Mesh fixation in TAPP laparoscopic hernia repair: introduction of a new method in a prospective randomized trial

Background

Mesh fixation is a critical step in TAPP laparoscopic hernia repair because tackers used for this purpose are associated with possible neuralgia.

Methods

For the present study, 70 patients referred with unilateral inguinal or femoral hernia were divided in two groups for hernia repair. In first group mesh was fixed with titanium tacker. In the second group mesh was fixed with a single suture of Vicryl.

Results

Patients in the Vicryl group experienced less postoperative pain and analgesic consumption. Six month follow-up demonstrated no hernia recurrence either.

Conclusions

According to results, use of Vicryl suture instead of a titanium tacker is beneficial owing to reduced pain, less analgesic consumption, and lower cost.     

Management of ovarian immature teratoma grade‐II in pregnancy,two cases report and literature review

Postoperative chemotherapy during pregnancy after first trimester is essential for patients with initial disease stage 1, grade 2 ovarian immature teratoma and it associates with lower disease progression and recurrence.     

Eye movement desensitization and reprocessing as a therapy for rape victims: A case series

A case series was conducted on three rape victims who were hospitalized with a diagnosis of major depressive disorder (MDD). Eye movement desensitization and reprocessing (EMDR) was employed to reduce their risk of suicide or suicidal ideations. EMDR can be an effective treatment to reduce the level of suicidal ideation in rape victims.     

Interaction between a variant of chromosome 9p21.3 locus and diet antioxidant capacity on metabolic syndrome in Tehrani adults

Background

Genome-wide association studies have shown that risk alleles on chromosome 9p21.3 locus, are associated with increasing the risk of cardiovascular diseases (CVDs). Several epidemiological studies have found that metabolic syndrome (MetS) is associated with CVDs. Dietary antioxidants also have shown to have potential favorable effects on MetS prevention. This study examined the interactions between rs1333048 genotypes on 9p21 genetic region and Total antioxidant capacity (TAC) on odds of MetS.

Methods

263 Tehrani adults were enrolled in this cross-sectional study. The MetS was defined according to the ATPIII. Dietary intake was assessed daily using a FFQ with 147 items. Dietary TAC was assessed according to United States Department of Agriculture database for oxygen radical absorbance capacity (ORAC). Bioelectrical impedance analysis method was used for body analysis and rs1333048 were genotyped by restriction fragment length polymorphism method. Participants were categorized into three groups based on rs1333048 genotypes.

Results

The results demonstrate that, prevalence of C allele was 52.85% and A allele was 47.15%. After adjustment for confunder variable, this study demonstrated an interaction between AA genotype and high Lyophilic oxygen radical absorbance capacity (L-ORAC) and high Hydrophilic oxygen radical absorbance capacity (H-ORAC) intake on low odds of MetS (OR?=?0.24, 95% CI?=?0.06–0.94, P for interaction?=?0.04, OR?=?0.26, 95% CI?=?0.06–0.99, P for interaction?=?0.04). Also, our result indicated, there was no interaction between AA genotype and high total oxygen radical absorbance capacity (T-ORAC) and total phenolic intakes on reduce odds of MetS (OR?=?0.07, 95% CI?=?0.07–1.10, P for interaction?=?0.07, OR?=?0.58, 95% CI?=?0.16–2.07, P for interaction?=?0.40) respectively.

Conclusion

The results of the present study indicate that high L-ORAC and high H-ORAC intake may modify the elevated odds of MetS in AA genotype of rs1333048 on the 9p21 genetic locus.

     

Effect of preparation design for all-ceramic restoration on maxillary premolar: a 3D finite element study

Purpose

The aim of this study was to investigate and quantify the effect of preparation design parameters on a premolar restored with two different CAD/CAM ceramic crowns by three-dimensional finite element analysis (FEA).

Vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 serum level in patients with chest pain and normal coronary arteries (syndrome X)

BACKGROUND: Plasma levels of soluble vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) mediators of leukocyte adhesion to vascular endothelium may implicate in the pathogenesis of the syndrome of chest pain with normal coronary arteries. HYPOTHESIS: We attempted to determine whether markers of endothelial activation are raised in patients with chest pain and normal coronary arteries. METHODS: We measured plasma VCAM-1, ICAM-1 (ng/ ml) in 36 patients (34 men, 2 women, aged 62 +/- 9 years) with stable angina, coronary artery disease (CAD), and a positive response to exercise test; in 21 patients (6 men, 15 women, aged 56 +/- 9 years) with chest pain and normal coronary arteriograms (syndrome X); and in 11 healthy control subjects (8 men, 3 women, aged 49 +/- 14 years). RESULTS: Plasma ICAM-1 levels were significantly higher both in patients with CAD (mean +/- standard error of the mean) (328 +/- 26, p < 0.05), and in syndrome X (362 +/- 22, p < 0.01) than in controls (225 +/- 29). VCAM-1 levels were also higher in syndrome X (656 +/- 42 ng/ml) and in patients with CAD (626 +/- 42 ng/ml) than in controls (551 +/- 60, p = 0.09). CONCLUSIONS: ICAM-1 and VCAM-1 levels are increased both in patients with CAD and with syndrome X compared with control individuals. These findings may suggest the presence of chronic inflammation with involvement of the endothelium in patients with anginal chest pain and normal coronary angiograms.     

Acetyl-L-carnitine confers neuroprotection against lipopolysaccharide (LPS) -induced neuroinflammation by targeting TLR4/NFκB,autophagy, inflammation and oxidative stress

Acetyl-L-carnitine has been shown to exert neuroprotection against neurodegenerative diseases. The present study was performed to evaluate neuroprotection effects of acetyl-L-carnitine against lipopolysaccharide (LPS) -induced neuroinflammation and clarify possible mechanisms. A single dose (500 µg/kg) of LPS was intraperitoneally injected to rats to induce model. The animals were intraperitoneally treated with different doses of acetyl-L-carnitine (30, 60, and 100) for 6 days. Y-maze task, single-trial passive avoidance and novel object recognition tests were used to evaluate memory impairments. ELISA assay was used to evaluate the expression of TLR4/NFκB, autophagic and oxidative stress markers. Our result showed that intraperitoneal injection of LPS resulted in initiation of neuroinflammation by activation of TLR4/NFκB, suppression of autophagic markers such as LC3 II/ LC3 I ratio and becline-1, and excessive production of ROS and MDA. Intraperitoneal administration of acetyl-L-carnitine contributed to neuroprotection against LPS -induced neuroinflammation by suppression of TLR4/NFκB pathway, restoring activity of autophagy and inhibition of oxidative stress. Collectively, our findings show that acetyl-L-carnitine attenuated LPS-induced neuroinflammation by targeting TLR4/NFκB pathway, autophagy and oxidative stress.

     

Childbirth at home: A qualitative study exploring perceptions of risk and risk management among Baloch women in Iran

Objective

to explain how women who choose to give birth at home perceive and manage the risks related to childbirth.

Design

a qualitative, methodological approach drawing upon the principles of grounded theory. Data were gathered by in-depth interviews with women who had given birth at home.

Setting

the study was conducted in Zahedan, the capital of Sistan and Balochestan province in southeast Iran.

Participants

21 Baloch women aged 13–39 years who had a planned home birth were interviewed. Nine had been attended by university-educated midwives, eight by trained midwives, and four by traditional birth attendants.

Findings

concerning perceived risks, women perceived giving birth in hospital to be risky because of medical interventions, routines and ethical considerations. The perceived risks for home birth were acute medical conditions. Women made their decision to give birth at home based on existing verbal, visual, and intuitive information. The following two categories related to risk management were identified: (1) psychological preparation and (2) medical and logistican preparation. All of the women relied on their own intuition, their midwife and the sociopsychological support of their families to transfer them to hospital in the case of complications.

Key conclusions and implications for practice

the women who chose to give birth at home accepted that there was a risk of complications, but perceived these to be due to fate. Technical risks were considered to be a consequence of the decision to give birth in hospital, and were perceived to be avoidable. In addition, the women considered ethical issues as risks that are sometimes more important than medical complications. Women's perceptions of risk, and the ways in which they prepare to manage risk, are central issues to help providers and policy makers adjust services to women's expectations in order to respond to the individuality of each woman.     

Do Males and Females Conceptualise Work and Social Impairment Differently Following Treatment for Different Mental Health Problems?

The Work and Social Adjustment Scale (WSAS) is used by psychiatric nurses for screening and evaluating patients' treatment outcomes for a variety of mental health problems. This study investigated longitudinal and gender measurement invariance of WSAS using structural equation modeling within a help-seeking problem gambling sample (n = 445), and an intervention program for depression and anxiety sample (n = 444). The concept of functional impairment was defined by all WSAS items in males and females at pre- and post-treatment assessments. These findings confirm that the WSAS is a robust and efficacious instrument for evaluating treatment outcomes in two differing populations.