption of foods and beverages containing probiotic microorganisms is a growing, global consumer trend. In this research, production of probiotic pomegranate juice containing Lactobacillus plantarum and Lactobacillus delbrueckii was studied. Study Design: Plackett-Burman statistical design was used to evaluate the impact of eleven process variables on the viability of both probiotics. Impact of incorporation of grape juice, tomato juice and pomegranate peel extract as well as phenolic compounds and vitamins have been investigated. Place and Duration of Study: Department of Food Science and Technology, Varamin Branch, Islamic Azad University, Varamin, Tehran, Iran, between Sep 2012 and July 2013. Methodology: Pomegranate juices were inoculated with probiotic bacteria and their survival was evaluated every week by pure plate method. The effect of 11 variables (in two levels) on survival of bacteria by the statistical design of Plackett-Burman was evaluated. For this purpose, 12 treatments in triplicate by the Minitab (version = 11.0) software at significant levels α= .01 were analyzed. Results: The highest survival rate of L. plantarum (4.74 ×106 CFU/mL) and L. delbrueckii (4 ×106 CFU/mL) was obtained by 10% v/v inoculation of a 48 h inoculum culture in MRS broth medium to enriched pomegranate juice (10% v/v Grape juice, 5% v/v tomato juice, 0.1% v/v pomegranate peel extract and 2.0 g.L glucose) which was inoculated in anaerobic condition for 72 h at 37ºC and kept for 2 weeks at environment temperature. Sensory evaluation shows the probiotic juice was accepted by consumers with no significant difference in comparison to control in terms of taste, odour and overall acceptability (P>.05). Conclusion: The results of this study suggest that grape, tomato juices and pomegranate peel extract exert a protective effect on L. plantarum and L. delbrueckii viability under acidic condition of pomegranate juice and storage time, which was associated with the chemical composition of them. This study indicates that develop of probiotic pomegranate juices with acceptable viability and stability of the probiotic is possible.

Reducing the incidence of chronic lung disease in very premature infants with aminophylline

The objective of this study is to assess the safety and preventative effects of aminophylline on the incidence of chronic lung disease [CLD] in very premature infants. This was a long follow-up randomized clinical trial. The prophylactic effect of aminophylline on the incidence of CLD was investigated in very premature infants. The study group received aminophylline for the 1[st] 10 days of life and control infants received no aminophylline during the 1st 10 days of life. Fifty-two infants participated [26 aminophylline, 26 controls]. Premature infants on aminophylline had clearly shorter oxygen dependency time than those in the control group. Median time of oxygen dependency was 3 [0-9.5] days and 14 [3-40.5] days in group A and C, respectively [P: 0.001]. Incidence of CLD was significantly different between the two groups. Only two infants [8.7%] on aminophylline developed CLD, when compared to 11 infants [44.0%], who did not receive aminophylline [P: 0.006]. No side-effects were reported in the neonates [P: 1]. This study supports the preventative effects of aminophylline on the incidence of CLD in very premature infants. In other words, the more premature the infants, the greater will be the preventative effect of aminophylline on the incidence of CLD

effect of neutral oligosaccharides on reducing the incidence of necrotizing

Necrotizing enterocolitis [NEC] is one of the most destructive diseases associated with conditions of neonatal prematurity. Supplementation with enteral prebiotics may reduce the incidence of NEC, especially in infants who fed exclusively with breast-milk. Therefore, we compared the efficacy and safety of enteral supplementation of a prebiotic mixture [short chain galacto-oligosaccharides/long chain fructooligosaccharides [SCGOS/LCFOS]] versus no intervention on incidence of NEC in preterm infants. In a single-center randomized control trial 75 preterm infants [birth weight [BW]