A Preliminary Study on the Therapeutic Effects of Hydroxychloroquine on Generalized Vitiligo

Vitiligo is a recalcitrant depigmentary autoimmune skin disorder. Hydroxychloroquine (HCQ) is an effective immunomodulatory drug which is widely used in treatment of autoimmune disorders. HCQ-induced pigmenta- tion has been previously found in patients taking HCQ due to other auto- immune diseases. The present study aimed to determine whether HCQ im- proves re-pigmentation of generalized vitiligo. HCQ was orally administered 400 mg daily (6.5 mg/Kg of body weight) by 15 patients with generalized vitiligo (more than 10% involvement of body surface area) for three months. Patients were evaluated monthly and skin re-pigmentation was assessed us- ing the Vitiligo Area Scoring Index (VASI). Laboratory data were obtained and repeated monthly. Fifteen patients (12 women and 3 men) with a mean age of 30.13±12.75 years were studied. After 3 months, the extent of re-pigmen- tation on all the body regions, including the upper extremities, hands, trunk, lower extremities, feet, and head and neck was significantly higher than the baseline (P value <0.001, 0.016, 0.029, <0.001, 0.006, 0.006, respectively). Patients with concomitant autoimmune diseases had significantly more re- pigmentation compared with others (P=0.020). No irregular laboratory data were observed during the study. HCQ could be an effective treatment for generalized vitiligo. The benefits are likely to be more evident in case of con- comitant autoimmune disease. The authors recommend additional large- scale controlled studies to draw further conclusions

Delayed Complications and Long-term Management of Sulfur Mustard Poisoning: Recent Advances by Iranian Researchers (Part І of ІІ)

Chemical warfare agents are the most brutal weapons among the weapons of mass destruction. Sulfur mustard (SM) is a potent toxic alkylating agent known as “the King of the Battle Gases”. SM has been the most widely used chemical weapon during the wars. It was widely used in World War I. Thereafter, it was extensively employed by the Iraqi troops against the Iranian military personnel and even civilians in the border cities of Iran and Iraq in the period between 1983 and 1988. Long-term incapacitating properties, significant environmental persistence, lack of an effective antidote, and relative ease of manufacturing have kept SM a potential agent for both terrorist and military uses. Even 3 decades after SM exposure, numerous delayed complications among Iranian victims are still being reported by researchers. The most common delayed complications have been observed in the respiratory tracts of chemically injured Iranian war veterans. Also, skin lesions and eye disorders have been observed in most Iranian SM-exposed war veterans in the delayed phase of SM intoxication. Thus, extensive research has been conducted on Iranian war veterans during the past decades. Nevertheless, major gaps still continue to exist in the SM literature. Part І of this paper will discuss the delayed complications and manifestations of exposure to SM among Iranian victims of the Iran–Iraq conflict. Part ІІ, which will appear in the next issue of Iran J Med Sci, will discuss the long-term management and therapy of SM-exposed patients

The effect of oral miltefosine in treatment of antimoniate resistant anthroponotic cutaneous leishmaniasis: An uncontrolled clinical trial.

BackgroundRecent circumstantial evidence suggests increasing number of Iranian patients with cutaneous leishmaniasis (CL) who are unresponsive to meglumine antimoniate (MA), the first line of treatment in Iran. Oral meltifosine was previously reported to be effective in visceral leishmaniasis as well CL. The current study is designed to determine efficacy and safety of oral miltefosine for the treatment of anthroponotic cutaneous leishmaniasis (ACL) cases who were refractory to MA in Iran.Methodology/principal findingsMiltefosine was orally administered for 27 patients with MA resistant ACL with approved L.tropica infection, at a dosage of ∼2.5 mg/kg daily for 28 days. Patients were evaluated on day 14 and 28, as well as 3, 6 and 12 month post treatment follow up sessions. Laboratory data were performed and repeated at each visit. Data were analyzed using SPSS version 17. Twenty-seven patients including 16 men (59.25%) and 11 women (40.74%) with mean age of 28.56 ± 4.8 (range 3-54 years old) were enrolled. Total number of lesions were 42 (1-4 in each patient). Most of lesions were on face (76.19%). Mean lesions' induration size was 2.38 ± 0.73 cm at the base-line which significantly decreased to1.31 ± 0.58 cm and 0.61 ±0.49 cm after 14 and 28 days of therapy, respectively (p value ConclusionOral miltefosine could be an effective alternative for the treatment of MA-resistant ACL

Evaluation of the Correlations between Depression, Anxiety, and Stress as DASS-21 Subscales and High-Risk Behaviors in the Adolescents in Torghabeh and Shandiz Towns, Iran

Introduction: Adolescence is a critical period in life, which is associated with tumultuous transitions and “storm and stress. The present study aimed to evaluate the correlation between depression, anxiety, and stress with the high-risk behaviors among the adolescents in Torghabeh and Shandiz towns, Iran. Materials and Methods: This cross-sectional study was conducted on 90 adolescents from the high schools. Participants were selected via two-stage sampling. Data were collected using the validated Depression, Anxiety, and Stress Scale (DASS-21) and history of high-risk behaviors in the students. Data analysis was performed in SPSS version 16. Results:Variable degrees of depression, anxiety, and stress were reported in 43.3%, 43.3%, and 38.9% of the students, respectively. Although the difference was not statistically significant, female students were more affected by the mentioned disorders compared to the male students. Among the high-risk behaviors, smoking cigarettes was significantly correlated with the depression, anxiety, and stress subscales. In addition, a significant association was observed between opium consumption and stress. However, no significant correlation was observed between smoking hookah and the DASS-21 subscales. Regular alcohol consumption was found to be significantly correlated with the higher rate of depression in the studied adolescents. Also, premarital sexual behaviors had a significant association with the stress and depression subscales. Conclusion: Lack of attention to depression, anxiety, and stress and their risk factors in adolescents may lead to variable degrees of life dissatisfaction in the community. Therefore, it is recommended that on-school mental screening programs be performed for high-school students in order prevent these complications