Background: Rheumatoid arthritis (RA) is a rheumatic disease that could be disabling if not treated. The aim of RA therapy is to resolve tenderness and swelling in the joints. The present study was conducted to compare two methods of RA treatment with disease-modifying anti-rheumatic drugs (DMARDs) and DMARDs with biologic drugs in two groups of patients. Materials and Methods: The present study was a nonrandomized clinical trial which was conducted from July to September 2017 on 110 patients who were selected based on the American College of Rheumatology (2010) criteria for RA. Patients were divided into two groups of 55: Groups A and B. For the treatment of Group A, prednisolone along with one or two drugs from the DMARDs combinations was used. Group B received one biologic drug besides with the drugs of the group A. T-test and covariance analysis was used to compare the outcomes of both groups. Results: Disease activity score (DAS-28) at the beginning of the study was 4.23 (0.81) in Group A and 4.51 (0.7) in Group B (P = 0.05). At the end of the study, DAS-28 was 3.52 (0.79) in Group A and 3.75 (0.85) in Group B (P = 0.1). DAS-28 activity index had a significant difference between both two groups at the beginning of the study (P = 0.05), but at the end of the study, the difference was not statistically significant (P = 0.1). Conclusions: Simultaneous use of DMARDs and biologic drugs in RA patients could lead to improvement the disease symptoms and decrease the severity and activity of the disease.

Background: The aim of this study was to evaluate the effect of extracorporeal shockwave therapy (ESWT) on pillar pain after carpal tunnel release. Materials and Methods: In this prospective randomized controlled trial, forty patients with pillar pain for at least 1 month after carpal tunnel release surgery were randomly assigned in two groups. ESWT group received four sessions of ESWT at weekly intervals, and patients in the control group received sham ESWT treatment at the same intervals, involved sound but no energy. At baseline, 1^st month, and 3^rd month, hand function (using Brief-Michigan Hand Outcome Questionnaire) and pain score were assessed and compared between groups. Results: At baseline, pain score and hand function score were similar in both groups. After 1^st month, pain score in ESWT and control groups was 3.7 versus 4.7, respectively (P = 0.066), and hand function score was 60.7 versus 52.2, respectively (P = 0.032). After 3 months, pain score in ESWT group was significantly lower than the control group (1.6 versus 3.6, respectively, P < 0.0001), hand function score in ESWT group was significantly better than the control group (75.4 vs. 63.7, respectively, P < 0.0001). Trend of decrease in pain score between groups was significantly different, but trend of increase in hand function score was not significantly different. Conclusion: After ESWT, hand function and pain score in patients with pillar pain improved faster compared to control patients. Hence, ESWT can be used as a safe and effective noninvasive technique in patients with pillar pain after carpal tunnel release.

Background: Malignancy in thyroid nodules is a common clinical problem, and epidemiological studies have shown that it is increasing. Since malignancy is a very important problem in treating patients and misdiagnosis leads to many physical and financial damages, the importance of diagnostic methods becomes more important. Hence, the aim of this study was to investigate the sensitivity and specificity of the two dimensional-shear wave elastography (2D-SWE) diagnostic method in comparison with fine-needle aspiration (FNA) in determining the malignant thyroid nodules. Materials and Methods: This study is cross-sectional which was performed on 57 thyroid nodules are proven by conventional ultrasound. Afterward, 2D-SWE images were taken with the help of a superSonic ultrasound machine. Then, FNA was performed from the thyroid nodules and the specimens were evaluated in a single specialized thyroid pathology center. The results of conventional sonography and 2D-SWE were compared with histopathologic results as a gold standard method. The elasticity quantity was recorded by measuring the amount of the appropriate quantities by a recording machine and analyzed using the SPSS and MedCalc software. Results: From 57 nodules studied, 50 nodules were evaluated with benign diagnosis and 7 nodules with the malignant diagnosis. Among all the parameters recorded by the machine, SWE. ratio provided the highest surface area under the curve and the highest sensitivity and specificity with 0.94, 100% and 84%, respectively, and a cut-off point of 1.7. Conclusion: The 2D-SWE method and the conventional ultrasound can be good references for decision making about with the thyroid nodules.

Background: Febrile seizure is the most common type of seizures among children, which is a terrible and frightening experience for parents who are concerned about its recurrence. The aim of this study was to evaluate the effect of diazepam on preventing the recurrence of febrile seizure following acellular pertussis vaccination. Materials and Methods: In this clinical trial, 121 children with a history of febrile seizure that required the pertussis vaccination were enrolled and divided into two groups; the first group was treated with oral diazepam for 48 h after vaccine injection and the control group received antipyretics only if fever occurred after the vaccination and used rectal diazepam for controlling seizure if a seizure occurred. The incidence of fever and seizure after the injection of the vaccine and incidence of febrile seizure were compared. Results: Nearly, 85.7% in the oral diazepam group and 87.9% in the rectal diazepam group had fever after receiving the pertussis vaccine, but the incidence of fever was not significantly different between the groups. Seven children (12.06%) in the rectal diazepam group had a seizure after pertussis vaccination, and none of the children in the oral diazepam group had a seizure after receiving the vaccine at 18 months of age. This difference was significant. Conclusion: Prophylaxis with diazepam administration in children with a history of febrile seizure can prevent recurrence of febrile seizure after pertussis vaccination.

Background: Hydatid cyst is a zoonotic and parasitic disease with worldwide distribution. Anticancer effects of hydatid cyst have been shown in cell culture experiments and animal model investigations. The mechanism of anti-cancer effects of hydatid cyst fluid has not been clearly elucidated, and the induction of apoptosis may have a role in this regard. Hence, in this study, the effect of hydatid cyst fluid (HCF) on the induction of apoptosis on mouse breast cancer (4T1) cell line in cell culture medium has been investigated. Materials and Methods: Echinococcus granulosus HCF antigens including Antigen B (AgB), glycolipid, glycoprotein, and 78 KDa fractions were prepared. Breast cancer cell line (4T1) was cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum and appropriate antibiotics. Apoptosis was determined by flow cytometry using the annexin V-fluorescein isothiocyanate apoptosis kit. Results: The 78 KDa and glycoprotein fractions induced more than 40% apoptosis. HCF and glycolipid antigens induced 39% and 34% apoptosis, respectively. However, less apoptosis observed after treatment with AgB fraction. Conclusion: Hydatid cyst antigens especially the 78 KDa and glycoprotein fractions induced apoptosis on mouse breast cancer cells.

Background: Achieving a rapid onset and durable methods of treatment for major depressive disorders is an issue pursuing in psychiatry. This study was designed to assess the therapeutic efficacy of intravenous (IV) ketamine injection in controlling depressive symptoms in comparison with electroconvulsive therapy (ECT) in major depressed disordered patients. Materials and Methods: Thirty-two patients over 18 years of age who were candidates for ECT were enrolled in the study. They were allocated into two groups using block design randomization. Sixteen patients received IV infusion of 0.5-mg/kg ketamine and 16 patients underwent a bitemporal ECT. To evaluate the changes in depression severity, researchers administered Hamilton Depression Rating Scale (HDRS) at baseline, before each treatment session, and four time points posttreatment (week 1 and months 1, 2, and 3). The Wechsler Memory Scale was used to evaluate the cognitive state of patients in week 1, month 1, and month 3 of the treatment. Results: The HDRS showed improvement in depressive symptoms in both the groups with no statistically significant difference. Cognitive state was more favorable (but not significant) in the ketamine group (P > 0.5). Conclusion: Treatment with IV ketamine in depressed people has the same antidepressant effects as ECT treatment without any memory deficiency.