History
# Registration date Revision Id
2 2018-02-11, 1396/11/22 37385
1 2015-09-05, 1394/06/14 20244
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  • Protocol summary

    Objectives: Leishmaniasis refers to a set of diseases caused by intracellular protozoan of the genus Leishmania. The disease is divided into three clinical categories, including cutaneous leishmaniasis, mucous leishmaniasis and visceral leishmaniasis. Content written about this disease in the context of traditional medicine is a clear indication of skin and mucocutaneous form of the disease. Many drugs are cited in traditional medicine to treat and cure it by different physicians. In this study, used topical products of leaves of Juniperus excelsa M.Bieb for the treatment of leishmaniasis. Design: Randomized, double-blind, placebo-controlled, multiple-center, phase three of trials Setting and conduct: Patients with cutaneous leishmaniasis reffer to dermatology clinics of Imam Reza and Shahid Faghihi. Major Inclusion criteria: patients 18 to 70 years who have cutaneous lesions are a maximum of 4. Major Exclusion criteria: severe disease; children under than 18 years of age and patient with complications. Sample size: 60 Intervention: Case group, receive topical products of Juniperus in addition to cryotherapy, and patients in control group receive placebo-up in addition to cryotherapy Main variables and outcome measures Assessment of the size and area will be done before of the treatment, weekly in the first month of treatment and every two weeks from second month to the end of the study.
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    اهداف: لیشمانیوز به مجموعه ای از بیماریها اطلاق می شود که به وسیله پروتوزوآی داخل سلولی از جنس لیشمانیا ایجاد می شود. این بیماری به سه دسته بالینی شامل لیشمانیوز پوستی، لیشمانیوز مخاطی و لیشمانیوز احشایی تقسیم می شود. مطالب نوشته در خصوص این بیماری در متون طب سنتی به طور مشخص نشان دهنده فرم پوستی و پوستی مخاطی این بیماری می باشد. داروهای متعددی در طب سنتی ایران برای درمان و بهبودی آن توسط اطبای مختلف ذکر گردیده است. در این مطالعه از فرآورده موضعی برگ گیاه اورس برای درمان سالک استفاده می‌گردد. طراحي: تصادفي، دوسويه كور، كنترل با دارو نما، چند مركزي، مرحله سه كارآزمايي نحوه انجام: جمعيت مورد مطالعه بيماران مبتلا به سالك مراجعه كننده به درمانگاه پوست شهيد فقيهي و امام رضا مي باشد. شرايط ورود اصلي شركت كنندگان: بیماران 18 تا 70 ساله مبتلا به سالک که حداکثر 4 ضایعه دارند. شرايط خروج اصلي شركت كنندگان: شامل کودکان زیر 18 سال و انواع شدید بیماری همراه با عوارض. حجم نمونه 60 نفر مداخله: بیماران در دو گروه 30 نفره علاوه بر کرایوتراپی، کرم حاوی عصاره اورس در گروه درمان و کرم دارونما در گروه كنترل دريافت مي‌كنند، .مدت زمان درمان 12 هفته در نظر گرفته می شود. متغيرهاي پيامد اصلي: ارزیابی اندازه و مساحت ضایعات بیماران مورد مطالعه علاوه بر قبل از شروع درمان، در ماه اول درمان به صورت هفتگی و از ماه دوم تا پایان مطالعه هر دو هفته یکبار صورت خواهد پذیرفت.
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    Determination of the efficacy of cryotherapy plus topical Juniperus excelsa M.Bieb, based on traditional Persian medicine, versus cryotherapy alone in the treatment of cutaneous leishmaniasis
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    تعیین تأثیر فرآورده دارویی موضعی اورس بر مبنای دانسته های طب سنتی ایرانی همراه با کرایوتراپی در مقایسه با کرایوتراپی به تنهایی در درمان لیشمانیوز جلدی
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    Two arm parallel group randomised clinical trial, triple-blinded
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    کارآزمایی بالینی دارای گروه کنترل، با گروه های موازی ، سه سویه کور ، تصادفی شده
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    Design of the study: Patients with cutaneous leishmaniasis lesions referring to Shohaday-e- Enghelab Health Center of Shiraz and Shahid Faghihi Dermatology Clinic. In order to blind the researcher, medications are named as "A" for 5% Juniperus excelsa M.Bieb cream and B for placebo. The patient don't aware of the type of drug he/she is assigned to. In addition, the groups are entered into statistical analysis as "A" and "B".
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    محیط مطالعه: شامل بیماران مبتلا به لیشمانیوز جلدی که به مرکز بهداشت شهدای انقلاب و درمانگاه پوست شهید فقیهی مراجعه می نمایند می باشند. جهت کورسازی محقق، داروها با نام های A برای کرم 5% عصاره گیاه اورس و B برای پلاسیبو نامگذاری می شوند. بیمار نیز از نوع داروی اختصاص داده شده به وی آگاهی ندارد. همچنین گروه ها با نام های A و B به آنالیز آماری وارد می شوند.
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    Inclusion criteria: 1- Age 18 to 70 years the maximum 2- The maximum duration of their involvement by leishmaniasis is 4 months 3-Having physical health except the cutaneous leishmaniasis infection 4- Having 4 or less of the lesion leishmaniasis lesions 5-Did not taking any of topical and systemic anti-Leishmania treatment during last 4 weeks 6-Cutaneous leishmaniasis is approved of by smear**** Exclusion criteria: 1-Patients with complex forms of leishmaniasis and symptoms of mucousal leishmaniasis 2-Having more than 4 lesions 3- The lesions greater than 5 cm 4- Sub-cutaneous nodules 5-Regional adenopaty if greater than 1 cm size 6-Patients with immunodeficiency disease 7-The infants and children less than 18 years 8-Women in lactation and pregnancy 9-Patients with satellite lesions or sporotrichoid lesions 10-Patients with facial cutaneous leishmaniasis lesions
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    شرایط ورود به مطالعه:شامل 1- سن 18 تا 70 سال 2- حداکثر 4 ماه از ابتلای ایشان به سالک گذشته باشد 3- داشتن سلامت کامل جسمی به جز ابتلا به لیشمانیوز پوستی 4- دارا بودن 4ضایعه یا کمتر ضایعه لیشمانیوز 5- عدم دریافت داروی موضعی و سیستمیک با داروهای رایج ضد لیشمانیا در طی 4 هفته گذشته 6- اثبات لیشمانیوز پوستی ازطریق اسمیر ***** شرایط خروج ازمطالعه: 1- نوع پیچیده و همراه با عوارض که عبارتند از بیمار دارای علایم لیشمانیای مخاطی 2-داشتن بیش از 4 ضایعه 3- ضایعات بیشتر از 5 سانتی متر 4-ندول های زیر جلدی 5- آدنوپاتی منطقه ای با سایز بیشتر از1 سانتی متر 6- افراد دارای نقص ایمنی 7- کودکان کمتر از 18 سال 8- زنان در وضعیت شیر دهی و بارداری 9- وجود ضایعات اسپروتریگویید یا ضایعات اقماری 10 بیمار مبتلا به لیشمانیوز در مناطق صورت و چهره بیمار
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    Group A: Use of topical product (5% extract of Juniperus excelsa M.Bieb leaf cream) on cutaneous leishmaniasis lesions, 3 times daily Group B: Use of Placebo cutaneous leishmaniasis lesions, 3 times daily
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    گروه A: استفاده از فراورده موضعی (کرم 5% عصاره برگ گیاه اورس) بر روی ضایعات لیشمانیوز جلدی سه بار در روز گروه B: استفاده از دارونما بر روی ضایعات لیشمانیوز جلدی سه بار در روز
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    The area of the cutaneous leishmaniasis lesions of the patients
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    مساحت ضایعات لیشمانیوز جلدی بیماران
  • General information

    Double blinded
    Triple blinded
    1
    1
    1
    Age 18 to 70 years the maximum
    The maximum duration of their involvement by leishmaniasis is 4 months
    Having physical health except the cutaneous leishmaniasis infection
    Having 4 or less of the lesion leishmaniasis lesions
    Did not taking any of topical and systemic anti-Leishmania treatment during last 4 weeks
    Cutaneous leishmaniasis is approved of by smear
    شامل سن 18 تا 70 سال
    حداکثر 4 ماه از ابتلای ایشان به سالک گذشته باشد
    داشتن سلامت کامل جسمی به جز ابتلا به لیشمانیوز پوستی
    دارا بودن 4ضایعه یا کمتر ضایعه لیشمانیوز
    عدم دریافت داروی موضعی و سیستمیک با داروهای رایج ضد لیشمانیا در طی 4 هفته گذشته
    اثبات لیشمانیوز پوستی ازطریق اسمیر
    Patients with complex forms of leishmaniasis and symptoms of mucousal leishmaniasis
    Having more than 4 lesions
    The lesions greater than 5 cm
    Sub-cutaneous nodules
    Regional adenopaty if greater than 1 cm size
    Patients with immunodeficiency disease
    The infants and children less than 18 years
    Women in lactation and pregnancy
    Patients with satellite lesions or sporotrichoid lesions
    Patients with facial cutaneous leishmaniasis lesions
    نوع پیچیده و همراه با عوارض که عبارتند از بیمار دارای علایم لیشمانیای مخاطی
    داشتن بیش از 4 ضایعه
    ضایعات بیشتر از 5 سانتی متر
    ندول های زیر جلدی
    آدنوپاتی منطقه ای با سایز بیشتر از1 سانتی متر
    افراد دارای نقص ایمنی
    کودکان کمتر از 18 سال
    زنان در وضعیت شیر دهی و بارداری
    وجود ضایعات اسپروتریگویید یا ضایعات اقماری
    بیمار مبتلا به لیشمانیوز در مناطق صورت و چهره بیمار
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    Random allocation software Ink was used to create a randomization table
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    از نرم افزار Random allocation software Ink و ایجاد بلوک های جایگشتی
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    In order to blind the investigator, medications are named A (Juniperus excelsa) and B (Placebo). The patient are not considered the type of drug are assigned to. The groups are also coded A and B for statistical analyzes.
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    جهت کورسازی محقق، داروها با نام های A (عصاره اورس) و B (پلاسیبو) نامگذاری می شوند. بیمار نیز از نوع داروی اختصاص داده شده به وی آگاهی ندارد. همچنین گروه ها جهت آنالیز آماری به صورت کد بندی شده A و B نام گذاری می شوند .
  • Recruitment centers

    #1
    Name of recruitment center - English: Dermatology clinic of Shahid Faghihi hospital
    Name of recruitment center - Persian: درمانگاه پوست بيمارستان شهيد فقيهي
    Full name of responsible person - English: Mohammad Mahdi Parvizi, MD, PHD
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Street address - English: Shahid Faghihi hospital, Zand blv., Shiraz, Fars, Iran
    Street address - Persian: شيراز، فارس، ايران، خيابان زند، بيمارستان شهيد فقيهي
    City - English: Shiraz
    City - Persian: شیراز
    Province:
    Country: Iran (Islamic Republic of)
    Postal code:
    Phone:
    Fax:
    Email:
    Web page address:
    Name of recruitment center - English: Dermatology clinic of Shahid Faghihi hospital
    Name of recruitment center - Persian: درمانگاه پوست بيمارستان شهيد فقيهي
    Full name of responsible person - English: Mohammad Mahdi Parvizi, MD, PHD
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Street address - English: Shahid Faghihi hospital, Zand blv., Shiraz, Fars, Iran
    Street address - Persian: شيراز، فارس، ايران، خيابان زند، بيمارستان شهيد فقيهي
    City - English: Shiraz
    City - Persian: شیراز
    Province: Fars
    Country: Iran (Islamic Republic of)
    Postal code: 7134844119
    Phone: +98 71 3212 5592
    Fax:
    Email: mmparvizi@gmail.com
    Web page address:
    #2
    Name of recruitment center - English: Imam Reza Subspecialty Clinic
    Name of recruitment center - Persian: درمانگاه تخصصي و فوق تخصصي امام رضا (ع)
    Full name of responsible person - English: Mohammad Mahdi Parvizi, MD, PHD
    Full name of responsible person - Persian: دكتر محمد مهدي پرويزي
    Street address - English: Imam Reza Subspecialty Clinic, Zand blv., Nemazee Square Shiraz, Fars, Iran
    Street address - Persian: شيراز، فارس، ايران، ميدان نمازي
    City - English: Shiraz
    City - Persian: شيراز
    Province:
    Country: Iran (Islamic Republic of)
    Postal code:
    Phone:
    Fax:
    Email:
    Web page address:
    Name of recruitment center - English: Enghelab Health center of Shiraz
    Name of recruitment center - Persian: مرکز بهداشت شهدای انقلاب شیراز
    Full name of responsible person - English: Mohammad Mahdi Parvizi, MD, PHD
    Full name of responsible person - Persian: دكتر محمد مهدي پرويزي
    Street address - English: Siouye blv. Enghelab Health center of Shiraz
    Street address - Persian: شیراز، بولوار سیبویه، مرکزبهداشت شهدای انقلاب
    City - English: Shiraz
    City - Persian: شيراز
    Province: Fars
    Country: Iran (Islamic Republic of)
    Postal code: 7164788363
    Phone: +98 71 3738 7735
    Fax:
    Email: mmparvizi@gmail.com
    Web page address:
  • Sponsors / Funding sources

    #1
    contact.organization_id:
    Name of organization / entity - English: vice chancellor for research of shiraz university of medical science
    Name of organization / entity - Persian: معاونت پژوهشی دانشگاه علوم پزشکی شیراز
    Full name of responsible person - English: Seyd Basir Hashemi, MD
    Full name of responsible person - Persian: دکتر سید بصیر هاشمی
    Street address - English: 7th floor,Vice Chancellor of Research, Shiraz University of Medical Sciences, Zand Blvd., Shiraz, Iran
    Street address - Persian: شيراز، فارس، ايران، خیابان زند، ساختمان مرکزی دانشگاه علوم پزشکی شیراز، طبقه هفتم
    City - English: Shiraz
    City - Persian: شیراز
    Province:
    Country: Iran (Islamic Republic of)
    Postal code:
    Phone:
    Fax:
    Email:
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Seyd Basir Hashemi, MD
    Full name of responsible person - Persian: دکتر سید بصیر هاشمی
    Street address - English: 7th floor,Vice Chancellor of Research, Shiraz University of Medical Sciences, Zand Blvd., Shiraz, Iran
    Street address - Persian: شيراز، فارس، ايران، خیابان زند، ساختمان مرکزی دانشگاه علوم پزشکی شیراز، طبقه هفتم
    City - English: Shiraz
    City - Persian: شیراز
    Province: Fars
    Country: Iran (Islamic Republic of)
    Postal code: 7134814336
    Phone: +98 71 3230 5410
    Fax:
    Email: vcrdep@sums.ac.ir
    Web page address:
    94-7556
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    Public
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    Domestic
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    Academic
    vice chancellor for research of shiraz university of medical science
    Shiraz University of Medical Sciences
    معاونت پژوهشی دانشگاه علوم پزشکی شیراز
    دانشگاه علوم پزشکی شیراز
  • Person responsible for general inquiries

    contact.organization_id:
    Name of organization / entity - English: Shiraz University of Medical Science, School of Traditional Medicine, Shiraz, Iran
    Name of organization / entity - Persian: دانشگاه علوم پزشکی شیراز، دانشکده طب سنتی، شيراز، ايران
    Full name of responsible person - English: Dr. Mohammad Mahdi Parvizi
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Position - English: PHD Student of traditional Persian medicine
    Position - Persian: دانشجوی دکترای تخصصی طب سنتی
    Latest degree:
    Area of specialty/work: 0
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: 7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خیابان زند، دانشکده پزشکی، ساختمان شماره 2، طبقه 7
    City - English: Shiraz
    City - Persian: شيراز
    Province:
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 7134845794
    Phone: +98 71 3234 7966
    Mobile: +98 917 323 7031
    Fax:
    Email: parvizim@sums.ac.ir; mmparvizi@gmail.com
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Dr. Mohammad Mahdi Parvizi
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Position - English: PHD Student of traditional Persian medicine
    Position - Persian: دانشجوی دکترای تخصصی طب سنتی
    Latest degree: phd
    Area of specialty/work: 58
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: 7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خیابان زند، دانشکده پزشکی، ساختمان شماره 2، طبقه 7
    City - English: Shiraz
    City - Persian: شيراز
    Province: Fars
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 7134845794
    Phone: +98 71 3234 7966
    Mobile: +98 917 323 7031
    Fax:
    Email: mmparvizi@gmail.com
    Web page address:
  • Person responsible for scientific inquiries

    contact.organization_id:
    Name of organization / entity - English: Shiraz University of Medical Science, Dermatology Department, Shiraz, Iran
    Name of organization / entity - Persian: دانشگاه علوم پزشکی شیراز، بخش بیماری های پوست، شیراز، ایران
    Full name of responsible person - English: Dr. Farhad Handjani,
    Full name of responsible person - Persian: دکتر فرهاد هنجنی
    Position - English: Professeur agrégé of Dermatology
    Position - Persian: دانشيار، متخصص بیماری های پوست
    Latest degree:
    Area of specialty/work: 0
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: Dermatology department of Shahid Faghihi Hospital, Zand blv. Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خيابان زند، بيمارستان شهيد فقيهي، بخش پوست بيمارستان شهید فقیهی
    City - English: Shiraz
    City - Persian: شیراز
    Province:
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code:
    Phone: +98 71 3231 9049
    Mobile: +98 917 111 2150
    Fax:
    Email: hanjanif@yahoo.com; hanjanif@sums.ac.ir
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Dr. Farhad Handjani,
    Full name of responsible person - Persian: دکتر فرهاد هنجنی
    Position - English: Associate professor of Dermatology
    Position - Persian: دانشيار، متخصص بیماری های پوست
    Latest degree: specialist
    Area of specialty/work: 42
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: Dermatology department of Shahid Faghihi Hospital, Zand blv. Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خيابان زند، بيمارستان شهيد فقيهي، بخش پوست بيمارستان شهید فقیهی
    City - English: Shiraz
    City - Persian: شیراز
    Province: Fars
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 7134844119
    Phone: +98 71 3231 9049
    Mobile: +98 917 111 2150
    Fax:
    Email: hanjanif@yahoo.com
    Web page address:
  • Person responsible for updating data

    contact.organization_id:
    Name of organization / entity - English: Shiraz University of Medical Science, School of Traditional Medicine, Shiraz, Iran
    Name of organization / entity - Persian: دانشگاه علوم پزشکی شیراز، دانشکده طب سنتی
    Full name of responsible person - English: Dr. Mohammad Mahdi Parvizi
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Position - English: PHD Student of traditional Persian medicine
    Position - Persian: دانشجوی دکترای تخصصی طب سنتی، شيراز، ايران
    Latest degree:
    Area of specialty/work: 0
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: 7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خیابان زند، دانشکده پزشکی، ساختمان شماره 2، طبقه 7
    City - English: Shiraz
    City - Persian: شیراز
    Province:
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code:
    Phone: +98 71 3234 7966
    Mobile: +98 917 323 7031
    Fax:
    Email: parvizim@sums.ac.ir; mmparvizi@gmail.com
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Dr. Mohammad Mahdi Parvizi
    Full name of responsible person - Persian: دکتر محمد مهدی پرویزی
    Position - English: PHD Student of traditional Persian medicine
    Position - Persian: دانشجوی دکترای تخصصی طب سنتی، شيراز، ايران
    Latest degree: phd
    Area of specialty/work: 58
    Area of specialty/work title - English:
    Area of specialty/work title - Persian:
    Street address - English: 7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
    Street address - Persian: شیراز، فارس، ايران، خیابان زند، دانشکده پزشکی، ساختمان شماره 2، طبقه 7
    City - English: Shiraz
    City - Persian: شیراز
    Province: Fars
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 7134845794
    Phone: +98 71 3234 7966
    Mobile: +98 917 323 7031
    Fax:
    Email: mmparvizi@gmail.com
    Web page address:
  • Sharing plan

    yes
    yes
    yes
    yes
    yes
    yes
    yes
    empty
    The charasrristic of the patients participating in the study is reported in the published article.
    empty
    مشخصات بیماران شرکت کننده در مطالعه در مقاله منتشر شده گزارش شده است.
    empty
    The documentation had been published on PLOS Neglected Tropical Diseases journal's website .
    empty
    مستندات بر روی موب سایت مجله PLOS Neglected Tropical Diseases منتشر شده است.
    empty
    All of the researchers
    empty
    تمام محققین
    empty
    Provided that cite to the article if thedata and results of this study are used
    empty
    به شرط رفرنس دادن به مقاله در صورت استفاده از اطلاعات و نتایج حاصل از این مطالعه
    empty
    PLOS Neglected Tropical Diseases journal's website
    empty
    وب سایت مجله PLOS Neglected Tropical Diseases
    empty
    visit the PLOS Neglected Tropical Diseases journal's website and also sending a request via the email to the researchers
    empty
    مراجعه به وب سایت مجله PLOS Neglected Tropical Diseases و نیز ایمیل به محققین
  • Trial results

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    http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005957http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005957
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    http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005957
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    Introduction: Cutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with these products are sparse. In-vitro and in-vivo studies have shown the anti-leishmanial and curative effects of extract of fruits and leaves of Juniperus excelsa (J. excelsa). The aim of this study was to determine the efficacy of topical J. excelsa M. Bieb extract as an adjuvant to cryotherapy for the treatment of human CL. Materials and Methods: This study was designed as a two-arm triple-blind randomized placebo-controlled clinical trial using a parallel design. Seventy-two patients with clinical diagnosis of CL confirmed by leishmania smears were allocated to receive either a topical formulation of leaf of J. excelsa extract (group A) or placebo (group B) for 3 months. Both groups received cryotherapy as baseline standard treatment. Patients were evaluated before and weekly after the intervention was initiated until complete cure. Results: Overall, 82% of patients in group A, experienced complete cure and 9% of them had partial cure. On the other hand, 34% in group B reported complete cure, while 14% of them had partial cure at the end of treatment protocol with a significant difference between the two groups (p< 0.001). The mean duration to healing of the lesions in patients who received J. excelsa extract was statistically significantly shorter than the placebo group (p=0.04). No significant side effect was seen in the J. excelsa extract group except for mild to moderate local irritation after a few weeks in a few numbers of patients. Conclusion: The results of this study showed that topical J. excelsa extract can be used as an adjuvant treatment modality in addition to cryotherapy for accelerating the time to cure in addition to increasing the complete cure rate in CL. Key Words: cutaneous leishmaniasis, Juniperus excelsa, Traditional Persian Medicine, herbal medicine, cryotherapy.
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    مقدمه: لیشمانیوز جلدی، یکی از شایع ترین بیماری های اندمیک در خاورمیانه و شمال آفریقا می باشد. روش های درمانی متفاوتی برای درمان این بیماری توصیه شده است، اما میزان موفقیت این روش ها محدود بوده است. داروهای گیاهی مختلفی برای درمان این بیماری نیز مورد استفاده قرار گرفته است اما کارآزمایی های بالینی مبتنی بر شواهد کافی در خصوص این محصولات وجود ندارد. اخیرا مطالعات آزمایشگاهی و حیوانی معدودی اثر گیاه اورس Juniperus excelsa) ( در درمان لیشمانیوز جلدی را نشان داده اند. هدف از این مطالعه، تعیین اثر بخشی عصاره گیاه اورس به عنوان یک درمان کمکی همراه با کرایوتراپی در درمان لیشمانیوز جلدی در انسان می باشد. روش کار: این مطالعه به صورت یک کارآزمایی بالینی تصادفی سازی شده سه سوکور با استفاده از دو گروه موازی بیمار و کنترل طراحی گردید. 72 بیمار که مبتلا به لیشمانیوز جلدی بودند و بیماری آن ها با داشتن نتیجه اسمیر مثبت مورد تأیید قرار گرفته بود جهت دریافت فرمولاسیون های موضعی حاوی عصاره گیاه اورس (به عنوان گروه A ) و دارونما (به عنوان گروه B ) به مدت 3 ماه وارد مطالعه شدند. هر دو گروه مورد مطالعه، کرایوتراپی را به عنوان درمان پایه ای استاندارد دریافت نمودند. بیماران قبل از دریافت درمان و نیز به صورت هفتگی پس از درمان تا دست یابی به بهبود کامل یا نهایتا تا 3 ماه پس ازآغاز درمان مورد ارزیابی قرار گرفتند. نتایج: به طور کلی 82% از بیماران گروه A، بهبود کامل را تجربه کردند و 9% از آن ها به بهبود نسبی دست یافتند. از سوی دیگر، 34% ازبیماران در گروه B بهبود کامل را گزارش کردند، در حالی که 14% از آن ها در پایان درمان به بهبود نسبی دست یافتند. اختلاف آماری معنی داری ازنظر نتیجه درمان بین گروه مشاهده شد(001/0 p< ). میانگین مدت زمان بهبودی در بیماران گروه A که فراورده عصاره گیاه اورس را مصرف کرده بودند به طور معنی داری کمتر از گروه دارونما بود (004= p ). در بیماران گروه A به جز حساسیت موضعی خفیف تا متوسط چند هفته پس از شروع درمان در تعداد کمی ازبیماران، هیچ عارضه قابل توجهی مشاهده نشد. نتیجه گیری: نتایج این مطالعه نشان داد که مصرف موضعی عصاره گیاه اورس می تواند به عنوان یک روش درمانی کمکی (ادجوانت) همراه با کرایوتراپی برای تسریع در زمان بهبودی و همچنین افزایش میزان پاسخ دهی به درمان در بیماران مبتلا به لیشمانیوز جلدی مورد استفاده قرار گیرد. کلمات کلیدی: لیشمانیوز جلدی، اورس، طب سنتی ایرانی، داروهای گیاهی، کرایوتراپی

Protocol summary

Study aim
Determination of the efficacy of cryotherapy plus topical Juniperus excelsa M.Bieb, based on traditional Persian medicine, versus cryotherapy alone in the treatment of cutaneous leishmaniasis
Design
Two arm parallel group randomised clinical trial, triple-blinded
Settings and conduct
Design of the study: Patients with cutaneous leishmaniasis lesions referring to Shohaday-e- Enghelab Health Center of Shiraz and Shahid Faghihi Dermatology Clinic. In order to blind the researcher, medications are named as "A" for 5% Juniperus excelsa M.Bieb cream and B for placebo. The patient don't aware of the type of drug he/she is assigned to. In addition, the groups are entered into statistical analysis as "A" and "B".
Participants/Inclusion and exclusion criteria
Inclusion criteria: 1- Age 18 to 70 years the maximum 2- The maximum duration of their involvement by leishmaniasis is 4 months 3-Having physical health except the cutaneous leishmaniasis infection 4- Having 4 or less of the lesion leishmaniasis lesions 5-Did not taking any of topical and systemic anti-Leishmania treatment during last 4 weeks 6-Cutaneous leishmaniasis is approved of by smear**** Exclusion criteria: 1-Patients with complex forms of leishmaniasis and symptoms of mucousal leishmaniasis 2-Having more than 4 lesions 3- The lesions greater than 5 cm 4- Sub-cutaneous nodules 5-Regional adenopaty if greater than 1 cm size 6-Patients with immunodeficiency disease 7-The infants and children less than 18 years 8-Women in lactation and pregnancy 9-Patients with satellite lesions or sporotrichoid lesions 10-Patients with facial cutaneous leishmaniasis lesions
Intervention groups
Group A: Use of topical product (5% extract of Juniperus excelsa M.Bieb leaf cream) on cutaneous leishmaniasis lesions, 3 times daily Group B: Use of Placebo cutaneous leishmaniasis lesions, 3 times daily
Main outcome variables
The area of the cutaneous leishmaniasis lesions of the patients

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT2015082523753N1
Registration date: 2015-09-05, 1394/06/14
Registration timing: prospective

Last update: 2018-02-17, 1396/11/28
Update count: 1
Registration date
2015-09-05, 1394/06/14
Registrant information
Name
Mohammad Mahdi Parvizi
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 71 3212 5592
Email address
parvizim@sums.ac.ir
Recruitment status
Recruitment complete
Funding source
Vice chancellor of Research, Shiraz University of Medical Sciences
Expected recruitment start date
2015-10-07, 1394/07/15
Expected recruitment end date
2016-03-20, 1395/01/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Determination of the efficacy of cryotherapy plus topical Juniperus excelsa M.Bieb, based on traditional Persian medicine, versus cryotherapy alone in the treatment of cutaneous leishmaniasis: a double-blind randomized clinical trial
Public title
Effectiveness of traditional medicine products Juniperus excelsa M.Bieb in the treatment of cutaneous leishmaniasis
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Age 18 to 70 years the maximum The maximum duration of their involvement by leishmaniasis is 4 months Having physical health except the cutaneous leishmaniasis infection Having 4 or less of the lesion leishmaniasis lesions Did not taking any of topical and systemic anti-Leishmania treatment during last 4 weeks Cutaneous leishmaniasis is approved of by smear
Exclusion criteria:
Patients with complex forms of leishmaniasis and symptoms of mucousal leishmaniasis Having more than 4 lesions The lesions greater than 5 cm Sub-cutaneous nodules Regional adenopaty if greater than 1 cm size Patients with immunodeficiency disease The infants and children less than 18 years Women in lactation and pregnancy Patients with satellite lesions or sporotrichoid lesions Patients with facial cutaneous leishmaniasis lesions
Age
From 18 years old to 70 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Investigator
  • Data analyser
Sample size
Target sample size: 60
Randomization (investigator's opinion)
Randomized
Randomization description
Random allocation software Ink was used to create a randomization table
Blinding (investigator's opinion)
Triple blinded
Blinding description
In order to blind the investigator, medications are named A (Juniperus excelsa) and B (Placebo). The patient are not considered the type of drug are assigned to. The groups are also coded A and B for statistical analyzes.
Placebo
Used
Assignment
Parallel
Other design features
invivo and invitro phase of the study has been completed and now this study is carried out the effects of drugs on humans, .

Secondary Ids

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Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Shiraz University of Medical Sciences
Street address
Shiraz University of Medical Sciences, Zand blv., Shiraz, Fars, Iran
City
Shiraz
Province
Fars
Postal code
14336 - 71348
Approval date
2015-08-23, 1394/06/01
Ethics committee reference number
IR.SUMS.REC.1394.91

Health conditions studied

1

Description of health condition studied
cutaneous leishmaniasis
ICD-10 code
B55.1
ICD-10 code description
Cutaneous leishmaniasis

Primary outcomes

1

Description
size and area of leishmaniasis lesion
Timepoint
previous of the starting the treatment, weekly in the first month of treatment and every two weeks from second month to the end of the study
Method of measurement
Cooley and math with the square millimeters

Secondary outcomes

1

Description
Duration of the healing the lesion
Timepoint
At the end of the treatment proccess
Method of measurement
The time interval between the beginning and end of treatment in days

Intervention groups

1

Description
Intervention group: cryotherapy as a standard treatment in addition to cream (topical pharmaceutical products) containing 5% extract of Juniperus excelsa M.Bieb adminnistrate, three times daily for 12 weeks.
Category
Treatment - Drugs

2

Description
control group: cryotherapy as a standard treatment in addition to topical placebo cream with drug-like compounds and color with the exception of Juniperus excelsa M.Bieb extract, administrate every 8 hours daily for 12 weeks.
Category
Placebo

Recruitment centers

1

Recruitment center
Name of recruitment center
Dermatology clinic of Shahid Faghihi hospital
Full name of responsible person
Mohammad Mahdi Parvizi, MD, PHD
Street address
Shahid Faghihi hospital, Zand blv., Shiraz, Fars, Iran
City
Shiraz
Province
Fars
Postal code
7134844119
Phone
+98 71 3212 5592
Email
mmparvizi@gmail.com

2

Recruitment center
Name of recruitment center
Enghelab Health center of Shiraz
Full name of responsible person
Mohammad Mahdi Parvizi, MD, PHD
Street address
Siouye blv. Enghelab Health center of Shiraz
City
Shiraz
Province
Fars
Postal code
7164788363
Phone
+98 71 3738 7735
Email
mmparvizi@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Seyd Basir Hashemi, MD
Street address
7th floor,Vice Chancellor of Research, Shiraz University of Medical Sciences, Zand Blvd., Shiraz, Iran
City
Shiraz
Province
Fars
Postal code
7134814336
Phone
+98 71 3230 5410
Email
vcrdep@sums.ac.ir
Grant name
محل پرداخت قراردادهای دانشگاه علوم پزشکی شیراز
Grant code / Reference number
94-7556
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Shiraz University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Dr. Mohammad Mahdi Parvizi
Position
PHD Student of traditional Persian medicine
Latest degree
Ph.D.
Other areas of specialty/work
Traditional Medicine
Street address
7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
City
Shiraz
Province
Fars
Postal code
7134845794
Phone
+98 71 3234 7966
Fax
Email
mmparvizi@gmail.com
Web page address

Person responsible for scientific inquiries

Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Dr. Farhad Handjani,
Position
Associate professor of Dermatology
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Dermatology department of Shahid Faghihi Hospital, Zand blv. Shiraz, Fars, Iran
City
Shiraz
Province
Fars
Postal code
7134844119
Phone
+98 71 3231 9049
Fax
Email
hanjanif@yahoo.com
Web page address

Person responsible for updating data

Contact
Name of organization / entity
Shiraz University of Medical Sciences
Full name of responsible person
Dr. Mohammad Mahdi Parvizi
Position
PHD Student of traditional Persian medicine
Latest degree
Ph.D.
Other areas of specialty/work
Traditional Medicine
Street address
7th floor, building No.2, School of Medical Science, Zand blv, Shiraz, Fars, Iran
City
Shiraz
Province
Fars
Postal code
7134845794
Phone
+98 71 3234 7966
Fax
Email
mmparvizi@gmail.com
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
The charasrristic of the patients participating in the study is reported in the published article.
When the data will become available and for how long
The documentation had been published on PLOS Neglected Tropical Diseases journal's website .
To whom data/document is available
All of the researchers
Under which criteria data/document could be used
Provided that cite to the article if thedata and results of this study are used
From where data/document is obtainable
PLOS Neglected Tropical Diseases journal's website
What processes are involved for a request to access data/document
visit the PLOS Neglected Tropical Diseases journal's website and also sending a request via the email to the researchers
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