Introduction: Solar lentigo is local and benign proliferation of melanocytes which is common in old individuals and creates a major concern considering beauty. Despite several and somehow expensive treatments such as laser and cryotherapy, chemical peeling with Trichloroacetic Acid (TCA) has recently attracted attentions considering its low cost and availability. The present study was designed to compare the efficacy and side effects of Trichloroacetic Acid (TCA) 35% and cryotherapy in the treatment of solar lentigo.Methods: This randomized clinical trial was performed on 35 individuals with solar lentigo on their hands. First, images were taken from both hands. Then, one side was treated with cryotherapy and the other side was treated with TCA 35%, randomly. This treatment was repeated after one month. The imaging was repeated at the end of the second month and both sides were compared with previous images regarding the degree of the improvement (lightening) of the lesions and the resultant side effects. Descriptive statistical methods and 2-chi square relation were used for analyzing data with SPSS 16.Results: The results demonstrated that cryotherapy resulted in more than 50% recovery (lightening >50%) in 60% of the cases which was statistically significant (P<0.05). In contrast, TCA 35% yielded more than 50% recovery in 46% of the cases which was significant, too. Comparing these modes of treatments regarding 50% recovery showed no statistically significant difference (P=0.219). Side effects were seen in 40% and 13.3% of the individuals who used cryotherapy and TCA 35%, respectively, which was statistically significant (P<0.05).Conclusions: According to the findings of the research, TCA 35%, compared to cryotherapy, has similar efficiency but fewer side effects in the treatment of solar lentigo.

Background: Tricyclic antidepressant (TCA) poisoning is a serious medical emergency due to its high toxicity and life-threatening complications. Objectives: This retrospective cross-sectional study evaluated the frequency of clinical, paraclinical, and prognostic findings of poisoned patients with TCAs who were referred to Shah Vali Hospital, Yazd, Iran, and Shahid Beheshti Hospital, Taft, Yazd, Iran, between 2014 and 2023. Methods: We collected neurological findings, cardiovascular findings, paraclinical findings, treatment measures, and prognosis of poisoned patients with TCA who were referred to Shah Vali Hospital in Yazd and Shahid Beheshti Hospital in Taft from 2014 to 2023. We examined the patient’s medical records to extract the findings.  Results: Over a decade-long study, 233 cases of poisoning resulting from TCAs were documented, with a mean age of 28.11 years. Most of these cases involved nortriptyline (42.5%) and amitriptyline (32.6%). Notably, 69.1% of the affected individuals were female. Neurological manifestations included agitation (42.9%), mydriasis (39.05%), and dryness of the skin and mucous membranes (52.3%). Additionally, seizures were reported in 10.7% of patients. Cardiovascular symptoms included shock in 6.2% of cases, tachycardia in 24.56%, and QRS complex prolongation in 14.16%. Elevated lead augmented vector right (aVR) was noted in 7.18% of patients, while rhabdomyolysis occurred in 7%. The primary treatment administered was sodium bicarbonate, utilized in 51.1% of cases. Furthermore, 8.2% of patients had a history of suicide attempts, predominantly associated with amitriptyline use. Ultimately, the mortality rate among this cohort was recorded at 1.7%. The findings suggested a significant association between different types of TCAs and factors, such as disease severity, rhabdomyolysis, gender, method of drug administration, and the occurrence of seizures (P=0.001). Additionally, a notable association was observed between mortality rates and QRS complex prolongation and rhabdomyolysis (P<0.001). Furthermore, a significant correlation was found between the frequency of QRS complex prolongation, seizures, and the necessity for tracheal intubation (P<0.01). However, no statistically significant association was found between mortality rates and gender and age (P<0.05). Conclusion: In conclusion, this study highlights that poisoning from TCAs remains a significant challenge in the management of poisoned patients across various regions. Nortriptyline and amitriptyline are the most commonly involved drugs in poisoning incidents, likely due to their widespread prescription in Iran. The observed higher prevalence of poisoning among women, coupled with the frequent occurrence of suicide attempts, underscores the necessity for addressing psychological factors and closely monitoring the use of these medications. Cardiac complications, particularly tachycardia and QRS complex prolongation on the ECG, are critical indicators of poisoning. Prompt treatment with sodium bicarbonate, along with effective management of severe conditions, such as seizures and hypotension, is essential to reduce mortality. Furthermore, a significant relationship exists between QRS complex prolongation and rhabdomyolysis about mortality outcomes.

Objective(s): Higher cellular reactive oxygen species (ROS) levels is important in reducing cellular energy charge (EC) by increasing the levels of key metabolic protein, and nitrosative modifications, and have been shown to damage the cardiac tissue of diabetic mice. However, the relation between energy production and heart function is unclear. Materials and Methods: Streptozotocin (STZ, 150 mg/kg body weight) was injected intraperitoneally once to mice that had been fasted overnight for induction of diabetes. After diabetic induction, mice received citrate (5 μ g/kg) through intraperitoneal injection every other day for 5 weeks. The caspase-3, plasminogen activator inhibitor 1 (PAI1), protein kinase B (PKB), commonly known as AKT and phosphorylated-AKT (p-AKT) proteins were examined to elucidate inflammation and apoptosis in the heart. For histological analysis, heart samples were fixed with 10% formalin and stained with hematoxylin-eosin (HE) and Sirius red to assess pathological changes and fibrosis. The expression levels of marker proteins, tyrosine nitration, activity of ATP synthase and succinyl-CoA: 3-ketoacid coenzyme A transferase-1 (SCOT), and EC were measured. Results: Intraperitoneal injection of citrate significantly reduced caspase-3 and PAI-1 protein levels and increased p-AKT level on the 5th week; EC in the heart was found to be increased as well. Further, the expression level, activity, and tyrosine nitration of ATP synthase and SCOT were not affected after induction of diabetes. Conclusion: Results indicate that application of citrate, a tricarboxylic acid (TCA) cycle intermediate, might alleviate cardiac dysfunction by reducing cardiac inflammation, apoptosis, and increasing cardiac EC.