The Comparative Effect of Biofeedback and Auriculotherapy on Alleviating Hot Flashes in Menopausal Women: A Pilot Study

Objectives@#Menopause is associated with a plethora of problems particularly hot flashes. This study aims to compare the effect of biofeedback and auriculotherapy on hot flashes in menopausal women in Kerman, Iran. @*Methods@#This study, a pilot clinical trial with a pretest–posttest control group design, was conducted on 39 postmenopausal women referring to the private offices of obstetricians and gynecologists in Kerman, Iran, in 2019. The participants were divided into 3 groups (n = 13 in each group) using simple random assignment. In the first and second intervention groups, the biofeedback program and auriculotherapy were conducted by the researcher 10 times in 45- and 30-min sessions twice a week, respectively. In the control group, routine care was provided. The participants completed the checklist of severity and frequency of hot flashes before, immediately, and 4 weeks postintervention. @*Results@#Immediate and 4-week postintervention biofeedback and auriculotherapy had a significant effect on reducing the severity and frequency of hot flashes (P < 0.001). However, the effect of auriculotherapy on mitigating the severity and frequency of hot flashes immediately and 4-week postintervention was more significant than that of biofeedback (P < 0.001). @*Conclusions@#Biofeedback and auriculotherapy may be effective in the treatment of hot flashes. Hence, they can be recommended as therapeutic methods for postmenopausal women.

value of red cell distribution width [RDW] and trauma-associated severe hemorrhage [TASH] in predicting hospital mortality in multiple trauma patients

Objective: To investigate the role of red cell distribution width [RDW] in comparison with Trauma-Associated Severe Hemorrhage [TASH] system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department

Methods: This follow-up study was conducted on multiple trauma patients [age = 18 years] with Injury Severity Scores [ISS] of = 16, who were referred to the emergency department from March 1, 2017, to December 1, 2017. First, all patients were evaluated based on the Advanced Trauma Life Support [ATLS] guidelines, and then, their blood samples were sent for RDW measurements at baseline and 24 hours after admission. The ISS, Revised Trauma Score [RTS], and TASH were measured in the follow-ups and recorded by third-year emergency medicine residents. Hospital mortality was considered as the outcome of the study

Results: In this study, 200 out of 535 multiple trauma patients were recruited. The frequency of hospital mortality was 19 [9.5%]. In the univariate analysis, there was no significant relationship between hospital mortality and RDW at baseline, RDW on the first day, and ?RDW [RDW at baseline - RDW on the first day], unlike ISS, RTS, TASH [p=0.97, P= 0.28, and p=0.24, respectively]. On the other hand, in the multivariate analysis, ISS, RTS, and TASH showed a significant relationship with hospital mortality. The greatest area under the ROC curve [AUC] was attributed to TASH and RTS systems [0.94 and 0.93, respectively]

Conclusion: TASH scoring system, which was mainly designed to predict the need for massive transfusion, may be of prognostic value for hospital mortality in multiple trauma patients, similar to ISS and RTS scoring systems

Multi-state survival analysis in renal transplantation recipients

Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models. This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multistate models. During 4.06 years [median] of follow-up; 28 [6.9%] recipients died and allograft failure occurred in 51 [12.6%] recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure [HR=0.38; 95% CI: 0.17- 0.87], pre-transplant hypertension [HR=2.94; 95% CI: 1.54- 5.63] and serum creatinine levels >1.6 upon discharge from the hospital [HR=7.38; 95% CI: 3.87- 7.08] increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly [HR=0.18; 95% CI: 0.04- 0.93]. It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type