The effectiveness of acupuncture, acupressure and chiropractic interventions on treatment of chronic nonspecific low back pain in Iran: A systematic review and meta-analysis.

BACKGROUND: Low back pain (LBP) is one of the most common health problems in adults. The impact of LBP on the individual can cause loss of health status and function related to pain in the back. To reduce the impact of LBP on adults, drug therapy is the most frequently recommended intervention. But over the last decade, a substantial number of randomized clinical trials of non-pharmacological intervention for LBP have been published. OBJECTIVE: To determine the effectiveness of acupuncture, acupressure and chiropractic (non-pharmacological) interventions on the treatment of chronic nonspecific low back pain in Iran. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was completed without date restrictions up to May 2013 in five major databases (Medline, CINAHL, Science Direct, CAJ Full-text Database, and Cochrane databases). Only randomized controlled trials published in Persian (Farsi) or English languages were included. Two independent reviewers extracted the data. The quality of the papers was assessed using the Cochrane Back Review Risk of Bias criteria. RESULTS: Initial searches revealed 415 papers, 382 of which were excluded on the basis of abstract alone. After excluding 23 papers due to duplication, the remaining 10 trial papers were subjected to a more detailed analysis of the full text, which resulted in three being excluded. The seven remaining trials had a lack of methodological and clinical homogeneity, precluding a meta-analysis. The trials used different comparators with regards to the primary outcomes, the number of treatments, the duration of treatment and the duration of follow-up. CONCLUSION: This systematic review demonstrates that acupuncture, acupressure and chiropractic may have a favorable effect on self-reported pain and functional limitations on NSCLBP. However, the results should be interpreted in the context of the limitations identified, particularly in relation to the heterogeneity in the study characteristics and the low methodological quality in many of the included studies.

Interfacial structure and melting temperature of alcohol and alkane molecules in contact with polystyrene films.

Infrared-visible sum-frequency-generation spectroscopy (SFG) is used to investigate the interfacial structure of hexadecanol (C16H33OH) and heneicosane (C21H44) in contact with polystyrene films (PS) spin coated on a sapphire substrate. The interfacial structure of hexadecanol is very different from heneicosane in contact with PS. In the crystalline state, the hexadecanol molecules are oriented with the C-C-C axis parallel to the surface plane in contact with PS. For the crystalline heneicosane/PS interface, the SFG spectra are very similar to those observed for molecules oriented with the symmetry axis of the methyl groups parallel to the surface normal. The structure of both hexadecanol (or heneicosane) and the phenyl groups changes sharply at the melting temperature of hexadecanol (or heneicosane). Upon heating the hexadecanol/PS sample above the glass transition temperature (T(g)) of PS, the hexadecanol molecules penetrate through the PS film and adsorb on the sapphire substrate. The adsorbed hexadecanol molecules are oriented with the symmetry axis of the methyl groups parallel to the surface normal. The structure of the PS molecules at the sapphire interface is different because the PS phenyl groups are now in contact with the hydrophobic tails of the hexadecanol molecules, rather than the hydrophilic sapphire substrate. The adsorbed hexadecanol molecules do not disorder at the bulk melting temperature of hexadecanol. In comparison, no adsorption of heneicosane molecules next to sapphire interface upon annealing was observed. The differences between the adsorption of hexadecanol and heneicosane can be explained by the preferential interactions between the hydroxyl groups of the alcohol and hydrophilic sapphire substrate.