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RECENT RESEARCH
Methods : This triple-blind randomized clinical trial was performed on 74 primiparous women delivered in Alzahra Hospital , Tabriz , Iran . Participants with mediolateral episiotomy ( incision length equal to and less than 5 cm ) were randomly assigned to the probiotic and placebo groups . The probiotic group received Lactobacillus casei 431 with 1.5 * 109 colony-forming unit / capsule once a day from the day after birth to 14 days . Wound healing as a primary outcome was measured by Redness , Edema , Ecchymosis , Discharge , Approximation and pain as a secondary outcome by the Visual Analogue Scale before discharge , 5 ± 1 and 15 ± 1 days after birth . The data were analyzed using independent t-test and repeated measures one way analysis of variance .
Results : The mean ( standard deviation : SD ) score of wound healing in the probiotic group altered from 4.91 ( 1.86 ) before discharge to 1.55 ( 0.99 ) during 5 ± 1 days after birth and reached to 0.95 ( 0.27 ) during 15 ± 1 days after birth . Further , the mean ( SD ) score of wound healing in the placebo group altered from 4.62 ( 1.99 ) before discharge to 2.80 ( 1.20 ) during 5 ± 1 days after birth and reached to 1.45 ( 0.71 ) during 15 ± 1 days after birth ( adjusted mean difference : -0.50 , confidence interval 95 %: -0.96 to -0.05 , P = 0.03 ).
Conclusion : Lactobacillus casei oral supplementation is effective in healing episiotomy wounds . It is suggested to evaluate the effect of topical use of Lactobacillus casei on episiotomy repair and pain in further studies .
Trial registration : Iranian Registry of Clinical Trials ( IRCT ): IRCT20170506033834N7 . Date of registration : 11 / 08 / 2021 .
Higuchi T , Ueno T , Uchiyama S , Matsuki S , Ogawa M , Takamatsu K . Effect of γ-tocopherol supplementation on premenstrual symptoms and natriuresis : a randomized , double-blind , placebo-controlled study . BMC Complementary Medicine and Therapies . 2023 ; 23 , Article number : 136 .
Background : This randomized , double-blind , placebocontrolled study aimed to investigate the effects of γ-tocopherol ( Toc ) supplementation on premenstrual symptoms and natriuresis .
Methods : We enrolled 51 Japanese women with premenstrual symptoms , particularly those who showed increased symptoms induced by water retention during the luteal phase compared with the follicular phase . Premenstrual symptoms were recorded in the first cycle ’ s postmenstrual follicular phase ; physical measurements and urine collection were conducted during the 48-h run-in period . The test supplement , which contained 180 mg of γ-Toc or placebo , was orally administered twice a day for 7 days during the luteal phase of the first and second cycles in a crossover manner . The same evaluation was conducted during the luteal phase , beginning in the morning of the sixth day of supplement administration .
Results : Compared with placebo intake , γ-Toc intake significantly reduced “ fatigue ” and “ irritability / anger ” symptoms . Furthermore , compared with placebo intake , γ-Toc intake significantly reduced the thigh circumference . Regarding the “ swelling of the legs ” and “ heavy legs ” symptoms and the thigh circumference , the biphasic trend of increasing and decreasing values in the daytime and morning , respectively , during the follicular phase was not observed at the luteal phase with placebo intake . Contrastingly , γ-Toc intake resulted in significantly lower values in the morning than placebo intake . The mean difference in 24-h urinary sodium excretion between γ-Toc and placebo intake was 10.6 mEq ( 95 % confidence interval ( CI ): -0.1 , 21.4 , p = 0.05 , power 55 %). Plasma γ-Toc and its metabolite γ-carboxyethyl hydroxychroman ( CEHC ) levels were significantly higher with γ-Toc intake than with placebo intake . There were no significant between-supplement differences in serum electrolyte levels or cumulative urinary potassium excretion .
Conclusion : γ-Toc intake could effectively alleviate certain premenstrual syndrome symptoms , particularly those related to water retention during the luteal phase . Furthermore , the underlying mechanism may involve the diuretic effect of γ-CEHC , which is a γ-Toc metabolite .
Trial registration : UMIN000047989 ; registration date : 10 / 06 / 2022 , retrospectively registered .
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