Mucocutaneous manifestations and nail changes in patients with end-stage renal disease on hemodialysis.

Mucocutaneous manifestations are common among patients on hemodialysis (HD). This study was undertaken to determine the prevalence of mucocutaneous manifestations in patients with end-stage renal disease (ESRD) who are on HD. In this cross-sectional, descriptive and analytic study conducted in 2009, 100 patients on HD at the Five Azar Hospital in Gorgan city were randomly selected. All the patients underwent detailed examination by a dermatologist to look for lesions in the skin, hair, nail and mucous membranes; if felt necessary, biopsy was obtained from the lesions. The findings were statistically analyzed using SPSS-13 software. For evaluation of normality of distribution, Kolmogorov-Smirnov was used, for quantitative variables Mann-Whitney and T-test (abnormal distribution) were used and for qualitative variables, Chi-2 and Fisher were used. In this study, P-value less than 0.05 was considered significant. Fifty-one males and 49 females were enrolled. The mean age was 49 ± 12 years. Diabetes was the most common cause of ESRD. In 95% of the patients, at least one mucocutaneous manifestation was present. Xerosis (78.3%) was the most common lesion, followed by pruritus (39.1%), lentigo (34.8%), skin discoloration (32.6%), leukonychia (32%) and thinning of the nail bed (24%). Xerosis, scaling, lentigo, folliculitis, idiopathic guttate hypopigmentation, leukonychia and half and half nail were associated with age. A significant relationship was seen between duration on dialysis and skin discoloration and leukonychia. Clubbing had a significant association with calcium-phosphorus product (Ca � P). There was a significant association between serum ferritin level and pruritus and tinea versicolor lesions. Our study shows that mucocutaneous manifestations are common among patients with ESRD. Identification of these manifestations and their association with causative factors are useful for preventing the lesions

A systematic review and meta-analysis of human biomonitoring studies on exposure to environmental pollutants in Iran

Population exposure to environmental contaminants can be precisely observed through human biomonitoring studies. The present study aimed to systematically review all the biomonitoring studies conducted in Iran on some selected carcinogen environmental pollutants. In this systematic review study, 11 carcinogen agents were selected including arsenic, cadmium, chromium, nickel, lindane, benzene, trichloroethylene (TCE), pentachlorophenol (PCP), radon-222, radium-224, � 226, � 228, and tobacco smoke. The Web of Science, PubMed, and Scopus databases were searched for peer-reviewed articles published in English. After several screening steps, data were extracted from the studies. Meta-analyses (a random-effect model using the DerSimonian-Laired method) were performed only for the biomarkers with more than three eligible articles, including cadmium in blood and breast milk, and arsenic in breast milk. Methodological quality of the studies was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for cross-sectional studies. Of the 610 articles found in the database search, 30 studies were eligible for qualitative review, and 13 were included in the meta-analysis (cadmium in blood (n = 3), cadmium in breast milk (n = 6), and arsenic in breast milk (n = 4)). The overall pooled average concentrations (95 CI) of cadmium in blood, cadmium in breast milk, and arsenic in breast milk were 0.11 (95 CI: 0.08, 0.14), 5.38 (95 CI: 3.60, 6.96), and 1.42 (95 CI: 1.02, 1.81) µg/L, respectively. These values were compared with the biomarker concentrations in other countries and health-based guideline values. This study showed that there is a need for comprehensive action plans to reduce the exposure of general population to these environmental contaminants. © 202

Clonal Population of Mycobacterium tuberculosis Strains Reside within Multiple Lung Cavities

(MTB) are localized within lung cavities of patients suffering from chronic progressive TB.Multiple cavity isolates from lung of 5 patients who had undergone pulmonary resection surgery were analyzed on the basis of their drug susceptibility profile, and genotyped by spoligotyping and 24-loci MIRU-VNTR. The patients past history including treatment was studied. Three of the 5 patients had extensive drug resistant TB. Heteroresistance was also reported within different cavity isolates of the lung. Both genotyping methods reported the presence of clonal population of MTB strain within different cavities of the each patient, even those reporting heteroresistance. Four of the 5 patients were infected with a population of the Beijing genotype. Post-surgery they were prescribed a drug regimen consisting of cycloserine, a fluoroquinolone and an injectable drug. A 6 month post-surgery follow-up reported only 2 patients with positive clinical outcome, showing sputum conversion.Identical spoligotype patterns and MIRU-VNTR profiles between multiple cavities of each patient, characterize the presence of clonal population of MTB strains (and absence of multiple MTB infection)

Single-dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double-blind randomized controlled trial

This study was designed to compare the therapeutic effects of topical clotrimazole and systemic fluconazole in pityriasis versicolor. A double-blind randomized controlled trial was carried out in the dermatological clinic of Gorgan, northern Iran, between April 2006 and May 2007. All consecutive patients with pityriasis versicolor were included and randomly divided into two groups. In the first group (G1), patients underwent treatment with a single dose of fluconazole capsule (400 mg) and placebo cream. In the second group (G2), patients underwent treatment with clotrimazole cream (twice daily) and placebo capsule. The course of treatment was 2 weeks. All subjects were re-evaluated 2, 4 and 12 weeks after the end of the therapeutic course. After 2 weeks, the rate of complete resolution of disease was significantly higher in G2 than G1 (49.1 vs 30). After 4 weeks, 41 patients (81.2) of G1 and 52 patients (94.9) of G2 showed complete resolution. After 12 weeks, 46 patients (92) in G1 and 45 patients (81.8) in G2 showed complete resolution. Recurrence rate in G1 and G2 were 6 and 18.2, respectively. No complications were seen in either group. In this study, clinical response at week 4 was greater in the clotrimazole group than the fluconazole group. Recurrence at week 12 after treatment was less with oral fluconazole than clotrimazole cream. So, for better evaluation, more studies need to be done. © 2010 Japanese Dermatological Association

Systemic Lupus Erythematosus and Homocysteine: Is there any relationship?

Background: Systemic lupus erythematosus (SLE), is an inflammatory multi organ disease with unknown origin, variable clinical manifestations and laboratory findings. Coronary artery disease is an important cause of mortality and morbidity in these patients. This study was designed to evaluate homocysteine as a new risk factor for cardiovascular complications. Methods: Sixty known case of SLE and 30 healthy controls were included. Disease activity in patients was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLE-DAD. Age, sex, drug history, diabetes mellitus, hypertension(>140/90mm Ng), Body Mass Index (>30kg/m2), early menopause(amenorrhea before 40 years old) and coronary artery disease,disease duration, duration of treatment with corticosteroids and anti malaria drugs were recorded in the questionnaire. Hematologiical and immunological tests were done along with lipid profile,24 hours urine protein and C-reactive protein in all individuals Analysis was done using chi-square tests, student's t test or Mann-Whitney test. Correlation was evaluated with Spearman's rank-order or Pearson's correlation coefficient. Results: Homocystine level was significantly higher in patients than controls (P-value=0.001). Only LDL, HDL and TG had significant relationship with homocysteine level. Homocysteine showed no relationship with the disease activity (P-value=0.609). Conclusions: Homocystine could be considerd as a potential risk factor for cardiovascular disease in subjects with an inflammatory condition such as SLE

A pilot study of scoliosis assessment using radiation free surface topography in children with GMFCS IV and V cerebral palsy

Background Prevalence of scoliosis in cerebral palsy (CP) parallels the extent of neurological impairment and causes significant morbidity. Monitoring is important but requires regular radiological investigation. Surface topography provides a non-radiological approach to scoliosis monitoring. Aim To evaluate validity, reproducibility and feasibility of Quantec® scans to monitor scoliosis in children with severe CP. Methods Twenty non-ambulant children with CP, Gross Motor Function Classification System (GMFCS) grade IV/V had clinical, radiological and Quantec spinal assessment. The children were supported during scans using a seating system specifically designed for this study. Validity was assessed by comparing Quantec (Q) angle with gold standard (Cobb angle), reproducibility analysed using Bland-Altman plots and feasibility assessed using a questionnaire. Results Prevalence of scoliosis on radiological examination was 65%. Of these children, 85% had curves with Cobb angle less than 28°. Quantec scanning was feasible with appropriate postural support. Mean (and standard deviation) for differences between Cobb and Quantec (Q) angle were 0.02° (6.2°) and for Quantec inter-observer variability were 0.5° (5.8°). Conclusions Quantec scanning was feasible, reproducible and had good validity when compared with Cobb angle in a supportive seating system. To consolidate these findings a further study needs to be undertaken with larger number of children with Cobb angles between 25° and 45°.</p

Mucocutaneons manifestation in end stage renal disease patients under hemodialysis in 5th Azar hospital in Gorgan, Iran (2009)

Background and Objective: Mucocutaneons manifestations are common in hemodialysis patients.The aim of this study was evaluate the prcvalence of cutaneous and mucosal manifestations in end stage renal disease (ESRD) patients who are on the maintenance hemodialysis. Materials and Methods: This cross sectional study was performed on 100 (51 males, 49 females) hemodialysis patients in 5 Azar hospital in Gorgan, North of Iran during 2009. Patients selected on randomly based an all of them completely examined by a deramatologist for any changes in skin, hair, nail and mucous membrane. If necessary biopsy perform and refer to a pathologist. Data analysed with SPSS-13, mann-whitney, t-test, Chi-Square and Fisher tests. Results: The average age was 49±12.3 years. The most common causes of ESRD was dibetes mellitus. The most common skin lesion was xerosis (78.3%), after that pruritis (39.1%) lentigo (34.8%) skin discoloration (32.6%) leukonychia (32%) thining of nail bed (24%) were common lesions. Lentigo was more common in female than male 42.85% vs 21.50% (p=0.042). Xerosis (p<0.01), scaling (p=0.042), lentigo (p<0.01), folliculitis (p<0.01), idio pathic guttate hypopigmentation (p<0.01) leukonychia (p<0.01) and half and half nail (p<0.01) have meaningful correlation with age. There was also meaningful correlation between dialyis duration and skin discoloration (p<0.031) and leukonychia (p<0.041). Clubhing and ca-p product also have meaningful correlation (p<0.027). Pruritis (p<0.048) and skin fungal infection (p<0.047) (tinea versi color) also have meaningful correlation with serum ferritin level. Conclusion: Mucocutaneous manifestation were common in end stage renal disease patients

A fabrication process for self-connected horizontal SiGe nanowires

International audienceWe present in this paper a low thermal budget process for self-connecting horizontal silicon-germanium nanowires. The guided nanowires on amorphous oxide layer have been elaborated by a chemical vapor deposition (CVD), using vapor-liquid-solid (VLS) mechanism, via a gold catalyst. We have optimized the growth parameters on reference samples with pre-patterned electrodes on SiO 2 /Si substrate. To control and eliminate the random growth of horizontal NWs, we have developed a technological process to guide these nanowires in nanotrenches created in the oxide to locate gold catalysts and confine planar growth. The silicon germanium nanowire (SiGe NW) connected the predefined electrodes showed an electrical behavior of an intrinsic SiGe NW

A global systematic, review-meta analysis and ecological risk assessment of ciprofloxacin in river water

The presence of antibiotics and their metabolites such as ciprofloxacin (CIP) in water resources attracted notable attention as a new international health concern. A systematic and review-meta analysis was performed to evaluate the concentration of CIP in the rivers along with the related ecological risk assessment. PubMed, Scopus and Embase databases were screened to retrieve the related articles among 1 January 1983 to 10 July 2018. Fifty-five articles (58 studies of data reports) comprising 1,886 samples from 20 countries were included. Furthermore, the meta-analysis was performed by the aid of a random effects model (REM) to estimate pooled concentration with 95 confidence intervals (CI). According to findings, the concentration of CIP in the river downstream of untreated wastewater was higher than other rivers located downstream of treated wastewater. Also, the meta-analysis of data based on year of study subgroup demonstrated that over time, the concentration of CIP in the rivers was increased. The ecological risk assessment showed that people settled in some regions of South Africa was at a potential (HQ: 1�10 value) adverse ecological risk of CIP in the river. Therefore immediate control plans besides appropriate removal techniques should be approached for complete eradication of antibiotics like CIP. © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group