Investigating the safety and efficacy of nerve stimulation for management of groin pain after surgical herniorrhaphy: a systematic review and meta-analysis.

PURPOSE: Chronic post-operative inguinal pain (CPIP) following inguinal hernia repair has been a major sequela affecting 4000-48000 patients annually. Optimal management of CPIP has been a challenge, and pharmacological management particularly with opioids has shown unsatisfactory results. The main objective of this systematic review is to investigate the safety and efficacy of neuromodulation as an alternative intervention for the management of post-operative inguinal pain. METHODS: A literature search was conducted by three reviewers to identify all relevant studies on the use of neuromodulatory interventions for treating post-operative inguinal pain. Data on study characteristics, neuromodulatory modalities, and patient's clinical data such as pre/post-interventional pain scores and analgesic requirements were extracted and reported. RESULTS: A total of 389 patients with 357 (95.9%) males and 15 (4.1%) females were evaluated. The mean age of study participants was 47.9 ± 10.4 years. There were 187 (48.1%) and 202 (51.9%) patients allocated to the control and trial groups, respectively. The most common neuromodulation modality was TENS (4, 36.4%), followed by SCS (3, 27.3%), PNS (3, 27.3%), and acupuncture-assisted (2, 18.2%). The overall mean follow-up duration of the entire cohort was 3.8 months. The mean difference between pre-operative and post-operative VAS scores in the trial groups was 4.65 (95% Confidence Interval [CI], 2.97, 6.33), which was statistically significant (P value < 0.05). Patient-reported outcome measures showed significant responsiveness toward their treatments. CONCLUSION: Nerve stimulation, in its many forms, is a safe and feasible option for the management of post-operative inguinal pain.

UNIVERSAL RADIATION PROTECTION SYSTEM (URPS); A NATURAL GLOBAL STANDARDISED TREND FOR HUMAN EXPOSURE CONTROL IN 21st CENTURY.

In order to address the many deficiencies with current radiological protection system worldwide, this paper proposes a new Universal Radiation Protection System (URPS) Hypothesis with novel philosophy, concepts and methodologies of applying principles of equal human health-effect risks of an individual per unit radiation dose either from environmental natural background (NBG) or man-made sources; a 'standardised integrated dose system' for integrating all individual doses with emphasis on national NBG doses; considering worker as a member of public; and a 'cause-effect conservation principle' for epidemiology risk estimation. The URPS also a radiation hypothesises fractionation weighting factors (WF); a 'URPS Model' for bridging 'linear no-threshold and hormesis models'; example dose limit for workers; as well as new terms and definitions. State-of-the-art developments on URPS hypothesis are presented and discussed with simple global natural trends for standardised human exposure control in order to protect workers, patients, public and environment by standardised methods independent of source and country of origin in the 21st century.

Gastric Cancer and Helicobacter pylori: Impact of hopQII Gene.

The Helicobacter pylori is a Gram-negative, microaerophilic bacterium found usually in the stomach and use a number of mechanisms to survive in the stomach lumen. The presence of these bacteria in the stomach can lead to gastritis and reduction in stomach acid production. Acute inflammation can directly damage to the peripheral cells that are responsible for the secretion of acid. The risk of developing gastric carcinoma is associated to heterogeneity of Helicobacter pylori virulence factors. The HopQII is one of the outer membrane proteins involved in bacterial adherence to gastric mucosa and has been suggested to also play a role in the virulence of H. pylori. The purpose of the current study was to investigate the association between different H. pylori virulence hopQII allele and patients with gastroduodenal disorders. For this purpose 58 stomach biopsies of patients with gastric cancer and 100 saliva samples from healthy individuals were collected. Then genomic DNA was purified and PCR for was done for desired genes via specific primers. The H. pylori infections were diagnosed by PCR for GlmM gene. Then frequencies of hopQII+ and hopQII- genotypes was determined in H. pylori infected cases. Statistical analysis showed that there were not significant differences between healthy and diseased ones for genotype hopQII+.

Association between Helicobacter pylori hopQI genotypes and human gastric cancer risk.

The Helicobacter pylori use a number of mechanisms to survive in the stomach lumen and can lead to gastritis and reduction in stomach acid secretion. It has been found that the risk of developing gastric carcinoma is associated to heterogeneity of H. pylori virulence factors such as HopQ. The HopQ is one of the outer membrane proteins involved in bacterial adherence to gastric mucosa and has been suggested to also main role in the virulence of H. pylori. The purpose of the current study was to investigate the association between different H. pylori virulence hopQI (types I) genotyping and patients with gastroduodenal disorders. For this purpose 58 stomach biopsies of the patients with gastric cancer and 100 saliva samples from healthy and H. pylori infected individuals were collected and studied. Then genomic DNA was purified and PCR was done for desired gene via specific primers. The H. pylori infections were diagnosed using PCR for GlmM gene. Then frequencies of hopQI+ and hopQI- genotypes were determined in H. pylori infected cases. Statistical analysis showed that there were not significant differences between healthy and diseased ones for genotypes hopQI+ and hopQI-. Then the hopQI+ cannot be as a risk factor genotype for gastric cancer.

A universal radiation protection system based on individual standardised integrated doses.

A 'Universal Radiation Protection System' (URPS) is proposed in this paper with a novel philosophy, concept and methodology. It applies a 'Standardised Integrated Dose System' (SIDS) based on health risk limits for workers and public, no matter where they live in the world. The URPS assigns equal radiation health risk limit to an individual by integrating doses from national natural background (NBG) radiation and from man-made sources. For public, the SIDS integrates doses from planned exposure situations within a dose limit (e.g. 1 mSv y(-1)) on top of the mean national NBG dose in a country. For workers, the SIDS integrates within a dose limit (e.g. 20 mSv y(-1)) of occupational dose and doses from mean national NBG and from planned exposure situations as a member of public within the public dose limit. A panorama overview and the rationale in support of the URPS are presented and discussed with a hope to ignite further thoughts and ideas towards establishing the URPS for universal use.

Effect of dietary and topical Celecoxib on expression of bcl-2, bax, c-erb-B2 and Ki67 in carcinogen-induced tongue carcinoma in rat.

The aim of the study is to determine the effect of Celecoxib administration, dietary or topical, on expression of Ki-67, c-erb-B2, bcl-2 and bax genes in rat tongue by the immunohistochemistry methods and also tdt-mediated dupt-biotin nick end labeling assay in order to explore their role in malignant transformation and the proliferation rate, apoptosis rate in tongue squamous cell carcinoma. Effects of celecoxib on tongue carcinogenesis were investigated in 40 adult male Sprague Dawley 3-3.5 months rats initiated with 30 ppm 4-nitroquinoline-1-oxide. The immunohistochemical expression of Ki-67, bcl2, bax and c-erb-B2 were also examined for analysis of the effects of Celecoxib on tongue carcinogenesis. Differences among groups were statistically analyzed with one-way analysis of variance (SPSS-13, p < 0.05). At week 8, the incidence of tongue precancer lesions was reduced by Celecoxib and there were significant differences in the average expression of Ki-67 (p = 0.00), c-erb-B2 (p = 0.01), bax (p = 0.02), bcl2 (p = 0.02) and also in TUNEL assay (p = 0.00). The results suggest probably that the level of c-erb-B2, bcl-2 and bax expression could show behavior of squamous cell carcinoma in initiation phase of developing carcinoma.

Antimicrobial effectiveness of furazolidone against metronidazole-resistant strains of Helicobacter pylori.

The occurrence of strains resistant to metronidazole is causing failure of the 4-drug regimen for eradication of Helicobacter pylori in the Islamic Republic of Iran. This study compared the in vitro efficacy of furazolidone with metronidazole, clarithromycin, amoxicillin and tetracycline in 70 H. pylori isolates from dyspeptic patients. Of the isolates, 33% were resistant to metronidazole but all were susceptible to furazolidone. Furazolidone could be considered as an appropriate substitute for metronidazole for H. pylori infections.

Neutron dosimetry in high energy X-ray beams of medical accelerators.

High energy X-ray beams from medical accelerators are used in cancer therapy. In such beams, neutrons are also produced due to photon-neutron interactions in the target material, collimator and beam flattening filter. The feasibility of employing fast-neutron-induced recoil particle tracks in polycarbonate foils developed by the electrochemical etching (ECE) method for the dosimetry of such neutrons was investigated. The experiments were carried out in, and out of, the beam of a Varian Clinac-18, an Allis-Chalmers 25 MeV betatron and a Brown Boveri 45 MeV betatron. Neutron dose equivalents were found both as a function of the photon dose and of the distance away from the centre of the beam. The neutron dose equivalent was found to be 0.6 and 1.3% of the X-ray dose at the centre position of the beam for a TSD = 100 cm and a 10 x 10 cm2 field for the 25 and 45 MeV betatrons respectively. Although the dosemeter showed adequate sensitivity to neutrons in the beam of the betatrons, it showed insensitivity to neutrons in the beam of the Clinac-18 which has a softer spectrum than the neutron energy threshold of the dosemeter. It can be concluded that this dosimetry method provides a new approach with a number of advantages compared to some other existing techniques for such measurements above the energy threshold of the dosemeter.