[Treatment of knee osteoarthritis with te comell undulate extract: a prospective controlled, double-blind randomized trial]

Lapacho is a herb that use for the treatment in herbal medicine of brezil, America and Europe. The FDA gave Lapacho a clean bill of health in 1981. The medicinal part of the tree is the bark. The active ingredient of lapacho is called lapachol. [3-7%] Te comella undulate is a species of bignoriaceae distributed in south of Iran that contains of 2-7% lapachol. This study compares topical extract of tecomella undulata bark with topical diclofenac in the knee asteorthritis. The clinical trial study was double blind patients with primary knee osteoarthritis were recruited using strict inclusion and exclusion criteria from Shiraz medical school clinics. All patients received topical agent. In group A received alcholic extract of tecomella undulota bark [20%] and in group B received topical diclofenac. [4 times a day for 4 weeks]. Subjects under went 2 office visitis 4 weeks after start of treatment and 2 weeks after finish of treatment. Evaluations measure tools were NRS and WOMAC. We have shown that 4 weeks of treatment with this extract of tecomella undulata bark relieved the symptoms of primary knee osteoarthritis significantly better than the topical diclofenac solution. The percentage improvement in NRS and WOMAC subscale score that we observed with topical extract of tecomella undulata brak therapy [41-48%] were similar to those reported for oral NSAID treatment. te comell undulate extract is a safe and effective approach for knee osteoarthritis with high success rate

[Skin manifestations of Iranian diabetic patients]

Background: diabetes mellitus is a common condition and a broad spectrum of cutaneous disorders may be encountered in patients with type 1 and type 2 diabetes mellitus.To obtain the prevalence and the main clinical characteristics of skin disorders in the Iranian diabetic patients

Materials and Methods: for a period of 6 months, all of the diabetic patients attending the outpatient diabetes and dermatology clinics of the University of Hamedan in the city of Hamedan in western Iran underwent a complete dermatologic examination. Only patients with type 1 insulin dependent [IDDM] and type 2 non-insulin-dependent [NIDDM] were included the study. We also studied the relation of the cutaneous manifestations with glycemic control, Body Mass Index [BMI] and diabetic complications

Results: diabetic skin manifestations were detected in 110 of 155 [71%] diabetic patients. The most frequent skin lesions in both type 1 and type 2 diabetic patients was cutaneous infections [71.8%]. No significant differences were observed between two types of diabetes regarding age, duration of disease and diabetic complications [retinopathy, nephropathy, neuropathy and large vessel diseases] [p-value>0.05]

Conclusion: in the outpatient diabetic population in the city of Hamedan in western Iran there is a high prevalence of skin lesions mainly represented by cutaneous infections

[Comparison of helicobacter pylori Seroprevalence between acne rosacea and healthy group]

Background and Objective: acne rosacea is a chronic skin disease with unknown etiology. Some reports have suggested an increased prevalence of helicobacter [H] pylori infection in patients with acne rosacea but it is controversial. This study was designed to compare the prevalence of H pylori between the acne rosacea patients and the healthy control group

Materials and Methods: this case-control study was performed on 30 patients with acne rosacea and 60 healthy individuals as a control group. 5 mL blood was taken from each person and anti-H pylori IgG was measured by enzyme-linked immunosorbent assay

Results: mean age was 45.8+/-14.05 years in acne rosacea patients and 41.4+/-12.3 years in control group. Seventeen [56.7%] of patients and fifty two [86.2%] of controls were infected by H pylori [P=0.002], but mean serum anti-H pylori IgG level was significantly higher in acne rosacea patients comparing to healthy control group [139.49+/-174.15 g/mL vs 38.87+/-23.50, P=0.005]

Conclusion: despite increased mean serum anti-H pylori IgG levels in acne rosacea patients, H pylori was more prevalent in healthy control group, in this study

olmsted syndrome: a case report

Olmsted syndrome is a rare congenital palmoplantar keratoderma distinguished by presence of massive palmoplantar hyperkeratosis and periorificial hyperkeratotic lesions. To date, 16 cases have been described in literature. Our case is a thirteen years old boy with massive palmoplantar hyperkeratosis and deep fissuring and horn-like lesions together with hyperkeratotic plaques on extensor surface of elbows and knees and periorificial hyperkeratotic plaques. Physical and mental development was normal and his family history was unremarkable. Routine laboratory tests were also normal. Radiological findings included osteoporosis of the bones of extremities and acro-osteolysis in the distal phalanx of fingers. Pathological samples showed massive hyperkeratosis, considerable acanthosis, focal parakeratosis, hypervascularity and mild lymphocytic infiltration in the upper dermis. Palmoplantar keratoderma is seen in different congenital palmoplantar keratodermas but the presence of other signs helps to differentiate these syndromes