Evaluating the efficacy of microneedling technique in treating striae alba lesions.

Striae alba, as an unsettling skin complication, has the potential to threaten the physical appearance and psychological health of individuals. So far, dermatologists' endeavors have been futile in finding an ideal treatment. This study evaluated microneedling as a novel treatment modality for striae alba scars. Microneedling was implemented in 1-3 sessions in 2-week intervals among patients with striae alba lesions. The lesions were photographed before and 3 months after the treatment, while all side effects were recorded. Two non-involved dermatologists and a patient self-report based on a visual analog score scale were utilized to evaluate the clinical improvement of striae scars. The complication rate among the 32 patients was 25%, which consisted of seven (21.9%) cases of post-inflammatory hyperpigmentation and one case (3.1%) of skin infection. The average improvement score among the patients in our study based on their self-report was 5.3 ± 1.3. (Range 4-8), while based on physician evaluation was 5.6 ± 1.2 (range 3.5-8). There was a significant association between lower age and higher self-report scores. Also, the improvement of lesions was more significant in skin type 3 compared to 2, based on physician assessment. In this study, MN was effective in ameliorating SA scars and was observed to induce better clinical satisfaction in younger patients and breast lesions. The studies concerning the use of MN in treating SA have yielded much attention lately, and they have denoted the relatively low cost of MN, its capability to be utilized over vast treatment areas, and its safety in that regard. Further research regarding the comparison of MN's efficacy in solo use versus implementing it as an adjuvant modality should be carried out.

Pharmacological treatment of tremor in multiple sclerosis; a systematic review.

BACKGROUND: Tremor is a relatively common symptom in Multiple Sclerosis (MS). It can negatively affect several aspects of the patients' life and is one of the most disabling symptoms in MS. Pharmacological treatment of MS-related tremor was studied for several years, though treatment is still challenging. This study will review all studies on the pharmacological treatment of tremor in MS and update the treatment recommendations. METHODS: Any relevant English-language clinical trial that investigated the pharmacological treatment of MS-related tremor in adults was eligible in this study. We searched Medline (PubMed), Scopus, EMBASE, and Web of Science. Bias assessment was performed by the CASP (Critical Appraisal Skills Programme) checklist. All methods followed PRISMA guidelines. RESULTS: The initial search resulted in 3024 articles; 26 articles were included as eligible studies, 13 articles had a low risk of bias, and remained for full manuscript review. The results of studies on 5-HT3 receptor antagonists as a single dose treatment were inconsistent. Botulinum toxin A had significant effects on MS-related tremor, but adverse effects and injection procedures limited its application. The application of cannabis-based medicine to treat MS-related tremor could not be recommended due to inconclusive therapeutic effects and several side effects. Levetiracetam had inconsistent results, and other anti-epileptic drugs were not studied precisely. Isoniazid has minor therapeutic effects and possible adverse effects in the treatment of MS-related tremor. CONCLUSION: Further well-designed comparative clinical trials with a large sample size can improve clinical management of tremor in patients with MS.

Physiological and antioxidative responses to GO/PANI nanocomposite in intact and demucilaged seeds and young seedlings of Salvia mirzayanii.

The current study aimed to investigate the impacts of different concentrations of GO/PANI nanocomposites (25, 50 and 100 mg L-1), in comparison with GO and PANI, on seed germination behaviors, morpho-physiological and biochemical traits in intact (mucilaginous) and demucilaged seeds, and young seedlings of the medicinal plant Salvia mirzayanii. Upon exposure to GO, seed germination was delayed and reduced, and growth attributes (root and shoot length, shoot fresh weight, and total chlorophyll content) declined, all of which could be attributed to the reductions in water uptake and oxidative stress particularly in demucilaged seeds. A hormetic dose-dependent response was observed for the growth traits in both intact and demucilaged seedlings upon exposure to GO/PANI concentrations, i.e. low-concentration stimulation and high-concentration repression. Elevated levels of H2O2 in shoot tissue of the seedlings exposed to GO and high concentration of GO/PANI, in comparison with those exposed to low levels of GO/PANI and control, were linked with the activities of the antioxidant enzymes SOD, CAT, POD, and total phenolics. Overall, the results showed high toxicity of GO on germination and early growth of S. mirzayani that was more evident in demucilaged seedlings, whereas GO/PANI stimulated germination, and the effects on seedling growth were stimulatory or inhibitory depending on the application dose and presence of mucilage. Furthermore, the capacity of GO/PANI nanocomposites to improve germination and cause a regular porosity pattern in roots accompanied by improved water uptake and early establishment of S. mirzayanii propose potential implications of GO/PANI nanocomposites for seeds/plants in drought-prone ecosystems.

Potential emerging treatment in vitiligo using Er:YAG in combination with 5FU and clobetasol.

BACKGROUND: Vitiligo is a pigmentary disorder of skin affecting at least 1% of the world population of all races in both sexes. Its importance is mainly due to subsequent social and psychological problems rather than clinical complications. Various treatment choices are available for vitiligo; however, laser-based courses have shown to give more acceptable results. OBJECTIVE: The aim of this trial was to evaluate the efficacy of Er:YAG laser as a supplementary medicine to topical 5FU and clobetasol in vitiligo patients. METHODS: Two comparable vitiligo patches from 38 eligible patients were randomized to receive topical 5FU and clobetasol in control group and additional Er:YAG laser in intervention group. Major outcomes of interest were the size of patch and pigmentation score at randomization and 2 and 4 months after therapy. RESULTS: Final sample included 18 (47%) male patients and age of 35.66±8.04. The performance Er:YAG group was superior in all sites. Reduction in the size of patches was greater in Er:YAG group (p-value=.004). Also, this group showed a higher pigmentation scores in the trial period than control group (p-value<.001). CONCLUSIONS: Greater reduction in the size and increase in pigmentation score was seen in Er:YAG group especially for short periods after therapy and repeating laser sessions may help improving final outcomes. Er:AYG could help in reducing complications of long-term topical treatments, achieving faster response, and improving patient adherence.

Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial.

OBJECTIVE: Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris. METHODS: In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2nd, and 3rd months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit. FINDINGS: The IPL group showed greater reduction in AGSS (P < 0.001) and TLC (P = 0.005) than the control group. However, the difference in ASI was not significant (P = 0.12). Patients in IPL groups were more satisfied than control group (P < 0.001). CONCLUSION: Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind.

Quantification of dry needling on myofascial trigger points using a novel ultrasound method: A study protocol.

INTRODUCTION: Myofascial pain syndrome (MPS) is a neuromuscular dysfunction consisting of both motor and sensory abnormalities. Considering the high prevalence of MPS and its related disabilities and costs, this study was designed to determine the reliability of new ultrasonographic indexes of the upper trapezius muscle as well as the sensitivity and specificity of 2D ultrasound imaging for diagnostic purposes. Furthermore, we sought to evaluate the effectiveness of dry needling (DN) on studied ultrasonographic indexes. MATERIALS AND METHODS: This study will be performed in two steps with two different designs. The first is a pilot study and was designed as a semi-experimental study to determine the sensitivity and specificity of ultrasonography for the diagnosis of MPS and the reliability of ultrasonographic measurements like muscle thickness, area of myofascial trigger points (MTrPs) in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and pennation angle of upper trapezius muscle. The second study is an interventional study which was designed to investigate the effectiveness of DN on ultrasonographic measurements, for which the reliability was determined in the first study. CONCLUSION: we will quantify the effectiveness of DN on MTrPs and muscle tissue by using novel ultrasonographic indexes. The results of the current study will provide baseline information to design more interventional studies to improve the evaluation of other treatments of MPS.