Showing papers by "Iran University of Medical Sciences published in 2014"

Ethical challenges of researchers in qualitative studies: the necessity to develop a specific guideline.

Abstract: Considering the nature of qualitative studies, the interaction between researchers and participants can be ethically challenging for the former, as they are personally involved in different stages of the study. Therefore, formulation of specific ethical guidelines in this respect seems to be essential. The present paper aimed to discuss the necessity to develop explicit guidelines for conducting qualitative studies with regard to the researchers' role. For this purpose, a literature review was carried out in domestic and international databases by related keywords. Health care providers who carry out qualitative research have an immense responsibility. As there is no statistical analysis in qualitative studies, the researcher has to both evaluate what he or she observes and to interpret it. Providing researchers with the necessary skills and applying stringent supervision can lead to better extraction of reliable information from qualitative studies. This article presents a debate in order to illustrate how researchers could cover the ethical challenges of qualitative studies and provide applicable and trustworthy outcomes. Researchers face ethical challenges in all stages of the study, from designing to reporting. These include anonymity, confidentiality, informed consent, researchers' potential impact on the participants and vice versa. It seems of paramount importance that health care providers, educators and clinicians be well informed of all the different aspects of their roles when acting as qualitative researchers. Hence, these adroit roles need to be well defined, and the use of practical guidelines and protocols in all stages of qualitative studies should be encouraged.

Barriers to evidence‐based medicine: a systematic review

Abstract: Introduction Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Methods Different database searching methods and also manual search were employed in this study using the search words (‘evidence-based’ or ‘evidence-based medicine’ or ‘evidence-based practice’ or ‘evidence-based guidelines’ or ‘research utilization’) and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Results Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. Conclusion The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled.

Factors influencing unsafe behaviors and accidents on construction sites: a review

Abstract: Objective. Construction is a hazardous occupation due to the unique nature of activities involved and the repetitiveness of several field behaviors. The aim of this methodological and theoretical r...

The effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus

Abstract: Objective: To assess the effect of ginger consumption on glycemic status, lipid profile and some inflammatory markers in patients with type 2 diabetes mellitus. Methods: In a double-blinded, placeb...

Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation

Abstract: Background Microdiscectomy or open discectomy (MD/OD) are the standard procedures for symptomatic lumbar disc herniation and they involve removal of the portion of the intervertebral disc compressing the nerve root or spinal cord (or both) with or without the aid of a headlight loupe or microscope magnification. Potential advantages of newer minimally invasive discectomy (MID) procedures over standard MD/OD include less blood loss, less postoperative pain, shorter hospitalisation and earlier return to work. Objectives To compare the benefits and harms of MID versus MD/OD for management of lumbar intervertebral discopathy. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (November 2013), MEDLINE (1946 to November 2013) and EMBASE (1974 to November 2013) and applied no language restrictions. We also contacted experts in the field for additional studies and reviewed reference lists of relevant studies. Selection criteria We selected randomised controlled trials (RCTs) and quasi-randomised controlled trials (QRCTs) that compared MD/OD with a MID (percutaneous endoscopic interlaminar or transforaminal lumbar discectomy, transmuscular tubular microdiscectomy and automated percutaneous lumbar discectomy) for treatment of adults with lumbar radiculopathy secondary to discopathy. We evaluated the following primary outcomes: pain related to sciatica or low back pain (LBP) as measured by a visual analogue scale, sciatic specific outcomes such as neurological deficit of lower extremity or bowel/urinary incontinence and functional outcomes (including daily activity or return to work). We also evaluated the following secondary outcomes: complications of surgery, duration of hospital stay, postoperative opioid use, quality of life and overall participant satisfaction. Two authors checked data abstractions and articles for inclusion. We resolved discrepancies by consensus. Data collection and analysis We used standard methodological procedures expected by The Cochrane Collaboration. We used pre-developed forms to extract data and two authors independently assessed risk of bias. For statistical analysis, we used risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes with 95% confidence intervals (CI) for each outcome. Main results We identified 11 studies (1172 participants). We assessed seven out of 11 studies as having high overall risk of bias. There was low-quality evidence that MID was associated with worse leg pain than MD/OD at follow-up ranging from six months to two years (e.g. at one year: MD 0.13, 95% CI 0.09 to 0.16), but differences were small (less than 0.5 points on a 0 to 10 scale) and did not meet standard thresholds for clinically meaningful differences. There was low-quality evidence that MID was associated with worse LBP than MD/OD at six-month follow-up (MD 0.35, 95% CI 0.19 to 0.51) and at two years (MD 0.54, 95% CI 0.29 to 0.79). There was no significant difference at one year (0 to 10 scale: MD 0.19, 95% CI -0.22 to 0.59). Statistical heterogeneity was small to high (I2 statistic = 35% at six months, 90% at one year and 65% at two years). There were no clear differences between MID techniques and MD/OD on other primary outcomes related to functional disability (Oswestry Disability Index greater than six months postoperatively) and persistence of motor and sensory neurological deficits, though evidence on neurological deficits was limited by the small numbers of participants in the trials with neurological deficits at baseline. There was just one study for each of the sciatica-specific outcomes including the Sciatica Bothersomeness Index and the Sciatica Frequency Index, which did not need further analysis. For secondary outcomes, MID was associated with lower risk of surgical site and other infections, but higher risk of re-hospitalisation due to recurrent disc herniation. In addition, MID was associated with slightly lower quality of life (less than 5 points on a 100-point scale) on some measures of quality of life, such as some physical subclasses of the 36-item Short Form. Some trials found MID to be associated with shorter duration of hospitalisation than MD/OD, but results were inconsistent. Authors' conclusions MID may be inferior in terms of relief of leg pain, LBP and re-hospitalisation; however, differences in pain relief appeared to be small and may not be clinically important. Potential advantages of MID are lower risk of surgical site and other infections. MID may be associated with shorter hospital stay but the evidence was inconsistent. Given these potential advantages, more research is needed to define appropriate indications for MID as an alternative to standard MD/OD.

Prevalence and Causes of Cesarean Section in Iran: Systematic Review and Meta-Analysis.

Abstract: Unfortunately, the prevalence of cesarean section has increased in recent years. Whereas awareness of the prevalence and causes is inevitable for planning and effective interventions, so aim of this study has designed and conducted for reviewing of systematic Prevalence and caesarean causes in Iran. In this meta-analysis, the required information have been collected using several keywords which are Cesarean section rate, Cesarean section prevalence, delivery, childhood, childbirth, relative causes, relative frequency, Iran and their Persian equivalents have been collected from databases such as CINAHL, Science Direct, PubMed, Magiran, SID, Iranmedex. Finally, we found 706 related articles and selected 34 articles among them for studying of cesarean Prevalence. We used CMA software with random model for Meta-Analysis. The prevalence of Cesarean was estimated48%. Using content analysis, Factors influencing the incidence of cesarean section were divided to 3 categories including social and demographic factors, obstetric-medical causes and non-obstetric-medical causes. Maternal education and grand multiparity in the field of demographic and social factors, previous cesarean in the field of obstetric-medical causes and fear of normal-vaginal delivery (NVD) and doctor's suggestion in the field of non-obstetric-medical causes were major causes of Cesarean. According to the high prevalence of caesarean section and it upward development, it seems to be essential designing and implementing of programs and interventions effectiveness including providing of Possibility of painless childbirth and education and psychological interventions, increasing of quality of natural delivery services, proper culture and prohibiting of doctors from Personal opinions and profit.

Enhanced chromium (VI) removal using activated carbon modified by zero valent iron and silver bimetallic nanoparticles.

Abstract: Recently, adsorption process has been introduced as a favorable and effective technique for the removal of metal ions from aqueous solutions. In the present study, bimetallic nanoparticles consisting of zero valent iron and silver were loaded on the activated carbon powder for the preparation of a new adsorbent (PAC-Feo/Ag). The above adsorbent was characterized by using XRD, SEM and TEM techniqes. Experimental data were exploited for kinetic, equilibrium and thermodynamic evaluations related to the adsorption processes. The Cr(VI) adsorption process was found to be favorable at pH 3 and it reached equilibrium state within 60 min. The stirring rate did not have a significant effect on the adsorption efficiency. Furthermore, the monolayer adsorption capacity of Cr(VI) based on the Langmuir model was measured to be 100 mg/g. The experimental equilibrium data were fitted to the Freundlich adsorption and pseudo second-order models. According to the thermodynamic study, the adsorption process was spontaneous and endothermic in nature, indicating the adsorption capacity increases with increasing the temperature. The results also revealed that the synthesized composite can be potentially applied as a magnetic adsorbent to remove Cr(VI) contaminants from aqueous solutions.

Zinc ferrite spinel-graphene in magneto-photothermal therapy of cancer

Abstract: A magneto-photothermal therapy for cancer (in vitro photothermal therapy of prostate cancer cells and in vivo photothermal therapy of human glioblastoma tumors in the presence of an external magnetic field) was developed using superparamagnetic zinc ferrite spinel (ZnFe2O4)–reduced graphene oxide (rGO) nanostructures (with various graphene contents). In vitro application of a low concentration (10 μg mL−1) of the ZnFe2O4–rGO (20 wt%) nanostructures under a short time period (∼1 min) of near-infrared (NIR) irradiation (with a laser power of 7.5 W cm−2) resulted in an excellent destruction of the prostate cancer cells, in the presence of a magnetic field (∼1 Tesla) used for localizing the nanomaterials at the laser spot. However, in the absence of a magnetic field, ZnFe2O4–rGO and also rGO alone (10 μg mL−1) resulted in only ∼50% cell destruction at the most in the short photothermal therapy and also in a typical radiotherapy (∼2 min gamma irradiation with a dose of 2 Gy). The minimum concentrations required for the successful application of the nanostructures in the photothermal and radiotherapeutic methods were found to be ∼100 and 1000 μg mL−1, while in the proposed magneto-photothermal therapy it was only ∼10 μg mL−1. The in vivo feasibility of this method was also examined on mice bearing glioblastoma tumors. Furthermore, the localization of the magnetic nanomaterials injected into the tumors was studied in the presence and absence of an external magnetic field. These results will stimulate more applications of magnetic graphene-containing composites in highly efficient photothermal therapy.

Comparing Efficacy of Three Methods of Tranexamic Acid Administration in Reducing Hemoglobin Drop Following Total Knee Arthroplasty

Abstract: The ideal method of providing tranexamic acid (TXA) for decreasing hemoglobin drop after TKA is still controversial. In this clinical trial, 200 patients were randomly allocated to four groups. In group 1,500 mg TXA was administered intravenously. In group 2, the joint irrigated with 3 g of TXA in 100 cc of saline. In group 3, 1.5 g of TXA was injected through the drain. Group 4 did not take TXA. Albeit all methods had a statistical effect on hemoglobin drop, drainage and number of transfused units when compared to controls, but intravenous injection of TXA seems to be much more effective in terms of reducing hemoglobin drop and transfused units; and what's more TXA injection by drain is more effective regarding to reducing postoperative drainage.

Application of ZnO–Fe3O4 Nanocomposite on the Removal of Azo Dye from Aqueous Solutions: Kinetics and Equilibrium Studies

Abstract: In this study, zinc oxide was immobilized on magnetite nanoparticles by chemical method and it was used as an adsorbent to remove reactive black 5 (RB5) dye from aqueous solution. The removal efficiency of RB5 was studied as the function of adsorbent dosage, pH, initial RB5 concentration, H2O2, and ionic strength (sodium carbonate, sodium bicarbonate, sodium sulfate, and sodium chloride). Removal efficiency of RB5 by ZnO–Fe3O4 was greater than that by ZnO and Fe3O4 in similar conditions. Maximum adsorption of ZnO–Fe3O4 was obtained at neutral pH, and adsorption capacity was estimated to be 22.1 mg/g. Adsorption kinetic study revealed that the pseudo-second-order model better described the removal rate than the pseudo-first-order model. Adsorption isotherm was analyzed by both Langmuir and Freundlich equations, and results showed that it was better described by the Langmuir equation. The removal efficiency of RB5 was increased with increasing initial H2O2 concentrations from 2 to 5 mM but was decreased above 5 mM. The adsorption capacities of RB5 was increased in the presence of NaCl but was greatly decreased in the presence of bicarbonate, carbonate, and sulfate ion. Adsorption activity of RB5 by ZnO–Fe3O4 composite was maintained even after five successive cycles, suggesting a promising adsorbent for wastewater-contaminated organic dyes.

Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: a randomised, double-blind, placebo-controlled pilot study

Abstract: To evaluate the effects of synbiotic supplementation on insulin resistance and lipid profile in individuals with the metabolic syndrome, we conducted a randomised, double-blind, placebo-controlled pilot study on thirty-eight subjects with the metabolic syndrome; they were supplemented with either synbiotic capsules containing 200 million of seven strains of friendly bacteria plus fructo-oligosaccharide or placebo capsules twice a day for 28 weeks. Both the synbiotic (G1) and the placebo (G2) groups were advised to follow an energy-balanced diet and physical activity recommendations. Parameters related to the metabolic syndrome and insulin resistance were measured every 7 weeks during the course of the study. After 28 weeks of treatment, the levels of fasting blood sugar and insulin resistance improved significantly in the G1 group (P 0·01 mmol/l) respectively; P< 0·001). The mean differences observed were greater in the G1 group. No significant changes were observed in LDL levels, waist circumference, BMI, metabolic equivalent of task and energy intake between the groups. The present results indicate that synbiotic supplementation increases the efficacy of diet therapy in the management of the metabolic syndrome and insulin resistance.

The Therapeutic Use of Analgesics in Patients With Liver Cirrhosis: A Literature Review and Evidence-Based Recommendations

Abstract: Context: Pain management in cirrhotic patients is a major clinical challenge for medical professionals. Unfortunately there are no concrete guidelines available regarding the administration of analgesics in patients with liver cirrhosis. In this review we aimed to summarize the available literature and suggest appropriate evidence-based recommendations regarding to administration of these drugs. Evidence Acquisition: An indexed MEDLINE search was conducted in July 2014, using keywords “analgesics”, “hepatic impairment”, “cirrhosis”, “acetaminophen or paracetamol”, “NSAIDs or nonsteroidal anti-inflammatory drugs”, “opioid” for the period of 2004 to 2014. All randomized clinical trials, case series, case report and meta-analysis studies with the above mentioned contents were included in review process. In addition, unpublished information from the Food and Drug Administration are included as well. Results: Paracetamol is safe in patients with chronic liver disease but a reduced dose of 2-3 g/d is recommended for long-term use. Non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided because of risk of renal impairment, hepatorenal syndrome, and gastrointestinal hemorrhage. Most opioids can have deleterious effects in patients with cirrhosis. They have an increased risk of toxicity and hepatic encephalopathy. They should be administrated with lower and less frequent dosing in these patients and be avoided in patients with a history of encephalopathy or addiction to any substance. Conclusions: No evidence-based guidelines exist on the use of analgesics in patients with liver disease and cirrhosis. As a result pain management in these patients generates considerable misconception among health care professionals, leading under-treatment of pain in this population. Providing concrete guidelines toward the administration of these agents will lead to more efficient and safer pain management in this setting.

Hydrogen Sulfide Protects the Brain Against Ischemic Reperfusion Injury in a Transient Model of Focal Cerebral Ischemia

Abstract: Hydrogen sulfide (H2S), a well-known toxic gas, is regarded as endogenous neuromodulator and plays multiple roles in the central nervous system under physiological and pathological states, especially in secondary neuronal injury. Recent studies have shown relatively high concentrations of hydrogen sulfide (H2S) in the brain and also cytoprotective effects of endogenous and exogenous H2S in models of in vitro and in vivo ischemic injury. H2S protects neurons by functioning as an anti-oxidant, anti-inflammatory, and anti-apoptotic mediator and by improving neurological function. Moreover, it protects neurons from glutamate toxicity. Therefore, the present study aimed to determine whether H2S provides protection in transient focal cerebral ischemia. Focal ischemia was induced by 60-min middle cerebral artery occlusion (MCAO), followed by 23-h reperfusion. Saline as a vehicle and NaHS (H2S donor; 1 and 5 mg) were intraperitoneally injected (IP) at the beginning of ischemia. Infarct volume, brain edema, and apoptosis were assessed 24 h after MCAO. Treatment with NaHS at doses of 1 and 5 mg markedly reduced total infarct volumes by 29 and 51 %, respectively (P < 0.001). In addition, NaHS at doses of 1 and 5 mg reduced brain edema (P < 0.05) and inhibited apoptosis by decreasing positive TUNEL cells (P < 0.001). The present study shows that treatment with H2S reduces brain injuries and postischemic cerebral edema in a dose-dependent manner likely through the blocking programmed cell death. We propose that H2S might be a promising therapeutic target for stroke, although more researches are necessary to take into account the potential therapeutic effects of H2S in stroke patients.

Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis.

Abstract: Major bibliographic databases were searched for studies examining the relationship between fruit and vegetable consumption and the risk of wheezing and asthma. Random-effects models were used to pool study results. Subgroup analyses were conducted by fruit and vegetable categories, study design, and age group. Twelve cohorts, 4 population-based case-control studies, and 26 cross-sectional studies published between January 1990 and July 2013 were identified. For the meta-analysis of adults and children, the relative risk (RR) and confidence intervals (CI) when comparing the highest intake group with the lowest intake group were 0.78 (95%CI, 0.70–0.87) for fruit and 0.86 (95%CI, 0.75–0.98) for vegetables. High intake of fruit and vegetables (RR = 0.76; 95%CI, 0.68–0.86 and RR = 0.83; 95%CI, 0.72–0.96) reduced the risk of childhood wheezing. Total intake of fruit and vegetables had a negative association with risk of asthma in adults and children (RR = 0.54; 95%CI, 0.41–0.69). Consuming fruit and vegetables during pregnancy had no association with the risk of asthma in offspring. High intake of fruit and vegetables may reduce the risk of asthma and wheezing in adults and children.

The mechanisms of radiation-induced bystander effect.

Abstract: The radiation-induced bystander effect is the phenomenon which non-irradiated cells exhibit effects along with their different levels as a result of signals received from nearby irradiated cells. Responses of non-irradiated cells may include changes in process of translation, gene expression, cell proliferation, apoptosis and cells death. These changes are confirmed by results of some In-Vivo studies. Most well-known important factors affecting radiation-induced bystander effect include free radicals, immune system factors, expression changes of some genes involved in inflammation pathway and epigenetic factors.

Magnetic heterogeneous catalytic ozonation: a new removal method for phenol in industrial wastewater

Abstract: In this study, a new strategy in catalytic ozonation removal method for degradation of phenol from industrial wastewater was investigated. Magnetic carbon nano composite as a novel catalyst was synthesized, characterized and then used in the catalytic ozonation process (COP) and compared with the single ozonation process (SOP). The influential parameters were all investigated. The results showed that the removal efficiency of phenol and COD (chemical oxygen demand) in COP (98.5%, 69.8%) was higher than those of SOP (78.7%, 50.5%) and the highest catalytic potential was achieved at optimal neutral pH. First order modeling demonstrated that the reactions were dependent on the concentration of catalyst, with kinetic constants varying from 0.023 1/min (catalyst = 0 g/L) to 0.071 1/min (catalyst = 4 g/L), whereby the optimum dosage of catalyst was found to be 2 g/L. Furthermore, the catalytic properties of the catalyst remained almost unchanged after 5-time reuse. The results regarding the biodegradability of the effluent showed that a 5-min reaction time in COP reduced the concentrations of phenol and COD to the acceptable levels for the efficient post-treatment in the SBR in a 4-h cycle period. Finally, this combined system is proven to be a technically effective method for treating phenolic contaminants.

Th17 cells and related cytokines in unexplained recurrent spontaneous miscarriage at the implantation window

Abstract: Unexplained recurrent spontaneous abortion (RSA) might be caused by the mother's immunological rejection of the fetus. In this cross-sectional study, the percentage of T helper 17 (Th17), T regulatory (Treg) cells and their cytokines as the main players of immunomodulation in peripheral blood lymphocytes during the luteal phase of 20 women with unexplained RSA were compared with 20 normal non-pregnant women. The percentage of Treg cells in the former was significantly lower compared with controls. The percentage of Th17 cells in the former was higher than controls. Expression of IL-23, IL-17, IL-6 cytokines in the former was significantly higher than controls, but the higher expression of IL-21 was not significant. The gene expression of TGF-β and FoxP3 in the former was lower than controls. Significant positive correlations were found between the percentage of Th17 cells with IL-23, IL-6 and IL-17 and between expression of IL-23 and IL-6 and IL-17. IL-6 gene expression showed a significant positive correlation with IL-17. Therefore, imbalance of Th17-Treg cells and the consequent changes in cytokine expression might be implicated in the pathogenesis of unexplained RSA and may provide new insight into the immunoregulatory events at the maternal-fetal interface.

A randomized, placebo-controlled trial of selenium supplementation in patients with type 2 diabetes: effects on glucose homeostasis, oxidative stress, and lipid profile

Abstract: Selenium is an antioxidant trace element Patients with diabetes are shown to have increased oxidative stress together with decreased selenium concentrations Whether raising serum selenium will improve blood glucose management in diabetes is largely unknown In this randomized, double-blind placebo-controlled trial, we assessed the effects of selenium on blood glucose, lipid profile, and oxidative stress in 60 patients with type 2 diabetes Selenium 200 µg/d or placebo was administered orally for 3 months Serum concentrations of fasting plasma glucose, glycosylated hemoglobin A1c (HbA1c), insulin, and lipid profile, as well as ferric-reducing ability of plasma and thiobarbituric acid-reactive substances were determined in the fasting state at baseline and after 3 months Mean (SD) serum selenium at baseline was 4269 (2947) µg/L and 4711 (4286) µg/L in selenium and placebo groups, respectively At endpoint, selenium concentration reached to 7198 (4508) µg/L in selenium recipients compared with 4538 (4645) µg/L in placebo recipients (P<001) Between-group comparison showed that fasting plasma glucose, glycosylated hemoglobin A1c, and high-density lipoprotein cholesterol were statistically significantly higher in the selenium recipient arm Other endpoints changes during the course of trial were not statistically different across the 2 treatment arms This study suggests that selenium supplementation in patients with type 2 diabetes may be associated with adverse effects on blood glucose homeostasis, even when plasma selenium concentration is raised from deficient status to the optimal concentration of antioxidant activity Until results of further studies become available, indiscriminate use of selenium supplements in patients with type 2 diabetes warrants caution

Developing and Using Expert Systems and Neural Networks in Medicine: A Review on Benefits and Challenges

Abstract: Complicacy of clinical decisions justifies utilization of information systems such as artificial intelligence (e.g. expert systems and neural networks) to achieve better decisions, however, application of these systems in the medical domain faces some challenges. We aimed at to review the applications of these systems in the medical domain and discuss about such challenges. Following a brief introduction of expert systems and neural networks by representing few examples, the challenges of these systems in the medical domain are discussed. We found that the applications of expert systems and artificial neural networks have been increased in the medical domain. These systems have shown many advantages such as utilization of experts' knowledge, gaining rare knowledge, more time for assessment of the decision, more consistent decisions, and shorter decision-making process. In spite of all these advantages, there are challenges ahead of developing and using such systems including maintenance, required experts, inputting patients' data into the system, problems for knowledge acquisition, problems in modeling medical knowledge, evaluation and validation of system performance, wrong recommendations and responsibility, limited domains of such systems and necessity of integrating such systems into the routine work flows. We concluded that expert systems and neural networks can be successfully used in medicine; however, there are many concerns and questions to be answered through future studies and discussions.

Menstrual blood-derived stromal stem cells from women with and without endometriosis reveal different phenotypic and functional characteristics

Abstract: Retrograde flow of menstrual blood cells during menstruation is considered as the dominant theory for the development of endometriosis. Moreover, current evidence suggests that endometrial-derived stem cells are key players in the pathogenesis of endometriosis. In particular, endometrial stromal stem cells have been suggested to be involved in the pathogenesis of this disease. Here, we aimed to use menstrual blood, as a novel source of endometrial stem cells, to investigate whether stromal stem cells from endometriosis (E-MenSCs) and non-endometriosis (NE-MenSCs) women differed regarding their morphology, CD marker expression pattern, proliferation, invasion and adhesion capacities and their ability to express certain immunomodulatory molecules. E-MenSCs were morphologically different from NE-MenSCs and showed higher expression of CD9, CD10 and CD29. Furthermore, E-MenSCs had higher proliferation and invasion potentials compared with NE-MenSCs. The amount of indoleamine 2,3-dioxygenase-1 (IDO1) and cyclooxygenase-2 (COX-2) in E-MenSCs co-cultured with allogenic peripheral blood mononuclear cells (PBMCs) was shown to be higher both at the gene and protein levels, and higher IDO1 activity was detected in the endometriosis group. However, NE-MenSCs revealed increased concentrations of forkhead transcription factor-3 (FOXP3) when compared with E-MenSCs. Nonetheless, interferon (IFN)-γ, Interleukin (IL)-10 and monocyte chemoattractant protein-1 (MCP-1) levels were higher in the supernatant of E-MenSCs-PBMC co-cultures. Here, we showed that there are inherent differences between E-MenSCs and NE-MenSCs. These findings propose the key role MenSCs could play in the pathogenesis of endometriosis and further support the retrograde and stem cell theories of endometriosis. Hence, considering its renewable and easily available nature, menstrual blood could be viewed as a reliable and inexpensive material for studies addressing the cellular and molecular aspects of endometriosis.

Therapeutic approaches for renal colic in the emergency department: a review article.

Abstract: Context: Renal colic is frequently described as the worst pain ever experienced, and management of this intense pain is necessary. The object of our review was to discuss different approaches of pain control for patients with acute renal colic in the emergency department.

Reliability and validity of the persian version of templer death anxiety scale-extended in veterans of Iran-Iraq warfare

Abstract: Objective: The purpose of this study was to determine the val idity and reliability of the Persian version of Templer Death Anxiety Scale-Extended (DAS-E) in veterans of Iran ‐Iraq Warfare. Methods: In this cross-sectional study, 211 male veterans o f Iran ‐Iraq Warfare completed the 51 item DASE. Principal components analysis with varimax rotat ion was used to assess domain structure of the DAS- E. Internal consistency reliability was assessed with Cronbach’s alpha. Test‐retest reliability was asses sed with intra-class correlation coefficients for absolute a greement for the individual items and domains. Results: The construct validity of the scale was obtained us ing exploratory factor analysis that showed four factors with Eigen values of greater than 1 (1, 11 items, α = 0.83; 2, 7 items; α = 0.87; 3, 5 items, α = 0.73; and 4, 4 items, α = 0.75). Test‐retest and internal consistency (tot al alpha) was 0.91 and 0.89, respectively. Conclusion: The DAS-E demonstrated suitable validity and relia bility among the veterans under study. The factor analysis demonstrated that the DAS-E has a multi-dimensional structure. With consideration of t he proper psychometric characteristics, this scale can be use d to further research about death anxiety in this p opulation. Declaration of interest: None. Citation: Sharif Nia H, Ebadi A, Lehto RH, Mousavi B, Peyrovi H, Chan YH. Reliability and validity of the persian version of templer death anxiety scale-exte nded in veterans of Iran‐Iraq warfare. Iran J Psych iatry Behav Sci 2014; 8(4): 29-37.