Introduction: Systemic sclerosis is a CHRONIC multisystem disease. Many patients with limited scleroderma do not meet the criteria of the American College of Rheumatology (ACR), although they clearly have skin changes. There is no information regarding the sensitivity and specificity of manifestations of scleroderma. The aim of this study was to determine the sensitivity and specificity of the vascular and skin signs in patients with limited scleroderma. Methods: Forty patients with limited scleroderma according to the ACR criteria, 40 patients with other collagen vascular diseases, and forty healthy persons were selected for this study. Ten parameters (acrocyanosis, acro-osteolysis, gangrene, Raynaud's phenomenon, pitting ulcer, more than 5 facial and palmar telangectasia, hyper- and hypopigmentation, vertical and horizontal mouth diameter, and the number of radial furrowing around the mouth) were evaluated in them. Results: The mean age for both groups of scleroderma and healthy persons was the same (40 years). The patients with collagen vascular disease had a mean age of 36 years old. More than 95% of patients in each group were female. The mean duration of the disease at onset was 7.6 years in the scleroderma patients. Raynaud's phenomenon and pitting ulcers had the highest sensitivity (97.5% and 82.5%, respectively). Acrocyanosis, acro-osteolysis, gangrene, pitting ulcer, hypo and hyper pigmentation, more than 5facial and palmar telangiectasia had 100% specificity. Receiver-operator curve (ROC) was used to determine the best cut-off point for vertical and horizontal mouth diameter and the number of radial furrowing around the mouth. The number of the radial furrowing around the mouth had the largest area under the curve with 80% sensitivity and 87.5% specificity for 5folds or more. Discussion: Raynaud's phenomenon is the best and the first sign to rule in or out the disease because it has the most positive likelihood ratio (39) and the least negative likelihood ratio (0.02). The 100% specificity of the skin signs may be due to the lack of dermatologic patients in the control group. It is therefore recommended to design studies with patients in their early onset of the disease and control groups consisting of patients with skin diseases.      

Background and Objective: Methadone is a synthetic opioid which is used in opium addiction therapy and relief of acute and CHRONIC pain. Side effects of Methadone were reported on heart and induction of Torsade De Pointes disease and increase QTc interval in electrocardiogram. This study was conducted to determine the effect of Methadone therapy on QTc interval in electrocardiogram and its relationship with dosage and duration of Methadone therapy.Method: This cohort study was conducted on 60 opium addicted patients (57 males, 3 females) whom referred to “Methadone Therapy Clinic” in 5 Azar teaching hospital in Gorgan, northern Iran during 2009-10. Patients were divided to three groups based on the dosage of methadone: 0-35 mg (27 cases), 35-55 mg (27 cases) and 55-120 mg (26 cases) per day. QTc interval in electrocardiogram was measured at the beginning of study, one month and 5 months afterward.Results: The mean±SD of QTc interval in patients at the beginning, one month and 5 months afterward of study was 0.42±0.027, 0.43±0.029 and 0.43±0.041 seconds, respectively. There was a significant increase in QTc interval after one month of methadone therapy, compared to the beginning of study. There was no significant difference in QTc interval between 1 month and 5 months following methadone therapy. There was no significant difference between QTc interval and different dosage of methadone.Conclusion: Methadone therapy increase QTc interval but there is not any relationship between dosage and duration of methadone therapy and QTc interval.

Background and aim: Anti-inflammatory and antinociceptive effects of Vitex agnus castus has been mentioned in traditional herbal medicine. In present study, we decided to evaluate the effects of anti-inflammatory and antinociceptive of Vitex hydro-alcoholic extract in mice.Methods: In this experimental research, 112 adult male NMRI mice were used.  Mice were divided into 7 groups for inflammatory test: first group was control. The second group was positive control group (receiving dexamethasone,15 mg/kg) and the other five groups received different doses of hydroalcoholic extract of Vitex fruit (265, 365, 465, 565, and 665 mg/kg, i.p.). Inflammation was induced by xylene in ear of mice. Formalin test was used for evaluation of antinociceptive effect of extract. In this test, mice were divided into 7 groups: control, morphin (10mg/kg) as positive control group, and Vitex extract groups (265, 365, 465, 565, and 665 mg/kg). All drugs were administered i.p., 30 min before each test. The data were analyzed using one-way ANOVA followed by Tukey-kramer multiple comparison test.Results: Results showed significant anti-inflammatory effects of extract at all doses as compared with control (P<0.05). In the first phase of formalin test (0-5 min) none of extract doses could inhibit acute pain, but in the second phase (15-30 min) CHRONIC pain was decreased at 265, 365, 465, and 565 mg/kg doses (P<0.05).Conclusion: The result of this research indicates that Vitex extract remarkably inhibits inflammation and second phase of nociception (inflammatory pain) and can be used for treatment of inflammatory diseases. However more researches are needed to find out the effective compounds in Vitex agnus castus fruit.

Background: Smoking is known as the major cause of CHRONIC obstructive pulmonary disease (COPD). In COPD, most of pulmonary function tests (PFTs) specially those indicating the diameter of airways are reduced. There are reports that bronchodilator drugs have no or a very little effect on PFT of COPD patients. Therefore, in this study PFTs of smokers were compared with those of nonsmokers, and the effect of bronchodilator inhaler (salbutamol) on PFTs of smokers were also examined.Materials & Methods: Pulmonary function tests were measured in 97 male smokers (height 171.71±6.68 cm, age 36.49±13.06 years old) and compared with 95 male nonsmokers (height 171.79±8.81 cm, age 35.56±12.83 years old). The subjects underwent measurement of spirometric flow and volume. The following variables were measured: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF), maximal expiratory flow at 75%, 50%, and 25% of the FVC (MEF75, MEF50, and MEF25 respectively). In addition, pulmonary function tests of 33 male smokers (height 172.79±11.94cm, age 38.30±6.65 years old) before and 10 minutes after administration of 200 A?g salbutamol inhaler were measured.Results: The results showed that most values of PFTs in smokers were significantly lower than those of non-smokers (p<0.001 for FVC, FEV1, PEF, MEF75, p<0.01 for MMEF, and p<0.02 for MEF50). However, there were not significant differences in MEF25 of smokers and non-smokers. There were significant correlations between the smoking duration and FEV1, PEF, MEF75, and MEF50 (p<0.05 to p<0.01), but correlations between smoking quantity and values of PFTs were not significant. The results also showed that all values of PFTs were significantly increased after salbutamol administration (p<0.05 to p<0.01). The enhancement in PEF, MEF75, and MEF50 was around 12% and that of MEF25 was 17%.Conclusion: The profound effect of smoking on PFT showed that smoking leads to constriction of large and medium sized airways which is mostly due to duration not to quantity of smoking. The airway constriction in smokers was reversible which, was mostly seen for medium sized airways.

Background: Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that is characterized by acute and CHRONIC inflammation.The etiology and pathophysiology of IBD is unidentified, and there are many obstacles on the definite treatment of this disease. Recently, the useful effects of some herbal medicine on improving UC have been studied. Melillotus officinalis L. (M.officinalis) is an herb with antioxidant and anti-inflammatory effects used as food, forage and medicine.Objectives: This study evaluated the antioxidant effects of M. officinalis aqueous extracts in the acetic acid- induced ulcerative colitis in rats.Methods: Fifty rats were randomly divided into five equal groups. Group I (Control healthy group) received 1 mL/kg of normal saline orally. Group II (control colitis group) received 1 mL/kg of normal saline orally. Group III (positive control) received 3 mg/kg prednisolone orally. Group IV received 1000 mg/kg M. officinalis aqueous extracts orally. Group V received 2000 mg/kg M. officinalis aqueous extracts orally. Ulcerative colitis was induced by intra-rectal acetic acid (3% v/v) administration. All treatments were done 24 hours after induction of colitis and continued for seven days. On the eighth day, the rats were sacrificed and colonic biopsies were taken for histopathological and biochemical studies. Data analysis was performed, using SPSS software and significance level was set at P0.05.Results: Treatment with M. officinalis aqueous extract could enhance colonic antioxidant capacity and decrease inflammation and acute colonic injury induced by acetic acid, which is dose-dependent. In addition, administrating the extract significantly (P£0.05) reduced the colonic level of malondialdehyde and myeloperoxidase, and significantly (P£0.05) increased the level of reduced glutathione (P£0.05). The extract had more effects at the dose of 2000 mg/kg than 1000 mg/kg dosage and prednisolone.Conclusions: This study revealed that M. officinalis had apparent curative effects on treating UC because of its antioxidant and antiinflammatory activities.

Epidural analgesia is a type of regional block, commonly used in human and veterinary practice to alleviate pain solelyor auxiliary to other methods of anesthesia. This method of analgesia is widely used in abdominal, perineal, tail and rear limb surgeries and procedures. It is also widely common to relieve pain after operations and in patients with CHRONIC pain. Many reports are available about analgesic properties of metoclopramide which is primarily used as antiemetic; meanwhile, Lidocaine was used to induce analgesia in different species of animal from long time ago. Since narcotics have limitation in prescribing by physicians and clinicians, promoting other types of drugs with analgesic effects seem worthwhile. The present prospective experiment was designed to study effects of metoclopramide on epidural analgesia induced by lidocaine in rabbits. Twelve healthy New Zealand white rabbits weighing 3-3.5 kg were divided randomly into two groups. In group A, 2 % lidocaine (1.5 ml) and in group B the combination of 2 % lidocaine (1.5 ml) and metoclopramide HCl (0.5 ml) was used to induce epidural analgesia. Two more injections with 48 hours and one week intervals were performed in the same manner. The onset time of analgesia (OT), duration of flaccid paresis (DFP) and duration of analgesia (DA) was determined in all treatments. Repeated measure ANOVA and Banferroni test were used to compare mean and variances within and between groups. Statistical analysis showed that there were no significant difference in mean of OT and DFP between groups (p>0.05). Whereas mean of duration of analgesia was significantly higher in group B (39.1±16.2 min) compared to group A (23.6±5.5 min) (p=0.018). In conclusion the addition of metoclopramide to lidocaine is effective in prolongation of epidural analgesia in rabbit.

Background & Objectives: Painful neuropathy is a state resulting from somatosensory disease or injury. Neurotrophins such as NT-4 are crucial for neural growth and development and protect the integrity of function and structure of nervous system. Paying heed to the importance of physical activity in neural plasticity, this study focuses on the investigation of CHRONIC effect of decreased activity on the form of spinal nerve ligation on NT-4 gene expression of male Wistar rat’s sciatic nerve fiber.Materials & Methods: Ten adult male Wistar rats in the weight range of 250±30 gr were randomly divided into two groups, including one healthy control group (C) and one group with decreased physical activity (SNL). Over six weeks, neuropathic pain behavior tests were conducted continually in both groups. At the end of the sixth week, the changes in NT-4 gene expression in sciatic nerve were measured with Real time technique.Results: The behavioral tests demonstrated that spinal nerve ligation induced thermal hyperalgesia and mechanical allodynia in the SNL group. Decreased pain threshold was observed throughout the study period (p<0.05). Additionally, in comparison with the C group, NT-4 gene expression in sciatic nerve fiber was significantly higher in the SNL group (p<0.05).Conclusion: In the present study, it was discovered that the decreased activity in the form of SNL is associated with increased NT-4 gene expression in the experimental group. With respect to the physiologic functions of NT-4 in nervous system, this elevation is probably a mechanism for neurogenesis in the injured area, and based on the previous studies, it seems that the increased activity could enhance the increased NT-4 gene expression and accelerate neurogenesis.

Background & Objectives: Body Dysmorphic Disorder (BDD) is an obsessive–, compulsive condition. BDD is a CHRONIC, disabling, and afflictive psychiatric condition that can lead to severe personal, social, occupational, educational, and familial problems or dysfunction and psychological distress. Patients with body dysmorphic experience numerous negative emotions, such as shame, self–, disgust, disappointment, anger, frustration, guilt, doubt, hesitancy, and uncertainty. Therefore, basic and specific interventions about emotions are necessary for this population. A novel therapeutic approach that has received special attention on emotions and the common components of disorders is transdiagnostic treatment. The present study investigated the effects of transdiagnostic treatment on body image avoidance and alexithymia in BDD. Methods: This was a quasi–, experimental research with pretest–, posttest and a control group design. The statistical population of this study included all college students referring to Shiraz University’, s Counseling and Psychotherapy Center as well as those undergoing plastic surgery in Motahari and Imam Reza Medical Clinics in Shiraz City, Iran, from January 2019 to May 2019. Clinical interviews were conducted for all patients with BDD who were willing to participate in the study. Finally, 30 patients with body dysmorphic disorder were selected by purposive sampling method and randomly assigned to either transdiagnostic treatment or control groups (n=15/group). The inclusion criteria of the study included an age range of 45–, 18 years, being diagnosed with BDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–, 5) criteria, and presenting no comorbid disorders (anxiety, depression, stress, & obsessive–, compulsive disorder). Furthermore, the study participants were selected among those who received no other psychotherapy, counseling, and medication programs during the study. The exclusion criteria were substance abuse or dependence over the past 6 months, having any other psychological disorders, concerns about or preoccupation with appearance, better explained by other psychological disorders, like eating disorders. The Body Image Avoidance Questionnaire (Rosen et al., 1991) and the Toronto Alexithymia Scale (Bagby et al., 1994) were administrated at the pretest and posttest phases to collect the necessary data. Then, the experimental group received 12 sessions of transdiagnostic treatment according to Barlow et al. ’, s protocol (2015),however, the controls received no intervention. Descriptive statistics (e. g., frequency, percentage, mean, & standard deviation) and inferential statistics, including Multivariate Analysis of Covariance (MANCOVA) and univariate Analysis of Covariance (ANCOVA) were employed in SPSS to analyze the obtained data. The significance level of the tests was set at 0. 05. Results: To determine the difference of all components, univariate ANCOVA was performed,the relevant results indicated that after removing the pretest effects, there was a significant difference in all components in posttest scores concerning body image avoidance and alexithymia between the study groups (p<0. 001). The MANCOVA data indicated that the mean scores of all components of body image avoidance, including clothing (p<0. 001), social activity (p<0. 001), eating restraint (p=0. 003), as well as grooming and weighting (p=0. 003), and all component of alexithymia, including difficulty identifying feelings (p<0. 001), difficulty describing feelings (p<0. 001), and externally oriented thinking style (p<0. 001) significantly decreased in the experimental group. Conclusion: Based on the present study results, transdiagnostic treatment is effective in improving the avoidance of body image and mood dysphoria in patients with BDD. Therefore, implementing comprehensive intervention programs with a transdiagnostic approach is required for these patients.

Some studies have shown the relief of neurosensory signs in diabetic patients by vitamin B12 supplementation. Symptomatic therapy is not a goal in medicine; therefore, for detecting causes of this relief, vitamin B12 level was compared in poor and well-controlled diabetic patients in this study. Diabetes mellitus, which is the most common metabolic disease, has systemic effect on immunity, neurosensory, cardiovascular, kidney, skin and other organs and it causes organic and psychological disorders in patients. It increases treatment cost and reduces the efficient personnel, directly and indirectly. Knowing the mechanism of vitamin B12 effect on neurosensory signs of diabetes mellitus can help us in preventive care. It has a significant high quality, it is more cost-benefit and is prior to treatment. This cross-sectioal study was carried out on 99 patients who referred to endocrine part of Rasool-e-Akram Hospital. Mean age of the patients was 58.5±4 and 55 patients(56.1%) were female. History taking, physical examination and blood sample was done for determining vitamin B12 and hemoglobin A1c. Vitamin B12 level was compared in poor and well-conrolled diabetic patients. SPSS software was used for analysis of the data. The most common signs and symptoms consisted of hand and foot neuropathy, polyuria, nocturia, retinopathy, polydypsia, amblyopia, weight loss, distal paresthesia, second cranial nerve neuropathy, touch and vibration sense loss and nephropathy. Vitamin B12 level had no significant difference in poor and well-controlled diabetic patients. Neuropathy, polyuria, polydypsia and retinopathy were the most common symptoms. Neuropathy in 43.4% of patients can be due to duration of diabetes in these patients(10 years). CHRONIC complications increase with duration of hyperglycemia. Insufficient use of vitamin B12 is not a risk facor for vitamin B12 deficiency. Cobalamine supplements are inexpensive and nontoxic. Adding these supplements in primary stages may prevent irreversible neurosensory complications. Because of low prevalence of vitamin B12 deficiency in patients with type II diabetes, prophylactic administration of vitamin B12 to all of these patients is not suggested. Long-scale, multicentered and controlled study for determining the patients with higher risk for vitamin B12 deficiency is also essential.

Background and Objectives: Collagen is a protein with several applications in the pharmaceutical, cosmetic, medical and food industries that is prepared from different sources such as cow, pig, poultry and fish. In this study, optimization of the extraction of collagen from eggshell membrane was examined.Materials and Methods: The efficiency of extraction of collagen in different concentrations of sodium hydroxide (2.0-2.1 N) at different treatment times periods (6-36 hours), different concentrations of pepsin (U/mg90-15) and enzymatic hydrolysis times (6-60 hours) was studied with response surface methodology (RSM). Also the properties of eggshell membrane collagen were characterized by amino acid analyzer, SDS- PAGE and solubility.Results: The most important factors for extraction of collagen using RSM according to central composite design were optimized. Optimum extraction conditions were as follows: NaOH concentration of 0.76 N, alkali treatment time of 18 h, enzyme concentration of 50 U/mg and hydrolysis time of 43.42 h. The experimental extraction yield under optimal conditions was found to be 30.049%. Collagen solubility in pH=3 and NaCl concentration of less than 2% was determined. The analysis showed that Glycine having 322/1000 amino acids as the most amino acids and the immuneacid (sum of Proline and hydroxylproline) of collagen was 19.5 %. SDS- PAGE protein pattern revealed two different a (a1 and a2) components with b and γ chains.Conclusion: Collagen was extracted from eggshell membrane with optimum extraction efficiency, which can be used in film production, gelatin and functional food components to maintain health and control CHRONIC diseases.