Unusual Presentations of Cutaneous Leishmaniasis in an Endemic Area, Kerman Province, Iran

Leishmaniasis is a infectious disease with broad spectrum of clinical features from typical noduloulcerative lesion to atypical lesions. In this article, we presented 4 cases with atypical presentation of cutaneous leishmaniasis lesions (including eczematous, sporotrichoid and lichenoid) in an endemic area in Iran, Kerman. The first case was a 28- year- old man presented with a pruritic purplish -red plaque with lichenoid appearance around proximal nail fold of right third finger since a few months ago. The second case was a young woman with an indurated yellowish-brown plaque with peripheral depigmentation firstly diagnosed as keloid with subsequent intralesional triamcinolone injection. The third case was a middle-aged woman with multiple ulcerated reddish-brown nodules and plaques in a linear array on both legs and one forearm (sporotrichoid pattern). The forth case was a man with a painful indurated reddish-brown plaque with yellowish crust and swelling resembling infected contact dermatitis

The Study of Substructures of Addiction Phenomena in High School Students Using Problem Finding Workshops

Background: Addiction is one of the complicated problems in Iranian young population. The social and cultural dimensions of this social disease are less considered. So considering socio-cultural and environmental resources, this study investigated the substructures of addiction according to the viewpoints of high-school students of Kerman in 2007-2008.Methods: This qualitative study accomplished in ten high schools through a one-day problem finding workshop and continued until data saturation. The resulted terms and phrases were analyzed by content analysis. To assure about the validity and reliability, the outputs reviewed by workshops participants, and classification and codification of the data were executed separately by two experts.Findings: A total of 212 students, (45.3% girls and 54.7% boys) participated in the study. The students introduced the followings as the addiction substantial fundaments: lack of knowledge, positive attitude and interpretation of addiction as a value, family or friends' habit, economy status, psycho-personality problems and availability. Rules infirmity or non-implementation of the current rules enforcement, geographical status and addiction as a conspiracy were also observed in students’ statements.Conclusion: The positive attitudes and historical roots of addiction along with the process of changing the values caused the growth of drug addiction in young population which could neutralize the security measures, legislations policy and even the knowledge. Therefore, intensification of personal protective factors and culturalization addressed for improving inner layers of values are recommended.Keywords: Addiction, Qualitative study, Students, Etiology

Design, Implementation, and Evaluation of a Short-Term Research Skills Training Course for Clinical Faculty Members: A New Experience at Kerman University of Medical Sciences

Background: Several research skills training courses are designed for both faculty members and students in educational and research institutions around the world. Objectives: The current study aimed to design, implement, and evaluate a short-term research skills training course for faculty members of Kerman University of Medical Sciences. Methods: The current scholarship study was conducted in three stages, in 2017. The first stage comprised of a comparative study needs assessment, and course design. The training course was conducted with the participation of 30 faculty members and the teaching of 10 experienced professors. Participants were evaluated through practical work and homework. Instructors were evaluated by participants using survey forms. The course was evaluated through interviews with several participants and professors. Results: After eight months of research and holding 16 sessions (which each took between 2 to 4 hours), a course with three main modules was designed in 2017. Instructors used appropriate teaching methods, including interaction with participants, problem-solving, discussing, teamwork, and practicing at home. According to the results of the evaluation, the content of the course was appropriate for the research activities of participants. Besides, they believed that the instructors were among the strengths of the course. Conclusion: Certainly, increasing research skills of faculty members will lead to better guidance of assistants and qualitative improvement of research conducted by students. Keywords: Training; Research skills; Faculty; Medica

Unusual Presentations of Cutaneous Leishmaniasis in an Endemic Area, Kerman Province, Iran

Leishmaniasis is a infectious disease with broad spectrum of clinical features from typical noduloulcerative lesion to atypical lesions. In this article, we presented 4 cases with atypical presentation of cutaneous leishmaniasis lesions (including eczematous, sporotrichoid and lichenoid) in an endemic area in Iran, Kerman. The first case was a 28- year- old man presented with a pruritic purplish -red plaque with lichenoid appearance around proximal nail fold of right third finger since a few months ago. The second case was a young woman with an indurated yellowish-brown plaque with peripheral depigmentation firstly diagnosed as keloid with subsequent intralesional triamcinolone injection. The third case was a middle-aged woman with multiple ulcerated reddish-brown nodules and plaques in a linear array on both legs and one forearm (sporotrichoid pattern). The forth case was a man with a painful indurated reddish-brown plaque with yellowish crust and swelling resembling infected contact dermatitis

Comparison of centralized and non- centralized research projects outcomes in years1384 to 1386

In order to encourage of faculty members in Kerman University of medical science، the Research council approved an internal guideline for writing and performance of non- centralized research projects by faculties، research centers and committees based on their research activities. The purpose of this research was determination of outcomes of centralized and non- centralized research projects regard to scientific products and expenditures from May2005 to May 2007. In this study، all research projects records were studied and the necessary data entered in checklists. If the accuracy of the data in records was corrupted، the investigators were called and the information was collected. Sixty-four centralized and non- centralized research projects were included in the study. The most projects related to faculties from schools. The median of personnel cost was 13452700Rials in centralized projects and 8066092Rials in non-centralized projects .The median of total costs were 28705760 Rials and 12876935 reials in respectively. In regard to number of projects، kerman university of medical science not placed in the inter-quartile range among the first level ranking universities. seven papers from non- centralized projects and 9 papers from centralized projects on the basis of trapezoid table ،gained 77 and 117 scores respectively. In spite of that median of total expenditures in non-centralized projects were less than half of centralized projects but indices such as published papers ،participation in congress and seminars and etc ، were similar to centralized projects outcomes. This indicated increment in ability of investigators because non-centralized projects were not arbitrated in the research council but they had acceptable output. Hence، to increase the productivity and optimum usage of research financial resources، the policy of university research managers must be toward decentralizing and giving research authorities to colleges and research committees Keywords: Centralized, Non, centralized, scientific productions, Cos

The Histopathological Changes and Immunohistochemical Findings of Acute, Chronic Nonlupoid and Chronic Lupoid Types of Cutaneous Leishmaniasis

Abstract: Background & Aims: Dry type localized cutaneous Leishmaniasis due to Leishmania tropica is one of the most prevalent cutaneous parasitic infections in Kerman province. It seems that cellular immune response and the nature of immune inflammatory cells comprising the inflammatory background play a determinant role in this infection. Methods: Skin biopsies of 53 patients with acute(<2 years duration), nonlupoid chronic(≥2 years duration) and lupoid chronic (new lesions around old scar) types of cutaneous leishmaniasis due to Leishmania tropica were studied by hematoxylin-eosin staining for evaluation of inflammatory cells and epidermal and dermal changes. Immunohistochemical staining was used to determine immunophenotypic patterns (CD1a, CD68, CD3, CD8, CD4, CD20) and to evaluate host immune response at tissue level, the correlation between the presence and concentration of certain cell types, and the clinical presentation and duration of disease. Results: Mean percentages of epidermal and dermal Langerhans cells CD1a+ were higher in lupoid than in acute lesions. Also, the predominant T lymphocyte in acute, chronic and lupoid leishmaniasis was T CD8+. Conclusion: It seems that Langerhans cells CD1a+ are responsible for the suppression of the inflammatory response against L.tropica infection and by providing Leishmania antigens in a steady state induce tolerance to the Leishmania antigens and consequently cause cutaneous chronic lupoid leishmaniasis. This study also suggests that T CD8+ play an effective role in parasite elimination and in the process of healing of cutaneous leishmaniasis due to Leishmania tropica. Keywords: Leishmania tropica, Immunohistochemistry, CD1 antigens, CD8-positive T-Lymphocyte

Efficacy of microneedling plus topical 4 tranexamic acid solution vs 4 hydroquinone in the treatment of melasma: A single-blind randomized clinical trial

Background: There are various treatment modalities for melasma, but none of them are effective on dermal component of melasma. Aims: In this study, we decided to evaluate the efficacy of microneedling plus tranexamic acid in comparison with 4 hydroquinone in the treatment of melasma. Methods: This is a single-blind randomized clinical trial on 70 participants with 14 dropout, and therefore, 60 patients with melasma completed the study. Patients were randomized based on simple randomization in 2 groups of A (microneedling plus topical 4 tranexamic acid, monthly) and B (topical 4 hydroquinone, nightly). Evaluation of mean MASI score, patient and physician assessments was performed at 4th, 8th and12th weeks of the treatment. Statistical analysis was performed by paired t test, chi-square test and Fisher's exact test, respectively. Results: Sixty women (30 patients in each group) were completed the study. Mean MASI score in group A was significantly lower at the end of the treatment (6.84 ± 4.31) than at the baseline (12.89 ± 5.16) (P <.01). Mean MASI score in group B was significantly lower at the end of the treatment (7.16 ± 4.38) than at the baseline (13.56 ± 4.88) (P <.01). There was no statistical difference between 2 groups regarding MASI score, physician and patient assessments during the treatment. Percentage of patient satisfaction was significantly higher than physician satisfaction in both treatment groups (P <.01). Conclusion: In our study, the combination of microneedling with tranexamic acid did not differ from 4 hydroquinone in the treatment of melasma. © 2020 Wiley Periodicals, Inc

Effect of gonadectomy on gender differences of thermal pain sense threshold in rat

Abstract: The previous studies have been suggested that tolerance, sensitivity and pain threshold are different between men and women. These differences can be affected by various factors. In this study, the effect of gonadectomy on gender differences in thermal pain threshold was tested by hot plate method in rats. Therefore the reaction time (The delay occurred in response to thermal stimulus) at zero, 15 and 30 minutes was registrated. Mean of those 3 values was respected as thermal pain sense threshold. Then the gonads were occluded and the pain sense threshold at 7th, 21st and 35th days was measured. The results were compared between sexes and also in each sex in different days. The results showed no gender differences before gonadectomy. However after gonadectomy the thermal pain threshold was decreased in both sexes and reached to its minimum value on 21st day an returned to basal value on day 35 in both sexes. Although this reduction was more dominant in males, no significant difference was observed between sexes. Gonadectomy in males caused a significant reduction of pain threshold in 7th and 21st days. Gonadectomy in females had no effect. In conclusion it seems that female sex hormones have no effect on thermal pain threshold, but testosterone was effective. Since pain sense threshold was also returned to basal value in male rats, we concluded that stimulatory effect of testosterone (up to day 21) may be more important than its organizational effect that appear after 30th day. Keywords: Gonadectomy, Thermal pain threshold, Reaction time, Ra