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Treatment of cutaneous leishmaniasis: cassia fistula fruit gel- intralesional glucantime Vs. placebo gel- intralesional glucantime combination
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Nazli Ansari , Marzieh Rahimi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Cutaneous leishmaniasis is a major health problem in Iran and especially Isfahan province is considered as an endemic area for this disease. Regarding the previous report of positive effects of Cassia fistula boiled extract in the treatment of cutaneous leishmaniasis, this study was designed to evaluate the effect of combination therapy with intralesional meglumine antimoniate and Cassia fistula fruit gel compared to placebo in this disease.
Methods: 140 patients with cutaneous leishmaniasis referring to Skin Disease and Leishmaniasis Research Center of Isfahan (SDLRC) were randomly allocated in two groups. One group received intralesional meglumine antimoniate injection and Cassia fistula fruit gel and the second group were treated with intralesional meglumine antimoniate and placebo gel. Improvement was defined as complete cure, partial cure and treatment failure.
Results: At 12 week, 47 patients treated with intralesional meglumine antimoniate and topical Cassia fistula fruit gel achieved complete cure (67.1%) compared to 29(41.4%) patients in placebo treated group. There was significant difference in cure rate between two treatment groups of this study (p<0.001). Nine patients (19%) in each group suffered from adverse effects of the treatment such as itching and erythema. There was no significant difference in this regard between two groups (p=0.82).
Conclusions: The results of this study shows the efficacy of Cassia fistula fruit gel in increasing the cure rate of cutaneous leishmaniasis lesions achieved by intralesional meglumine antimoniate. Combination therapy of intralesional meglumine antimoniate and Cassia fistula fruit gel could be suggested as a choice for the treatment of acute cutaneous leishmaniasis lesions.

Comparison of the effectiveness of three drugs, rosuvastatin, atorvastatin, and simvastatin, on lipids using network meta-analysis: a meta-analysis study
Aso Yazdani, Hamed Tavan, Kourosh Sayehmiri,
Volume 82, Issue 5 (8-2024)
Abstract
Background: One of the main causes of death in the world is cardiovascular disease. While there is no denying that lipids play a risk factor in cardiovascular disease, statins are effective medications for treating this condition. We used network meta-analysis to compare the impact of three drugs atorvastatin, simvastatin, and rosuvastatin on lipids.
Methods: Type of study of this research was a systematic review and network meta-analysis. Databases such as Scopus, PubMed, ISI, Science Direct, Google Scholar, SID, MagIran, web of Science, and Cochrane Library were searched. Keywords atorvastatin, simvastatin, and rosuvastatin were used in the search strategy. We did both standard meta-analyses and network meta-analyses. Consistency was checked by comparing direct and indirect effect sizes. The time period for searching articles was from 2000 to June 2024. All relevant articles published in English or Persian were reviewed. Paired wised comparisons were made using the intervalplot command in STATA. The surface under the cumulative ranking (SUCRA) was used to rank the efficacy of treatments. The Q test and I2 index were used to assess the heterogeneity of the studies.  Data were analyzed using STATA Ver. 17.
Results: From the 61 articles that were included in the network meta-analysis (atorvastatin 43 studies, rosuvastatin 22 studies, simvastatin 21 studies, and placebo 15 studies). The total sample size was 62178 patients.  The results showed that the effect of, atorvastatin, rosuvastatin, and simvastatin with placebo on fat lipids was significant (P<0.001). Still, there was not a substantial difference between the effects of the three drugs. The best treatment for reducing LDL was atorvastatin (standard mean difference (SMD) =-5.18, 95% confidence interval (CI);-7.42,-2.95, P<.001). SMD LDL for rosuvastatin and simvastatin were -4.35(95% CI; -6.81,-1.89), and -3.44(95% CI;-5.89,-.98) respectively.  The surface under the cumulative ranking (SUCRA) showed that the probability that Rosuvastatin was the best drug for reducing triglycerides was 82.4% and the likelihood that atorvastatin was the best drug for reducing cholesterol was 80.3%.
Conclusion: Atorvastatin, rosuvastatin, and simvastatin have a better effectiveness than placebo in reducing fat lipids. Atorvastatin was the best treatment to reduce LDL, and TC and increase HDL. Rosuvastatin was the best drug to reduce TG. Atorvastatin, rosuvastatin, and simvastatin were the effective treatments to reduce fat lipids respectively.

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