Experience of using photodynamic therapy for treatment of genitourinary syndrome of menopause

This study reports about efficacy and safety of photodynamic therapy in Genitourinary Syndrome of Menopause (GSM).Material and methods. The study group included 12 patients with a diagnosis of urogenital syndrome of menopause. The trismeglumine salt of chlorin E6 in the form of a 1% gel was used as a photosensitizer. LED phototherapy apparatus Garmonia (photodynamic therapy apparatus (emitter 660 nm) was used as a radiation source. The PDT procedure was performed once every 7 days. The following scales were used to assess the effectiveness: Vaginal Health Index, Visual Analogue Scale, Dermatology Life Quality Index score, and general satisfaction with the course of procedures was also assessed.Results. The patients noted a significant regression of itching, burning, pain and dyspareunia after the course of photodynamic therapy. There was a decrease in dryness, on average, up to 3 points upon completing the course of procedures. Itching completely regressed in 6 out of patients. Dyspareunia significantly decreased in 4 patients and completely disappeared in 2 patients. The greatest effect according to the results of assessing the index of vaginal health was noted in relation to Ph-metry, as well as in relation to elasticity (4.17 points) and moisture (4.33 points). The median satisfaction score with treatment outcomes was 2.7 at last follow-up. There were no serious side effects during the entire period of treatment and after it.Conclusions. The following study reports that the photosensitizer with trismeglumine salt of chlorin E6 and PDT with a wavelength of 660 nm with an exposure for 30 minutes, an energy of 100 J/cm2, a power of 100 mV/cm2 , once every 7 days, is an effective and harmless method of treating GSM.

Effect of light-emitting diode phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars

Purpose: This study aimed to assess the effect of light-emitting diode (LED) phototherapy on pain and trismus following surgical extraction of impacted mandibular third molars. Materials and Methods: This double-blind randomized controlled clinical trial evaluated 50 patients between 20 to 35 years requiring extraction of their impacted mandibular third molars. The patients were randomized into two groups of LED phototherapy and control by flipping a coin. Patients in the LED group underwent LED phototherapy immediately after surgery with red light at 618nm wavelength, 20 mW/cm2 power density and 4 J/cm2 energy density in continuous-wave mode (irradiated area: 3.15cm×1.5cm=4.725cm2). The LED device was used in off mode in the control group (as placebo). The level of postoperative pain was measured by the numerical rating scale, and trismus of patients was evaluated by measuring the maximum mouth opening (MMO). The two groups were compared by the Mann-Whitney and NPar tests. Results: The mean difference in MMO postoperatively, compared with baseline, was lower in the LED group than the placebo group but not significantly (P=0.465). The two groups were not significantly different regarding the level of pain. Conclusion: LED phototherapy with the parameters applied in this study failed to significantly decrease the level of pain and trismus following surgical extraction of impacted mandibular third molars.

The effect of Head Covering on Phototherapy-Induced Hypocalcemia in Jaundiced Full-Term Neonates

Background Phototherapy is the main method used in treatment of significant indirect hyperbilirubinemia and it reduces the risk of exchange transfusion. Hypocalcemia is one of the side effects of phototherapy due to inhibition of pineal gland via transcranial illumination, resulting in decline of melatonin secretion that further inhibits the effect of cortisol on bone calcium and ultimately increase the bone uptake. Aim To assess the effect of head covering to ameliorate hypocalcemic effect of different types of phototherapy in full term jaundiced neonates. Patients and Methods A prospective randomized controlled study that included 120 jaundiced neonates requiring phototherapy which divided into two main groups; group I (treated with lamp phototherapy) which was equally subdivided into two groups, group A (without head cover) and group B (with head cover) and group Il (treated with LED phototherapy) which was equally subdivided into group C (without head cover) and group D (with head cover). Results Head cover reduced the incidence of phototherapy induced hypocalcemia without affecting rate of decline of bilirubin on both types of phototherapy used. In lamp hypocalcemia (<8mg/dl) was detected in 33.3% in jaundiced neonates without head cover which was significant higher than those with head cover 6.7%. As for LED, yet not statistically significant hypocalcemia was detected in 13.3% in jaundiced neonates without head cover, which was higher than those with head cover 3.3%. Conclusion Incidence of phototherapy induced hypocalcemia is reduced by using head cover especially while using lamp phototherapy.

Phototherapy effect on CD4 lymphocytes of Full Term Neonates with Jaundice

Background Neonatal jaundice is one of the most common problems that affect newborn infants, and phototherapy is usually used for treatment. Phototherapy is generally considered a very safe and well-tolerated treatment for hyperbilirubinaemia. However, clinical users should be aware of the unwanted effects of using phototherapy. Affection of neonatal immune system due to phototherapy has been reported. Objectives Evaluation of the effect of phototherapy on neonatal immune system through measuring the level of CD4+ lymphocytes. Methods A prospective cohort study was conducted on full term newborns assigned to three groups: group1 neonates with hyperbilirubinemia treated by conventional phototherapy, group2 neonates treated by LED phototherapy and healthy neonates as control group. The percentages and absolute counts ofCD4+ lymphocytes were measured by flow cytometry before phototherapy and 48 h after exposure. Results The study showed a significant decrease in CD4+ percentage in patients after 48 h of exposure to conventional phototherapy (P value < 0.05). There was a significant decrease in CD4+ absolute counts after 48 h of exposure to both types of phototherapy. Conclusion Conventional and LED phototherapy which is used in the treatment of neonatal hyperbilirubinemia, caused a decrease in CD4+ absolute count 48 hours after phototherapy. Also conventional phototherapy caused a decrease in CD4+% 48 hours after exposure.

Cylindrical intensive vs. double surface LED phototherapy for neonatal hyperbilirubinemia

Background High bilirubin levels may lead to complications such as bilirubin encephalopathy or even death. Therefore, neonatal hyperbilirubinemia patients require appropriate treatment in the form of phototherapy or exchange transfusion. With the advancement of technology, various types of phototherapy, such as the cylindrical intensive phototherapy (bilisphere) and double LED, are now available. Objective To compare cylindrical intensive phototherapy to double surface LED phototherapy in neonatal hyperbilirubinemia. Methods This cohort study was conducted in neonates with hyperbilirubinemia at at Syamsudin SH Hospital, Sukabumi, West Java, who were treated with either cylindrical intensive phototherapy or double surface LED phototherapy. The variables observed were subjects’ characteristics, bilirubin levels pre- and post-therapy, duration of phototherapy, length of stay, and total treatment cost. The data were analyzed using univariate and bivariate analyses. Results Of 47 neonates, the mean bilirubin levels were 19.36 mg/dL pre-therapy and 12.26 mg/dL post-therapy. Subjects’ overall mean duration of phototherapy was 24 hours, mean length of stay was 1 day, and mean cost of treatment was IDR 813,175. There was no significant difference in the bilirubin decrease between the cylindrical intensive phototherapy and double LED groups. However, there were significant differences between the cylindrical intensive phototherapy and double LED groups in duration of phototherapy (10.75 vs. 75.17 hours, respectively (P<0.000), mean length of stay (1 vs. 3.13 days, respectively (P<0.000), and total cost of treatment (IDR 598,918 vs. IDR 1,036,747, respectively P<0.000). Conclusion While the decrease in bilirubin was not significantly different in neonatal hyperbilirubinemia patients who underwent cylindrical intensive phototherapy compared to double LED therapy, cylindrical intensive phototherapy relates to significant shorter phototherapy duration, length of stay, and total treatment cost. Hence, cylindrical intensive phototherapy phototherapy is considered to be more time-efficient and cost-efficient than double LED phototherapy.

Effect of Light-Emitting Diode Phototherapy on Allograft Bone After Open Sinus Lift Surgery: A Randomized Clinical Trial (Concurrent Parallel)

Introduction: Phototherapy with a light-emitting diode (LED) is used in medicine due to its potential bio-stimulatory effects on the human body. However, controversy still exists regarding the efficacy of low-level laser therapy (LLLT) and phototherapy with LED. This in vivo study aimed to quantitatively and qualitatively assess the newly formed bone following LED phototherapy of the human maxillary sinuses. Methods: This randomized clinical trial (concurrent parallel) was conducted on 44 patients in two groups (n=22) at the Implant Department of Tehran University of Medical Sciences. Randomization was done by a random sequence generator program. The inclusion criteria were absence of chronic sinusitis and chronic bone marrow conditions, no history of surgery at the site, absence of diabetes mellitus, no history of chemotherapy or radiotherapy, maxillary premolar edentulism, and signing informed consent forms. Group A underwent LED phototherapy with 620 ± 2 nm wavelength for 20 minutes daily for a total of 21 days after sinus lift surgery. Group B served as the control group and did not receive phototherapy. After 6 months, the grafted sites were re-opened for implant placement, and bone biopsy samples were obtained using a trephine bur. The samples were stained with hematoxylin and eosin and inspected under a light microscope. The results were statistically analyzed using the Mann-Whitney U test. Both the surgeon and pathologist were blinded to the group allocation of patients. Results: Forty tissue specimens were analyzed. Insignificant differences existed between the two groups in terms of the degree of inflammation, bone quality, and maturity of collagen. Histological analyses revealed no significant difference in the mineralized areas of bone between the two groups (P>0.05). Conclusion: The results indicated that LED phototherapy cannot significantly enhance osteogenesis after sinus lift surgery. No side effects were observed in the experimental group.