Background and Objectives: Low-level laser therapy (LLLT) has been shown to promote chronic wound healing in conditions of reduced microcirculation. In this preliminary study, we report the results of using LLLT to heal foot ulcers in patients with diabetes mellitus. Materials and Methods: Twenty-three patients with a diabetic foot wound for at least 3 months were included in this double-blind randomized clinical trial. Patients were randomized to receive placebo treatment ( n = 10) or LLLT ( n = 13) (685 nm, energy density 10 J/cm ² ) in addition to conventional therapy. Patients were followed for 20 weeks. Ulcer size reduction and the number of patients with complete healing were compared between the LLLT and placebo groups. Results: There were no significant differences in baseline characteristics of patients and foot ulcers receiving LLLT and placebo treatment. At week 4, the size of ulcers decreased significantly in the LLLT group ( p = 0.04). After 20 weeks, in the LLLT group, eight patients had complete healing and in the placebo group only three patients experienced complete wound healing. The mean time of complete healing in LLLT patients (11 weeks) was less than that in placebo patients (14 weeks) though the difference was not statistically significant. Conclusions: The study provides evidence that LLLT can accelerate the healing process of chronic diabetic foot ulcers, and it can be presumed that LLLT may shorten the time period needed to achieve complete healing.

BACKGROUND AND OBJECTIVES: In this study, methylene blue‐mediated photodynamic therapy (MB‐PDT) was used as a possible alternative method for the treatment of oral lichen planus (OLP).STUDY DESIGN/MATERIALS AND METHODS: Thirteen patients with 26 OLP lesions were enrolled in this study. Patients were instructed to gargle a 5% methylene blue solution in water for 5 minutes. Ten minutes later, irradiation was performed by laser light (λ = 632 nm, light exposure dose = 120 J/cm²). Lesions were evaluated pre and post‐operatively and at follow‐up sessions by changes in sign and symptom (pain) scores, and size of lesions.RESULTS: Improvement in sign scores was achieved in 16 lesions. Four keratotic lesions disappeared completely. There was a statistically significant decrease in sign and symptom scores 1 week after treatment and at follow‐up sessions up to 12 weeks. Average reduction in size of lesions was 44.3%.CONCLUSION: MB‐PDT seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB‐PDT in control of OLP for a longer period of time. Lasers Surg. Med.

Background: Antibiotic resistance of urinary tract pathogens has increased worldwide. Knowledge of the antibiotic resistance patterns of uropathogens in specific geographical locations is an important factor for choosing an appropriate empirical antimicrobial treatment. The aim of this study was to provide information regarding local resistance patterns of urinary pathogens to the commonly used antibiotics in Tehran, Iran. Methodology: Urine samples collected and submitted to two pathobiology laboratories in Tehran were identified by conventional methods over a period of three years (December 2006 to May 2009). Antimicrobial resistance testing was performed by the standard disk diffusion technique in accordance with the recommendations of the Clinical and Laboratory Standards Institute. Results: Of the total 13,333 mid-stream urine samples collected from suspected cases of urinary tract infection, 840 (6.3%) were positive for pathogenic bacteria. Escherichia coli (E. coli) was the most common isolate (68.8%) followed by Proteus spp. (12.4%), and Klebsiella spp. (9.6%). E. coli isolates were mostly susceptible to nitrofurantoin (71.3%), followed by ciprofloxacin (68.1%); however, only 38.2% of E. coli isolates were susceptible to trimethoprim-sulfamethoxazole. Conclusion: Nitrofurantoin may be considered as a first-line empiric antibacterial agent for urinary tract infections in outpatients in Tehran, Iran.

PURPOSE: This study was conducted to evaluate the antimicrobial effects of medicinal maggots of Lucilia sericata on Staphylococcus aureus and Pseudomonas aeruginosa on diabetic foot ulcers (DFUs). DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The sample comprised 50 adult patients from the clinic of the Academic Center for Education, Culture and Research of Tehran University of Medical Sciences, Iran. All participants who had at least 1 DFU present for at least 12 weeks, an arterial brachial index value of more than 0.6, and a hemoglobin A_1c value of less than 8% were included in this study. METHODS: Subjects were randomly selected for the maggot-treated (treatment) or conventional treatment (control) group. Conventional treatments such as antibiotic therapy, debridement, and offloading were done for both groups, but maggot therapy (MT) was added to the protocol of the treatment group. Bacterial burden was monitored and compared for both groups using cultures collected using swab technique. Wound secretions were measured and compared in both groups. RESULTS: The number of infected cases with S aureus in the treatment group was significantly reduced after 48 hours in comparison with the control group (P = .047). The number of infected cases with P aeruginosa was significantly reduced after 96 hours (P = .002). We also found that wound secretions in the treatment group were significantly higher than in the control group (P < .00). CONCLUSIONS: Our findings indicate that MT is a safe and efficacious treatment of DFUs.

Objective To evaluate the immediate and long-term effectiveness of mindfulness-based stress reduction (MBSR) on biological and symptomatological markers of health among human immunodeficiency virus–positive (HIV+) patients in Tehran, Iran. Methods Using a randomized controlled trial design, data from 173 HIV+ patients (CD4 count > 250) not yet receiving antiretroviral therapy, who participated in either an 8-week MBSR (n = 87) or a brief education and support condition (n = 86) at the Imam Khomeini Hospital, were analyzed. Assessments included CD4 count, Symptom Checklist-90-Revised (SCL-90R), and Medical Symptom Checklist (MSCL) at baseline, immediate post-treatment, and at the 3-, 6-, 9-, and 12-month follow-up periods. Results The treatment-adherent sample had a mean (standard deviation) age of 35.1 (6.5) years and 69% were male. Linear mixed-model estimates indicated that, in the MBSR condition, the mean CD4 count increased from baseline up to 9 months after treatment and then returned to baseline level at 12 months. Improvements in mean SCL-90R (up to 6 months) and MSCL (up to 12 months) scores were observed for the MBSR condition, whereas education and support condition scores remained the same over time; however, only MSCL improvements significantly differed between groups and these changes lasted up to the final assessment. Conclusions Findings suggest that among treatment-adherent Iranian HIV+ patients not yet receiving antiretroviral drug treatment, MBSR seems to have the strongest potential to improve self-reported medical symptoms. Trial Registration Iranian Registry of Clinical Trials: IRCT201106084076N2. Abbreviations HIV+ = human immunodeficiency virus–positive AIDS = acquired immune deficiency syndrome HAART = highly active antiretroviral therapy CD4 count = CD4⁺ T lymphocyte count MBSR = mindfulness-based stress reduction ESC = education and support condition SCL-90R = Symptom Checklist-90-Revised MSCL = Medical Symptom Checklist