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Background: Faculty Development Programs (FDPs) aim to improve the academic careers of faculty members. This study was designed to assess the attitudes of faculty members and the impact of FDP on their academic improvement. Methods: 12 faculty members took part in the research from 2016 to 2019. Using a Delphi method, an open secure questionnaire was provided to 12 junior faculty members in the Department of Anesthesia, Critical Care (DACC), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran. Then, the keywords of the latter were analyzed, leading to a 32-item closed-answer questionnaire, filled out by the same participants. Also, the impact of the study was assessed using bibliometric improvement indices. Results: Both the response rate and participation rate were 100%. Approximately all the participants considered FDP an advantageous and promising academic program. 65 percent of the participants had academic improvement, from "Assistant Professor" to "Associate Professor" rank. Besides, the cumulative number of citations to the participants had a 16.2 times improvement. Both latter results were significantly higher than the mean improvement of the cohort faculty members in the DACC, SBMU. Conclusion: Faculty members of DACC, SBMU had positive attitudes towards FDP and described it as "a well-designed multilateral academic teamwork, thriving ethical, educational, managerial and research-related capacities". Also, objective improvement in some academic indices was observed. In many academic environments including developing countries, FDPs are effective scientific investment methods. [ABSTRACT FROM AUTHOR]

Background: Knee osteoarthritis is highly prevalent and causes debilitating pain, progressive movement limitation, and significant socio-economic costs. Intra-articular corticosteroids are widely used to control it, but only short-term effects have been proven for them. Also, they have shown many local and systemic side effects, including cartilage destruction and infection susceptibility. Knee prolotherapy in various forms of hypertonic dextrose injection has shown significant restorative effects, long-lasting pain and activity improvement, negligible side effects, and low cost. The objective is to compare the early effectiveness of intra-articular dextrose with corticosteroids regarding pain and activity changes in knee osteoarthritis. Materials and Methods: In this short-term blinded randomized clinical trial, 70 participants (knees) with primary osteoarthritis grade II or more were divided (1=1) into two random groups that received a single injection of triamcinolone 40 mg or hypertonic dextrose 20% five cc. Visual analog score (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score for activity were assessed before, one week after, and one month after injection. The data was analyzed using independent t-test, chi-square, Fisher's exact tests, Repeated measure test, and the linear mixed model regression. Results: The rest and activity VAS score and WOMAC score were reduced in both groups one week and one month after injection, and the difference between the two groups was non-significant for the VAS score but significant for the WOMAC score in favor of the dextrose group. Conclusion: The early analgesic and activity-improvement effects after hypertonic dextrose injection in the arthritic knee are significant and comparable to corticosteroids. [ABSTRACT FROM AUTHOR]

Background: Heel pain is commonly caused by chronic plantar fasciitis, associated with pain and activity limitation in patients. Although steroid injection is a popular method to treat this disease, it has side effects and provides short-term pain relief. The study was designed to investigate the effects of dexmedetomidine and corticosteroid injection in treating chronic plantar fasciitis. Materials and Methods: A total of 70 participants were divided into two groups. The intervention group received a mixture of dexmedetomidine (1μg/kg) with 1 ml of lidocaine 2%. The control group received a combination of 1ml of corticosteroid (40mg triamcinolone) with 1ml of lidocaine 2%. Outcome measures were evaluated with Numerical Rating Scale (NRS) and Maryland foot score (MFS) before, one, and three months after the intervention. Results: Significant improvements in NRS and MFS were observed in both groups at 1 and 3 months of followup compared to baseline(P<0.001). NRS score improvement in the first month was more significant in the corticosteroid group compared to the dexmedetomidine group. However, after three months, the dexmedetomidine group experienced greater pain reduction (P=0.012) and higher functional ability (P<0.001) than the corticosteroid group. Conclusion: Local injection of dexmedetomidine provided significant and long-term effects on pain severity and physical activity. Corticosteroids caused an immediate but short-term effect, whereas sustained improvement in the dexmedetomidine group was observed during the follow-up. [ABSTRACT FROM AUTHOR]

Background: Almost everyone experiences low back pain at some point in his or her lives. Low back pain is becoming more prevalent in low-income and middle-income countries much more rapidly than in high-income countries. The objective of this study was to evaluate the effect of melatonin on pain control and quality of life in patients with chronic low back pain. Materials and Methods: Sixty patients with low back pain aged 45 and 75 years, with a history of back pain more for than 12 weeks and visual analogue scale (VAS) score more than three, who were referred to pain clinics of Akhtar Hospitals (Tehran, Iran) during June to August 2018. Patients were randomly assigned to one of the melatonin or control groups. Control group received diclofenac sodium 25mg tablet two or three times daily and the experimental or melatonin group, in addition to receiving diclofenac sodium 25mg tablet twice a day, received melatonin tablet (3mg) 30 to 40 minutes before bedtime for four weeks. Before the beginning of the study, at the end of the fourth week, both groups underwent VAS test and the levels of IL-1ß and TNF-a were measured in these groups and they were asked to complete the quality of life questionnaire. Analysis of the data done by using covariance and Shapiro-Wilk tests through SPSS 22. Results: Melatonin consumption reduced the pain and level of IL-1ß and TNF-a in the experimental group compared to the control group (p<0.05). However, use of melatonin did not have a significant effect on quality of life (p>0.05). Conclusion: In general, it can be stated that use of melatonin, in addition to reducing the pain, reduces the antiinflammatory factors in patients with chronic low back pain. Based on the results of this study, melatonin can be recommended as a supplement for treatment of chronic low back pain. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of ginger and vitamin D3 supplement on inflammatory factors and pain severity in adults with low back pain. To achieve the research objectives, 120 patients with chronic low back pain admitted to Akhtar and Imam Hossein Hospitals were selected by random sampling method in 2017. They were randomly divided into three groups: ginger, vitamin D3 and control. The drugs were provided for each group in uniform packages with specific code for six weeks. In order to evaluate the variables, visual analogue scale (VAS, CRP, IL-6) was used before the start of the study and six weeks after the study. Data were analyzed using covariance analysis. The results showed no significant difference between ginger and vitamin D3 in the levels of VAS and IL-6, while significant difference was found between the ginger group and the control group and between vitamin D3 group and control group. Other results revealed that CRP reduction was significantly higher in both ginger and vitamin D3 groups than that in the control group. In addition, ginger led to significant reduction in CRP factor compared to vitamin D3. It is recommended for physicians to use ginger, which has fewer side effects, as a substitute for chemical drugs. [ABSTRACT FROM AUTHOR]

Background: Discogenic low back pain is one of the leading causes of pain and disability across the world. A growing interest in the area of regenerative medicine, led by an improved understanding of the role of mesenchymal stem cells in tissue homeostasis and repair. Cases Report: We had two patients suffered from chronic discogenic low back pain. They were underwent injection of intra-discal 1.5 cc of Adipose Derived Mesenchymal Stem Cells (ADMSC) and followed up for 6 months. After this period of time, there was a significant reduction in both VAS and ODI scores in patients. Conclusion: These data warrant further studies so that we can enhance our understanding of the other unknown mechanisms, which may exist behind stem cell injection. If the effectiveness of such injection to reduce pain and improve function is shown in the upcoming studies, it may provide a new insight for increasing this method of treatment as a proper option in the near future. [ABSTRACT FROM AUTHOR]

Background: Opioid analgesics are the mainstay of the treatment of postoperative pain. Appropriate monitoring of patients receiving opioid analgesics is essential to detect those with side effects such as respiratory depression. The discovery of Acetaminophen as a COX-3 variant may represent a primary central mechanism by which acetaminophen decrease pain. The aim of this study was to assess the effect of intravenous acetaminophen on morphine requirement in post-operation pain after elective cesarean section. Materials and Methods: In a randomized clinical trial, patients' candidate for elective cesarean section. In experiment group, intravenous acetaminophen (1000 mg/6 hour) was administered and normal saline to control group. Visual analogue scale (VAS) was measured at 1, 3, 6, 12, and 24 hours post-operation. Besides, Morphine dose requirement were measured during next 24 hours. Results: 83 patients were enrolled in the study; which 44 patients assigned in placebo group and 39 in Acetaminophen. Mean Age of placebo group was 29.64±5.55 and Acetaminophen was 30.33±5.50 which was not significantly different (p=0.568). Only at 1 and 3 hours, there was a significant difference between two groups of study. Total dose of morphine requirement was 5.73±2.78 mg/24 h in placebo group and 3.64±2.42 in Acetaminophen group which was significantly different (p=0.001). Conclusion: Intravenous Acetaminophen could decrease post cesarean pain and decrease post operation total morphine requirement particularly at first 3 hours post operation. [ABSTRACT FROM AUTHOR]

PURPOSE: To study the simultaneous effects of prone position and anesthesia on intraocular pressure (IOP) and the time impact on post anesthesia visual loss development in percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: Twenty patients who were candidates for PCNL were recruited in this study. Intraocular pressure was measured in five occasions: 1. Base line; 2. Ten minutes after anesthesia (Supine-I); 3. Ten minutes after position change to prone (Prone-I); 4. At the end of the operation (Prone-II); and 5. Ten minutes after position change to supine (Supine-II). The data were analyzed by SPSS software using repeated measures ANOVA and paired t test. RESULTS: The participants consisted of 17 (85%) men and 3 (15%) women, with the mean age of 44 years. The duration of the prone position was 79.75 ± 22.73 minutes. Intraocular pressure changed significantly in five positions (P = .000). It was lower in supine-I than baseline, higher in prone-I than base line and supine-I, lower in supine-II than prone-II, and highest in prone-II (P = .000). There was a linear relationship between IOP and prone position duration (r = 0.67; P = .001). CONCLUSION: Intraocular pressure dropped significantly after anesthesia and increased in prone position. There was a linear relationship between IOP rise and the prone position duration, doubled within two hours. Therefore, in PCNL carried out in prone position, it is recommended to observe safety measures and necessary precautions for IOP rise and possible post anesthesia visual loss, particularly in glaucoma. [ABSTRACT FROM AUTHOR]

Objective: Autologous transplantation of epidermal cells has been used increasingly to treat vitiligo patients and is a simple, safe, and relatively efficient method. However, the outcome is not always satisfactory, and some patients show less or no response to this treatment. This study was evaluated to identify genes expressed differently among responders and non-responders to cell transplantation to find potential markers that could predict 'patients' responses to this type of cell therapy. Materials and Methods: Eleven stable vitiligo patients who received autologous epidermal cell transplantation were included in this clinical trial study. Before cell transplantation, skin samples were obtained from the recipient’s vitiligo lesions. After epidermal cell transplantation, patients were followed for at least six months to assess the response to epidermal cell injection. RNA sequencing was used to determine potential gene expression profile differences between responder and non-responder vitiligo patients. Results: The RNA sequencing results showed differences in expression levels of 470 genes between the skin specimens of responder versus non-responder patients. There were 269 up-regulated genes and 201 down-regulated genes. Upregulated genes were involved in processes, such as Fatty Acid Omega Oxidation. Down-regulated genes were related to PPAR signaling pathway, and estrogen signaling pathway. Among the most differentially expressed genes (DEGs) with the most altered RNA expression levels in responders versus non-responder patients, we selected three genes (up-regulated genes KRTAP10-11 and down-regulated genes IP6K2 and C9) as potential biomarkers, which are involved in associated pathways. Conclusion: Based on our findings, it is estimated that proposed genes might predict the response of vitiligo patients to cell therapy. However, further studies are required to clarify the role of these genes in pathogenesis and to characterize gene expression in a larger number of vitiligo patients in the context of epidermal cell transplantation therapy (registration number: IRCT201508201031N16). [ABSTRACT FROM AUTHOR]

Objective: Recently, the promising potential of fibroblast transplantation has become a novel modality for skin rejuvenation. We investigated the long-term safety and efficacy of autologous fibroblast transplantation for participants with mild to severe facial contour deformities. Materials and Methods: In this open-label, single-arm phase IIa clinical trial, a total of 57 participants with wrinkles (n=37, 132 treatment sites) or acne scars (n=20, 36 treatment sites) who had an evaluator's assessment score of at least 2 out 7 (based on a standard photo-guide scoring) received 3 injections of autologous cultured fibroblasts administered at 4-6 week intervals. Efficacy evaluations were performed at 2, 6, 12, and 24 months after the final injection based on evaluator and patient's assessment scores. Results: Our study showed a mean improvement of 2 scores in the wrinkle and acne scar treatment sites. At sixth months after transplantation, 90.1% of the wrinkle sites and 86.1% of the acne scar sites showed at least a one grade improvement on evaluator assessments. We also observed at least a 2-grade improvement in 56.1% of the wrinkle sites and 63.9% of the acne scar sites. A total of 70.5% of wrinkle sites and 72.2% of acne scar sites were scored as good or excellent on patient assessments. The efficacy outcomes remained stable up to 24-month. We did not observe any serious adverse events during the study. Conclusion: These results have shown that autologous fibroblast transplantation could be a promising remodeling modality with long-term corrective ability and minimal adverse events (Registration Number: NCT01115634). [ABSTRACT FROM AUTHOR]

Background: Shoulder osteoarthritis (OA) is a painful condition in which movement of the shoulder becomes restricted. Treatment is aimed at pain reduction and maintain or improve functions. Intra-articular steroid injections have proven to be an effective and cost-effective treatment option. However, long-term use can weaken the shoulder tendons and cause histological changes. Recently, botulinum toxin has been evaluated for the treatment of the chronic joint pain. Its injection into the painful shoulder joints may inhibit the inflammatory mediators and the neuropeptide release which act on articular nociceptors and produce pain. Objective: The present study compared the efficacy of ultrasound-guided intra-articular Botox and corticosteroid injections in glenohumeral joint in terms of reduction of pain scores and enhancing range of movement in patients with shoulder OA. Methodology: Fifty eligible patients with shoulder OA were randomly assigned to two groups of Botox and corticosteroid (each with 25 patients). Ultrasound-guided intraarticular injections were randomly performed in all participants. Patients were evaluated in terms of effect on pre-procedure pain scores, range of abduction, internal rotation and external rotation, at 2 weeks and 12 weeks after injection. Two-way ANOVA and t-tests were utilized to analyze the data. Results: The study results indicated that the injection of Botox and corticosteroid in the shoulder joint cause reduction in pain and increased range of movements of the patients with glenohumeral OA. Botox injection exerts more long-lasting effects in comparison to the corticosteroid group. Mean pain scores were lower in Botox group in comparison to the steroid group (2.75 vs. 4.24); patients in the Botox group experienced more pain reduction at week-12 and more increase in range of abduction, internal rotation and external rotation. Conclusion: It is concluded that intra-articular Botox injection can be more useful than intra-articular steroid injection in terms of pain reduction and function improvement. [ABSTRACT FROM AUTHOR]