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Introduction: Sensory stimulation of comatos patients is an important nursing intervention for increasing their LOC and tactile stimulation especially massage is one of the most important stimulations. The nurse as a person, who is responsible for this, must know the effects of this intervention on patients. But there are some conflicts about this intervention's effects especially on vital signs (pulse, blood pressure and respiration). This study was done to determine the effect of massage on comatos patient's vital signs who were hospitalized in intensive care unit. Materials and Methods: This study is a clinical trial. Samples were consisted of 100 comatos patients, divided into two equal groups randomly. The two groups were matched in age, geneder and glascow coma scale. Samples in experimental group received 20 minutes massage on their back, feet and hands in three continuous days. Vital signs in experimental group were measured before and immediately after intervention and vital signs in control group were measured at the same time with experimental group. A check list used was used for collecting data. Data was analyzed using descriptive and analytic statistics (T, paired T and Chi-square tests). Results: Findings showed that massage decreased vital signs significantly as followed: pulse rate and diastolic blood pressure in each three days (p<0.05), systolic blood pressure in first and third days (p<0.05), respiration rate in second day (p<0.05). Conclusion: This study showed that massage can decrease comatos patients' vital signs which can be the indicator of their relaxation and decreasing stress.

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Background: Radiotherapy is one of the cancer treatment methods. Prescribed dose for each fraction is considered based on radiosensitivity of tumoral and normal tissues. Viral agents are the effiectiv factors on tissue sensitivity. This research aimed to determine the effect of ionizing radiation of Cobal 60 on radiosensitivity of Hela cells infected with Measles virus. Methods and Materials: In this study, the radiosensitivity of Hela cells is investigated experimentally and qualitively. The cells have been cultivated in two groups (experimental and blank) and plating efficiency has been obtained. Then 100λ measles virus with serial dilution method was used to induce infection in different ratio for experimental group. After cell growth and passage, the two groups were irradiated with 2Gy gamma radiation of cobalt 60. Results: Results respectively indicated cell death increases up to 5-7%, 15-20% and 50-65%, after 2Gy irradiation by Co 60 for contaminating to Measles in low, moderate and high concentrations. Conclusion: Radiosensitivity of tumoral cells increases when they are infected by viral agent. The result in radiotherapy of cancers showed, in prescribing dose fraction non cancer disease should be considered.

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Background Vancomycin resistant enterococcus (VRE) is the third major cause of nosocomial infections in hospitals after staphylococcus and E. coli. The aim of this study was to evaluate resistance pattern of VRE to the antibiotics recommended by CLSI. Materials and Methods: In this clinical trial, 833 enterococci, obtained from urine, wound, blood, and stool, were selectively collected from hospitals in Tehran. After verification of the VRE isolates through the use of 30µg vancomycin disc and agar dilution, VREs were isolated, and their inhibiting concentrations were determined. The sensitivity of these enterococci to antibiotics was assessed at CLSI’s M100 standard. Results: Of the 833 isolated enterococci, 4% had a high level of resistance to vancomycin, and 38.5% had a low level of resistance to vancomycin. Of the VREs, 8.5%, 85%, 50%, 42%, 94%, 30%, 70%, 24%, 6%, and 97% were resistant to vancomycin, ampicilin, erythromycin, tetracycline, rifampin, chloramphenicol, gentamicin, synercid, linozolid and penicillin, respectively. All these VRE isolates were sensitive to nitrofurantoin. Conclusion: In this study, all VRE isolates were sensitive to nitroforantoin, and this antibiotic, as a drug of choice for urinary tract infections, can also be recommended in the treatment of resistant enterococci.

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Background: One way of embryo preservation is cryopreservation, but this process may damage and lead to the loss of the embryos, and bring about chromosomal abnormality. This has led researchers to seek techniques for short term preservation of embryos in 0-10 ºC temperatures. The aim of this study was to determine the effect of short time exposure to 4°C temperature on the expression profiles of mono-carboxylic transporter genes 1,2 ,3, and 4(MCT1-4) in 4-cell mouse embryos. Materials and Methods: In this fundamental study, forty 4-cell mouse embryos from NMRI strain were randomly divided into two groups. The first group consisted of fresh 4-cell embryos, and the second group included 4-cell mouse embryos that were exposed to 4°C temperature for 24 hours. After RT-PCR, the samples were electro-phoresised for expressing the MTC1-4 genes. Results: The expression of MCT 1-3 was observed in the first group, but the obtained results did not indicate their expression in the second group. Conclusion: Preservation of 4-cell embryos in 4°C for 24 hours inhibits the expression of MCT 1-3 genes. Keeping embryos in 4°C temperature is not a proper way for their short time preservation.

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Background: Nowadays, the use of inflammatory biomarkers in the diagnosis of appendicitis is on the rise. On the other hand, the role of oxygen free radicals in various inflammatory states has been verified. Noticing the high prevalence of negative appendectomy (9.3-22.2%), the aim of this study was to investigate the level of blood total antioxidant capacity (TAC) as a biomarker for early diagnosis of acute appendicitis. Materials and Methods: In this prospective analytical trial, over a one-year period, 407 patients, with preoperative diagnosis of acute appendicitis who had undergone operation, were studied. After measuring the TAC level, data were analyzed through the analytic ROC curve and parametric mean comparison tests. Results: Of all the patients, 298 were identified with appendicitis. TAC levels in adult female and male groups were respectively 663.9±164.75 and 752.58±167.37 µm/L which revealed a significant difference (p<0.0001). Also, in children, the mean of TAC level in perforated appendicitis sub-group was significantly greater than those in gangrenous and suppurative groups. Conclusion: TAC level can be used as a predictive factor for the diagnosis of perforated appendicitis in children however, it cannot be used as a biomarker for the diagnosis of appendicitis. Because of the significant difference existing between the level of TAC in male and female patients, further studies are suggested to investigate the level of inflammatory biomarkers with respect to menstrual cycle in women.

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In the Holy Quran, it is stated that “eating honey has healing for people” “Fihe shefaho lenas”. The word “healing” in Quran has not been used about any other food but honey and one Sura in Quran is dedicated to Nahl (bee). This study investigates the importance of honey from the perspective of Quran and medicine. This review article investigated the therapeutic properties of honey from the perspective of Quran and medicine through text analysis and manual and online search. Medicine has proven that honey due to its low moisture, high osmosis, and high acidity inhibits the growth of infectious agents and creates a sterile coat on the wound. Prophet Mohammad said, “Lam yastashfeo almariz bemasale sharbato olasal”, meaning that nothing cures the sick person the way honey does. Studies have shown that honey is effective in strengthening child development and treatment, prevention, and improvement of skin, respiratory, liver, gallbladder, eyes, ears, and nose diseases and cancer. The application of natural honey to healing diabetic and cutaneous ulcers and the topical application of honey to open wounds can accelerate the healing process. Oral administration of dates honey syrup can enhance the natural progression of delivery and womb contractions which decrease the need for cesarean. It can be concluded from the review of the literature that emphasis of Quran on the use of honey in diet and its reference to the healing property of honey for people has not been without a cause. Modern medicine also verifies the curative properties of honey for many diseases.

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Background: Diagnosis of acute appendicitis is one of the challenges that surgeons face in the emergency ward. Although Alvarado score has been recommended in the diagnosis of acute appendicitis, this criterion has some limitations in terms of age, sex, and race. The aim of this study was to evaluate the effectiveness of Alvarado score in the diagnosis of acute appendicitis based on the age and gender. Materials and Methods: In this cross-sectional study, 407 patients who underwent operation with the preoperative diagnosis of acute appendicitis from June 2008 to August 2009 were included in the study. The patients’ data were recorded by the investigators. The data were compared by parametric tests. The sensitivity and specificity were determined by the optimal cut-off point on ROC curve using MedCalc software version 10.2.0.0. Results: The optimal cut-off point for women was lower than men (6 and 7, respectively). The rate of negative appendectomy in the group with Alvarado scores 9 and 10 was 11.8%, while the negative appendectomy rate in the other two groups with Alvarado scores 7 and 8 and 5 and 6 were 29.9% and 52.8%, respectively. Conclusion: The diagnostic value of Alvarado score of 8 and less in physical examination is lower than the abdominal tenderness exam alone. Also, the cut-off point for the diagnosis of acute appendicitis in women should be considered lower than that in men. On the other hand, the cut-off point in adolescents and children is higher than adults.

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Background: Brucellosis is a zoonotic disease in humans and animals that its control is dependent on the prevalence of diseases in animal populations. The purpose of this study was to compare the sensitivity and specificity of common diagnostic tests for brucellosis. Materials and Methods: In an analytical cross-sectional study, 297 serum samples from an infected herd that had a history of abortion were prepared and evaluated through standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests. In addition, microbial culture was done for positive serum samples, lymph nodes, and infected organs. Results: Based on the total 297 serum samples tested, the sensitivities for standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests were 89, 81.5, 75.3, 89.7, and 93.2% , whereas specificities were determined to be 97.4, 94, 96, 98, and 99.3%, respectively. Conclusion: The findings of this study show that the standard tube agglutination test, complement fixation test, and ELISA are more sensitive than other tests. Moreover, ELISA test was the most sensitive and specific serological test for diagnosis of brucellosis in the present study

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Background: One of the most important complications of tonsillectomy is laryngospasm which leads to airway obstruction, arterial hypoxemia, and hypercarbia. Thus the present study was carried out to compare the effect of propofol with sodium thiopental, as an induction agent of anesthesia, on the incidence and intensity of laryngospasm after extubation in tonsillectomy. Materials and Methods: This double-blind clinical trial was done on 60 3-12-year-old patients who were chosen for elective tonsillectomy at Qods Hospital in Qazvin. The patients were randomly divided into two equal groups. Method of anesthesia was the same in these two groups except for the induction of anesthesia one group received sodium thiopental and the other group received propofol. At the end of the operation, patients were extubated after the restoration of spontaneous respiration with adequate tidal volume and respiratory rate. Then the incidence and intensity of laryngospasm was evaluated. Data were analyzed by t-test, Chi-square, and Fisher's exact test using SPSS software. Results: Overall, 83% of the patients in the sodium thiopental group and 93% of the patients in the propofol group did not develop laryngospasm and there were no statistical differences between the two groups in terms of the incidence and intensity of laryngospasm after extubation in tonsillectomy (P=0.535). Conclusion: As an induction agent in general anesthesia, propofol has the same effect as sodium thiopental on the incidence and intensity of laryngospasm after tonsillectomy.

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Background: Live attenuated Shigella vaccines have shown promise in inducing protective immune responses in human clinical trials. The aim of this study was to design and construct pDS132::∆icsA as a suicide plasmid for targeted deletion of a region of icsA gene in Shigella. Materials and Methods: In this experimental study, species and serotypes of Shigella isolated from diarrhea samples of children at Firozabadi and Milad Hospitals of Tehran were confirmed by using serological and PCR tests. Identification primers of icsA gene were designed and then cloned to the pGEM-5zf vector and sequenced. According to icsA restriction enzyme map, 1751 bp of icsA gene was deleted by HincП restriction enzyme and the ∆icsA was constructed successfully. The pGEM∆icsA vector was digested by use of SphI and SalI enzymes and was then cloned to a suicide vector (pSD132). Precision of the process was confirmed by phenotype and genotype tests. Results: The Shigella dysenteriae type 1 strain was verified by serological tests and PCR. Sequence of the icsA gene in the native strain was identical to the strains submitted in the gene-bank database. Since the pDS132::∆icsA contains 1484 bp derived from icsA gene, it can be used to disrupt icsA gene as a specific suicide vector. Conclusion: Application of suicide systems facilitated mutant construction in more specific and effective methods in comparison with the other primary techniques such as serial passage.

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Background: Leukemia is the most common type of cancer in children which its relapse decreases the patients’ survival rate. The aim of this study was to determine the risk factors involved in leukemia relapse in patients in Shahid Faghihi Hospital, Shiraz, during 2004-2009 years. Materials and Methods: In this retrospective cohort study, 280 patients with acute lymphoblastic leukemia and acute myeloid leukemia were included. Patient characteristics were analyzed with respect to their association with recurrence through Chi-square test, Fisher’s exact test, and logistic regression model using SPSS software version 16 (P-value<0.05). Results: Logistic regression model revealed a statistically significance relationship between age and recurrence of the disease (odds ratio (OR) = 0.35, 95% confidence interval (CI) = 0.15-0.82), odds ratio of relapse in the 5-10 years old age group was 0.35 times more than the 0-5 years old age group (p=0.01). Conclusion: Noticing the greater likelihood of relapse in 0-5 years old age group compared with the 5-10 years old age group, more attention and better follow-up for decreasing the side effects of the disease and enhancing the survival rate of the 0-5 y/o age group are recommended.

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Background: Numerous factors, such as Enterococcus antimicrobial resistance and expression of virulence factors, may account for the maintenance and prevalence of Enterococci infection. The aim of the present study was to assess the occurrence of esp and eep genes in the E.faecalis and E.facium strains isolated from the patients with urethral system infections. Materials and Methods: In this experimental study, 214 clinical samples, including 80 catheters and 134 urine samples, were collected from the patients. The identification of the isolated samples was based on the growth on Bilesculin agar culture media, tolerance of 6.5% Nacl, gram staining, and catalase, hydrolysis of hyporate, telorite reduction, arginine hydrolization, and fermentation of the carbohydrates tests. The assessment of genes was done by PCR method. Results: esp gene was present in 83% of the urine samples and in 97% of the catheters while eep gene was present in 100% of the urine samples and 90% of the urine catheters. The results of antibiogram indicated that the multi-antibiotic resistance was about 78.1% against vancomycin and tetracyclin, 75% against cyprofeloxin and tetracyclin, 59.3% against vancomycin and cyprofeloxin, and about 53% against vancomycin and streptomycin. Conclusion: The findings of this study indicate that esp gene plays an important role in formation of biofilm in patients. Due to the presence of eep gene in almost all of the samples, it can used as a rapid identical agent for the assessment of pheromone production and provision of suitable conditions for plasmid transformation between clinical strains and the prevalence of antibiotic resistance.

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Background: Doxorubicin (DOX) is a widely used anticancer drug, but its use in clinical chemotherapy is limited due to its side effects, including testicular toxicity. The aim of this study was to investigate the protective effect of nano-zinc oxide (nZnO) on DOX-induced reproductive toxicity in male rats.

Materials and Methods: In this experimental study, adult male Wistar rats were randomly divided into four groups, including one control and three experimental groups. They received saline, DOX (6 mg/kg), nZnO (5 mg/kg), and nZnO followed by DOX (i.p), respectively. Treatment was performed for 3 days. After 28 days, post-administration histological changes and reproductive indices were studied.

Results: Administration of DOX induced a significant reduction in seminiferous tubules diameter and thickness of germinal epithelium. Also, fertility and fecundity indices, number of litters and epididymal sperm concentration, decreased, whereas degenerated Leydig cells and deformed Sertoli cells increased.

Conclusion: Coadministration of nZnO significantly improved DOX-induced changes. These findings show the protective role of nZnO in DOX-induced reproductive toxicity.

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Background: Considering the fact that more than one third of the world’s population is infected with Mycobacterium tuberculosis bacteria, identifying individuals with latent tuberculosis infection (LTBI) is vital for controlling TB. Tuberculin skin test (TST) and IFN-gamma release assays are practical methods used for screening people with LTBI. Due to the insufficiency of data on endemic tuberculosis region and the need for evaluation of these methods in a high-risk population, this study was performed in Zahedan.

Materials and Methods: This descriptive study was carried out on 75 individuals, including 21 health care workers (HCWs) as well as 54 family members of patients with active TB. IFN-&gamma release assay and TST were also carried out on the participants.

Results: Of the 75 participants, 26 had positive IFN-&gamma release assay results and 49 persons showed negative results. TST was also performed and 12 participants did not show up for taking the results. Among the remaining 63 participants, 60.31% had more than 10 mm indurations. The results in 32.25% of the participants were positive for both IFN-gamma release assay and skin test, whereas 34.92% of the participants presented negative tests results for both IFN-gamma release assay and skin test. The agreement between these two tests was 66.67 % (P=0.001, K=0.36, 95% Confidence Interval).

Conclusion: The results showed a weak agreement between the two tests.

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Background: Brucellosis is a debilitative disease that imposes heavy costs on the economy and society. Therefore, using the most accurate and efficient method to diagnose this disease is essential. In Iran, Brucella melitensis is the common causative agent for brucellosis and BP26 protein of this bacterium has a good level of antigenicity. Thus, the aim of this study is to produce Brucella melitensis recombinant BP26 protein with a PET28a expression vector.

Materials and Methods: In this applied-fundamental study, genomic DNA was isolated from bacterial culture through proteinase K (pK) and phenol/chlorophorm protocol. Then, two pairs of primers were designed based on the known sequence in the gene bank for amplification of Brucella melitensis bp26 gene and PCR reaction was set up and optimized. The PCR product was cloned first into PTZ57R/T vector and accessed on the PET28a vector and sequenced. The recombinant vector was transformed and expressed into E. coli BL21 (DE3). Then, the recombinant protein was purified with Ni-NTA column of chromatography against His tag.

Results: The size of PCR product was in accordance with the part of bp26 gene size in the gene bank. The bp26 gene without adding IPTG had little expression and 3 hours after adding IPTG with a 1 Mm concentration to culture media, extreme expression was observed.

Conclusion: The production of recombinant BP26 protein from isolated Brucella melitensis native to Markazi province was done. Noticing the importance of BP26 protein and its significance for future studies on providing brucellosis diagnosis kits, its production was made possible.

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Background: Familiarity with different methods and medications in anesthesia and producing sufficient depth of anesthesia are very important in anesthesia practice. Due to the central analgesic and sedative effect of lidocaine in the presence of the sufficient blood level, it can be used for general anesthesia. This study was carried out to compare the effect of halothane with lidocaine infusion on BIS during maintenance of anesthesia.

Materials and Methods: In this randomized double-blind controlled clinical trial, 66 patients scheduled for elective inguinal herniorrahaphy were randomized into two equal groups. For maintenance, one group received halothane (1%) with O2-N2O and another group received lidocaine infusion (100 &mug/kg/min). BIS was checked every 5 minutes for half an hour. Statistical analysis of data was done by Chi-square and T-test through SPSS software. P-values less than 0.05 were considered meaningful.

Results: Mean of BIS was 65.72 in the lidocaine group and 56.7 in the halothane group during the first 30 minutes. There was a significant statistical difference between the two groups (p<0.05).

Conclusion: Mean of BIS in lidocaine group was higher than that in the halothane group. If this indicates the presence of a light level of anesthesia, increasing the dose of hypnotics and opioids leads to an increase in the depth of anesthesia. However, since there is not any device for monitoring the effect of opioids on the central nervous system and the level of anesthesia, simultaneous monitoring of BIS and hemodynamic parameters seems to be a more reasonable idea.

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Background: Funnel plot is a graphical tool for investigating publication bias in meta-analysis studies. The aim of this study is to introduce another application of funnel plot that is monitoring one of the Iranian family performance indices and determining the position of each health center of Markazi province in terms of patient referral rates by general practitioners to specialists and to compare it with bar and caterpillar plots.

Materials and Methods: In order to draw the funnel plot, the average monthly percent of referrals for each district of Markazi province in 2011 was computed. In this study, Iranian Ministry of Health and Medical Education standard figure of 10% was considered as the limit of referral to the second level of Iranian health services. The 99% confidence interval of the control limit for each district was computed according to 3 standard deviations of the percent of referrals relative to the total patient visits.

Results: Based on funnel plot results, five out of ten districts were in the expected range of referral (Ashtian, Saveh, Tafresh, Khomein, and Komijan). However, in other five districts, the referral rate was greater than the expected rate (Arak, Shazand, Zarandiyeh, Delijan, and Mahallat). Mahallat district had the highest rate of referral.

Conclusion: The funnel plot was more informative than the other two plots Thus, it can be viewed as a useful tool in monitoring health programs throughout the country.

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Background: Monitoring of facial nerve function during surgery help surgeons to preserve the nerve during parotid gland surgery. EMG is currently the standard method for monitoring, however, the rates of facial nerve paresis and paralyses are 68-18% and 3%, respectively. The disadvantages of this method are its cost and lack of access to it everywhere. Unipolar alternating electric current stimulation of the facial nerve causes contraction of the muscles and the nerves, and the damage can be avoided.

Materials and Methods: In this study, patients in the years 1388 to 1390 using monopolar electrocautery was undergoing parotidectomy and one month after surgery, the facial nerve injury were examined. During the study period, twenty patients had undergone total or superficial parotid gland resection and one excluded due to facial nerve involvement before surgery.

Results: In this study, 19 patients were studied. The mean age of patients participating in this study, 43.1 ± 13.9 years and 63.2% of them (12 cases) were female. A temporary palsy (5.4%) was observed and there was no paralysis.

Conclusion: Due to its availability and low cost, using electrocautery devices compared with standard facial nerve monitoring, EMG, is beneficial and the treatment results are also satisfactory.

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Background: Cancer stem cells are subpopulation of cancer cells that show self-renewal potential and the capacity to differentiate into diverse populations comprising a tumor. One of the characteristics of CSCs is their ability to form floating spheroids under anchorage-independent conditions in a serum-free media. The aim of this study was isolation of colon cancer stem cells by sphere formation assay and characterization of them in human colonic adenocarcinoma HT-29.

Materials and Methods: In this experimental study, colon CSCs markers including CD44 and EPCAM in spheroid and HT-29 cells were analyzed by flow cytometry. The expression levels of stemness genes in both spheroid and HT-29 cells were investigated using real-time PCR. Tumorigenic potential of spheroid cells was evaluated using in vivo xenografts assay.

Results: Our data showed over 92% of spheroids were CD44+/EpCAM+, while HT-29 cells only have expressed 37% of CD44/EpCAM markers. In compared with the HT-29 cells, expression levels of ‘‘stemness’’ genes, like Sox2, Oct4, Nanog, C-myc, and Klf4 were significantly increased in spheroid cells (p< 0.05). Further, As little as 2500 spheroid cells were sufficient to obtain tumor growth in nude mice, while 1x106 of HT-29 cells was needed to form tumor.

Conclusion: Our data suggest that spheroid formed by colon cancer cell lines highly enriched in CSCs and showed increasing expression of stemness genes and tumorigenic in nude mice.

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Background: Diabetes mellitus is a common metabolic disorder that is associated with many complications such as peripheral neuropathies. This study was designed to investigate the effect of Brassica juncea on peripheral neuropathic pain in diabetic rat.

Materials and Methods: In this experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic (control, B. juncea extract at doses 150 and 300 mg/kg) groups. Experimental diabetes was induced by the intraperitoneal injection of streptozotocin (60 mg/kg). After four weeks treatment, animals were subjected to Tail-flick test to evaluate pain threshold and data were analyzed using SPSS software. Statistical significance was considered at p<0.05.

Results: The results of this study showed that diabetes significantly decreased pain threshold in the rats. Also diabetes-induced hyperalgesia was significantly decreased by treatment with extracts of B. juncea at doses 150 and 300 mg/kg (p<0.05 and p<0.01, respectively).

Conclusion: Our observation indicates that B. juncea could be a therapeutic option for control and treatment of hyperalgesia associated with diabetic neuropathy in diabetic patients. However, further studies are required to elucidate the antinociceptive effects of B. juncea.