Background: Vitiligo is an acquired multifactorial disorder. Different treatments are used for it and all of them have adverse side-effects. Vitiligo is an autoimmune disease associated with other autoimmune diseases such as hypothyroidism, hyperthyroidism, rheumatoid arthritis, diabetes mellitus, and so on. In these diseases, deficiency of vitamin D and B12 are proposed. So in this study, treatment response and remission in patients taking oral vitamin D and B12 was administered.Methods: 60 patients with active vitiligo were randomly divided into three groups. Group I received topical PUVA for 6 months; group II received topical PUVA and 1 cc oral drops of vitamin D3 daily for 2 months, and then topical PUVA alone for following 4 months; and group III received topical PUVA and 1 cc oral drops of vitamin D3 daily and sublingual tablets of vitamin B12 daily for 2 months, and then treated with topical PUVA for following 4months. Cure rate and side effects were evaluated using Vitiligo Area Scoring Index (VASI) at the third and sixth months. Findings: In each of the three treated groups at different times, the average changes in the area and extent of the lesion were not significantly different. Pruritus and erythema occurred in some patients.Conclusion: In this study, the reduction in the extent and area of lesions in the group receiving vitamin D compared to the control group were higher that indicated the role of vitamin D in preventing progression of active vitiligo.

Background: Chronic diabetes is substantially associated with circulatory disorders in lower limbs. Vacuum-Compression therapy (VCT) has been commonly used in treatment of peripheral circulatory disorders. VCT is based on intermittent alteration of Positive- Negative pressure phases. The purpose of this study was to determine effects of VCT on diabetic subjects' peripheral blood flow.Methods: In this Before-After and case-series study, 18 type 2 diabetic subjects with diabetic neuropathy and/or peripheral vascular disease (PVD) completed the study. Subjects received 45 min of VCT for 10 sessions three times weekly. Blood flow (calf+foot) was measured via venous occlusion plethysmography.Results: Among Variables of "Arterial Inflow", "Venous Outflow", "Venous Capacity", "Postischemic Reactive Hyperemia" and "Peak Flow of Reactive Hyperemia", only "Venous Outflow" significantly improved after 10 sessions treatment via VCT (P<0.05).Conclusions: Arterial blood inflow, which was the most important determinant evaluated in this study, was not increased via VCT. Additional studies are required to investigate the effective VCT parameters and duration of each session and number of sessions, considering progressive and deteriorative natural history of diabetes.

BACKGROUND AND OBJECTIVE: Thiopental sodium is not an ideal intravenous drug for inducing general anesthesia and compared to intravenous anesthetic drugs like propofol has a long standing recovery time. The aim of this study was to compare the recovery duration of propofol and thiopental sodium in ECT (Electroconvulsive therapy).METHODS: In a clinical trial, 70 patients aged between 15-40 years old in A.S.A class I & II were selected for ECT.They were randomly divided into two groups of 35 patients. After patient monitoring, 2-3 mg/kg thiopental sodium or 1-1.5 mg/kg propofol (randomly in each patient) and then 0.5 mg/kg succinylcholine were administered. Patients were ventilated with mask and oxygen (%100). After ECT, seizure and recovery durations were recorded. During these procedures, blood pressure and heart rate were recorded before and after anesthetic induction and 1 and 5 min after ECT.FINDINGS: Mean recovery duration of propofol and thiopental sodium were 5.49±2.57 min and 6.4±3.69 min, respectively (p=0.233). Also, seizure duration of propofol and thiopental sodium were 32.06±13.78 sec and 35.06±10.08 sec (P=0.302). Hemodynamic changes (systolic blood pressure) in two groups were not significant except at 1 minute after seizure (p<0.05).CONCLUSION: According to the results, there was not a significant difference between two groups in seizure and recovery duration. But propofol can prevent increasing hemodynamic response to ECT better than thiopental sodium. In patients with hypertension or restriction of thiopental sodium, propofol can be a suitable replacement.

Background and Aims: Velopharyngeal dysfunctions are frequently reported in patients with repaired cleft palate. For patients with small gap in velopharygeal sphincter, behavior therapy has been suggested to treat their velopharyngeal dysfunction. CPAP therapy, as a behavior therapy, can be used to increase palate muscles strength and to make VP closure complete using a continuous positive airway pressure during speech tasks. The aim of the present study was to determine the effect of CPAP therapy on hypernasality and nasal turbulence in repaired cleft palate patient with small velopharyngeal gap. Materials and Method: A single-subject study was conducted with multiple baselines to study the effect of CPAP therapy on the speech of an eight-year-old boy with repaired cleft palate, small gap in velopharyngeal valve, hypernasality, and nasal turbulence. The participant received CPAP therapy for 48 sessions during two months. Perceptual assessment was done at baseline, during intervention, and in follow-up phases. Visual analysis and Improvement Rate Difference (IRD) were used to analyze data. Result: The patient showed one-point decrease in the severity of hypernasality on intervention phase and another point decrease occurred on the follow-up phase. This reduction maintained by the end of the study. Also, nasal turbulence was shown to decrease by two points during the intervention phase and therefore normal level was achieved. The achievements were remained unchanged on follow-up phase. The IRD for both parameters were found to be 0/75. Conclusion: The present study showed that CPAP therapy seems to reduce the severity of hypernasality and nasal turbulence due to strengthen palatal muscles in patients with small velopharyngeal gap.

Introduction: Musculoskeletal problems are the common complaints of patients refer to internal medicine clinics and the pain is the most important of them. There are different physiotherapy methods for reduction of pain and action potential simulation therapy (APS therapy) is one of newest methods. The aim of this study was to determine reduction of pain with APS therapy. Materials & Methods: In 47 patients with different musculoskeletal pain APS therapy performed in 6 days each for 16 minutes and with current of 0.7-1.2 mA. Pain (VAS), Global functional status (ACR) and relief of pain (VAS) before and after study compared.Results: APS therapy reduced pain (p<0.001) and increased Global functional status (p<0.001) and increased relief of pain (p<0.005) but there was not any correlation between this reduction of pain with APS therapy and educational status and past history of physiotherapy and duration of illness in these patients.Conclusion: APS therapy is a useful physiotherapy modality for reduction of pain in musculoskeletal problems.

Purpose: Animal and limited human studies have shown high dose P-UVA therapy to cause cataract and rarely retinal damage. This study was designed to evaluate the ocular complications of oral administration of psoralen cambined with long wave ultraviolet irradiation (P-UVA).Patients and Methods: This is a cross-sectional study on 50 patients who had received at least 50 sessions of P-UVA therapy. All patients underwent visual acuity testing, slit lamp biomicroscopy and indirect ophthalmoscopy before and after treatment.Results: There were two instances of cortical cataract formation, the first a 37 year-old female treated for 107 sessions because of vitiligo who had not used blockling sunglasses and the second a 57 year-old female affected by vitiligo and treated for 100 sessions. This patient had been compliant in wearing absorptive lenses. Total irradiation dose was 847 j/cm2 in the first and 608 j/cm2 in the second case. In addition to these two cases, in 13 patients punctate and linear lens opacities of no clinical significance were noted. None of the patients experienced decreased visual acuity or changes in the conjunctiva or retina (Including a 65 year-old patients with MF treated for 197 sessions to a total dose of 2004 j/cm2; this patients was aphakic in one eye and pseudophakic in the other).Conclusion: It seems prudent to examine the lens and the fundus with a widely dilated pupil during follow-up of patients on long term P-UVA therapy.