Evaluating the efficacy and safety of vascular IPL for treatment of acute cutaneous leishmaniasis: a randomized controlled trial

Lasers in Medical Science - Treatment of cutaneous leishmaniasis (CL) continues to be a health concern, and alternative therapies with fewer side effects are substantially needed. This study aimed...     

Evaluation of coexistence of the Human Herpesvirus type 8 (HHV‐8) infection and pemphigus

Background Human Herpesvirus type 8 (HHV‐8) is a new member of the herpes virus family, first found in the tissue of acquired immune deficiency syndrome (AIDS)‐related Kaposi’s sarcoma. Environmental factors including viral infection may play a role in the onset and/or development of pemphigus. Some studies based on polymerase chain reaction findings suggest an association between HHV‐8 and pemphigus. The aim of this study is investigation of the association of pemphigus with HHV‐8 and the relationship between inflammatory and acantholytic cells with HHV‐8 infection. Methods Tissue‐extracted DNA from 41 paraffin‐embedded skin tissues from patients first presenting with pemphigus was tested using nested PCR for the presence of HHV‐8. A total of 37 cases had pemphigus vulgaris (PV) and 4 patients had pemphigus foliaceus (PF). For our control group, normal skin of 21 cosmetic surgery patients were included. Furthermore, microscopic slides with H&E staining were evaluated for the number of inflammatory and acantholytic cells per microscopic field. Results Skin lesions from 13 of 37 patients (35.1%) with PV and 2 of 4 cases (50%) with PF were positive for HHV‐8 DNA. All specimens in our control group were negative for this virus. Conclusion HHV‐8 infection might be a contributing factor in the initiation or development of pemphigus.     

No Evidence of Human Papilloma Virus Infection in Basal Cell Carcinoma

Background:

Basal cell carcinoma (BCC) is the most common skin cancer among whites, and several risk factors have been discussed in itsdevelopment and progress. Detection of human papilloma virus (HPV) deoxyribonucleic acid (DNA) BCCs in some studies suggests that the virus may play a role in the pathogenesis of this disease. Several molecular studies showed conflicting reports.

Aims:

The purpose of this study was to investigate the association between HPV and BCC using polymerase chain reaction (PCR).

Materials and Methods:

HPV DNA detection was done for 42 paraffin-embedded tissue specimens of BCC and 42 normal skin samples around the lesions by PCR using GP5+/GP6+ primers.

Results:

HPV DNA was not found in any of the 42 samples of BCC, and only one normal skin sample around the lesions was positive for HPV DNA by PCR.

Conclusion:

In this study, no statistically significant difference was seen between the presence of HPV DNA in BCC and normal skin around the lesion, and HPV is not likely to have an important role in pathogenesis of BCC.     

Relationship between Delivery Type and Menstrual Disorders: A Case-Control Study

Background: High incidence of menstrual disorders at late ages of fertility ac-counts for 20% of clinical visits and 25% of gynecological surgeries. This study was conducted to identify the relationship between delivery type and menstrual disorders in women referring to hospitals affiliated to Medical Universities in Tehran in 2008. Methods: In this case-control study, which was conducted from April to August, 2008 in Tehran, 160 women aged 36 to 44 years, 8o women with and 80 without menstrual disorder as case and control groups were enrolled respectively. Data collection tool was a questionnaire (included questions regarding demographic and obstetrical characteristics). Higham pictorial chart (scores more than 80 denoted menorrhagia), a verbal multidimensional scoring scale (from 0 for painless to 3 for severe pain), and Holmes-Rahe scale for assessing stress were used. Results: About 93.1% of the cases and 65% of the controls had experienced dysmenorrhea at the begging of the study (P=0.009). In other words, 65% of women with dysmenorrhea had a history of C-section. Women with menstrual disorders had more caesarian sections (53.7%) than those without the disorders (27.5%) (P<0.001) with an odds ratio estimate of 3.06 [95% CI: 1.58, 5.91]. There were significant differences in the number of pads/tampons used (P=0.009) and amount of uterine bleeding based on Higham chart (P=0.009) among case and control group. Conclusion: Caesarian may be considered as a risk factor for menstrual disor-ders particularly at late ages of fertility. Therefore, pregnant women should be consulted by health providers regarding advantages versus disadvantages of caesarian before selective C-section.     

Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome: a systematic review and meta-analysis

Introduction: Nowadays, selection of COCs with maximum antiandrogenic effects is one the main issues in treatment of women with polycystic ovary syndrome (PCOS).

Objective: This systematic review and meta-analysis aimed to compare the effects of COCs on the clinical and biochemical parameters of hyperandrogenism (HA) in patients with PCOS.

Methods: Electronic databases (PubMed, Scopus, ScienceDirect and web of science) were searched from 1987 to November 2015 to identify clinical trials investigating effect of the various COCs on the clinical and biochemical parameters of HA in patients. In this meta-analysis, both fixed and random effect models were used. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses.

Results: Findings showed that COC use for 3–12 months was significantly associated with an increase in sex hormone-binding globulin (SHBG) levels and a decrease in Ferriman–Gallwey (FG) score, total testosterone (TT), free testosterone (FT), androstenedione (A4) and dehydroepiandrosterone sulphate (DHEAS) levels. Type of progestin or duration of treatment had no important effects on declining androgen levels. Long-term use of COCs (6–12 months) was more effective in improving hirsutism, compared to short term. COCs containing cyproterone acetate (CPA) for 12 months had the strongest effect in improving hirsutism.

Conclusions: This study shows that, in patients with PCOS, COCs can effectively improve biochemical and clinical parameters of HA. All COCs studies have similar effects on the hormonal profiles of these patients, and products containing CPA may be an effective treatment in hirsute patients with PCOS.     

Food Hypersensitivity in Patients Over 14 Years of Age Suffering from Atopic Dermatitis

Background:

Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce.

Aims and Objectives:

Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis.

Materials and Methods:

The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity.

Results:

A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%).

Conclusion:

Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen–associated foods play a role in the majority of patients suffering from atopic dermatitis.     

Comparison of intralesional two percent zinc sulfate and glucantime injection in treatment of acute cutaneous leishmaniasis

Introduction:

Cutaneous leishmaniasis is an endemic disease in developing countries caused by different species of leishmania parasite, and if left untreated, it will result in a deformed scar after a relatively long period. Although various systemic and topical treatments have been proposed for leishmaniasis, pentavalent Antimony compounds remain the first-line treatment for it. Considering the cases with treatment failure, potential side effects and reluctance of patients to receive the drug, there are continuing efforts to find better treatment alternatives.

Aim:

Comparison of the effect of intralesional 2% zinc sulfate injection with Glucantime in treatment of acute cutaneous leishmaniasis.

Materials and Methods:

In this clinical trial, 45 patients with clinical diagnosis of cutaneous leishmaniasis and positive direct smear for leishman body were treated by intralesional injection of either 2% zinc sulfate or Glucantime. After simple randomization, in one group the patients were treated with 2 bouts of intralesional 2% zinc sulfate with a 2-week interval, and in the other group they were treated with 6 weekly bouts of intralesional Glucantime. The patients were monitored in two week intervals for 8 weeks. Healing of the lesions was evaluated clinically and by direct smear, and the data were analyzed using SPSS (11.5) software, t-Student, Mann-Whitney and Analysis of covariance (ANCOVA) statistical tests.

Findings:

In the end of study, 34 patients completed the study, 10 of whom received intralesional Glucantime and 24 of whom received intralesional 2% zinc sulfate. The healing rate after 8 weeks was 80% in the group receiving intralesional Glucantime and 33.3% in the one receiving 2% zinc sulfate (P=0.009).

Conclusion:

Based on the results of this study, intralesional injection of 2% zinc sulfate was less effective in treatment of cutaneous leishmaniasis than intralesional Glucantime.