Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity

Objective:Only a few numbers of studies have been published on the use of abobotulinumtoxinA(Dysport®)in idiopathic detrusor overactivity(IDO).This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport®injections.Methods:Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500-900 units of Dysport®between April 2014 and July 2015.All patients were followed up for 5 years after their initial injection and interviewed on the phone.Results:A total of 236 women with IDO aged from 18 years to 84 years(mean±standard deviation:49.6±15.9 years)were included in our study.The median follow-up time for patients was 36.5(range:10-70)months,and the median recovery time after injection was 18.5(range:0-70)months.A total of 83(35.2%)patients stated that they had subjective improvement of their symptoms whereas 84(35.6%)patients did not report any improvement in symptoms.The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9(standard deviation 3.4).There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire.Conclusion:In a sub-population of overactive bladder patients with IDO who have failed first-line therapy,a single intravesical Dysport®injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.

Effect of cognitive behavioral therapy on anxiety and depression of infertile women: A meta-analysis

Objective:To investigate the effect of cognitive behavioral therapy on anxiety and depression in infertile women.Methods:This study was performed in 2019 by searching Google Scholar,Scopus,PubMed/MEDLINE,Cochrane library,EMBASE,Proquest,ISI Web of Science,MagIran,SID and IranMedex.Eligible studies were selected by two reviewers and outcomes of interest were extracted.The meta-analysis was performed using the random effect models.Ⅰ-square statistic test was used for heterogeneity analysis.Presence of publication bias was also checked.Results:Eleven studies were included in this review.Between-group differences(cognitive behavioral therapy and control groups)in risk ratio for infertile women's depression was d=-1.36;95%CI=-1.81,-0.90;P<0.001.For infertile women's anxiety,between-group differences in risk ratio wasd=-0.83;95%CI=-1.18,-0.47;P<0.001.Conclusions:Cognitive behavioral therapy is effective in the reduction of depression and anxiety in patients with or withoutin vitro fertilization/intracytoplasmic sperm injection treatment.However,the lack of high-quality studies makes it challenging to make a solid and precise conclusion.Well-designed studies should be undertaken in the future to confirm these results.

Road safety data collection systems in Iran: A comparison based on relevant organizations

Purpose:Various organizations and institutions are involved in road traffic injury(RTI)and crash registration such as police,forensic medicine organization,hospitals and emergency medical services.But there is a substantial uncertainty in interpreting the data,duplicated data collection and missing data in relation to RTI in most systems.This study aims to identify data sources for RTI surveillance in Iran and to explore traffic safety data source domains,data elements and detailed information by each data source.Methods:This is a qualitative study which was conducted in 2017 in Iran.Data were collected employing semi-structured interviews with informants in road safety organizations in relation to traffic safety including Police,Ministry of Health and Medical Education as well as Forensic Medicine Organization and other authorities-in-charge.For completing the preliminary extraction information,the minimum data set was used and compared in each system.Results:Eight different organizations relevant to road traffic safety were identified.The main domain of data provided by each one consists of Emergency Medical System form,Police KAM114 form,Ministry of Transport and Road Administration,Red Crescent Organization/Disaster Management Information System,Ministry of Health and Medical Education,Forensic Medicine Organization,Insurance Company and Ministry of Justice.Each system has its own database,based upon its scope and mainly at crash and postcrash status and little on pre-crash circumstance.Conclusion:All current registry systems are not surveillance systems for RTI prevention.Huge data have been collected in various registry systems in Iran,but most of the collected variables are duplicated in each system.On the other hand,some variables like alcohol and substance abuse,child seat belt,helmet use in relation to RTI prevention are missed in all systems.Accordingly,it is a critical need to integrate and establish a comprehensive surveillance system,with focus on the goal of each system and collection of minimum data in each organization,which currently is underway.