Background:Postoperative pain is a common complication that can lead to serious morbidities and delayed recovery.Objectives:The aim of this study was to investigate the effect of low-level laser therapy on acute pain after tibial fracture surgery.Patients and Methods:In this randomized clinical trial, 54 patients who were candidate for tibial fracture surgery were allocated randomly to two groups, namely, control and laser therapy. Both groups had the same type of surgery and technique of spinal anesthesia. Patients in laser group were treated with the combination of two lasers (GaALAs, 808 nm; and GaALInP, 650 nm) at the end of the surgery while control group received laser in turn-off mode with the same duration as laser group. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) and the amount of analgesic use during 24 hours after surgery.Results:Laser group experienced less pain intensity in comparison with control group at second, fourth, eighth, 12th, and 24th hours after surgery (P Value < 0.05). In addition, the amount of consumed opioid in laser group was significantly less than the control group (51.62 ± 29.52 and 89.28 ± 35.54 mg, respectively; P Value, 0.008).Conclusions:Low Level Laser Therapy is a proper method to reduce postoperative pain because it is painless, safe, and noninvasive and is easily accepted by patients.

<b><i>Background/Aims:</i></b> Research evidence regarding immune system responses and adaptations to psychological or physical stresses is controversial. This study aimed to investigate the effect of 8-week psychological stress and exercise activity (chronic adaptation) and the acute response of possibly adapted rats to psychological stress and exercise considering IFN-γ, IL-4, and IL-4/IFN-γ. <b><i>Methods:</i></b> Thirty-two rats were divided into 4 groups of 8 animals including control, exercise, psychological stress, and combination of exercise with psychological stress. IL-4 and IFN-γ cytokines were measured pre-experiment (preEX), immediately postexercise (IpostEX), and 72-h postexperiment protocol (72hpostEX). <b><i>Results:</i></b> There were no significant differences between the study groups regarding IFN-γ, IL-4, and IL-4/IFN-γ in preEX (<i>p</i> &#x3e; 0.05), IpostEX (<i>p</i> &#x3e; 0.05), and 72hpostEX (<i>p</i> &#x3e; 0.05). However, IL-4 increased significantly in IpostEX compared with preEX in exercise (<i>p</i> = 0.012) and combination of exercise with psychological stress (<i>p</i> = 0.03) groups. <b><i>Conclusions:</i></b> Exercise and combination of exercise and psychological stress induce similar acute response to IL-4 in chronic trained and stressed rats. Also, exercise may induce an acute synergistic effect with psychological stress on IL-4.

Background: The drug-induced liver injury (DILI) has a wide range of clinical presentations, from asymptomatic liver enzyme elevations to cirrhosis. Herbal dietary supplements may be beneficial to reduce the risk of hepatotoxicity. This study aimed to evaluate the effects of different doses of clove extracts on humoral factors in rats with hepatotoxicity induced by thioacetamide. Materials and Methods: In this experimental study, rats were divided into nine groups (10 rats per each). The Control group received no treatment. The Sham group was treated with oral administration of distilled water (0.5 ml) for 21 days. The positive control group received thioacetamide (50 mg/kg for three days) intraperitoneally. The clove group was divided into three subgroups and given daily oral administrations of 50, 150, and 300 mg/kg of clove hydroalcoholic extracts (for 21 days). Rats in the experimental group were divided into three subgroups and subjected to 50 mg/kg thioacetamide injection after receiving hydroalcoholic extracts of clove (50, 150, and 300 mg/kg, respectively) for 21 days in the last three days. All rats were sacrificed after 48 hours to measure liver function parameters (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total plasma protein, and albumin). Results: The rats that received thioacetamide showed liver damage by increased serum liver biomarkers and decreased levels of total plasma protein and albumin compared to the control group. The different doses of clove extract resulted in a significant improvement of liver damage by reduced serum liver enzymes levels and increased total plasma protein and albumin. Conclusion: Oral administration of the different doses of the clove extract (50, 150, and 300 mg/kg) for 21 consecutive days could significantly improve the changes associated with serum biomarkers of hepatotoxicity

Background: Low back pain could related to disc herniation and managed by surgery. Also, less invasive options, including epidural corticosteroid injection, are available; however, it is associated with side effects. This study aimed to evaluate the effectiveness of autologous conditioned serum (ACS) in treating unilateral lumbar radicular pain. Materials and Methods: In this randomized, controlled, double-blind clinical trial study, a total of 68 patients received the transforaminal epidural injection, 28 patients received ACS, and 30 patients received 40 mg triamcinolone. Under fluoroscopic guidance in anterior-posterior and lateral views, a single injection of ACS or triamcinolone was done via the transforaminal epidural technique. Pain intensity was assessed with a visual analogue scale (VAS) and Oswestry disability index (ODI) at three weeks, three months, and six months. Results: A significant reduction in pain intensity was observed in patients of two groups. There was no significant difference between the two groups during the three months of the study. At the final evaluation at six months, the ACS group showed superiority over the triamcinolone based on the VAS score (P<0.05) and ODI (P=0.007). Conclusions: ACS therapy is a new effective option in treating lumbar radicular pain due to herniated disc. Since no specific complication has been reported, it can be used as a substitute for corticosteroids in such cases.

Background & Objective: The cesarean section increases worldwide and has many side effects, including acute pain. This study investigated the relationship between physical activity during pregnancy, analgesic consumption, and maximal postoperative pain in women with low segment cesarean section. Materials & Methods: 340 Cesarean section women were interviewed by demographic and global physical activity questionnaires during the pre-operative visits. The participants were categorized into high, moderate, and low physical activity groups (high PA, moderate PA, low PA, respectively) according to the global physical activity questionnaire guidelines. The maximal postoperative pain (MPP), the type, and doses of analgesia used/2 days were recorded. Pearson correlation, Chi-square, and one-way ANOVA were used to analyze the data. Results: MPP was reduced in the high PA group (5.48 ±1.72) compared to the moderate (6.46±1.30) and low PA groups (6.97±1.92; p<0.0005, p<0.0005, respectively). There was a difference between the moderate and low PA groups (p=0.04). Paracetamol was the common analgesic without significant difference among groups (p=0.37). The numbers of paracetamol doses significantly reduced in the high PA group (3.31±1.65) compared to the low PA group (4.03±2.01, p=0.01). MPP had a significant and low negative correlation with total physical activity (r=-0.25, p=0.0005). There was a negative significant correlation between occupation (r=-0.491, p=0.0005), recreational (r=-0.262, p=0.0005), and travel activities (r=--0.150, p=0.006) with MPP. There was a low positive correlation between sedentary activity and MPP (r=0.23, p=0.0005). Conclusions: Maternal physical activity can be a non-pharmacological and cost-effective method of pain management.