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BACKGROUND: Breast cancer is one of the most common cancers in Iran and round the globe. Seroma formation is the most common primary complication after mastectomy (partial/radical). Nowadays, drainage is used as a routine method to reduce seroma formation after mastectomy, although there is no consensus about the appropriate time to perform drainage after this surgery. This study evaluated the effects of short-term and long-term drainage after mastectomy along with removal of axillary lymph nodes. METHODS: This randomized clinical trial was performed on 88 women who underwent mastectomy with ALND in hospitals in Yazd (were randomly divided into two groups). Suction drains were inserted for all patients at completion of surgery. The data collection tool was a researcher-made form based on variables. In the first group, the drain was removed 24 hours after surgery and the patients were discharged, but the second group was discharged with the drain in place after 24 hours and the drain was removed 5 days after surgery. Data were analyzed with SPSS18 using T-Test, Chi square, and Mann-Whitney U test. RESULTS: The results showed that 28 (31.8%) participants had formed seroma, of whom 22 (50%) were in the 1-day drainage group and 6 (13.6%) were in the 5-day drainage group. There was a statistically significant correlation among seroma frequency, mean aspiration volume, mean number of aspirations, mean seroma volume in sonography one week after surgery, and mean seroma volume in sonography between the two groups three weeks after surgery (P<0.05). CONCLUSION: Based on the results, it can be concluded that long-term drainage reduces the risk of seroma formation after mastectomy with removal of axillary lymph nodes compared to short-term drainage. Complementary study be performed by considering other underlying factors such as comorbidities to obtain the best drain removal time in breast cancer patients.

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BACKGROUND: Recently, the radiation application research center for the atomic energy organization of Yazd (Iran) has developed a hydrogel dressing which was evaluated for quality and safety in 2008. Its efficacy for assisting in the wound healing process was approved for animal use, and its use has proven to be more effective than a related Syrian material. OBJECTIVES: We have already confirmed the safety and efficacy of Irgel use on mice (1, 2), so this study was conducted in order to further evaluate its effectiveness on human burn wounds, and to compare its efficacy with MaxGel, another hydrogel. A randomized clinical trial study was conducted to compare the efficacy of hydrogel produced by the radiation application research center (Yazd Branch) with MaxGel and routine dressing on burn repair in the Yazd Burn hospital. MATERIALS AND METHODS: In this study, 90 patients with second-degree burn injuries who were admitted to the Yazd Burn hospital were randomly divided into three equal groups. In the negative control group, the wounds were covered with sterile vaseline gauze followed by double sterile dry gauze and ultimately bandaged. In the test group, the wounds were covered by an Iranian hydrogel sheet (Irgel) instead of vaseline gauze, while in the positive control group, the wounds were covered by MaxGel instead of Irgel. At each visit (every other day), each dressing was renewed by its respective method and the wound area, pain score, and body temperature were recorded. At the beginning and at the end of the first and second week, five milliliters of venous blood were taken from all patients to evaluate hematologic parameters such as peripheral blood cell count, liver function, blood urea nitrogen, and creatinine. RESULTS: Before the intervention, the extent of the burns and pain sensations were quite similar among the different groups, but at the second week, the burn areas and pain scores for the Irgel group were significantly less than those of the normal control and the positive control groups (P < 0.05). CONCLUSIONS: Based on our findings, both gels assist in the process of burn wound healing and pain reduction more effectively as compared with routine dressing. However, Irgel had better effects on wound healing and pain relief than MaxGel, which indicates a better quality of Irgel for this particular kind of treatment.

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BACKGROUNDS: In Persian traditional medicine, palm date spathe (PDS) is introduced as an analgesic. Therefore, this study was designed to investigate the analgesic effect of hydroalcoholic extract of PDS on acute and chronic pain in mice in comparison with diclofenac and morphine. MATERIALS AND METHODS: In this study, which was conducted in summer 2014, 220 male mice (20-30 g) were randomly divided into two categories, each consists of 11 groups as follows: A normal control group, a solvent (Tween 80) control group, 3 morphine positive control groups (2, 4 and 8 mg/kg), 3 diclofenac positive control groups (10, 20 and 30 mg/kg), and 3 main experimental PDS groups (2, 20, and 200 mg/kg). Hot plate was applied on animals in one category and writing test on the other category to assess acute and chronic pain, respectively. RESULTS: In the writing test, the average writing time and number of animals receiving a maximum dosage of morphine, diclofenac, and PDS were significantly less than the control group. In the hot plate test, only groups receiving different doses of morphine at different time points and those received 30 mg/kg diclofenac at 15 min after the intervention showed significant difference with the control group. CONCLUSION: 200 mg/kg extract of PDS, revealed a significant analgesic effect on chronic pain, but it did not show any analgesic effect on acute pain.

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BACKGROUND: Mumijo (shilajit) has been well known in traditional medicine as a remedy for a number of diseases, such as bone fractures, wounds, inflammation, and headache. It is also widely used as an analgesic agent in folk medicine, but no scientific documentation exists concerning that effect. OBJECTIVE: The current study was conducted to evaluate the ability of mumijo to reduce sensitivity to painful stimuli when compared with morphine sulfate and sodium diclofenac. METHODS: A total of 176 animals were randomly and equally divided into 2 groups with 88 mice each-one for formalin test and the other for writhing test. For each test, the animals were allocated into 10 equal groups, based on the dosage of the analgesic, plus a negative control group, with 8 mice in each group. INTERVENTION: The analgesic effect of mumijo extract in doses of 0.75, 7.5, 75, and 750 mg/kg was assessed and compared witha group receiving distilled water-the negative control group, and that for groups receiving 1, 2, or 4 mg/kg of morphine sulfate or 10, 20, or 30 mg/kg of sodium diclofenac-the positive control groups. RESULTS: The results showed a significant decrease in pain intensity for all mice receiving doses of mumijo extract during a 1-h formalin test when compared with the distilled water group. For all the mumijo groups except the one receiving 750 mg/kg, the analgesic effect was significantly lower than that for the morphine sulfate group receiving 4 mg/kg. No significant differences existed between all mumijo and all diclofenac groups. In a writhing test, a significant inhibition of the pain response induced by acetic acid also occurred in all 4 mumijo-administered groups as opposed to the group receiving distilled water. No significant differences existed between the writhing response in groups receiving 75 and 750 mg/kg of mumijo and any doses of diclofenac or morphine. The comparison among the different doses of mumijo in the formalin test did not show any significant differences, but in the writhing test, the maximum dose showed a more effective analgesic action. CONCLUSION: The findings indicated a significant analgesic effect for mumijo extract on chronic pain in mice, occurring in a dose-independent manner.

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Pain is a universal complaint, which needs further investigations for new pain relieving agents. Carum copticum (L.) Sprague ex Turrill is a plant in Umbelliferae family, which is mentioned to have some therapeutic effects on headache and joint pains in Iranian traditional literature, but there are not enough scientific reports to prove its effects on pain. So, we conducted to design an experimental clinical trial study to assess and compare the analgesic effect of ethanolic extract of Carum copticum fruit with morphine by using a tail-flick analgesiometer device. Our results indicate that the test drug produced significant increase in tail-flick latency (TFL) during 2h post-drug administration (p<0.05). The peak of the effect was observed at 45min after drug injection, which was comparable to that of 1mg/kg morphine (i.p.). Positive results in this type of analgesiometric test indicate that the antinociceptive action may be of the opoid type. The present study supports the claims of Iranian traditional medicine showing that Carum copticum extract possesses a clear-cut analgesic effect. However, further investigations are required to evaluate the efficacy and safety of this herbal medication in man.

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