A Comparison of The Effects of Clobetasol 0.05% and Photodynamic Therapy Using Aminolevulinic Acid With Red Light in the Treatment of Severe Nail Psoriasis

Introduction: The treatment of nail psoriasis is often difficult and unsatisfactory due to therapy resistance. This study aimed to compare the efficacy of clobetasol 0.05% ointment and photodynamic therapy (PDT) using aminolevulinic acid (ALA) and red light in the treatment of severe nail psoriasis.Methods: This open-trial study included 69 nails of 8 patients with severe nail psoriasis. Thirty-four nails were treated with clobetasol 0.05% ointment and 35 nails were treated with ALA-PDT. ALA-PDT treatment was performed every 3 weeks for 5 cycles; the nails were treated with clobetasol under occlusion every day during the study. All the patients were followed up after 24 weeks. The severity of nail involvement was measured by the Nail Psoriasis Severity Index (NAPSI) scores at the baseline and during the treatment.Results: There were no significant differences in the NAPSI scores between the treatment groups in the baseline and weeks 3, 6 and 9 (all P > 0.05), although significant differences were found in weeks 12, 15 and 24 (follow-up) (P < 0.001). A significant time-effect improvement was found in all the nail-matrix, nail-bed and total NAPSI scores in both treatment groups (all P < 0.001). The patients did not report intense pain and discomfort during irradiation.Conclusion: Clobetasol 0.05% ointment seems to be effective in treating nail psoriasis after a treatment period of 15 weeks. However, the efficacy of ALA-PDT at a 24-week follow-up was greater than that of clobetasol.

The effects of regular exercise program on dialysis efficacy, muscle atrophy and physical performance in hemodialysis patients

زمینه و هدف: سبک زندگی غیر فعال و عوارضی همچون آتروفی عضلانی و ضعف عضلانی از جمله مشکلات بیماران همودیالیزی است. هدف از این مطالعه بررسی اثر تمرینات ورزشی بر کیفیت دیالیز، آتروفی عضلانی و عملکرد جسمانی بیماران همودیالیز می باشد. روش بررسی: در این مطالعه نیمه تجربی، 30 بیمار همودیالیزی به صورت داوطلبانه انتخاب شدند و به صورت تصادفی در دو گروه کنترل و تجربی قرار گرفتند. گروه تجربی تمرینات ورزشی فزاینده را با دوچرخه به مدت 20 هفته، 3 جلسه در هفته و هر جلسه 60 دقیقه انجام دادند. کیفیت دیالیز با نمونه گیری خونی قبل و بعد از دیالیز جهت تعیین شاخص های کیفیت دیالیز (Kt/v) و میزان کاهش اوره (URR)، آتروفی عضلانی به وسیله آنتروپومتری و چربی زیر پوستی و عملکرد جسمانی به وسیله آزمون 2 دقیقه راه رفتن ارزیابی شد. داده ها با استفاده از آزمون های تی و کوواریانس در نرم افزار SPSS تجزیه و تحلیل شدند. یافته ها: در گروه تجربی، آتروفی عضلانی از 57/56 به 37/59 سانتیمتر و عملکرد جسمانی از 87/132 به 27/165 متر افزایش معنی داری نشان داد (05/0>P) اما در گروه کنترل تغییری مشاهده نشد. کیفیت دیالیز در هر دو گروه تفاوت معنی داری را نشان نداد (05/0< P). نتیجه گیری: نتایج این مطالعه نشان داد که انجام تمرین ورزشی منظم در حین دیالیز در بیماران همودیالیزی باعث افزایش عملکرد جسمانی و کاهش آتروفی عضلانی می شود ولی بر کیفیت دیالیز آنها تاثیر معنی داری ندارد. با توجه به نتایج بدست آمده تمرینات ورزشی می تواند در حین دیالیز به عنوان یک فرآیند درمان برای کاهش اثرات دیالیز مورد استفاده قرار گیرد

The effect of new road traffic laws on fatal and non-fatal injury rates in Iran

Background and aims: This study aimed to evaluate the effect of enforcement of new traffic laws on the fatal and non- fatal injury rates in Iran. Methods: In a longitudinal, interventional controlled trial study, all subjects with history of fatal and non-fatal injuries were studied. Their injuries were caused by six risky violations (unauthorized speed, illegal overtaking, red traffic light crossing, reverse gear movement in the highways, and vehicle arrestment due to two simultaneous violations) from June 2010 to November 2010 (as control) and from June 2011 to November 2011 (as case). Available forensic data were used and the outcome of new road traffic laws was analyzed. Results: The new traffic laws led to reduction of fatal and non-fatal road traffic injuries in urban and metropolitan roads after implementation, with a continuing trend during six months. Reduction of fatal and non-fatal road traffic injuries was higher for 20-29 years age group. The effect of new traffic laws on reduction of fatal and non-fatal injuries was 8.7 and 33.3, respectively. Reduction of fatality and injury rate at crash scene, after six months of intervention, was 0.4 and 11.1 per 100,000 populations, respectively. Conclusion: The enforcement of the first phase of new traffic laws has reduced fatal and non-fatal rates of road traffic injuries in Iran. It seems that strict enforcement and amendment of new traffic regulations could further increase their efficiency

Epidemiology of Pediatric Acute Poisoning in Iran: A Systematic Review and Meta-Analysis

Background: The epidemiology of pediatric poisoning differs from one country to another. Due to the scarcity of reviews on this issue in Iran, we performed a systematic review and meta-analysis of studies providing data on Iranian pediatric poisoning epidemiology. Methods: PubMed, Web of Sciences, Science direct, Embase, Scopus and the Persian databases Magiran, Scientific Information Database (SID), and Iranmedex were searched. Twenty-seven studies published between 2002 and 2019 were included, based on the inclusion and exclusion criteria. Results: 54.7% of the participants in the reviewed studies were male, and 88.1% of them were unintentional. Most of the children were in the age range of 3-5 years. Non-pharmaceutical agents were the most common causes of poisonings (n=7175, 59.2%) and among them, illicit drugs (19.3%) followed by hydrocarbons (16.4%) constituted the most common non-pharmaceutical poisonings. Illicit drugs, especially opioids, showed an upward trend from 2002 to 2019. Among pharmaceuticals, central nervous system (CNS) drugs (50.4%), especially benzodiazepines (BZDs) (25.8%) and analgesics (14.5%), were the most frequent agents implicated. CNS complaints (51.8%), followed by gastrointestinal complaints (27.6%), were the most common symptoms. Ingestion was the most common route of poisoning (22.1%). Most of the poisoning cases occurred in summer (28.2%). 21.7% of the cases were hospitalized and the mortality rate was 0.8%. A remarkable downward trend in both hospitalization and death rates occurred over time. Conclusion: Overall, non-pharmaceutical toxicity was found to be the most common cause of poisoning. However, considering the agents separately, pharmaceuticals, illicit drugs, and hydrocarbons were the most common causes of poisoning, respectively. In contrast to the decreasing trend in hydrocarbons, pesticides, and pharmaceutical poisonings, we found an increase in opioid poisoning during our study period

Effect of Squill Oxymel on Knee Osteoarthritis: A Triple-Blind, Randomized, Controlled Clinical Trial

Osteoarthritis (OA) of the knee is a major health problem in the society. Iranian Traditional Medicine (ITM) or Persian Medicine (PM) as a branch of complementary medicine has been practiced in Iran for many centuries. An herbal medication known as squill oxymel has been used by PM physicians for OA. Our aim is to investigate the effect of squill oxymel on OA of the knee joint. Eighty eight patients were assigned to receive a placebo or squill oxymel syrup (10 ml each morning on empty stomach) for 8 consecutive weeks. Acetaminophen tablets were considered as the rescue medicine. Ultimately, 43 patients in the placebo group and 40 patients in the treatment group completed the trial and were included in the statistical analysis. Patients were followed for 4 weeks after cessation of treatment. The Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire and Visual Analog Scale (VAS) were considered as the main outcome measures. Laboratory tests including AST, ALT, BUN, Cr plus inflammatory tests including WBC, ESR, and CRP with specific tests i.e. IL6 and SOD at the beginning and the end of intervention were measured. The results showed the positive effect of treatment on the outcome of knee pain (p=0.04) and daily activity (p=0.01) of KOOS after Cessation of treatment. On the other hand, VAS decreased in both treatment and placebo groups while it showed significance intra-group and showed no significance between the two groups. After 4 weeks of cessation of treatment, the positive effect of the squill oxymel on the treatment group continued in some of the subscales of KOOS, including symptoms, knee pain and daily activities, but stopped in the placebo group. In general, both clinically and statistically significant improvement was observed after cessation of treatment. Squill oxymel syrup showed promising results in management of knee OA but future researches with larger sample size and longer duration are necessary

A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran

OBJECTIVES Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran. METHODS We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied. RESULTS A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals. CONCLUSIONS The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients

Cytomegalovirus infection and risk of preeclampsia: A meta-analysis of observational studies

Background: Cytomegalovirus (CMV) infection is one of the most common infectious diseases in pregnant women in terms of global impact and is related with many adverse health consequences during pregnancy. For the first time, we performed a systematic review and meta-analysis study to evaluate the possible association between CMV infection and preeclampsia (PE). Methods: A comprehensive literature search to identify the relevant papers published earlier than February 2018 was performed in PubMed, ISI (Web of Science), Google Scholar and SCOPUS databases. We followed the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines for design, analysis and interpretation of results. Pooled odds ratio (OR) and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. Heterogeneity was assessed with Q-test and I2 statistics. Results: A total of 13 studies including 6158 pregnant women (2734 women with PE and 3424 healthy controls) met the eligibility criteria. The results of meta-analyses based on PCR (OR: 3.09; 95% CI:0.72–13.24; I2=57.3%), IgG-ELISA (OR: 1.24; 95% CI:0.83–1.85; I2=71%) and IgM-ELISA (OR: 1.04; 95% CI:0.66–1.65; I2=0.0%) demonstrated that CMV infection could not be a potential risk factor for PE. Conclusions: In conclusion, results of the present study demonstrated that CMV infection could not be a potential risk for developing PE. More epidemiological and experimental studies are needed to investigate the impact of CMV infection on the development of PE

Comparative proteome analysis of human esophageal cancer and adjacent normal tissues

Objective(s): Ranking as the sixth commonest cancer, esophageal squamous cell carcinoma (ESCC) represents one of the leading causes of cancer death worldwide. One of the main reasons for the low survival of patients with esophageal cancer is its late diagnosis. Materials and Methods: We used proteomics approach to analyze ESCC tissues with the aim of a better understanding of the malignant mechanism and searching candidate protein biomarkers for early diagnosis of esophageal cancer. The differential protein expression between cancerous               and normal esophageal tissues was investigated by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). Then proteins were identified by matrix-assisted laser desorption/ ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF-MS) and MASCOT web based search engine. Results:We reported 4 differentially expressed proteins involved in the pathological process of esophageal cancer, such as annexinA1 (ANXA1), peroxiredoxin-2 (PRDX2), transgelin (TAGLN) andactin-aortic smooth muscle (ACTA2). Conclusion: In this report we have introduced new potential biomarker (ACTA2). Moreover, our data confirmed some already known markers for EC in our region

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services