Background and Objectives: Botox decreases wrinkles in face and chin. This drug minimizes muscle activity with its side effects being rare. This article presents one of this rare cases.Case: A 30-year-old woman with petosis, diplopia, dysartheria, dysphagia and muscle weakness was admitted to the hospital. She had no history of disease. She had three Botox injections during the preceding month. In the examination, muscle weakness 4.5 (cervical extensor, ocular and pharynx) was detected. Her diagnosis was myasthenia gravis. With TPE, force enhancement after muscle stretch was seen and she was separated from artificial ventilation.Conclusions: Myasthenia gravis is caused by antibody-acetylcholine receptor at the neuromuscular junction or motor end plate. Therapeutic plasmapheresis decreases the level of antibody-acetylcholine receptor.

Background: Treatment of major depression is crucial to decrease the burden of disease. Hence, in this study, theefficacy of Botox was compared with placebo for treatment of patients with major depression.Methods: In this randomized clinical trial, 28 consecutive patients with major depression were enrolled. The patientswere randomly assigned to receive either Botox or placebo and the scores of Beck Depression Inventory were determinedand compared at baseline and after two and six weeks in the groups and between the groups. In addition, thedrug adverse effects were compared between groups. This study had been registered in TCTR withTCTR20170409001 code.Results: There was a statistically significant difference two group for 6th week Beck Score (P=0.004), but at baselineand after two weeks, there was no significant difference (P>0.05). None of the patients experienced side effects.Conclusion: Finally, Botox is effective for treatment of patients with major depression and it has a high safety

Based on the conducted anatomic studies at our institutions as well as clinical experience with migraine surgery, we have refined our onobotulinumtoxin A (Botoxâ) injection techniques. Pain management physicians are in unique position to be able to not only treat migraine patient, but also to be able to collaborate with neurologists and peripheral nerve surgeons in identifying the migraine trigger sites prior to surgical deactivation.The constellation of migraine symptoms that aid in identifying the migraine trigger sites, the potential pathophysiology of each trigger site, the effective methods of botulinumtoxin and nerve block injection for diagnostic and treatment purposes, as well as the pitfalls and potential complications, will be addressed and discussed in this paper.

Background: Pain is the most common postoperative complication of hemorrhoidectomy. We evaluated the effectiveness of intrasphincteric Botox injection on posthemorrhoidectomy complications including pain reduction and wound healing. Materials and Methods: In this randomized, double‑ blind clinical trial, patients with Grades 3 or 4 symptomatic hemorrhoids who underwent open (Milligan‑ Morgan) hemorrhoidectomy were enrolled. The experimental group received intrasphincteric Botox injection during hemorrhoidectomy, while the controls received normal saline injection. Hemorrhoid grades, constipation status, history of hemorrhoidectomy, duration of operation, pain at rest and after defecation in six follow‑ up periods (6, 12, 24, and 48 h and 7 and 14 days after operation), wound healing (during follow‑ up after discharge with a 2‑ week period), analgesic use, and Botox side effects were evaluated and compared in the two experimental and control groups. Results: In this trial, 34 and 33 patients were randomly allocated in the experimental and control groups, respectively. Operation time was significantly higher in Botox group (P = 0. 009). Mean dose of analgesics use in Botox was significantly lower (P < 0. 001). Rate of wound healing during follow‑ ups was significantly higher in Botox group in the fifth follow‑ up (P = 0. 009). Frequency of urinary retention (P = 0. 02) and moderate itching (P = 0. 01) was significantly higher in placebo than Botox group. Mean of postoperative pain at rest in Botox group was significantly lower at 12th, 24th, and 48th h and 7th and 14th days after operation (P < 0. 01). Mean of postoperative pain in Botox group was significantly lower at 3rd to 5th defecation (P < 0. 01). Conclusion: Our findings indicated that a single‑ dose injection of Botox during Milligan‑ Morgan hemorrhoidectomy is associated with less postsurgical pain at rest and during defecation and improved wound healing. It is suggested that it is a safe and effective procedure during hemorrhoidectomy regarding the procedure‑ related complications.

Background and purpose: The increasing growth of cosmetic surgeries, especially Botox has raised  the need for further attention to this cosmetic treatment. The current study investigated the role of body image, social support and religious beliefs in predicting Botox cosmetic surgery in Kermanshah.Materials and methods: This causal- comparative study was performed in two groups of Botox applicants (n=330) and those who were interested in having Botox cosmetic surgery (n=310) attending skin care and beauty clinics. They were selected by convenient sampling in Kermanshah, Iran, 2014. Data was collected using three questionnaires: the Santa Clara Strength of Religious Faith (1997), the Zimet's Perceived Social Support (1998) and the Appearance Schemas Inventory developed by Cash (1990). Data analysis was done in SPSS V.19 applying discriminate analysis.Results: Significant difference was found between the two groups in predictive variables (P<0.05). Among the predictive variables, the body schema of body appearance (SC 0.67), perceived support from significant others (SC 0.43), and perceived support from family (SC -0.34) were the main predicting factors for Botox cosmetic surgery.Conclusion: According to this study, the body schema of body appearance, social support by significant others, and perceived support by family play significant roles in predicting cosmetic surgeries.

Inroduction & Objective: Botox is the pure and ready form of Clostridium botulinum that now a days it is used for beautification usages and it has medical treatment for migraine headaches, seat diseases, chronic pelvic pain, urinary problems, excessively sweating. But it has been used unconsciously and in unsuitable time among majority of people specially among women, it has been decided to study teratogenic effects of Botox drug for a single dose of it on 3, 4, 5 & 6 pregnancy days and it’s results on 15th day on BALB/c mice embryos and because there isn`t any internal studies and all foreigner studies are few in number.Materials and Methods: After preparing the drug, its fatal dose with LD50 was determined in vivo conditions (12.22 mg/kg.bw) by regarding to the threshold dose, (3.55 mg/kg.bw) the experiments continued. In 3, 4, 5 & 6th gestation, injection was done as interaperitoneal on BALB/c mice. Simultaneously with experimental groups, 2 control and injected distilled water groups were regarded to compare the achievements. The experiments were repeated 3 times to get confidence about achievements and the data were studied by SPSS statistics software by ANOVA method.Results: Studying of results indicate that more embryos have abnormalities such as: hypodermic bleeding, hemorrhage in placenta, exoencephaly, exohepatic lesion, absence of limb, the limb malformation, polyps in hands, syndactyl on 3, 4, 5 & 6 pregnancy days.Conclusion: Results indicates not to use Botox in pregnancy period because of it’s indemnifiable effects such as making different abnormalities.