The Sexual Health Needs of Women with Spinal Cord Injury: A Qualitative Study

Sexual health as an important aspect of reproductive health, is a foundation for physical and emotional health which also affects couples and families’ wellbeing. Furthermore, disability could impact couple’s sexual relationships. Studies show that people with physical disability receive less sexual education which in turn exposes them to a higher risk for sexually transmitted infections. This qualitative study explored the sexual needs of women with spinal cord injury (SCI) aged 18–55 years old living in Tehran. In depth and individual semi-structured interviews were hold for data collection until data saturation was reached. They were recruited from the Organization of Welfare and Protection Center of Spinal Cord Disables of Iran. In this study 23 individuals were chosen using purposive sampling. The collected data was analyzed using the content analysis approach suggested by Graneheim and Lundman. The sexual health needs of women with SCI was explained in two themes and nine categories. The themes were “physical rehabilitation” and “couples’ sexual consultation”. The categories of the first theme were “resolving physical problems contributing to sexual relationships” and “complementary medicine application”. The categories of the second theme were “the husband’s emotional support”, “concentration”, “protecting sexual health”, “the need for having sexual relationships”, “diminishing factors for unpleasant sexual relationships”, “paying attention to wife’s readiness to start sexual relationships” and “decreasing factors that suppress spouse’s sexual desire”. This study showed that women with spinal cord injury require sexual rehabilitation. They overcome their physical problems with the help of complementary medicine and sexual counselling around the aforementioned categories for promoting the quality of their sexual health.     

Synthesis,characterization, molecular docking,and biological activities of coumarin–1,2,3-triazole-acetamide hybrid derivatives

Coumarins and their derivatives are receiving increasing attention due to numerous biochemical and pharmacological applications. In this study, a series of novel coumarin–1,2,3-triazole-acetamide hybrids was tested against some metabolic enzymes including α-glycosidase (α-Gly), α-amylase (α-Amy), acetylcholinesterase (AChE), butyrylcholinesterase (BChE), human carbonic anhydrase I (hCA I), and hCA II. The new coumarin–1,2,3-triazole-acetamide hybrids showed K_i values in the range of 483.50–1,243.04 nM against hCA I, 508.55–1,284.36 nM against hCA II, 24.85–132.85 nM against AChE, 27.17–1,104.36 nM against BChE, 590.42–1,104.36 nM against α-Gly, and 55.38–128.63 nM against α-Amy. The novel coumarin–1,2,3-triazole-acetamide hybrids had effective inhibition profiles against all tested metabolic enzymes. Also, due to the enzyme inhibitory effects of the new hybrids, they are potential drug candidates to treat diseases such as epilepsy, glaucoma, type-2 diabetes mellitus (T2DM), Alzheimer's disease (AD), and leukemia. Additionally, these inhibition effects were compared with standard enzyme inhibitors like acetazolamide (for hCA I and II), tacrine (for AChE and BChE), and acarbose (for α-Gly and α-Amy). Also, those coumarin–1,2,3-triazole-acetamide hybrids with the best inhibition score were docked into the active site of the indicated metabolic enzymes.     

Hepatitis B virus (HBV) genotype and YMDD motif mutation profile among patients infected with HBV and untreated with lamivudine.

OBJECTIVES: A few reports exist on hepatitis B virus (HBV) genotype distribution in Iran; however the sample sizes of these studies are insufficient. The first objective of this study was to determine the HBV genotype distribution with a large sample size (147 specimens). The second objective was to determine the incidence of the lamivudine-resistant YMDD mutant profile among HBV-infected patients not treated with lamivudine; some studies have reported that YMDD mutants are detectable even before antiviral treatment. METHODS: We used two cost-effective PCR-based methods that have been developed in-house: gap-PCR and artificially created restriction site-PCR (ACRS-PCR). Also, 11 samples were randomly selected and bi-directionally sequenced and subjected to phylogenetic analysis. RESULTS: Gap-PCR results revealed genotype D of HBV in all patients, and ACRS-PCR results disclosed the absence of mutation within the YMDD motif before antiviral therapy in the study population. Phylogenetic analysis supported the former genotyping results with the segregation of all Iranian HBV isolates in the genotype D branch with a high bootstrap value (99%, 1000 replicates). CONCLUSIONS: The present study using two cost-effective methods showed that genotype D of HBV is dominant among Iranian HBV-infected subjects, and HBV lamivudine-resistant strains do not exist naturally among Iranian patients not treated with lamivudine.     

Selective Internal Radiation Therapy with Yttrium-90 for Intrahepatic Cholangiocarcinoma: A Systematic Review on Post-Treatment Dosimetry and Concomitant Chemotherapy

Selective internal radiation therapy (SIRT) with yttrium-90 (⁹⁰Y)-loaded microspheres is increasingly used for the treatment of Intrahepatic Cholangiocarcinoma (ICC). Dosimetry verifications post-treatment are required for a valid assessment of any dose-response relationship. We performed a systematic review of the literature to determine how often clinics conducted post-treatment dosimetry verification to measure the actual radiation doses delivered to the tumor and to the normal liver in patients who underwent SIRT for ICC, and also to explore the corresponding dose-response relationship. We also investigated other factors that potentially affect treatment outcomes, including the type of microspheres used and concomitant chemotherapy. Out of the final 47 studies that entered our study, only four papers included post-treatment dosimetry studies after SIRT to quantitatively assess the radiation doses delivered. No study showed that one microsphere type provided a benefit over another, one study demonstrated better imaging-based response rates associated with the use of glass-based TheraSpheres, and two studies found similar toxicity profiles for different types of microspheres. Gemcitabine and cisplatin were the most common chemotherapeutic drugs for concomitant administration with SIRT. Future studies of SIRT for ICC should include dosimetry to optimize treatment planning and post-treatment radiation dosage measurements in order to reliably predict patient responses and liver toxicity.     

In vitro isolation of stem cells derived from human dental pulp

Agha‐Hosseini F, Jahani M‐A, Jahani M, Mirzaii‐Dizgah I, Ali‐Moghaddam K. In vitro isolation of stem cells derived from human dental pulp.
Clin Transplant 2009: DOI: 10.1111/j.1399‐0012.2009.01137.x.
© 2009 John Wiley & Sons A/S. Abstract: Stem cells are characterized by the ability to differentiate and to self‐renew. Stem cells derived from human dental pulp have been shown to differentiate into osteoblasts serving as a potential source of autologous bone produced in vitro. The purpose of the present study was to isolate mesenchymal stem cells from dental pulp. Dental pulp was gently extracted from 27 intact human permanent third molars of patients aged 18–25. Cow horn forceps were used to isolate intact dental pulp in sterilized condition. The pulps were cultured in a medium containing Dulbecco’s modified Eagle’s medium‐low glucose (DMEM)‐LG and Amphotericin 1%. The cells were subsequently expanded by passages, two passages were performed before they were stored in liquid nitrogen for further examination. DMEM + fetal bovine serum (FBS) 10% L‐Glutamin 0.1% + Trypsin 2.5% + ethylene diamine tetraacetic acid (EDTA) were used for passage. Light microscope and flow cytometry were used to study the cells. The isolated dental pulp cells expressed mesenchymal stem cell markers. The cells were negative for CD34 and CD31 and CD45 but were positive for CD13, CD44, CD90, CD166, and CD105. These results indicate that dental pulp can be use as a source of stem cells that we can isolate and culture.     

Disturbed grip function in women with rheumatoid arthritis.

OBJECTIVE: Hand dysfunction is a frequent cause of disability in rheumatoid arthritis (RA). In patients with RA, we studied the precision grip-lift sequence in relation to pain, stiffness, and observer assessed hand function and their relation to patients' experience of clumsiness and tendency to drop objects. METHODS: Performance of the precision grip-lift sequence was studied in 23 women with RA and 7 age and sex matched controls. The results were correlated to self-estimation of pain and stiffness of hands and to observer assessed measurements of hand function. RESULTS: A prolongation of the preload and loading phases and of the acceleration part of the transition phase as well as a disturbance of the safety margin (SM) during precision grip-lift were noted. Patients with good hand function (low Grip Ability Test score; GAT) displayed normal or increased SM compared to the healthy controls, whereas patients with more pronounced disease exhibited a lower SM. Disturbances seen in the precision grip-lift performance were related to stiffness, range of motion, and GAT score. In RA patients with decreased hand function the SM was correlated to feeling of clumsiness, but did not explain the frequency of object dropping. CONCLUSION: A disturbance in the precision grip-lift performance was noted in patients with RA. These grip performance changes need further investigation to determine possible mechanisms.     

Assessment of Pubertal Development in Iranian Girls

Objective

We estimated pubertal development of 7,493 normal Iranian girls aged 6 to 20 years in a cross-sectional study.

Methods

Pubertal stages were assessed according to Tanner. The mean ages to achieve secondary sexual characteristics as well as the mean age at menarche were estimated. Weight and height were measured and body mass index (BMI) was calculated. Reference curves for different breast stages and menarche were constructed. The percentiles for attaining each stage were compared to data proposed by Tanner.

Findings

The mean age at breast bud stage (B2) was 10.10, pubic hair stage (P2) was 9.83, and menarche age was 12.55 years. The anthropometric variables were interpreted in different maturity stages. The mean age at attainment of puberty was compared with those of other populations.

Conclusion

Not only the onset of puberty in Iranian girls but also the duration of puberty is similar to data from most other countries. A lower age limit for the definition of precocious puberty than the traditional 8 years is documented for Iranian girls. However, it should be noted that considering the rate of evolution of pubertal findings is more important than the age of their appearance.     

Standardized percentile curves of body mass index of Iranian children compared to the US population reference.

OBJECTIVE: To present standardized percentile curves of body mass index (BMI) for Iranian children, and compare these to the US population reference. SUBJECTS: 1599 boys and 1702 girls aged 2-18 y living in urban Tehran as a part of a random cluster sample survey of 1 in 1000 families throughout Iran. MEASUREMENTS: Heights (cm) and weights (kg) were collected by trained health staff. RESULTS: Standardized BMI reference curves for Iranian boys and girls were constructed. The curves are shown to fit the data well. The development pattern of BMI for boys and girls are compared. CONCLUSIONS: The major differences observed between Iranian and the US BMI charts underline the need for population-specific reference data. For children over six years the 5th and 95th percentiles of our data may be used provisionally as cut-off points for defining thinness and obesity for Iranian children and adolescents.