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      A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable?

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          Abstract

          Averagely 80% to 90% of breastfeeding women experience the nipple pain and fissures. The important factor for successful breastfeeding is to treat this problem. This study has done as a review with the aim of analysis of the clinical trials in the field of the prevention and treatment of the nipple fissures and pain due to the importance of breastfeeding. For this purpose, the key words of sore, nipples, fissure, trauma, wound, prevention, treatment, therapeutics, therapy, clinical trial, breastfeeding and their Persian synonyms and all of their possible combinations were searched in the national databases: SID and Iran Medex and Magiran, and in the international databases: PubMed, Scopus, Medline, Science direct by May 2017. The Jadad criterion was used to assess the quality of the articles and the articles with a score of 3 or more were included in this study. Finally, 48 clinical trials were reviewed that 17 of them (sample size 1801) scored 3 or more based on the Jadad criterion. Seven articles were also in the non- drug treatment group (sample size 491) and 2 articles in the drug treatment group (sample size 337) and 8 articles in the herbal treatment group (sample size 973).The results show that menthol and warm water compress as well as teaching the correct breastfeeding methods are effective treatments to prevent and treat the nipple pain and fissures. Moreover, applying the herbal medicine for prevention and treatment of the issues raised from breastfeeding may have beneficial such as Aloe vera, Portulaca olearacea. However, more studies with a great methodology are necessary to obtain more accurate evidence.

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          Most cited references46

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          Effect of pulsing in low-level light therapy.

          Low level light (or laser) therapy (LLLT) is a rapidly growing modality used in physical therapy, chiropractic, sports medicine and increasingly in mainstream medicine. LLLT is used to increase wound healing and tissue regeneration, to relieve pain and inflammation, to prevent tissue death, to mitigate degeneration in many neurological indications. While some agreement has emerged on the best wavelengths of light and a range of acceptable dosages to be used (irradiance and fluence), there is no agreement on whether continuous wave or pulsed light is best and on what factors govern the pulse parameters to be chosen. The published peer-reviewed literature was reviewed between 1970 and 2010. The basic molecular and cellular mechanisms of LLLT are discussed. The type of pulsed light sources available and the parameters that govern their pulse structure are outlined. Studies that have compared continuous wave and pulsed light in both animals and patients are reviewed. Frequencies used in other pulsed modalities used in physical therapy and biomedicine are compared to those used in LLLT. There is some evidence that pulsed light does have effects that are different from those of continuous wave light. However further work is needed to define these effects for different disease conditions and pulse structures. (c) 2010 Wiley-Liss, Inc.
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            The Review on Properties of Aloe Vera in Healing of Cutaneous Wounds

            Treatment of wounds is very important and was subject of different investigations. In this regard, natural substance plays crucial role as complementary medicine. Various studies reported that aloe vera has useful effects on wounds especially cutaneous wounds healing. Therefore in the current review, we examined the effect of aloe vera on cutaneous wound healing and concluded that although aloe vera improves the wound healing as well as other procedures both clinically and experimentally, more studies are still needed to approve the outcomes.
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              Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments

              Background: Persistent nipple pain is one of the most common reasons given by mothers for ceasing exclusive breastfeeding. We aimed to determine the frequency of nipple pain as a reason for consultation, the most common attributed aetiologies, and the effectiveness of the advice and treatment given. Methods: All consultations at the Breast Feeding Centre of Western Australia (WA) were audited over two six-month periods in 2011 (n = 469) and 2014 (n = 708). Attributed cause(s) of nipple pain, microbiology results, treatment(s) advised, and resolution of pain were recorded. Results: Nipple pain was one of the reasons for consultation in 36% of cases. The most common attributed cause of nipple pain was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis, and vasospasm. Advice included correction of positioning and attachment, use of a nipple shield, resting the nipples and expressing breastmilk, frenotomy, oral antibiotics, topical treatments, and cold or warm compresses. Pain was resolving or resolved in 57% of cases after 18 days (range 2–110). Conclusion: The multiple attributed causes of nipple pain, possibly as a result of a cascade of events, suggests that effective early lactation management for prevention of nipple pain and early diagnosis and effective treatment are crucial to avoid early weaning.
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                Author and article information

                Journal
                J Pharmacopuncture
                J Pharmacopuncture
                Journal of Pharmacopuncture
                The Korean Pharmacopuncture Institute (KPI)
                2093-6966
                2234-6856
                September 2018
                30 September 2018
                : 21
                : 3
                : 139-150
                Affiliations
                [1 ]Graduate student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
                [2 ]Student Research Committee, Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
                [3 ]Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
                [4 ]Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
                [5 ]Student Research Committee, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
                [6 ]Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
                [7 ]Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
                Author notes
                [* ] Corresponding Author: Vahid Reza Askari. Student Research Committee, Department of Pharmacology, Faculty of Medicine, Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-513-8002-262, Fax: +98-511-8828-564, askariv941@ 123456mums.ac.ir , vahidrezaaskary@ 123456yahoo.com .
                [+]

                The authors had equal contribution as first author.

                Article
                2093-6966-v21-n03-139
                10.3831/KPI.2018.21.017
                6168189
                30283701
                4bb2b9c5-f8e4-4a20-8a92-9e4a01412935
                © 2018 Korean Pharmacopuncture Institute

                This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 February 2018
                : 16 April 2018
                : 02 August 2018
                Categories
                Review Article

                pain,fissure,clinical trial,systematic review,nipple,prevention
                pain, fissure, clinical trial, systematic review, nipple, prevention

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