[Dexamethasone phonophoresis in burn hypertrophic scar]

Background: Hypertrophic scars are one of the complications following a burn injury. Intralesional corticosteroid injection is an invasive method for treatment of this complication. We had design a single blinded randomized control trial to deliver dexamethasone by phonophoresis and evaluate its efficacy on hypertrophic burn scars characteristics

Methods: 56 cases of hypertrophic burn scar due to burn injury allocated randomly to dexamethasone and control group. Individuals in case group received 10 sessions of dexamethasone 0.4% phonophoresis. Patients in control group had placebo phonophoresis [ultrasound with normal routine aquatic gel without any dexamethasone] with the same protocol. At the beginning of study and one week after last session, hypertrophic scar characteristics and pruritus were measured by "Vancouver Scar Scale", and "5-D Pruritus Scale" respectively in both groups

Results: Despite mild improvement in Vancouver Scar Scale score one week after intervention in dexamethasone phonophoresis group in comparison to control subjects, but this difference was not significant [p<0/08]. Pruritus score perceived subjectively were significantly lower one week after intervention in dexamethasone groups in comparison to control subjects [p<0/01]

Conclusion: Dexamethasone phonophoresis is a safe and effective treatment method for burn hypertrophic scar pruritus, but its efficacy for scar characteristics improvement needs to be evaluated by larger studies with long-term follow up period

Effect of Enhanced External Counterpulsation and Cardiac Rehabilitation on Quality of Life, Plasma Nitric Oxide, Endothelin 1 and High Sensitive CRP in Patients With Coronary Artery Disease: A Pilot Study

OBJECTIVE: To investigate the effect of enhanced external counterpulsation (EECP) on plasma nitric oxide (NO), Endothelin 1 (ET1), high sensitive C-reactive protein (HSCRP) and quality of life (QoL) in patients with coronary artery disease (CAD). METHODS: We conducted a pilot randomized clinical trial in order to evaluate plasma NO, ET1, HSCRP and QoL before and after twenty sessions of EECP (group A) and cardiac rehabilitation (CR, group B) in 42 patients with CAD (21 in each group). RESULTS: Forty-two patients (33 male and 9 female) were included in the study. The mean age was 58.2+/-10 years. The mean HSCRP was 1.52+/-0.7 in the EECP group and it was reduced to 1.27+/-0.4 after intervention. The reduction in HSCRP was not statistically significant in EECP and CR groups with p=0.33 and p=0.27, respectively. There was not significant improvement of NO, ET1, and QoL in the EECP and CR groups shortly after therapy (p>0.05). CONCLUSION: Although the short-term EECP treatment in CAD patients improved HSCRP, NO, ET1, and QoL compared with the baseline those improvements are not statistically significant. Further studies are necessary with large study groups and more sessions.

Effects of balance training using balance simulator instrument on postural stability in the patients with idiopathic parkinson's disease

Parkinson's Disease [PD] is a kind of motion disorders of central nervous system that is caused by degeneration of basal ganglia. Postural instability is one of the important clinical presentations of PD. The aim of present study was to determine the efficacy of balance trainings using balance simulator instrument on postural stability along with medications in this spectrum of patients. In this interventional study, thirty patients with PD and balance disturbances were selected and referred to rehabilitation ward during a 7-month period. Patients underwent 12 sessions of physical therapy programs for 4 weeks. Design of study was an interventional before-after trial. Evaluation was performed using Timed Up and Go [TUG], Berg Balance Scale questionnaire, falling risk and postural instability indices of Biodex instrument and obtained data were analyzed using t-test and wilcoxon statistical tests. The IRCT code for this study is 201212163217 N6. The mean TUG before trainings was 21.8 +/- 12.91 seconds and reached to 17.8 +/- 9.29 [s] afterward [P<0.001]. The fall risk and postural instability of 29 patients improved after interventions and deteriorated just in one case. The average of BBS before exercises was 42.6 +/- 11.16 and increased to 48.4 +/- 7.06 after intervention significantly [P<0.001]. Performing balance trainings lead to increase in walking speed, decrease in fall risk and improvement of postural stability and daily functional activities in patients with PD. Further studies for comparing the effectiveness of diverse rehabilitation treatments as well as long term follow up of patients will be necessary