Comparison of Topical Erythromycin with and without Zinc Acetate in the Treatment of Mild to Moderate Acne Vulgaris

Background and Objective: Considering the role of bacteria in causing some forms of acne, in recent years, the use of antibiotics along with other medications has had positive results in acne treatment; therefore, the present study aimed to compare the effect of the combination of topical erythromycin and zinc acetate with topical erythromycin alone in treating mild to moderate acne vulgaris. Materials and Methods: In this clinical trial, 76 patients with acne vulgaris who were referred to a specialized skin clinic were selected and randomly assigned into two treatment groups, namely, A (n=39) and B (n=37). Group A was treated with a local solution of erythromycin 4% without zinc acetate, and group B was treated with a combined local solution of erythromycin 4% and zinc acetate 1.2%. The treatment continued twice a day for three months. Results: In groups, A and B, respectively, the average lesion intensity score before treatment was 21.1 ± 6.5 and 21.9 ± 5.4 (P=0.555), the first month of treatment was 17.0 ± 6.4 and 15.7 ± 5.9 (P=0.578), the second month of treatment 9.1 ± 4.5 and 6.4 ± 3.3 (P=0.014), the third month of treatment 4.0 ± 3.0 and 2.0 ± 3.0 (P=0.001), and the frequency of complete recovery was 38.5 and 64.9%, respectively (P=0.021). In group B, the severity of papules in the second (P=0.002) and third (P=0.001) months of the treatment was significantly lower than in group A. Conclusion: Based on the obtained results, using a combination of erythromycin 4% with zinc acetate 1.2% as a topical solution is more effective than the topical solution of erythromycin 4% alone in treating acne lesion

A comparative study of 20% azelaic acid cream versus 5% tranexamic acid solution for the treatment of postinflammatory hyperpigmentation in patients with acne vulgaris: A single-blinded randomized clinical trial

Background: There is a lack of evidence on the therapeutic efficacy of topical tranexamic acid (TA) for the treatment of acne-related postinflammatory hyperpigmentation (PIH). The current study aimed to assess the efficacy of twice-daily administration of 20% azelaic acid (AZA) cream versus 5% TA solution for the treatment of PIH in patients with acne vulgaris. Materials and Methods: Patients in the present single-blinded randomized clinical trial were randomized into AZA or TA groups for 12 weeks. The rate of healing was assessed by scoring recorded photographs based on postacne hyperpigmentation index (PAHI) at baseline, 4th, 8th, and 12th weeks. The frequency of side effects was examined and recorded at each study time point. Results: Thirty volunteers in each treatment group completed the intervention. PAHI score in both AZA and TA groups improved during the study course (Ptime 0.05). Conclusion: Topical administration of 20% AZA cream and 5% TA solution was comparably efficient in the treatment of acne-related PIH with a significantly better safety profile of TA in the 1st month of the treatment

Maternal mortality in Yazd Province, Iran

Introduction: Five hundred thousand maternal deaths occur each year worldwide, many of which are in developing countries. The maternal mortality rate is a measure that demonstrates the degree of adequacy of prenatal care and of economic and social conditions. The aim of this study was to determine the frequency and causes of pregnancy-related mortality rates in Yazd Province. Methods: This cross-sectional study examined the maternal deaths related to pregnancy that were recorded in Yazd Province, Iran, from 2002 to 2011. All maternal deaths that occurred during pregnancy, during delivery, and 42 days after birth were analyzed in this study. The data were collected through a questionnaire, and both direct and indirect causes of maternal deaths were determined. Results: Forty pregnancy-related deaths occurred in this period, and the maternal mortality rate was 20.8 deaths per 100,000 live births. The mean age of death in the mothers in this study was 29.17. Fifty-five percent of women of the women who died delivered their babies by cesarean section, and only 20% of them delivered their babies vaginally. Bleeding was the most common cause of maternal mortality (30%), and it was associated directly with maternal mortality. Furthermore 20% of the mothers died due to heart disease and cardiac complications, which were associated indirectly with maternal mortality. Conclusion: Cesarean section and its complications were the main cause of death in many cases. Thus, providing a strategic plan to reduce the use of this procedure, educate mothers, and ensure adequate access to pre- maternal care and to care during pregnancy are the most important measures that can be taken to decrease the maternal mortality rate