595nm Pulsed Dye Laser: An Alternative to Treat Basal Cell Carcinomas

INTRODUCTION: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Proffered treatment for these lesions is surgery. Based on patient’s age, drug allergies, and place of lesions, surgery may not be the best option, and alternative treatments should be considered. Pulsed dye laser (PDL) may be a good alternative therapy. The aim of the present study was to determine the effectiveness and safety of this laser in the treatment of BCCs in Iranian patients.METHODS: Patients with definite diagnosis of BCC enrolled in the study. For each patient, one lesion proved to be superficial, or nodular BCC via histopathology was treated with PDL for four sessions and after the last session, re-biopsy was done to determine any remnant of tumor. All patients were followed for 6 to 13 months to capture any recurrence of as soon as possible.RESULTS: A total of 12 patients including eight male and four female were selected. All patients completed the study in accordance to the treatment protocol. All patients cleared clinically resulting flat hypo pigmented scar, but in pathology, two patients showed remnants of tumor and were referred for surgery. No side effects, but mild erythema and irritation were noted in all patients. No recurrences were found during the follow up period.CONCLUSION: It seems that PDL may be an effective alternative therapy for some subtypes of BCCs with acceptable safety profile. Further studies with larger sample sizes are required to support this opinion

Solar Lentigines: Evaluating Pulsed Dye Laser (PDL) as an Effective Treatment Option

INTRODUCTION: Solar lentigines are among commonest cosmetic problems. There are many topical therapies suggested to treat these lesions including cryotherapy, chemical peeling with tri chloro acetic acid (TCA) and laser therapy with q-switched lasers as well as long pulsed lasers. Considering possible treatment side effects (PIH, scar) with cryotherapy and peeling in Iranian patients (darker skin types) it seems necessary to try to find alternative measures. The aim of the present study was to evaluate effect of long pulsed dye laser (LPDL) on lentigines via an objective method (computerized dermoscopy).METHODS: Patients with pathologically confirmed lentigines were selected if they agreed to participate in the study,were not treated before, hadn’t history of psoriasis, vitiligo, scar formation and were not pregnant. Letigines were dermoscopied before and after treatment with PDL (V-beam, 595nm, Candela Corp. Wayland, USA) using fluence of 10 joules, without DCD (dynamic cooling device) via extra compress lens provided with laser system. The resulting figures were compared by two academic unrelated dermatologists as well as by computerized analysis. Post laser side effects were treated with topical antibiotics and mild topical steroids. Patients were followed for six months after the end of the study to determine the rate of recurrence via dermoscopy of sites of previous lesions and also delayed side effects.RESULTS: A total of 21 patients with the same number of lesions, were included in the study. Mean age of patients was 54.2 years (±23.3) ranging from 39 to 71 years. Included patients were 18 females and three males. From 21 treated lesions, 11 were located on the hands and 10 on the face. Comparing before and after photographs taken through dermoscopy system, revealed that approximately 57% of patients had more than 75% improvement. Mean pigment analysis score (calculated by computerized dermoscope software) was respectively 8 and 2 before and after PDL therapy, showing noticeable decrease in pigment density of lesions. Side effects were mild erythema and local irritation responding to topical mild steroids. No hypo or persistent hyper pigmentation or other delayed side effects was seen after six months follow up. One patient experienced transient hyper pigmentation of treatment site after treatment. During six months follow up, no recurrences were seen.CONCLUSION: In conclusion, PDL is a safe and effective option to treat lentigines if applied properly using compression method, especially in Iranian patients. However, further studies with larger sample size are required to confirm these results

Effect of anti-inflammatory drug (Piroxicam) on the development of fatty streak and biochemical factors in cholesterol-fed rabbits

زمینه و هدف: با توجه به اینکه هنوز علت اصلی مرگ و میر در اکثر نقاط دنیا بیماریهای قلبی- عروقی است، پیشگیری و درمان این بیماریها با توجه به مکانیسم های جدید ارائه شده قابل توجه است. این پروژه با تکیه بر مکانیسم جدید بیماریهای عروقی مبنی بر یک بیماری التهابی در صدد یافتن ترکیبات خاص در پیشگیری از تشکیل و پیشرفت رگه های چربی (fatty streak) در آترواسکلروز بوده است. روش مطالعه: در یک مطالعه مداخله ای 20 خرگوش نر به مدت 14 هفته مورد بررسی قرار گرفتند. خرگوشها بصورت انتخابی در 4 گروه 5 تایی تقسیم شدند و همه این گروهها در ابتدا به مدت2 هفته تحت رژیم پایه قرار گرفتند. سپس، گروه اول تا پایان دوره تحت رژیم استاندارد، گروه دوم علاوه بر رژیم استاندارد، روزانه mg6 پیروکسیکام تزریقی دریافت کردند، گروه سوم تحت رژیم پرکلسترول و گروه چهارم علاوه بر رژیم پرکلسترول روزانه mg6 پیروکسیـــکام تزریقی دریافت کردند. در طـــی این دوره در دو نوبت (بعد از رژیم پایه و در پایـــان دوره) از خرگوشها جهت آزمایشات بیوشیمیـــایی مختلف از جمله کلسترول تام، لیپوپروتئین با دانسیته پائین (LDL)، لیپوپروتئین با دانسیتـــه بالا (HDL)، مالون دی آلدئید، قند خون ناشتا (FBS)، CRP (C-Reactive protein) کمی، تری گلیسیرید و ظرفیت آنتی اکسیدان خونگیری به عمل آمد. در پایان پس از اتوپسی، نمونه آئورت و کرونرهای راست و چپ مورد بررسی پاتولوژی قرار گرفت. نتایج: رژیم پرکلسترول در مقایسه با رژیم استاندارد باعث ایجاد fatty streakدر عروق کرونر و آئورت شد (0001/0

Comparing Load of Working Memory during Spontaneous and Active EEG in Children with Specific Learning Disorder

The goal of the present study is to compare working memory load during spontaneous EEG (Electroencephalogram) with task condition by monitoring theta power in frontal regions of brain, in children with specific learning disorder. Theta recording was done during eyes closed (EC), eyes opened (EO) and task (VCPT) conditions for 52 children with specific learning disorder aged between 7 to 12 years old (22= girls, 30= boys). The learning disorder diagnosis was done by means of stanford binet IQ test, and Persian Academic Achievement test. EEG data was collected and digitized by means of WinEEG software and analyzed in SPSS with paired samples t-test. The results showed significant differences between theta power in VCPT condition with both EC and EO conditions in Fz. This finding is consistent with finding about normal groups. Although working memory deficit is one of core cognitive deficits in this group, but still cognitive efforts happen for mental processing. Strong significance can shows a source for omission errors in this group, because high amplitude of frontal midline theta may happens with the entrance of irrelevant information in attentional pathways

Refractory Port Wine Stains (PWS): Long Pulsed Alexandrite Laser as an Option

INTRODUCTION: Port wine stains (PWS) are congenital vascular malformations. Pulsed dye laser (PDL) is the treatment of choice till now, although many lesions do not respond completely. One of possible options is long pulsed alexandrite laser. Some literatures confirmed its efficacy. The aim of the present study is to determine the efficacy of this laser as an option in treating refractory PWS in Iranian patients.METHODS: Patients with refractory PWS lesions that did not respond to at least six PDL sessions were included if they had no history of Isotretinoin consumption in past year, history of keloid or hypertrophic scar formation, active infection in laser site and if they were not pregnant. All patients signed an informed consent. Alexandrite laser with fluencies from 36-40J/Cm2, 12 mm spot size, 3 ms pulse duration and dynamic cooling device tuned to 50/50 ms was used in three successive sessions to treat lesions. All patients photographed before each session and after 8 weeks from the last sessions. Then, pictures were rated by two blinded dermatologist rater to determine degree of response based of visual analog scaling from score 1(below 25% response) to score 4 (more than 75% response).RESULTS: A total of 20 patients comprised of 12 males and 8 females with mean age of 23 years were included. 35% (7 patients) had score of 1, 35% (7 patients) had score of 2, 25% (5 patients) had score of 3 while one patient (5%) reached score 4. No serious side effect was observed. There was no significant relationship with age, gender and size of lesions and response rate.CONCLUSION: It seems that considering a conservative approach, long pulsed alexandrite laser may be an effective option in treating refractory PWS lesions. Although future studies with higher sample size using higher fluences are required to confirm these results

Rituximab therapy improves recalcitrant Pemphigus vulgaris

Pemphigus is a severe life-threatening blistering disease associated with autoantibodies against cell adhesion proteins desmogleins 1 and 3. Patients with severe pemphigus commonly show high rates of relapse after conventional immunosuppressive therapy. The newly developed drug Rituximab showed impressing promises in the treatment of refractory pemphigus vulgaris (PV). In the present study the efficacy of a single course rituximab therapy in the treatment of PV was investigated. Eighteen patients with severe recalcitrant PV were recruited to this study. Pemphigus disease activity index (PDAI), anti-desmoglein 1 and anti-desmoglein 3 antibody titers, and percent of CD20 positive cells were measured at baseline, 10 ± 1, and 22 ± 2 weeks after rituximab therapy. Rituximab was given intravenously at dose 375 mg/m2 once weekly for 4 weeks. Rituximab therapy caused a dramatic reduction in the PDAI, accompanied by decreases in anti-desmoglein 1 and anti-desmoglein 3 antibody titers over the follow-up course. The B-cell population decreased at the first follow-up, but returned to its baseline levels at the second follow-up. Rituximab therapy decreased the dose of immunosuppressive drugs required to control the disease. It seems that the rituximab may be effective and safe for treatment of refractory PV

The Role of Stearoyl-coenzyme A Desaturase 1 in Liver Development, Function, and Pathogenesis

Stearoyl-coenzyme A desaturase 1 (SCD1) is a microsomal enzyme that controls fatty acid metabolism and is highly expressed in hepatocytes. SCD1 may play a key role in liver development and hepatic lipid homeostasis through promoting monounsaturated protein acylation and converting lipotoxic saturated fatty acids into monounsaturated fatty acids. Imbalanced activity of SCD1 has been implicated in fatty liver induction, inflammation and stress. In this review, the role of SCD1 in hepatic development, function and pathogenesis is discussed. Additionally, emerging novel therapeutic agents targeting SCD1 for the treatment of liver disorders are presented

Interleukin-6 as A Prognostic Biomarker in Perinatal Asphyxia

Abstract Objective Early diagnosis is considered as a priority for prevention and treatment of asphyxia-related complications. The main aim of the present study was to evaluate the prognostic value of interleukin-6 (IL-6) and hypoxic ischemic encephalopathy grade in prediction mortality and developmental status of neonates affected by prenatal asphyxia. Materials & Method The cohort study was conducted on 38 term asphyxiated infants at Ghaem hospital, Mashhad, Iran, during 2013-2017. The HIE grade and serum IL-6 levels were determined at the time of birth. The developmental status was determined using the Denver II test at the end of two-year follow-up. Results  HIE grade 3 resulted in 83% mortality rate and developmental delay in all the survivors. The average IL-6 level was 2.7 ng/ml in the control group (not affected HIE) which increased up to 29, 175 and 136 ng/ml in those with HIE grades 1, 2 and 3, respectively. Roc curve analysis revealed the cut-off levels 24 pg/ml to predict the developmental delay with sensitivity and specificity of 96 and 92%, respectively. Conclusion  The IL-6 level and HIE grade are the potential prognostic biomarkers for determination of mortality and morbidity rate in the asphyxiated neonate

Global prevalence of nosocomial infection: A systematic review and meta-analysis

Objectives: Hospital-acquired infections (HAIs) are significant problems as public health issues which need attention. Such infections are significant problems for society and healthcare organizations. This study aimed to carry out a systematic review and a meta-analysis to analyze the prevalence of HAIs globally.   Methods: We conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. We found 7031 articles. After removing the duplicates, 5430 studies were screened based on the titles/abstracts. Then, we systematically evaluated the full texts of the 1909 remaining studies and selected 400 records with 29,159,630 participants for meta-analysis. Random-effects model was used for the analysis, and heterogeneity analysis and publication bias test were conducted.   Results: The rate of universal HAIs was 0.14 percent. The rate of HAIs is increasing by 0.06 percent annually. The highest rate of HAIs was in the AFR, while the lowest prevalence were in AMR and WPR. Besides, AFR prevalence in central Africa is higher than in other parts of the world by 0.27 (95% CI, 0.22-0.34). Besides, E. coli infected patients more than other micro-organisms such as Coagulase-negative staphylococci, Staphylococcus spp. and Pseudomonas aeruginosa. In hospital wards, Transplant, and Neonatal wards and ICU had the highest rates. The prevalence of HAIs was higher in men than in women.   Conclusion: We identified several essential details about the rate of HAIs in various parts of the world. The HAIs rate and the most common micro-organism were different in various contexts. However, several essential gaps were also identified. The study findings can help hospital managers and health policy makers identify the reason for HAIs and apply effective control programs to implement different plans to reduce the HAIs rate and the financial costs of such infections and save resources

Sensitivity analysis of fuel consumption in highways by intention to road geometrical parameters

Transportation sector accounts for the largest part in consumption of gasoline and gas oil. Increase in fuel consumption along with decrease in energy efficiency as well as energy conversion with high waste has caused irreparable damages to environment and economical- social development. In addition, raising the price of all types of fuels and rationing these products, has made it necessary to pay attention to this section. In this paper, traffic flow of Garmsar-Semnan road in Iran as a case study will be analysed using simulation by CORSIM software. Then, by changing geometrical parameterss in the road, the changes in fuel consumption will be examined. Geometrical and traffic information related to the road under study has been obtained through measurement in the path and field perception. Furthermore, to validate the results of the fuel consumption of used software, a field survey was conducted which indicates slight difference between the actual values and the results of the software. The results of the changes in geometrical factors show that simultaneous change in slope and elimination of curves in this road will have the greatest impact in reducing fuel consumption of the vehicles and consequently reducing the environmental pollution