Dermatologists Communication Skills and Performance From Point of View of Patients

Introduction: Effective communication is an important issue in patient-doctor interaction which is even more important regarding chronic disorders which need a strong relationship between patient and clinician for better compliance and optimal control disease. Objectives: This study was aimed to develop the best cultural adapted Persian version of the 28-item Calgary- Cambridge Observation Guide (CCOG) questionnaire. Methods: In this descriptive‑analytic study, data collected from 400 patients attending the outpatient dermatology clinics of 3 major hospitals in Tehran using the modified Persian version of CCOG questionnaire, both before and after being visited by dermatologists. Results: The difference of CCG scores for all of questions, except for questions number 1,16 and 22, was statistically significant. The highest score, both before and after visiting, attained by question regarding being respectful. The lowest scores for necessary behavior and the adequate amount of execution were related to questions number 3 (Introducing self) and 4 (Introducing role), respectively. Age and educational level of patients were significantly correlated with their expectations regarding communication skills of clinician. Conclusions: This study showed the acceptable validity of modified Persian version of CCOG-24 item questionnaire. Our findings also demonstrated that there was a significant difference between what patients expected from a dermatologist and the manner they actually were treated regarding physician communication skills

Prolactin level changes in pemphigus vulgaris:A cohort study

Background: Prolactin (PRL) appears to play a role in the pathogenesis of autoimmune diseases. Limited evidence showed an association between serum PRL levels and the activity of pemphigus vulgaris (PV). This study intends to determine PRL level changes in pemphigus patients during therapy and its correlation with disease type and severity. Methods: In this cohort study, we measured serum PRL levels by enzyme-linked immunosorbent assay (ELISA) in newly diagnosed PV patients at three time points: before therapy initiation and after two and four months. Concomitantly, we estimated disease severity by the Pemphigus Disease Area Index (PDAI). Results: We examined 42 new cases of PV. Among 32 cases who completed the study, mean serum PRL levels at the three time points were 15.9±14.1 ng/mL (before treatment), 16.7±9.8 ng/ mL (2 months after initiation of treatment), and 15.2±9.2 ng/mL (4 months after initiation of treatment). Mean PDAI values were 19.3±12.8 (before treatment), 3.7±6.2 (2 months after initiation of treatment), and 0.6±1.5 (4 months after initiation of treatment). Although the disease activity decreased significantly (P&lt;0.001), there was no significant change observed in PRL level (P=0.760). We observed no significant correlations between PRL levels and PDAI for before (r= - 0.25; P=0.180), 2 months after initiation of treatment (r= 0.02; P=0.920), and 2 months after initiation of treatment (r=0.04; P=0.800). Conclusion: The results suggest that no significant association exists between serum PRL concentrations and the severity of PV.</p

Prolactin level changes in pemphigus vulgaris:A cohort study

Background: Prolactin (PRL) appears to play a role in the pathogenesis of autoimmune diseases. Limited evidence showed an association between serum PRL levels and the activity of pemphigus vulgaris (PV). This study intends to determine PRL level changes in pemphigus patients during therapy and its correlation with disease type and severity. Methods: In this cohort study, we measured serum PRL levels by enzyme-linked immunosorbent assay (ELISA) in newly diagnosed PV patients at three time points: before therapy initiation and after two and four months. Concomitantly, we estimated disease severity by the Pemphigus Disease Area Index (PDAI). Results: We examined 42 new cases of PV. Among 32 cases who completed the study, mean serum PRL levels at the three time points were 15.9±14.1 ng/mL (before treatment), 16.7±9.8 ng/ mL (2 months after initiation of treatment), and 15.2±9.2 ng/mL (4 months after initiation of treatment). Mean PDAI values were 19.3±12.8 (before treatment), 3.7±6.2 (2 months after initiation of treatment), and 0.6±1.5 (4 months after initiation of treatment). Although the disease activity decreased significantly (P&lt;0.001), there was no significant change observed in PRL level (P=0.760). We observed no significant correlations between PRL levels and PDAI for before (r= - 0.25; P=0.180), 2 months after initiation of treatment (r= 0.02; P=0.920), and 2 months after initiation of treatment (r=0.04; P=0.800). Conclusion: The results suggest that no significant association exists between serum PRL concentrations and the severity of PV.</p

Neurological diseases and bullous pemphigoid:A case-control study in Iranian patients

Introduction: Neurological diseases are important co-morbidities found in association with bullous pemphigoid. Various neurological conditions (stroke, Parkinson's disease, dementia, epilepsy and multiple sclerosis) have been reported as associations of this bullous disease; whether these are significant has not been definitely proved. However, the presence of neurological conditions is a predictor of poorer prognosis. Objectives: Our aim was to examine the association of bullous pemphigoid and neurological diseases in Iranian bullous pemphigoid patients. Methods: The medical records of one hundred and sixty consecutive bullous pemphigoid patients who presented to the Autoimmune Bullous Diseases Research Center, Tehran, Iran, from 2006 to 2011 were examined for evidence of any neurological disease. The control group comprised of 317 age- and sex-matched subjects. Results: Neurological diseases were seen in 42 (26.4%) patients with bullous pemphigoid and in 29 (9.1%) controls (odds ratio: 3.53 (2.1-5.9), P&lt; 0.001). Comparing cases to controls, stroke was seen in 17.5% versus 4.1%, odds ratio 4.96 (2.49-9.88); dementia in 5.6% versus 1.9%, odds ratio 3.09 (1.08-8.84); Parkinson's disease in 2.5% versus 2.2%, odds ratio 1.14 (0.33-3.94); epilepsy in 2.5% versus 0.6%, odds ratio 4.04 (0.73-22.3); and multiple sclerosis in 0 versus 0.3% odds ratio 1.00 (0.98-1.01). Limitations: The main limitations of our study were referral bias, retrospective design and a rather low sample size. Conclusions: Neurological diseases in general, and stroke and dementia in particular, were significantly associated with bullous pemphigoid in our study.</p

Neurological diseases and bullous pemphigoid:A case-control study in Iranian patients

Introduction: Neurological diseases are important co-morbidities found in association with bullous pemphigoid. Various neurological conditions (stroke, Parkinson's disease, dementia, epilepsy and multiple sclerosis) have been reported as associations of this bullous disease; whether these are significant has not been definitely proved. However, the presence of neurological conditions is a predictor of poorer prognosis. Objectives: Our aim was to examine the association of bullous pemphigoid and neurological diseases in Iranian bullous pemphigoid patients. Methods: The medical records of one hundred and sixty consecutive bullous pemphigoid patients who presented to the Autoimmune Bullous Diseases Research Center, Tehran, Iran, from 2006 to 2011 were examined for evidence of any neurological disease. The control group comprised of 317 age- and sex-matched subjects. Results: Neurological diseases were seen in 42 (26.4%) patients with bullous pemphigoid and in 29 (9.1%) controls (odds ratio: 3.53 (2.1-5.9), P&lt; 0.001). Comparing cases to controls, stroke was seen in 17.5% versus 4.1%, odds ratio 4.96 (2.49-9.88); dementia in 5.6% versus 1.9%, odds ratio 3.09 (1.08-8.84); Parkinson's disease in 2.5% versus 2.2%, odds ratio 1.14 (0.33-3.94); epilepsy in 2.5% versus 0.6%, odds ratio 4.04 (0.73-22.3); and multiple sclerosis in 0 versus 0.3% odds ratio 1.00 (0.98-1.01). Limitations: The main limitations of our study were referral bias, retrospective design and a rather low sample size. Conclusions: Neurological diseases in general, and stroke and dementia in particular, were significantly associated with bullous pemphigoid in our study.</p