BackgroundConsidering the complications that colostomies may cause, patient self-assessments of their social, emotional, physical, sexual and functional conditions may help their surgeons to evaluate the impact of their interventions or use supplementary methods to maintain patient functional status or decrease its loss to the minimum level. The aim of this study was to evaluate the Quality of Life in Iranian patients with colostomies and to compare the age and gender differences among them.MethodThis cross-sectional study was conducted from 2009 to 2010 to evaluate the quality of life of 96 patients who had undergone surgery for rectal cancer and had permanent colostomies. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire (EORTC QLQ)-C30 and the EORTC QLQ-CR38 were used to assess patient Quality of Life.ResultsThe mean scores for the functional subscales were as follows: Physical Function, 70.9 (±2.2); Role Function, 68.4 (±2.6); Emotional Function, 56.9 (±2.7); Cognitive Function, 68.7 (± 2.6); and Social Function, 64.2 (±3.3). The EORTC questionnaires showed significant differences between males and females. Males had better body image scores. Sexual Function and Sexual Enjoyment were impaired in both males and females, but males had significantly higher scores and better roles in Physical and Sexual Functions. More sexual enjoyment problems in older ages were observed in both males and females.ConclusionHaving a colostomy was associated with a high level of emotional and sexual function impairment. The differing challenges between males and females should encourage us to design sex-specific interventions that improve the quality of life in this group of patients.
BackgroundAnal sphincter defects are a major cause of fecal incontinence causing negative effects on daily life, social interactions, and mental health. Because human adipose-derived stromal/stem cells (hADSCs) are easier and safer to access, secrete high levels of growth factor, and have the potential to differentiate into muscle cells, we investigated the ability of hADSCs to improve anal sphincter incontinence.MethodsThe present randomized double-blind clinical trial was performed on patients with sphincter defects. They were categorized into a cell group (n = 9) and a control group (n = 9). Either 6 × 106 hADSCs per 3 ml suspended in phosphate buffer saline (treatment) or 3 ml phosphate buffer saline (placebo) was injected. Two months after surgery, the Wexner score, endorectal sonography, and electromyography (EMG) results were recorded.ResultsComparing Wexner scores in the cell group and the control group showed no significant difference. In our EMG and endorectal sonography analysis using ImageJ/Fiji 1.46 software, the ratio of the area occupied by the muscle to total area of the lesion showed a 7.91% increase in the cell group compared with the control group.ConclusionThe results of the current study show that injection of hADSCs during repair surgery for fecal incontinence may cause replacement of fibrous tissue, which acts as a mechanical support to muscle tissue with contractile function. This is a key point in treatment of fecal incontinence especially in the long term and may be a major step forward.Trial registrationIranian Registry of Clinical Trials IRCT2016022826316N2. Retrospectively registered 7 May 2016.
Background Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being.This study was conducted to evaluate ergonomic factors and profession-related postures and also investigate relationship between demographic factors and work condition with pain in dental students. Material and Methods 60 freshman and sophomore dentistry students were randomly chosen as the subjects of control group, and 60 of 5th and 6th-year students were selected as the members of exposure group. Data related to the subjects such as sex, doing exercise, severity of musculoskeletal pain were obtained through questionnaire. Students’ postures were directly observed while treating patients and they were scored by REBA method. Data were analyzed by SPSS software using Man-Whitney, Kruskal-Wallis, Spearman and Kendall correlation tests. Results 80.8% of the subjects were not aware of the correct ergonomic postures for dental procedures. Severity of musculoskeletal pain in the exposure group (15.9± 4.2) was significantly higher than the control group (10.5 ±3.2), (p <0.001). Risk of the most subjects (84%) was at the medium level. Students who were more involved in clinical activities experienced more muscular pains. Conclusions The musculoskeletal disorders are probable prolonged in working hours in static positions, incorrect work postures, implying more force and even tools and instruments. Therefore, students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong. Key words:Posture, dentistry, students, musculoskeletal pain.
The risk of most prevalent complications of colostomy construction increases in elder patients. The high prevalence of psychosocial and skin problems in patients with a colostomy, needs special attention especially from the viewpoint of education by trained stoma nurses and preparation of standard equipment.
This study is a meta-analysis of the previous epidemiological studies which investigated the quantitative estimates of the association between independent or combined exposure to noise and mixed organic solvents and hearing loss until October 2014. Overall, 15 studies with information on 7530 individuals (6% female) were included. Having assessed -by puretone audiometry -the adjusted odds ratio estimates for the association between solvents mixture exposure and the risk of developing hearing loss stood at 2.05 (95% confidence interval (CI): 1.44-2.9). Similarly, for subjects who were concurrently exposed to noise and solvents mixture, an OR of 2.95 (95% CI: 2.1-4.17) was obtained. There was some evidence of heterogeneity within each of the 2 exposure groups (p heterogeneity < 0.001). This heterogeneity was not explained by differences in strength of effect between duration of exposure, the number of solvent and exposure index in subgroups of solvents mixture exposure. Based on the available data, our analysis has provided the evidence of increased risk of developing hearing loss for workers exposed to organic solvents even at quite low concentration. Moreover, if such exposure is accompanied by noise, it will exacerbate the extent of hearing loss. Int J Occup Med Environ Health 2017;30(4):521-535
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