Hamedan University of Medical Sciences

INTRODUCTION:Low back pain (LBP) is a well-recognized and major cause of disability worldwide. This study aimed to compare the effects of dynamic neuromuscular stabilization (DNS) exercises with and without the Feldenkrais method (FM) on pain, balance, and hip muscle strength in elderly women with chronic non-specific LBP (CNLBP). METHOD:In this randomized controlled trial, 40 women aged 60-80 years with CNLBP were randomly allocated to either the DNS exercise (DNSE) group or the combined DNS and Feldenkrais method exercise (DNS-FME) group for an 8-week intervention. Three participants dropped out, leaving 37 completers (18 in the DNSE group and 19 in the DNS-FME group). Baseline and post-intervention assessments were conducted 1-3 days before the first session and 1-3 days after the final session, respectively. Outcome measures included pain intensity, Berg Balance Scale score, and hip muscle strength. Data were analyzed using repeated-measures ANOVA, with statistical significance set (p < 0.05). RESULTS:After the 8-week intervention, significant group-by-time interactions were observed for all outcome variables (p < 0.05). Post-hoc analysis with Bonferroni correction revealed that the DNS-FME group exhibited significantly greater reductions in pain intensity (p < 0.001) as well as significantly greater improvements in hip adductor strength (p < 0.001) and hip abductor strength (p < 0.001) compared to the DNSE group. Although balance improvements were noted in both groups, the between-group difference did not reach statistical significance. CONCLUSION:The addition of the Feldenkrais method to dynamic neuromuscular stabilization exercises provides superior benefits in pain reduction and hip muscle strengthening in elderly women with chronic non-specific low back pain. Both interventions improve balance, but combined training may offer greater clinical advantages. These findings support integrating sensorimotor awareness techniques into rehabilitation programs for older adults with low back pain.

ABSTRACT:This systematic review summarizes the evidence informing 2 recommendations from the updated American Society of Hematology guidelines for the treatment of newly diagnosed acute myeloid leukemia in older adults, comparing conventional induction and postremission therapy vs hypomethylating agents (HMA)- or low-dose cytarabine (LDAC)-based strategies, with or without venetoclax. We searched Ovid MEDLINE and Embase, and Cochrane CENTRAL through February 2024, and monitored these databases for new studies throughout November 2024. We included randomized controlled trials (RCTs) and nonrandomized studies (NRS). Reviewers screened studies, extracted data, assessed risk of bias, conducted random-effects meta-analyses, and rated certainty of evidence using GRADE (grading of recommendations, assessment, development, and evaluation). We included 21 studies (3 RCTs, 18 NRS). Compared with HMA- or LDAC-based monotherapy, conventional 7+3-type remission induction therapy may reduce mortality at longest follow-up (risk ratio [RR], 0.94; 95% confidence interval [CI], 0.85-1.04; low certainty), increase complete remission rates (odds ratio, 1.75; 95% CI, 1.25-2.38; high certainty), and may reduce recurrence at longest follow-up (RR, 0.81; 95% CI, 0.64-1.04; low certainty). Conventional therapies probably increase most severe toxicities (moderate certainty). Compared with HMA or LDAC combined with venetoclax, very low certainty evidence suggests that conventional therapy may reduce 1-year mortality (RR, 0.72; 95% CI, 0.60-0.87), increase allogeneic transplant rates (RR, 2.28; 95% CI, 1.70-3.06), result in no important differences in complete remission or recurrence, and have variable effects on severe toxicities. Conventional therapy may have benefits over HMA or LDAC alone; however, compared with HMA or LDAC plus venetoclax, the evidence remains of very low certainty.

Introduction: Childbirth is a physiological phenomenon that usually begins naturally with the spontaneous onset of pain in the 38-42 weeks of pregnancy and ends with the exit of pregnancy products. Spontaneous onset of labor and delivery is influenced by various factors such as changes in the level of estrogen, progesterone and prostaglandin hormones, changes in myometrial sensitivity to oxytocin and prostaglandins and the mutual effects of these factors. This study was conducted with aim to compare the effect of misoprostol and propranolol with misoprostol alone in induction of labor in mothers. Methods: This double-blind randomized clinical trial was conducted on 240 pregnant women referred to Kowsar Hospital during 2024. The data collection tool was a checklist including the patient's personal characteristics and clinical data. The control group was given 50 micrograms of sublingual misoprostol up two doses along with placebo, and the intervention group was given 50 micrograms sublingual misoprostol up to two doses and 20 mg propranolol tablets every 6 hours up to two doses. Induction with oxytocin was continued with the onset of uterine contractions. Data analysis was performed with SPSS (version 25) and Chi-square test and independent t-test. P<0.05 was considered statistically significant. Results: According to the results, there was no statistically significant difference between the two groups in terms of the number of pregnancies (p=0.676) and the Apgar score of the newborns (p=1.000). Moreover, the variables of hemoglobin before (p=0.959) and after (p=0.852) and its changes (p=0.842), systolic blood pressure (p=0.334) and diastolic blood pressure (p=0.484) did not have a statistically significant difference between the two groups. However, the mean of heart rate of the intervention group (85.18 ± 3.76) was significantly lower than that of the control group (86.22 ± 3.99) (P=0.040). In comparing the duration of labor phases, there was no statistically significant difference between the two groups in terms of latent phase (p=0.570), phase 1 (p=0.660), and phase 2 (p=0.704). Conclusion: Adding oral propranolol to misoprostol did not accelerate the duration of labor phases. Among the clinical variables, only the mean heart rate of the intervention group (85.18) was lower than that of the control group (86.22).

Background and purpose: Colorectal cancer (CRC) continues to be a major contributor to cancer-related mortality despite advances in diagnosis and management, highlighting the need for targeted, cost-effective therapies. Phytochemicals like curcumin (Cur) and silibinin (Sil) show promising anticancer effects, supported by preclinical and clinical evidence. Nanocarriers, such as niosomes (Nio), enhance the delivery and bioavailability of these bioactive molecules. The present study evaluates the anticancer potency of Cur and Sil, alone and in combination, in free and niosome-encapsulated forms against HCT116 cells, advancing plant-based nanotherapeutics for CRC. Methods: Niosomes were prepared by thin-film hydration; physicochemical characterization was carried out using DLS, FE-SEM, and FTIR. Cytotoxicity of free, encapsulated, and combined drugs on HCT116 cells was measured using the MTT assay. Cell cycle and apoptosis were analyzed via flow cytometry. Gene expressions of hTERT, BAX, BCL-2, Casp3, Casp7, CCND1, and MMP9 were assessed by qRT-PCR. Cell migration was evaluated with a scratch assay. Results: The synthesized niosomes exhibited suitable physicochemical characteristics for effective drug delivery. MTT assays demonstrated that both curcumin (Cur) and silibinin (Sil) inhibited HCT116 cell proliferation individually. Their combination – whether free, niosome-encapsulated, or niosome-encapsulated with hyaluronic acid – produced a significant decrease in IC₅₀ values. The nano-formulated combination also showed superior induction of apoptosis and cell cycle arrest compared to free drugs. These effects were supported by significant changes in gene expression (p < 0.05). Conclusion: These findings show that co-loaded formulation reduced viability in the tested colorectal cancer cell line, with greater in vitro activity observed for the hyaluronic acid decorated formulation.

This study aimed to model the structural equations representing the effects of noise exposure and noise sensitivity on noise annoyance, mental disorders, and cognitive failure in the paper-making industry. This cross-sectional study was carried out among 350 participants working in the paper-making industry who were exposed to noise. The Weinstein Noise Sensitivity Scale, Noise Annoyance Questionnaire, Cognitive Failure Questionnaire, and the Depression, Anxiety, and Stress Scale (DASS) were utilized to evaluate participants’ levels of noise sensitivity, annoyance, cognitive failures, and mental health disorders. To test the research hypotheses and conduct structural equation modeling, SMART PLS software was employed. Structural equation modeling revealed a direct and significant effect of noise exposure on noise annoyance ( p = 0.002), as well as on mental disorders, including anxiety ( p = 0.005), depression ( p < 0.001), stress ( p < 0.001), and cognitive failure ( p < 0.001). Additionally, indirect effects were observed using stress and depression as mediators ( p = 0.048 and p = 0.017). Noise sensitivity similarly impacted annoyance ( p < 0.001), anxiety ( p < 0.001), depression ( p < 0.001), stress ( p < 0.001), and cognitive failure ( p < 0.001). An indirect effect of noise sensitivity on cognitive failure was noted through stress ( p = 0.031), anxiety ( p = 0.007), and depression ( p < 0.001). Noise exposure had a more pronounced effect on cognitive failure compared to noise sensitivity. Conclusively, exposure to elevated noise levels significantly contributes to noise annoyance, mental disorders (stress, anxiety, and depression), and cognitive failure among workers. Individuals with higher noise sensitivity score were found to be more vulnerable to these adverse effects compared to those with lower sensitivity.