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Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity. Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks) undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS), chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group. Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393). The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1%) and suture 32 cases (24.1%). The survey was conducted using the Chi-square test was not significant (P=0.381). Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001). Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P

The aim of this study was to evaluate the efficacy and safety of a constant dose of aqueous extract of Echium amoenum. Thirty-five patients with mild to moderate major depressive disorder who had a score  18 on the Hamilton Depression Rating Scale were enrolled in the study and randomly assigned to receive either placebo or 375mg of aqueous extract of Echinum amoenum. Patients were followed for 6 weeks. Efficacy was assessed by the Hamilton Depression Rating Scale, in week 0, 1, 2, 4, and 6. In the week 4 and 6, drug was superior to placebo. This difference was significant at the fourth week (p =0.018) and marginally non-significant at the sixth week. The extract of Echium amoenum did not cause more adverse effects than placebo during the study. It is concluded that the aqueous extract of Echium amoenum can be considered as an effective and safe treatment for major depressive disorder. However further studies in warranted.

Background: Patients with advanced emphysema often have elevated markers of systemic inflammation, a phenotype associated with greater clinical compromise and increased mortality. We hypothesized that endoscopic lung volume reduction using emphysematous lung sealant therapy might attenuate the state of inflammation in patients with advanced emphysema by eliminating damaged tissue; similar to what has previously been reported following lung volume reduction surgery. Methods: To explore this hypothesis, serum C-reactive protein (CRP) was measured at baseline, 12, 24 and 48 weeks following ELVR therapy with Emphysematous Lung Sealant (ELS) at 5 centers participating in clinical trial NCT00884962 (www.clinicaltrials.gov). Results were correlated with post-treatment changes in BODE Index, systemic white cell count, and vital status out to 3 years. Results: Baseline CRP for the 29 patient cohort was elevated (5.3 ± 8.7 mg/L) compared to normal. Sixteen (16) of 29 patients (55%) had serum levels above the “high risk threshold” (3 mg/L). ELS therapy was associated with a transient increase in CRP followed by a progressive decline. At 48 weeks, the CRP level of the cohort had decreased to 2.2 ± 3.2 mg/L (p=0.041); only 9 of 29 (31%) showed persistently elevation. 3 years post treatment, 28 of 29 patients were alive (3.4% mortality), while 24 and 36 month mortality for this cohort predicted from baseline BODE Index was 12% and 35% respectively. Conclusions: ELS therapy reduces chronic inflammation in patients with advanced emphysema, manifest as a reduction in CRP. Model predictions suggest this is associated with a reduction in long term mortality risk. Larger prospective studies are needed to further evaluate this question.

BACKGROUND AND PURPOSE: To assess patient radiation exposure in comprehensive stroke imaging using multidetector row CT (MDCT) combining standard CT of the head, cerebral perfusion (CTP), and CT angiography (CTA) studies. METHODS: Examination protocols for CT and CTA of cerebral and cervical vessels, as well as CTP were simulated using a Somatom Sensation Cardiac 64. Effective doses were derived from measurements with the use of lithium-fluoride thermoluminescent dosimeters (LiF-TLD) at several organ sites using an Alderson-Rando phantom. RESULTS: LiF-TLD measurements resulted in effective doses of 1.7 mSv for CT, 1.9 mSv for CTA of intracranial vessels, and 2.8 mSv for CTA of cervical vessels, respectively. Depending on examination parameters, effective doses varied between 1.1 and 5.0 mSv for cerebral CTP. For CTP, local doses in the area of the primary beam ranged between 114 and 444 mGy. CONCLUSIONS: Comprehensive stroke imaging may result in up to 9.5 mSv with possible local doses of 490 mGy. Although critical doses for organ damage (eg, cataract formation or hair loss) are not reached, physicians need to be aware of possible radiation induced sequelae particularly in repetitive examinations.