---

Introduction: Sneddon syndrome is a combinaison of skin lesions (Livedo Reticularis) and acute cerebrovascular accident. The syndrome involves many organs such as kidney, heart, skin and brain. Some patients have a good prognosis when taking Aspirin and Diprydamol. In this article a case of this syndrome is reported. Case: The patient is a 40 years old woman with a history of 8 times intrauterine fetal deaths. She was admitted to the neurology ward with signs of weakness in left side of the body (hemiparesis), dysarthria, 7th central nerve paralysis, and skin lesions (Livedo Reticularis). All laboratory data such as serology and microbiology were normal. After skin biopsy from the lower limbs and rule out possible secondary etiologies, this patient was recognized with Sneddon syndrome and recieved antiplatelet treatment. Conclusion: Despite the fact that this syndrome is rare, it seems considering the probability of appearing this syndrome, especially in young patients who are suffering from acute cerebrovascular signs and skin lesions in the same time, early treatment can prevent the desease from developing to other organs.

---

Background: Immune thrombocytopenic purpurais an acquired disorder. Conventional treatment of immune thrombocytopenic purpuraincludes prednisolone (1mg/kg/day). Customarily, steroidsareadministered for about 3-6 weeks however,steroids have several side effects. The aim of this study was to compare theefficacy of two and three-week prednisolone therapy in patients with immune thrombocytopenic purpura Materials and Methods: In this randomized clinical trial, 66 patients with confirmed immune thrombocytopenic purpurawho had referred to KhansariHospital, Arak, were randomly selected and administered prednisolone (1mg/kg/day) for two and three weeks alternatively. Patients’ platelet count and complications associated with the treatment (diabetes and hypertension) were compared. Results: At the end of the treatment course, there was not a significant difference in mean platelet count between the two groups (p=0.748). Side effects in two and three-week protocols were 15.2% and 18.2%, respectively however, distribution of the complications (side effect) in the two groups was equal (p=0.9). Conclusion: Considering the absence of significant differencesin mean platelet count between the two groups at the end of the two treatment protocols and the higherpercentageof side effects in the patients that had received the three-week prednisolone therapy protocol, it seems that the two-week course of immune thrombocytopenic purpuratreatment is as effective as the three-week protocol.

---

Background: Platelet glue is a human plasma product that is rich in platelets growth factors and fibrinogen and has haemostatic and healing properties. In the present study, the effect of fibrin sealant rich in platelet growth factors on healing burn wounds was evaluated.

Materials and Methods: This randomized clinical trial was done on 50 burn patients divided into two equal groups and followed for one month. Both groups received antibiotics during the treatment. Granulation tissue formation and epithelialization were the tokens of wound recovery and positive response to treatment. Data analysis was done by Fisher’s exact test, Mann-Whitney test, and t-test using SPSS software version 16.

Results: The mean of time to complete healing was significantly different in intervention and control groups (p=0.001). Time to recover 100% was 11.5±2.2 days in the intervention group and 16.2±5.3 days in the control group. The intervention group healed about 1.4 times faster than the control group.

Conclusion: Autologous platelet gel can be used as a new therapeutic approach in healing burn wounds. With this product, burn wounds can be expected to heal more quickly.

---

Background: Maturation of oocytes and fertilization in vitro can be considered as one of the most important steps to treat infertility. In this study maturation medium was enriched with Platelet extraction (PL) which has high concentration of growth factors. Meiosis resumption and maturation was monitored after 18 hours of maturation.

Materials and Methods: In this experimental study, oocytes at germinal vesicle stage were obtained from mature NMRI female mice. Maturation medium was &alphaMEM and the control groups had 5-10% FBS and the medium in the experimental groups was enriched by 5, 10% PL and the combination of 5% PL and 5% FBS. Meiosis resumption and maturation were observed after 18 hours.

Results: The rate of matured oocytes in the experimental group 5% PL for both COC and DO group was significantly higher than the control groups (P<0.05). The maturation rate for 5% PL was 61% for the COC group and 72% for the DO group while this rate for 5% FBS control group was 53% and 50% respectively.

Conclusion: PL had a significant effect on meiosis resumption and maturation of oocyte at germinal vesicle stage. Based on these results, PL could be used as a maturation promoting factor.

---

Background: Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP) is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome.

Materials and Methods: In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS) and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH) and western Ontario rotator cuff  (WORC) index. Range of motion (ROM) of shoulder was measured in five directions by goniometry . All of these parameters were evaluated before intervention and in 1, 3, 6 months later.

Results: with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05). Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration.

Conclusion: PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.