Clinical evaluation of liposome-based gel formulation containing glycolic acid for the treatment of photodamaged skin.

Background: Long contact of UV causes skin damage. Glycolic acid (GA) as an alpha hydroxy acid is used to treat photodamaged skin. However, GA leads to side effects including; burning, erythema and peeling.Purpose: The aim of this study was to develop a controlled delivery systems loading GA in order to increasing its efficacy and lowering its side effects.Methods: Liposomes were evaluated for encapsulation efficiency, size and morphology. Optimized formulation was dispersed in HPMC gel bases and drug release kinetics were also studied. Clinical efficacy and safety of GA-loaded liposomal gel and GA gel formulation were evaluated in patients with photodamaged skin.Results: The EE% and average particle size of liposomes were 64 ±2.1 % and 317±3.6 nm, respectively. SEM image showed that liposomes were spherical in shape. In vitro release kinetics of GA from both formulations followed Weibull model. Clinical evaluation revealed that GA-loaded liposomal gel was more effective than GA gel formulation. Treatment with GA-loaded liposomal gel resulted in a statistically significant reduction in the scores of hyperpigmentation, fine wrinkling and lentigines. Moreover, liposomal gel formulation was able to minimize side effects of GA.Conclusion: According to the obtained results, the liposome-based gel formulation can be used as potential drug delivery system to enhance permeation of GA through skin layers and also reduce its side effects.

The effect of cognitive behavioral therapy on sexual function in reproductive aged women with hypothyroidism: a randomized controlled clinical trial.

BACKGROUND: Hypothyroidism is the most common clinical disorder of the thyroid gland which is associated with an increased prevalence of sexual dysfunction even if treated with medication. OBJECTIVE: The aim of this study was to determine the effect of cognitive-behavioral therapy (CBT) on sexual function in reproductive-aged women with hypothyroidism. MATERIALS AND METHODS: This randomized clinical trial was performed on 66 reproductive-aged women with hypothyroidism referring to selected health centers in Izeh, Iran. Data collection tools included demographic information form and Female Sexual Function Index (FSFI). Eligible individuals were randomly assigned to case (n = 33) and control (n = 33) groups using block randomization with the block size of 4. In addition to standard hypothyroidism treatment, the case group received 8 sessions of cognitive-behavioral group therapy, while the control group received only standard treatment. RESULTS: Before of treatment, there was no significant difference between the mean score of sexual function and its dimensions between the case and control groups (p < 0.05). However, immediately and 4 weeks after completion of treatment, the mean total score of sexual function and its dimensions in the case group increased significantly compared to the control group (p < 0.001). CONCLUSION: According to the results of this study, CBT can be effective in improving sexual dysfunction in reproductive-aged women with hypothyroidism. However, before recommending this therapy to women suffering from hypothyroidism, more detailed studies are needed to prove the effectiveness of this intervention, as an adjuvant treatment to the standard pharmacotherapy.

The Efficacy of Phonological Processing Treatment on Stuttering Severity in Persian Pre-School Children.

OBJECTIVES: Correct phonological encoding is crucial to fluent speech production. Phonological working memory and phonological awareness are important phonological processes that affect phonological encoding. The purpose of this study was to investigate the effect of phonological processing on stuttering severity of Persian pre-school children. MATERIALS & METHODS: Six children were targeted in this study in Ahvaz City, southern Iran in 2018, with Quasi-experimental design (Before and after clinical trial). These children participated in a treatment protocol, scheduled in 13-sessions. The treatment protocol of the phonological processing included nonword repetition in the phonological working memory and phonological awareness therapy. Overall, 30 nonwords were taken to examine the phonological working memory. The Persian test of language development was taken to examine phonological awareness. Stuttering severity measurements were performed with pre- and post-treatment. The severity rating was instructed to the parents based on Guitar protocol. They were asked to keep score every day until the end of the treatment sessions, and they reported the score to the therapist. RESULTS: The stuttering severity score in pre and post-treatment was significant (P=0.027), and in the follow-up, phase was not significant (P=0.236); stuttering severity was reduced in children who stutter. Moreover, the severity rating score reported by parents during treatment was significant (P= 0.0001). This showed a reduction in stuttering severity. CONCLUSION: The poor performance of phonological awareness and phonological working memory in phonological processing affect stuttering severity. Treatment of sub-systems of phonological processing can have an important role in reducing stuttering severity and increasing speech fluency.

Effect of the 5A Model on Clinical Status Indexes of COPD Patients.

PURPOSE: This RCT study investigates the effects of a self-management program on clinical status indexes of COPD patients. DESIGN: In this study, 50 COPD patients referred to the respiratory clinic participated. METHODS: Patients were randomly assigned to control and intervention groups. The control group received standard care, and the intervention group received standard care plus the self-management program. Patients were assessed by spirometry, Modified Borg scale, and 6-minute walking test at the baseline and the end of 12-weeks. Paired t-test, independent t-test, and chi-square were used to analyze variables. FINDINGS: No significant difference was noted in the spirometry indexes mean in the two groups; however, significant differences were noted in dyspnea and exercise tolerance at the end. CONCLUSION/CLINICAL RELEVANCE: Using the 5A model can lead to increased exercise tolerance and decreased dyspnea in COPD patients. Therefore, this self-management program is recommended as an effective way to improve their functional status.

Acetazolamide and Thyroid-Associated Ophthalmopathy; a Preliminary Tested Hypothesis in a TertiaryReferral Center.

This study evaluated the effect of acetazolamide on thyroid-associated ophthalmopathy (TAO). Patients with a VISA classification index equal to or more than four were enrolled in the study and were randomly assigned into two groups. In both groups, treatment was initiated using prednisolone. Patients in the case group received acetazolamide tablets 250 mg daily in addition to prednisolone. Three months later, the VISA inflammatory score of patients in both groups were determined. Subsequent to intervention with acetazolamide, the VISA inflammatory score of patients in the case group were reduced as follows; orbital pain (57.1% versus 41.7%, P=0.736), eyelid edema (42.8% versus 27.1%, P=0.67), chemosis (53.3% versus 33%, P=0.31), injection of the eyelids (60% versus 41.6%, P=0.342), and conjunctival injection (50% versus 46.13%, P=0.73). However, these reductions were not statistically significant when compared with those observed in the control group (P=0.246). In conclusion, the effect of acetazolamide on all the parameters of the VISA inflammatory score was examined independently. All patients in the case group revealed a reduction in VISA inflammatory score following intervention. However, these reductions were not statistically significant. Further studies with large sample sizes are required.

Focal adhesion kinase (FAK) involvement in human endometrial remodeling during the menstrual cycle.

BACKGROUND: Endometrial remodeling occurs during each menstrual cycle in women. Reports have shown that, in a variety of cell types, processes such as proliferation, signaling complex formation and extra cellular matrix remodeling require a cytoplasmic tyrosine kinase, focal adhesion kinase (FAK). The present study has focused on the expression pattern of FAK in human endometrium during the menstrual cycle. The purpose of this study was to ascertain the probable function of FAK in menstrual cycle changes and the role of FAK in tissue repair and tissue remodeling in vivo. METHODS: Formalin-fixed paraffin-embedded endometrial samples were obtained from 400 pre-menopausal, non-pregnant women, who underwent hysterectomy and biopsy for benign diseases. Forty six samples with no tissue abnormalities were studied and ABC staining method of immuno-histochemistry methods was applied. Positive staining of FAK by different cell types of human endometrium was scaled and compared with each other by using histologic score method. RESULTS: All different cell types of endometrium showed various patterns of FAK expression in different stages of menstruation. FAK in glandular and luminal epithelial cells is up-regulated during the early proliferative (EP) to mid-secretory (MS) phases. FAK in stromal cells is up-regulated during the EP, early and MS phases in comparison to the late secretory (LS) phase. FAK expression in endothelial cells is up-regulated during the EP and MS phases in comparison to LS phase. This study showed that endometrial FAK expression is a phase-dependent manner during the menstrual cycle. CONCLUSION: It appears that up-regulation of FAK during the proliferative phases is responsible for endometrial regeneration and high expression of FAK in the EP and MS phases may associate with the implantation. Down-regulation of FAK during the LS phase may facilitate apoptosis in human endometrium. It seems that FAK as a key kinase plays a critical role in endometrial remodeling that it may regulate by steroid hormones.