Background:Rheumatoid arthritis is a symmetric peripheral polyarthritis of unknown etiology that, untreated or if unresponsive the therapy, typically leads to deformity and destruction of joints due to erosion of cartilage and bone. Omega-3 fatty acids have been shown to reduce morning stiffness, the number of tender joints and swollen joints in patients with rheumatoid arthritis. This study is designed for evaluation of omega-3 effects on disease activity and remission of rheumatoid arthritis in DMARDs treated patients and on weight changes and reduction of analgesic drugs consumption versus placebo.Methods:Sixty patients with active rheumatoid arthritis (49 female and 11 male) underwent rheumatologist examination and disease activity score were calculated. Then patients were enrolled in this 12 week, double blind, randomized, placebo- controlled study. The patients in both groups continued their pre study standard treatment. The patients were visited every 4 weeks, 4 times and data were recorded.Results:Significant improvement in the patient’s global evaluation and in the physician’s assessment of disease was observed in those taking omega-3. The proportions of patients who improved and of those who were able to reduce their concomitant analgesic medication were significantly greater with omega-3 consumption. There were no weight changes.Conclusion:Daily supplementation with omega-3 results has significant clinical benefit and may reduce the need for concomitant analgesic consumption without weight changes.

Background:Despite a favorable clinical experience, little evidence exists for the efficacy of greater occipital nerve block (GONB) in migraine treatment. Considering such a premise, we wished to evaluate the therapeutic efficacy of GONB in patients affected by migraine headaches.Methods:A randomized double-blinded controlled trial was conducted on 48 patients suffering from migraine headaches. A syringe containing 1.0 mL of lidocaine 2%, 0.5 mL of either saline (control group, N = 24) or triamcinolone 0.5 mL (intervention group, N = 24) was prepared for each patient. Patients were assessed prior to the injection, and also 2 weeks, 1 month, and 2 months thereafter for severity and frequency of pain, times to use analgesics and any appeared side effects.Results:No significant differences were revealed in pain severity, pain frequency, and analgesics use between the two groups at the four study time points including at baseline, and 2, 4, and 8 weeks after the intervention. However, in both groups, the indices of pain severity, pain frequency, and analgesics use were significantly reduced at the three time points after the intervention compared with before the intervention.Conclusion:GONB with triamcinolone in combination with lidocaine or normal saline with lidocaine results in reducing pain severity and frequency as well as use of analgesics up to two months after the intervention, however any difference attributed to the drug regimens by assessing of the trend of pain characteristics changes.

, the SARS-CoV-2 virus has infected more than 27 million people and left more than 800 000 victims. According to statistics, a high percentage of patients with COVID-19 recover and only a small percentage of them succumb to death. Studies have documented the important role of the immune system in determining the fate of COVID-19 patients. Observations have so far shown that destructive and severe inflammation is the leading cause of death in patients with COVID-19. 1 Significant increases in the levels of inflammatory cytokines (TNF, IL-1β, IL-6, IL-8), colony-stimulating factors (G-CSF and GM-CSF) and inflammatory chemokines (MCP1, IP10 and MIP1α) and the destructive role of inflammatory monocytes and macrophages indicate the role of inflammation in COVID-19 pathogenesis. 2,3 Acute respiratory distress syndrome (ARDS) and cytokine storm are the two main causes of severe COVID-19. 1

Background:Reducing the wound healing time is crucial in wound as it lowers the chance of infection and decreases complications and cost. Grape seed extract has the ability to release endothelial growth factor and its topical application results in contraction and closure of the skin wound. Furthermore, it possesses antioxidant and antibacterial properties. In several studies it has been proved effective in animals. Therefore, due to low side effects and recognition of herbal medicine, we decided to evaluate the effect of grape seed extract 2% herbal cream on human skin lesions.Materials:This study is a double blind clinical trial conducted on two groups of treatment and placebo. Surgery was performed on skin lesions such as skin tags and moles which were found on the neck, trunk and limbs (except for face). After enrollment and obtaining informed consent from participants, they were randomized into two groups of treatment and placebo. Excision of the lesions was done by surgical scissors. The lesions got restored by secondary intention method. After the first day of treatment, the patients were visited on the 3rd, 7th, 10th, 14th, and 21st day. Grape seed extract cream 2% was produced and coded by the Faculty of Pharmacy, Ahvaz University of Medical Sciences. In order to compare the two groups, T-test was used. For time assessing, analysis of variance with repeated measures was employed.Results:The results showed complete repair of wounds averagely on day 8 for the treatment group and on day 14 for the placebo group, which was clearly significant in terms of statistical difference (p=0.00).Conclusion:Proanthocyanidins in grape seed extract trigger the release of vascular endothelial growth factor and its topical application causes wound contraction and closure. Curing skin lesions with grape seed extract caused proliferation areas with protected boundaries in epithelium, increased cell density and increased deposition of connective tissue at the wound site which in general improves cellular structure in wound. In addition, its anti-inflammatory and anti-microbial properties are effective in wound healing.

Background:Hemoptysis is the expectorating of blood from the tracheobronchial tree or pulmonary parenchyma. There is conflicting information about usefulness of radiography, MDCT, and bronchoscopy for investigating site and cause of the bleeding in patients with hemoptysis. The present study attempted to evaluated efficacy of these methods for identifying hemoptysis’ cause and etiology on 40 patients with the disease.Methods:A total of 40 patients with Hemoptysis who were referred to Golestan and Emam Khomeini hospitals were evaluated. Complete history of symptoms, volume and duration of Hemoptysis and demographic information were documented. Radiography, MDCT, and bronchoscopy were performed on all patients in order to investigate the site and cause of the bleeding.Results:Results showed MDCT had higher efficacy in identifying bleeding site than radiography, while efficacy of radiography and bronchoscopy or efficacy of MDCT and bronchoscopy weren’t significantly different. In addition, sensitivity of MDCT (60%) for detecting cause of the bleeding was higher than that of radiography (25%) and bronchoscopy (32.5%).Conclusion:The present study suggests MDCT as a suitable method in screening patients with hemoptysis, because it managed to detect site and causes of bleeding more efficiently than other methods. Additionally, we concluded that MDCT is an appropriate technique for diagnosing malignancies that cause hemoptysis in patients.