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Multiple sclerosis patients often experience various symptoms that can greatly impact their quality of life. There are various brain stimulation techniques that have been evaluated for their ability to reduce the symptoms of multiple sclerosis. However, there is inconsistency in the specific stimulation methods used and the symptoms targeted in the existing research. This umbrella review conducted in order to evaluate the effectiveness of brain stimulation and identify limitations and gaps for further research. In this umbrella review, we conducted a searched on Web of Knowledge, PubMed, and Scopus database. We specifically looked for reviews, with or without meta-analyses, that have investigated the effects of brain stimulation methods on symptoms of multiple sclerosis. All articles were examined by AMSTAR 2 (A Measure Tool to Assess Systematic Review 2). We identified 155 articles, of which 14 were eligible for inclusion. Of those, five were qualitative studies and nine were meta-analyses. Among the included studies, four examined the use of deep brain stimulation, while ten investigated the therapeutic potential of noninvasive brain stimulation. Considering the heterogeneity of studies, the current evidence suggests that repetitive transcranial magnetic stimulation may be effective in treating pain and improving motor function, while transcranial direct current stimulation may be useful in alleviating fatigue and enhancing certain aspects of cognitive performance. Deep brain stimulation, on the other hand, appears to be effective in reducing tremors. However, further research is warranted to validate these findings and address the existing limitations in the field. [ABSTRACT FROM AUTHOR]

Background: Simple open prostatectomy is still the treatment of choice for removing large prostates; however, peri-surgical bleeding accompanied by this technique has always been a challenge for urologist surgeons. Therefore, the present study aimed to investigate the effect of surgicel on reducing bleeding in trans-vesical prostatectomy. Materials and Methods: The present double-blinded clinical trial included 54 patients with Benign Prostatic Hyperplasia (BPH), divided into two groups of 27, and underwent trans-vesical prostatectomy. After removing the prostate, the prostate adenoma was weighed in the first group. Then, two surgicel were inserted into the prostate loge for prostate adenomas weighing 75 g or less. For larger prostates, another surgicel was inserted for each 25 g weight higher than the limit of 75 g. However, no Surgicel was inserted in the control group. Other steps of the procedure were the same in both groups. Moreover, hemoglobin and hematocrit levels were assessed in both groups; preoperation, intra-operative, 24 h, and 48 h postoperative. In addition, all the fluid used for bladder irrigation was collected, and its hemoglobin level was assessed. Results: According to our results, no intergroup difference in hemoglobin level changes, hematocrit changes, International Prostate Symptom Score (IPSS), postoperative hospital stay, and number of packed cells received. However, the postoperative blood loss in bladder lavage fluid was significantly higher in the control group (120.83 ± 46.66 g) as compared to the surgicel group (72.56 ± 32.53 g) (P < 0.001). Conclusion: The present study concluded that using surgicel in trans-vesical prostatectomy could reduce postoperative bleeding without increasing the chance of postoperative complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Music is an economical, advantageous and reliable means of reducing stress or stress-related problems. OBJECTIVE: The present study aims to evaluate the effects of playing music during surgery on the performance of the surgical team through a systematic review of published studies. METHODS: The relevant databases of Medline/PubMed, Scopus and Science Direct were searched up to July 2018 to find related articles. The comprehensive literature search was reduced to 19 articles that met inclusion criteria. RESULTS: The articles comprised 13 studies and reported on the positive effects of music on the performance of the surgical team. The effects included a more relaxing and pleasant environment, more accurate and precise performance of tasks, a decrease in the mental workload and task completion time, increased situation awareness, a reduction in stress and anxiety and improved memory consolidation. Five studies reported on the negative effects of music during surgery as being a negative impact on task completion, poor auditory performance and increased likelihood of having to repeat requests. The remaining article reported no significant differences between groups compared. CONCLUSIONS: Most studies reported positive effects of music on the surgical team during surgery. These results indicate that it may be possible to improve the performance of the surgical team during surgery while playing controlled music. [ABSTRACT FROM AUTHOR]

• New methodology for prediction of the rTMS treatment of MDD to improve treatment efficacy and reduce health care costs. • Effective connectivity used for transforming EEG signals to image and provides an informative feature map. • An ensemble of Transfer Learning models was developed using the weighted majority voting to predict the treatment outcome. Repetitive Transcranial Magnetic Stimulation (rTMS) can be used as an effective treatment for Major Depressive Disorder (MDD) especially when a patient does not respond to multiple antidepressants. However, the prediction of the treatment outcome of rTMS is a vital task to prevent starting an inefficient treatment which may waste several important weeks for the patient and clinic. In the present study, we acquired 19-channel Electro-Encephalogram (EEG) for 34 MDD patients diagnosed with drug-resistant Depression before initiating rTMS treatment. Effective Connectivity matrix was obtained from four frequency bands of EEG signal to create connectivity images which, simultaneously, represent spatial and frequency information of EEG signals. Then, we investigated five powerful pre-trained Convolutional Neural Networks (CNN) named VGG16, Xception, InceptionResNetV2, DenseNet121, and EfficientNetB0 as Transfer Learning (TL) models to predict rTMS treatment outcome by discriminating Responders and NonResponders. VGG16 and DenseNet121 achieved the best performance with an accuracy of 89.22%. Additionally, we developed a new ensemble model based on all pre-trained CNN models using a weighted majority voting approach. The Differential Evolution Optimization (DEO) algorithm is used to find the optimal weights for the ensemble model and the mean accuracy of 92.28% was obtained. The superior performance of the optimized ensemble of these pre-trained CNN models, using effective connectivity images obtained from EEG signals, shows that the proposed method is highly capable of predicting the treatment outcome of rTMS. [ABSTRACT FROM AUTHOR]

Approximately 10-20% of women of reproductive age suffer from endometriosis, with 70-90% of these women reporting chronic pain symptoms that persist during their menstrual cycle. We are presenting a case in which a novel form of noninvasive brain stimulation called transcranial direct current stimulation was used as an intervention in a 32-year-old woman with persistent, chronic pain symptoms caused by endometriosis for 20 years. Ten daily, 20-min sessions of 2-mA anodal transcranial direct current stimulation were applied over the left primary motor cortex. Acutely, visual analog scale pain symptoms were reduced by 60%. There were also significant decreases in modules of the Endometriosis Health Profile. At the 4-month follow-up, the patient still expressed an overall decrease in pain symptoms of 30%. [ABSTRACT FROM AUTHOR]

Introduction: Trichotillomania is a chronic disorder characterized by the frequent hair loss due to the increasing tension that results in pulling out one's hair. Several treatments have been proposed for this disorder, but there have not been enough studies to compare the effects of relevant therapeutic approaches. This study has been done aimed at comparing the effectiveness of the emotional intelligence skills training and drug therapy in reducing the symptoms of Trichotilominia in patients suffering from it. Materials and methods: The research was conducted using a semi-experimental method, being of a pre-test and post-test design. The statistical population included all patients with Trichotilominia living in the city of Urmia that amounted to 40 people who were replaced in two groups of drug therapy (n = 20) and emotional intelligence skills training (n = 20). For the drug therapy group, prescribed psychiatric medications were given and the impacts of medications were tracked, and for the other group, the emotional intelligence training was offered in 16 meetings of 45 to 60 minutes. Data collection was conducted in the pre-test and post-test through the scale of Mokeni Massachusetts, the average hairs pulled were counted, and the research data were analyzed using by the variance analysis method. Results: The findings of the current study indicated that the impact of emotional intelligence skills training was more in reducing the symptoms of those suffering from Trichotilominia than that of the drug therapy method. Conclusion: According to the study results, it can be concluded that the emotional intelligence skills training can be widely used as an alternative method for the long-term and costly treatment of Trichotilominia. [ABSTRACT FROM AUTHOR]

Purpose: The aim of study was to investigate the outcome of surgery in patients with penile fracture in Al-Zahra hospital. Materials and Methods: This cross sectional study was conducted on 187 patients with penile fracture underwent surgery in Al-Zahra hospital during 2016-2020. Data such as penile fracture causes, erectile dysfunction, time of surgery after penile fracture, degree of penile curvature and etc were extracted from medical records. Results: The most common reason of penile fracture in these patients was manipulation and trauma with frequency 70 (37.4%) and 69 patients (36.9%), respectively. Lower urinary tract symptom, urinary tract injury, penile curvature, penile nodule and erectile dysfunction were observed in 1 (0.54 %), 2(1.06 %), 76 (40.64%), 75 (40.1%), 43 (23%) patients, respectively. Mild and moderate erectile dysfunction was seen in 38 (88.3%) and 5 (11.62%) patients, respectively. There was a significant relationship between erectile dysfunction with the degree of penile curvature, surgical time and size of defect (P < .01). Furthermore, significant relation was observed between penile nodules and suture type (P = .000). Conclusion: According to findings, erectile dysfunction was observed in 23 % of patients; however most of these patients had mild erectile dysfunction. Moreover, erectile dysfunction was influenced by penile curvature, surgical time and size of defect. Therefore, early surgery and special attention to patients with severe penile curvature are proposed for prevention of erectile dysfunction in these patients. [ABSTRACT FROM AUTHOR]