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Introduction: Coffee is a diuretic plant, cause vascular expansion and reduce free radical oxygen. There is evidence that show its effects on kidney. Low dose of coffee reduces blood urea and cratinine but its overdose may lead to glomeruloschelrosis. In this study, the effect of high dose of coffee on rat kidney was evaluated by stereological method.
Materials and Methods: In an experimental study, 48 Sprgue-Dawley rats 230-250 gr were selected and divided randomly into 4 groups. The control group was fed with only tap water and the experimental groups were fed with different doses of aqueous extracts of coffee (0.25, 0.5, 0.125 gr/kg) twice daily. After 48 hours, the animals were deeply anesthetized and right kidneys were removed. The Sum slides were prepared and stained with Hematoxyline. Eosin. From each kidney, 15-17 glomeruli were selected and means of glumerular volume were estimated, according to Cavalieri principle and point counting methods.
Results: Our findings revealed that low dose of coffee extraction were led to increase in glomerular volume, but higher doses decreased these volumes. These results were significantly different form control group (p<0.05).
Conclusion: It seems that decrease in glomerular volume leads glomeruloschlorosis and reduction of glomerular filtration rate. However, there should be more investigation such as urea and cratinine measurement to calrify the exact mechanisms.

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Introduction: Radius end fracture is one of the most common fractures of the upper limb, the treatment of which is controversial, and improper treatment can have significant side effects. In this study, we intend to examine the results of treatment with an external fixative method.
method: It was easy to study without control and sampling. The study was performed on 30 fractures (26 patients) for one year, based on radiographs of the fracture site of type 4 universal 5. Surgery with standard techniques was performed under general or regional anesthesia, and patients were followed up for up to one year after surgery and examined for shortness of breath, joint surface angle, range of motion, and pain.
Results: Twenty-four men and two women with a mean age of 5.28 years were examined. In all patients, clinical and radiographic effusion occurred. There were two cases of mild infection at the site of the pin, which were treated with medication. In one case, there was a slight sensation in the sensory branch of the radial nerve, which disappeared after a while, and in no case was there a tendon lesion. The mean deviation to the palm was 6.6.5.5 and the ulnar deviation was 4.5 to 12.5.
There were 4 cases of pain during strenuous activity, 2 cases of mild movement restriction and one case of severe movement restriction.
Conclusion: Compared to other studies, the results of this study are much better in many cases and it is recommended to use this treatment in the treatment of unstable fractures of the lower end of the radius and especially if it develops into the radiocarpal joint.

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Introduction: Experimental  animals  like  diabetes  rats  display  an  augmented  nociceptive  response  to  chemical, mechanical  and  thermal  stimuli  in  long  term. Furthermore, hyperalgesia  is  one  of  the  major  symptoms  of  diabetic  neuropathy  in  some  patients. Considering  the antidiabetic  potential  of  chard, this  study  was  carried  out  to  evaluate  the  possible  analgesic  effect  of  chard-mixed  food  intake  in  male  streptozotocin-induced  diabetic  rats.
Materials  and Methods: In  this  study  rats  were  randomly  divided  into  control, chard-treated  control, salicylate-treated control, diabetic, and  chard-treated  diabetic  groups. At  the  end  of  experiment, nociceptive  response  was  evaluated  in  both  acute  and  chronic  phases  of  the  standard  formalin   test  based  on  a  four  level  scale.
Results: Results  showed  that  there  was  a  significant  increase  in  the  number  of  pain  scores  in  both  acute  and  chronic  phases  in  diabetic  rats, and  administration  of  chard  for  one  month  did  not  significantly  reduce  the  pain  scores  in  both  phases  of  the  test.  Meanwhile, sodium  salicylate  as  positive  control, only  reduced  this  score  in  the  second  phase.
Conclusion: It  can  be  concluded  that  oral  administration  of  chard  for  one  month  despite  of  its  antidiabetic  potential  could  not  significantly  reduce  the  nociceptive  responses  in  diabetic  rats.
 

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Introduction: Considering the increasing incidence of atherosclerosis and cardiovascular disorders in diabetes mellitus, this study was conducted to evaluate the beneficial effect of two-month administration of Plantago Psyllium (PP) seed on the contractile reactivity of isolated aorta in diabetic rats. Materials and Methods: In this experimental study, 32 male Wistar rats were randomly divided into four control, PP-treated control, diabetic and PP-treated diabetic groups. To induce diabetes, Streptozotcin (STZ) was intraperitoneally administered (60mg/Kg). PP-treated groups received PP mixed with standard pelleted food at a weight ratio of 6.25%. After 2 months, contractile reactivity of thoracic aortic rings to KCl and Noreadrenaline were determined using isolated tissue setup. Data was analyzed using ANOVA and Tukey tests. Results: Serum glucose level showed a significant increase in diabetic group after one and two months (p<0.001), but it,s decrease in PP-treated diabetic group was not significant in comparison to diabetic group. Also PP-treated diabetic group showed a lower contraction to KCl (p<0.05) and noreadrenaline (p<0.01) as compared to diabetic group. Meanwhile, there was no significant difference between control and PP-treated control groups regarding contractile reactivity. Conclusion: It can be concluded that oral administration of PP for 2 months can decrease the contractile responsiveness of vascular system and this may prevent the development of hypertension in diabetic rats.

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Introduction: Use of medicinal plants for decreasing blood glucose and lipids to normal level is clinically important. In this respect, Silybum marianum (SM) is a plant that can lower lipid peroxidation and lipids in an experimental model of hyperlipidemia. Therefore, the effect of chronic oral administration of this plant on serum glucose, triglyceride, total cholesterol, and HDL and LDL cholesterol level of diabetic rats was investigated. Materials and Methods: In this experimental study, female rats (n=36) were randomly divided into 4 groups, including control, SM-treated control, diabetic, and SM-treated diabetic groups. The treatment groups received oral administration of plant-mixed pelleted food (6.25%) for 4 weeks. Serum glucose, triglyceride, total cholesterol, LDL and HDL cholesterol levels were determined before the intervention, and at 2nd and 4th weeks after the intervention. Data was analyzed using repeated measure ANOVA, One way ANOVA, student and pairt T and Tukey tests. Results: Serum glucose level in diabetic group was increased in seond and 4th weeks after the intervention as compared to one week before that (p<0.001) and SM treated diabetic rats only had a mild non-significant effect. In addition, triglyceride level in diabetic group increased 4 weeks after the intervention in comparison to related data one week before that (p<0.05) and there was a significant lower level of triglyceride in SM-treated diabetic rats (p<0.05). Furthermore, a similar significant reduction was obtained for treated-diabetic group as compared to diabetic group regarding serum cholesterol level (p<0.05). On the other hand, HDL- and LDL- cholesterol levels were significantly higher (p<0.05) and lower (p<0.05) in SM-treated diabetic group as compared to untreated diabetic group respectively. Conclusion: Oral chronic administration of SM had no significant hypoglycemic effect and led to appropriate changes in blood lipid profile.

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Background: The face the main channel through which the individual communicates. It is the site of beauty and attractiveness. Physical attractiveness has stereotyping nature. Because the precise content of the stereotype depends on cultural values. The aim of this study was described the range of psychosocial issues burned disfigurement people that psychosocial support programmes may need to address after hospitaization. Methods and Materials: Part of data from a larger study grounded theory approach was reported by this Paper. In this qualitative study, individual in depths interview performed with 21 participants. Interviews were analyzed using a content analysis. Results: After data analyzed five axial category emerging from this qualitative study included social behaviors and beliefs (reproach, retirement, wrong thoughts and beliefs, stigmatize, pity) emotional problems (grief, shame, fear of expulsion, aversion, hopelessness) reactions assessment (positive assessment, Negative assessment) strategy (hidden, separation, self-presentation) and weariness. Conclusion: Findings indicated negative behaviors' and beliefs' of people cause emotional problems in disfigured people. Thise persons perform inappropriate strategy against behaviors' and beliefs' of people. Therefore This persons need to appropriate supportive programs for community, family and person instruction to knowledge, attitude and practice promotion.

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Background: Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Results: In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Conclusion: Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.

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Background: Researches showed that there is a relationship among alopecia areata, psychological factors and prevalence of psychological disorders. In addition alopecia areata has a great effect on the quality of life of these patients. The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management therapy on female patients`s the quality of life with alopecia areata. Methods and Materials: This is a case-control study with pre and post-test exam which is carried out in Isfahan Skin Disease and Leishmaniasis Research Centre. The participants consisted of 20 alopecia areata patients diagnosed by specialists. The questionnaire was Skindex-16 which was completed by patients before and after the intervention. Cognitive-behavioral stress management therapy was done on the case group in eight sessions over a period of two months. Data was analyzed with covariance (ANOVA). Results: The mean of quality of life scores in experimental group in v.s control group significantly decreased (P<0.05). Conclusion: It seems, cognitive-behavioral stress management therapy couses in quality of life improvement in patients with alopecia areata.

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  Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU) , this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats.

  Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated .

  Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl.

Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats. Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU), this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated. Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl. Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats.

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Background: Labor pain, which is a natural, unique and multi- factorial pain, is considereds a major part of women's anxiety at reproductive ages. There are two pharmacological and non-pharmacological approaches for reducing this pain. Since the pharmacological approach involves side effects, lots of attention has recently been given to the non-pharmacological methods. One of these methods, is use inc birth ball the, which includes sitting and rocking on the birth ball. The purpose of this study was to evaluate the effects of using birth ball on labor pain, the duration of active phase and contractions of physiologic labor. Materials and Methods: In this randomized control-clinical trial, sixty primiparous women (18-35 year old) were selected and randomly assighed into birth ball and control groups. The severity of pain was measured through Visual Analogue Scale (VAS) and the pain score, interval between contractions and duration of active phase were compared between the two groups. Results: The average pain score in the birth ball group was significantly lower than the control group (p<0.05). In terms of interval between the contractions, duration of active phase and uterine contractions, there were no significant differences between the two groups. Conclusion: Although use of birth ball did not have any effects on the duration of active phase, uterine contractions and interval between uterine contractions, this complementary therapy reduced the severity of pain during the active phase of delivery. Therefore, this safe method is suggested to be used during normal vaginal delivery and physiologic labor. Also, conducting a study, which examines the effects of using a combination of complementary methods, is recommended

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Background: Perineal pain following episiotomy affects mothers’ mental health and their quality of life. Using cooling gel pad is a new approach which is used for pain relief, but the pain related to episiotomy is still typically treated with oral analgesics. This study was conducted to investigate the effect of gel pad on post-episiotomy pain in primiparous women in Kamali Hospital of Karaj. Materials and Methods: This single-blind clinical trial was conducted on 60 primiparous women who referred for labor to Kamali Hospital of Karaj. The participants were randomly allocated to two groups: Those receiving gel pads (for 20 minutes four hours after labor and in case necessary, for up to 5 days) and the control (receiving the hospital routine). The two groups were evaluated in terms of episiotomy pain intensity through visual analogue scale (VAS) and analgesics usage. Results: The two groups did not show any significant differences in demographic features and other intervening variables. In terms of reduction in pain intensity, there were significant differences between the two groups 4 hours (p=0.002), 12 hours (p=0.009), and 5 days (p=0.000) after episiotomy. Analgesics usage, five days after delivery, in gel pad group was significantly lower than the control group (p<0.001) Conclusion: Using gel pad reduces the perineal pain intensity following episiotomy and decreases the need for using analgesics.

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Background: Familial hypercholesterolemia (FH) is a disorder with autosomal dominant pattern caused mainly by mutations in the low-density lipoprotein receptor (LDLR) and apolipoprotein B-100. The aim of this study was to investigate the frequency and type of LDLR gene mutations in an Iranian population of patients with high blood cholesterol. Materials and Methods: In this descriptive-lab based study, a total of 50 non-related possible FH subjects from Cheharmahal Bakhtiari were studied. All subjects were tested for presence of LDLR gene mutations in 9 exons of the LDLR gene including 2, 4, 6, 7, 8, 9, 10, 12, and 14. The shifted bands were detected on electrophoresis gels and confirmed by subsequent DNA sequencing method. Results: Overall, four different polymorphisms were identified in 18% of the patients. We found 1413G>A, 1725C>T and 1773C>T, 2140+5G>A in 2,23,2 and 2 subjects respectively from which 1413G >A and 1773C>T were detected in both alleles of the gene. Conclusion: The results did not indicate the involvement of LDLR gene mutations of FH in the samples studied.

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Background: Chronic diabetes mellitus is accompanied with disturbances in learning, memory, and cognitive skills. Noticing the existing evidence regarding the anti-diabetic potential of hesperetin, the effect of its chronic administration on learning and memory in diabetic rats was investigated. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, hesperetin-treated control, diabetic, and hesperetin/glibenclamide-treated diabetic groups. For evaluation of learning and memory, initial (IL) and step-through latencies (STL) were determined at the end of the study using passive avoidance test, and the alternation behavior percentage was obtained using Y maze. Results: STL significantly decreased in the diabetic (p<0.01) and hesperetin-treated diabetic (p<0.05) groups in comparison to the control group however, the difference between these two groups was not significant. Alternation percentage in the diabetic group was significantly lower in comparison to the control group (p<0.05), but the hesperetin-treated diabetic group revealed a significant difference in comparison to the diabetic group (p<0.05). Conclusion: Although long-term treatment with hesperetin does not enhance the capability of retention and recall in diabetic animals on the passive avoidance test, it can improve the short-term spatial memory in diabetic animals.

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Background: The UN report on the 41% increase of cesarean labor and its risks in Iran in recent years on the one hand and its association with cognitive and psychological factors on the other motivated us to identify the involving variables so as to control unnecessary cesarean sections. The aim of this study was to investigate the role of fear of pain and related psychological variables (pain catastrophizing, catastrophic cognition, childbirth attitude, depression-anxiety-stress, and experience of pre-menstruation (PMS) in prediction of cesarean labor. Materials and Methods: In this cross-sectional study, 300 pregnant women from Atieh private and Shahid Akbar Abadi public Hospitals (150 participants from each) were selected and matched by variables, such as age, level of education, month of pregnancy, previous experience of deliveries, tendency to cesarean, type of hospital, and having PMS. To collect data, a battery of questionnaires, including fear of pain, pain catastrophising, catastrophic cognition, childbirth attitude, and depression-anxiety-stress (DASS) were used. The results were analyzed through correlation coefficient and logistic regression. Results: Education, previous experience of deliveries, month of pregnancy were not significant but such variables as the tendency to cesarean, type of hospital, and age were significant (P<0.05). Such variables as pain catastrophizing, catastrophic cognition, and childbirth attitude were significant but other variables, including fear of pain , depression-anxiety-stress, experience of PMS were not significant (P>0.05). Conclusion: Such variables as the experience of cesarean, type of hospital, and age as well as pain catastrophizing, childbirth attitude, and catastrophic cognition are significant variable in prediction of cesarean labor in pregnant women.

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Background: Because of high mortality and morbidity of severe acute pancreatitis (AP) and its increasing incidence in recent years, early detection of severity of AP is very important. Since interleukin (IL) rapidly responds to body temperature changes, this study was done to examine the relationship between blood levels of interleukin 15 and 17 and severity of acute pancreatitis. Materials and Methods: In this cross-sectional study, 52 patients with AP were studied. For all patients, paraclinical information, Ranson criteria, and APACHE-II were completed. Serum interleukin 15 and 17 levels were measured by ELISA method. Then the relationship between them and AP severity was determined based on Ranson criteria and APACHE-II. Results: In this study, 36.5% of the patients were male and 63.5% were female and the mean age was 61.06 years. The serum level of IL-17 was negatively correlated with the severity of AP based on Ranson criteria (p=0.021, r= -0.319). ROC curve showed significant values for blood level of IL-15 and CRP in AP diagnosis. Sensitivities were 92.3% and 78.8% and specificities were 40% and 48%, respectively. Conclusion: Based on Ranson criteria, the role of serum level of IL-17 as an unknown factor was seen significant in determining the severity of AP. However, the diagnostic value of serum IL-15 should also be verified with further studies.

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Background: Insomnia has major negative effects on quality of life in postmenopausal women and can reduce their physical, psychological and social function. About 64.8 percent of women prefer to use herbal supplements for sleep problems. The present study aimed to evaluate the satisfaction of taking Valerian on the improvement of sleep quality and sleep score in postmenopausal women during six month. Materials and Methods: In this clinical trial, satisfaction of taking Valerian and sleep score of 100 postmenopausal eligible women who were referred to health care centers of Tehran University of Medical Sciences were evaluated. Research tools had three part of personal caharctristictic, Pittsburg sleep Quality Scale, and for satisfaction Visual Analogue Scale (VAS 0-10). Data gathering were in tree phase immediately after intervention, one and six month after valerian withdrawal. Results: The difference between intervention and control group in satisfaction and sleep scores was significant only immediately after taking Valerian (p=0.001) and there was no statistically significant difference within valerian or placebo group in one and six month later. Also there was statistically significant difference in three times of evaluation and satisfaction and improvement in sleep score were reduced within the time. Conclusion: Valerian can improve the sleep quality in postmenopausal women in intervention duration and after withdrawal there is no difference between placebo and valerian group so continued use of this supplement is necessary for improving of sleep quality.

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Background: Multiple sclerosis is a chronic and degenerative disease of the central nervous systemthat due to such reasons as its chronic nature, no prognosis, and absence of a definitive treatment causes stress in patients. Thus, this study was designed to examine the impact of peer educational program on stress in patients with multiple sclerosis in 2011. Materials and Methods: In this clinical trial, 110 patients with multiple sclerosis were randomly allocated to test and control groups (each group including 55 patients). After preparing 5 multiple sclerosis patients as the peer group, six training sessions forthe test group were held by the peer group over two months. Data collection tool was DASS 21 questionnaire that assessed patients’ stress before and after 4 months which was completed by both groups. In order to analyze the results, SPSS software 16 was used. Results: The results showed that before intervention, there was not astatistically significant difference between the two groups in stress score(p=0.24) while a statistically significant difference was seen between the two groups after intervention (p=0.001). Also, stress score in test group was statistically significant (p=0.001) but there was not a statistically significant difference between the stress scores of the patients in the control groups (p=0.39). Conclusion: Peer group educational program caused stress reduction in patients with multiple sclerosis. Hence, it is recommended that peer groups be used for education of multiple sclerosis.

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Background: Nowadays, international concern about the impact of antibiotic residues on the environment increased and their removal has received a lot of consideration. The aim of this study was to investigate the efficiency of Fenton’s advanced oxidation process (H2O2/Fe+2) in sulfadiazine antibiotic removal from aqueous solutions. Materials and Methods: An experimental-laboratory scale study was done on a synthetic wastewater containing sulfadiazine antibiotic with 0.079, 0.19, and 0.47 mM concentrations under Fenton’s process. Then optimal values of affecting parameters, such as initial antibiotic concentration, molar ratio of reagents, [Fe+2] and [H2O2] concentration, detention time, and pH, were determined. The discharged effluent analyzed by HPLC-UV to identify the antibiotic residues. Results: The results showed that the optimal parameters in the Fenton’s oxidation process to remove the sulfadiazine included antibiotics at pH 3.5, molar ratio of [H2O2] / [Fe +2] equal to 1.5, and contact time of 15 minutes, respectively. In these optimal conditions, the efficiency of removal of antibiotic in concentrations of 0.079, 0.19, and 0.47 mM were 99.82%, 97.97% and 78.23% and the wastewater COD removal degrees were 83.33%, 78.57%, and 78.57%, respectively. Conclusion: The experiments showed the efficient removal of sulfadiazine antibiotic in wastewater by Fenton’s oxidation process. The efficiency of this method can also be considered in eliminating other antibiotics resistant to biological treatment

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Background: Balance is one of the basic needs for daily activities. It has an important role in static and dynamic activities. The purpose of this study is to evaluate the balance of people with peripheral neuropathy after 4-weeks of functional and balance exercise program.

Materials and methods: In this quasi-experimental study, 22 diabetic patients with diabetic peripheral neuropathy (experimental group, n=11 control group, n=11) with the mean age of 53.79 years, mean height of 163.41cm, and mean weight of 71.49 kg, were randomly selected. Berg and T.G.U.G tests were used to evaluate the balance of patients. 12 sessions of combined training (balance and functional training) were used as intervention program. A paired t-test was used for the differences of pre-post test and independent t-tests were used to compare the experimental and control groups.

Results: The paired sample t-test showed that training program has significant effect on functional and dynamic balance. The comparison between the two groups showed no significant deference between pre-functional balance tests and significant post-functional balance test after training program.

Conclusion: Patients with diabetic neuropathy may have an impaired balance. The most important reason is the damage of proprioceptive receptors as combined training (balance and functional training) may improve balance and blood circulation in this organ also putting extra load on the visual system, vestibular and proprioceptive stimulation system and improves balance. Hence, it can be recommended as exercises to improve balance.

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  Background : Hand eczema (HE) is a common skin disease which often needs long term treatment.. There are several reports about the efficacy of topical doxepin in the treatment of pruritic dermal diseases. This study was undertaken to compare the efficacy and safety of 5% doxepin cream and clobetasol 0.05% versus clobetasol 0.05% alone in the treatment of hand eczema.

  Materials and Methods: a randomized double blind placebo-controlled, study was carried out during years of 2011-2012.In total 70 patients with moderate to severe hand dermatitis were selected randomly to be treated with either the doxepin 5% cream+ clobetasol or clobetasol+placebo twice daily for 8 days. Efficacy assessments were performed at baseline and 8days after termination of therapy, according to hand eczema severity index (HECSI) and visual analogue scale (VAS). Statistical analysis was done using SPSS software, version 18.0 and statistical tests including paired T-test and independent T-test.

  Results: Overall, 56 patients completed our study. Out of them 32 were male and 24 were female. The reduction of HECSI score and VAS was statistically significant in the treatment and placebo group (p&le0.05), but differences in HECSI and VAS reduction between treatment and control group were not significant.

Conclusion: Although there is some evidence that doxepin 5% cream is effective in reducing the signs and symptoms of eczematous dermatitis, few trials have been performed. We suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated.