Introduction: Methotrexate is widely used as the most common disease-modifying anti-rheumatoid drug (DMARD) and is known as the first line treatment for rheumatoid arthritis (RA). Objectives: To assess the side effects of methotrexate in Iranian patients with RA and to compare them with the known side effects from previous studies. Patients and Methods: We conducted a cross-sectional study of 300 patients who fulfilled the EULAR 2010 criteria of RA. The following data were recruited from patients’ profiles; age, body mass index (BMI), duration of treatment with methotrexate, initiating dose, maximum dose and current dose of methotrexate, history of fatty liver disease or hepatitis B and concomitant use of sulfasalazine, leflunomide or hydroxychloroquine. Results: In 149 out of 300 patients (49.66%), Methotrexate therapy was stopped or tapered due to side effects including nausea (23%), flu-like symptoms (8%), hepatotoxicity (12%) and hair loss (6%). The patients with hepatotoxicity had a higher duration of treatment with methotrexate (10.35 compared with 5.83; P<0.001) and also the higher initiating dose of methotrexate (12.91 compared with 12.17; P=0.010). All of the RASS (rheumatoid arthritis severity scale) indexes including disease activity, functional impairment, and physical damage are related to the presence of hepatotoxicity (P<0.001). Conclusion: Methotrexate is an excellent and effective agent for the treatment of RA and its potential side effects during the treatment are dependent on the methotrexate dosage, the level of anti-citrullinated protein antibody (ACPA) and anti-MCV antibodies and concomitant use of other drugs such as leflunomide.

Objective The average age of the world population is growing increasingly. Since aging is the biggest risk factor for cardiac diseases, the incidence of these types of disease will increase significantly in the near future. However, their occurrence may be prevented by some factors, such as the practice of aerobic exercise and the use of herbal medicine. Materials and methods Thirty male Wistar rats, at 18 months old each, were divided into 5 groups (n = 6): control (NO), gavage (GO), exercised (EO), extract-fed (EXO), and exercised and extract-fed (EEO). The animals of the GO group received distilled water and were put on a silent electric running machine. The animals of the EO and EEO groups were assigned to a treadmill training protocol at low and moderate intensities for 1 hour/day, 5 days/week for 12 weeks. The animals of the EXO and EEO groups were treated with rosemary (Rosmarinus officinalis) extract for 12 weeks. At the end of the experiment, the hearts of the rats were collected and submitted to hematoxylin and eosin and Mallory trichrome staining. Images of these stained samples were captured, and a morphometric analysis of the cardiac tissue was performed. Results The rats in the EO, EXO and EEO groups showed a reduction in the intercellular space when compared with those of the NO and GO groups. The rats in the EO and EEO groups showed an increase in the clarification of the intercalated discs and in the width of the cardiomyocytes, when compared with those in the other groups. The nuclei of the heart cells of the animals in the EXO group were seen as more euchromatic than others. Conclusion Aerobic exercise causes changes in the cardiac muscles of rats and confirms the capacity of the fibers to adapt to the requirements of the proposed aerobic exercise. The antioxidants found in rosemary extract improve cell activity to achieve a better performance. However, applying these two factors simultaneously indicates the reduction of their positive influences.

Background: Aging, which has globally increased, reduces male fertility and damages the testes. The effect of aerobic exercises and the use of medicinal plants like rosemary on fertility remains controversial. Objectives: The aim of this study was to evaluate the effects of rosemary extract and exercise on testicular tissue. Methods: In this study, 30 male Wistar rats were divided into five groups: (1) Control group (without treatment); (2) Gavage group [received the solvent of rosemary extract (distilled water) and put on a turned-off treadmill for 10 minutes daily]; (3) Exercise group (put on a turned-on treadmill based on an exercise protocol for 12 weeks); (4) Extract group (received 100 mg/kg of rosemary extract for 12 weeks); (5) Exercise and extract group (received 100 mg/kg of rosemary extract and concurrently put on a turned-on treadmill for 12 weeks). After the treatment, the testis tissue of rats was collected, and the seminiferous tubular diameter, luminal diameter, and epithelial height were analyzed. Also, spermatogenic lineage was counted in different groups. Results: The tubal diameter and epithelial height significantly increased following the consumption of rosemary extract and exercise training compared with the control group (P < 0.01). Also, a significant increase was observed in the luminal diameter in the exercise group compared to the control group (P < 0.01). The rosemary extract and exercise training significantly increased the number of spermatogonia cells (P < 0.01). However, there were no significant differences in the number of primary spermatocyte and spermatozoa cells among the different groups (P > 0.05). Conclusions: Generally, low-intensity aerobic exercise improved testicular histomorphology parameters. However, rosemary extract had no positive effects as an aerobic exercise on male fertility during aging.