Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four differe... more Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four different categories of clinical manifestation: classical; endemic; iatrogenic; and acquired immunodeficiency disorder (AIDS)-associated. 1 Its cutaneous morphological appearance ranges from bluepurple macules to infiltrated plaques and nodules. 1,2 The iatrogenic type is associated with various immunosuppressive treatments for malignancies, including lymphoma and multiple myeloma, and autoimmune diseases and organ transplants. 1-6 It manifests, on average, 12-20 months after the initiation of immunosuppressive therapy. Visceral involvement, most commonly in lymph nodes and in gastrointestinal and pulmonary sites, is reported in 20-50% of cases. 6,7 Pemphigus vulgaris (PV) is a blistering disease of the skin and mucous membranes. Treatment is essential because it carries a risk for infection and fluid or electrolyte disturbances that may be fatal. 8 Pemphigus is managed by a number of agents, some of which are associated with risk for developing KS. 1,2,6-9 The occurrence of aggressive visceral KS in a patient with PV raises serious questions regarding its management because both diseases are life-threatening, and any improvement in one may be undermined by a deterioration in the other.
Background: Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many d... more Background: Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH. Materials and Methods: This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night. Results: According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients. Conclusions: The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four differe... more Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four different categories of clinical manifestation: classical; endemic; iatrogenic; and acquired immunodeficiency disorder (AIDS)-associated. 1 Its cutaneous morphological appearance ranges from bluepurple macules to infiltrated plaques and nodules. 1,2 The iatrogenic type is associated with various immunosuppressive treatments for malignancies, including lymphoma and multiple myeloma, and autoimmune diseases and organ transplants. 1-6 It manifests, on average, 12-20 months after the initiation of immunosuppressive therapy. Visceral involvement, most commonly in lymph nodes and in gastrointestinal and pulmonary sites, is reported in 20-50% of cases. 6,7 Pemphigus vulgaris (PV) is a blistering disease of the skin and mucous membranes. Treatment is essential because it carries a risk for infection and fluid or electrolyte disturbances that may be fatal. 8 Pemphigus is managed by a number of agents, some of which are associated with risk for developing KS. 1,2,6-9 The occurrence of aggressive visceral KS in a patient with PV raises serious questions regarding its management because both diseases are life-threatening, and any improvement in one may be undermined by a deterioration in the other.
BACKGROUND: Many normal children have heart murmurs. Most of these murmurs are innocent but diffe... more BACKGROUND: Many normal children have heart murmurs. Most of these murmurs are innocent but differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is important. Some clinicians do not refer the suspected patients to cardiologist due to anxiety-provoking for the family. The aim of this study was to assess the children with heart murmurs who previously their murmurs labeled as an innocent murmur. METHODS: During 18 months, 36 children with heart murmur been labeled as innocent were reassessed prospectively as outpatients by a pediatric cardiologist. FINDINGS: Overall, 8 different type of congenital heart diseases in 36 patients (17 boys, 19 girls) were diagnosed. The mean age of diagnosis of innocent murmur was at 24 months old. The mean age of detection of congenital heart defects in these patients was 43.5 months old. Physicians referred 80% of patients while 75% of these were referred when were visited by other physicians than their fa...
Neonatal lupus erythematous (NLE) is a rare condition presented by lupus dermatitis shortly after... more Neonatal lupus erythematous (NLE) is a rare condition presented by lupus dermatitis shortly after birth or later following sun exposure. Sturge-Weber syndrome (SWS) is also an uncommon congenital condition characterized by extensive capillary malformation and ophthalmic and/or neurologic involvement. Here, we describe the first case of coexistence of NLE and SWS which posed a significant diagnostic challenge to clinicians.
Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder rarely seen in the pediatric p... more Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder rarely seen in the pediatric population. It usually presents as large and tense bullae, predominantly distributed in the acral areas. Herein, we describe a case of childhood BP with an atypical presentation mimicking toxic epidermal necrolysis (TEN). This case shows us that juvenile BP should be considered in the differential diagnosis of TEN in children, particularly if there are unusual features and an intractable course.
Objective Although ventricular septal defect (VSD) is the most common congenital heart disease, i... more Objective Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. Methods This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Findings Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, ...
any normal children have heart murmurs. M ost of these murmurs are innocent but differentiation o... more any normal children have heart murmurs. M ost of these murmurs are innocent but differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is important. Some clinicians do not refer the suspected patients to cardiologist due to anxiety-provoking for the family. The aim of this study was to assess the children with heart murmurs who previously their murmurs labeled as an innocent murmur. Background: During 18 months, 36 children with heart murmur been labeled as innocent were reassessed prospectively as outp atients by a p ediatric cardiologist. Methods: Overall, 8 different type of congenital heart diseases in 36 patients (17 boys, 19 girls) were diagnosed. The mean age of diagnosis of innocent murmur was at 24 months old. The mean age of detection of congenital heart defects in these patients was 43.5 months old. Physicians referred 80% of patients while 75% of these were referred when were visited by other physicians than their family phy...
Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2014
Background: Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug ... more Background: Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The causative drugs and clinical patterns of ACDRs are different in various populations. This study was conducted to identify the clinical patterns, causative drugs and reasons for drug administration in patients hospitalized due to ACDR. Materials and Methods: This retrospective study was carried out in a referral university hospital, Isfahan, Iran. The medical records of all patients who were hospitalized in the Dermatology Department due to ACDRs were reviewed covering an 8-year period between December 2006 and August 2013. Results: A total number of 282 patients with the mean age of 29.48 ± 21.18 years were hospitalized in this time period, of which 61% were females. The most common clinical patterns regarding the final diagnosis were Stevens-Johnson syndrome (SJS) (32%), exanthematous drug eruptions (24.5%) and toxic epidermal necrolysis (TEN) (11%). Anticonvulsants were the...
Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usual... more Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, respectively. Heart murmur ...
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2014
Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The ... more Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The causative drugs and clinical patterns of ACDRs are different in various populations. This study was conducted to identify the clinical patterns, causative drugs and reasons for drug administration in patients hospitalized due to ACDR. This retrospective study was carried out in a referral university hospital, Isfahan, Iran. The medical records of all patients who were hospitalized in the Dermatology Department due to ACDRs were reviewed covering an 8-year period between December 2006 and August 2013. A total number of 282 patients with the mean age of 29.48 ± 21.18 years were hospitalized in this time period, of which 61% were females. The most common clinical patterns regarding the final diagnosis were Stevens-Johnson syndrome (SJS) (32%), exanthematous drug eruptions (24.5%) and toxic epidermal necrolysis (TEN) (11%). Anticonvulsants were the most frequently implicated drug group (51.8...
Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usual... more Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, respectively. Heart murmur ...
Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterize... more Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterized by painful progressive necrosis of the wound margins. Rarely, postoperative pyoderma gangrenosum (PPG) manifests as a severe disturbance of wound healing following surgical interventions. Only rare cases of this complication have been reported after appendectomy. We report a case of PPG in a 29-year-old female after appendectomy. She was successfully treated with oral prednisolone. Postoperative pyoderma gangrenosum should be kept in mind in the differential diagnosis of any postoperative delayed wound healing, because this disease is simply distinguished from a postoperative wound.
No ideal treatment has been established for Striae distensae (SD), particularly in the late phase... more No ideal treatment has been established for Striae distensae (SD), particularly in the late phase (Striae Alba (SA)) .Various types of lasers have been recently proposed as treatment options for SD. This study aims to compare the clinical efficacy of a fractional CO2 laser as well as a combination of fractional CO2 laser and Pulsed dye Laser (PDL) in the treatment of SA. Materials and Methods: Eighty-eight SA lesions in three female patients were included. Lesions on each half of the body were randomly enrolled in each group. Group 1 (n = 44) were treated by Fractional CO2 laser resurfacing and group 2 (n = 44) by a combination of PDL and Fractional CO2 laser, alternately. Digital Photographs were taken and the surface area of each lesion was measured digitally (using the PictZar Digital Planimetry Software) at the baseline and four weeks after treatment. The clinical improvement was assessed by comparison of the pre-and post-treatment photos and the participants' views about their degree of improvement, using a 10-point verbal analog scale (VAS). Results: The mean surface area decreased significantly in both groups after treatment. The mean difference between the pre-and post-treatment surface area was 0.62 ± 053 for group 2 and 0.41 ± 0.43 for group 1 (P-value = 0.03). Mean VAS and dermatologist assessed improvement scale in group 2 (6.68 ± 0.77 and 2.2 ± 0.76 respectively) were significantly higher than those in group 1 (5.45 ± 0.90 and 1.8±0.72 respectively, P-value <0.001 and 0.04 respectively). Conclusion: The combination of PDL and fractional CO2 laser was more effective than fractional CO2 laser alone and could be suggested as a clinical option in the treatment of SA.
Introduction: The current study evaluated the value of red blood cell (RBC) indices and the corre... more Introduction: The current study evaluated the value of red blood cell (RBC) indices and the corresponding cutoff points for β-thalassemia control programs in Iran. Materials and Methods: 1,150 individuals (575 couples) with low RBC indices and normal hemoglobin A2 who had been referred to the Genetic Centre of Isfahan, were tested during pre-marital screening analyses, in the 2 year period, 2006-2008. β-thalassemia mutations were evaluated. Results: β-thalassemia was identified in 67.8% of the cases with both mean corpuscular volume (MCV) less than 78fl and mean corpuscular hemoglobin (MCH) less than 26 pg. However, 4.1% of the individuals with 78≤ MCV≤ 80 tested positive for thalassemia. MCV showed a higher diagnostic reliability than MCH. However, the accompaniment of MCH<26 with MCV<78 increased the risk of thalassemia 35 times. A significant association was found between the prevalence of minor β-thalassemia and educational levels, race and familial relationships. Conclusion: According to the results of this study, it seems that MCV=80fl can be used as a proper cut-off point for the screening of minor β-thalassemia. Although in the present study MCV was found to have a higher diagnostic reliability than MCH, MCH <26 along with MCV are very helpful indices for the counselor physician to estimate the risk of minor β-thalassemia more accurately.
Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic ... more Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH. This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night. According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients. The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four differe... more Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four different categories of clinical manifestation: classical; endemic; iatrogenic; and acquired immunodeficiency disorder (AIDS)-associated. 1 Its cutaneous morphological appearance ranges from bluepurple macules to infiltrated plaques and nodules. 1,2 The iatrogenic type is associated with various immunosuppressive treatments for malignancies, including lymphoma and multiple myeloma, and autoimmune diseases and organ transplants. 1-6 It manifests, on average, 12-20 months after the initiation of immunosuppressive therapy. Visceral involvement, most commonly in lymph nodes and in gastrointestinal and pulmonary sites, is reported in 20-50% of cases. 6,7 Pemphigus vulgaris (PV) is a blistering disease of the skin and mucous membranes. Treatment is essential because it carries a risk for infection and fluid or electrolyte disturbances that may be fatal. 8 Pemphigus is managed by a number of agents, some of which are associated with risk for developing KS. 1,2,6-9 The occurrence of aggressive visceral KS in a patient with PV raises serious questions regarding its management because both diseases are life-threatening, and any improvement in one may be undermined by a deterioration in the other.
Background: Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many d... more Background: Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH. Materials and Methods: This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night. Results: According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients. Conclusions: The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four differe... more Kaposi's sarcoma (KS) is a human herpesvirus 8 (HHV-8)related vascular neoplasm with four different categories of clinical manifestation: classical; endemic; iatrogenic; and acquired immunodeficiency disorder (AIDS)-associated. 1 Its cutaneous morphological appearance ranges from bluepurple macules to infiltrated plaques and nodules. 1,2 The iatrogenic type is associated with various immunosuppressive treatments for malignancies, including lymphoma and multiple myeloma, and autoimmune diseases and organ transplants. 1-6 It manifests, on average, 12-20 months after the initiation of immunosuppressive therapy. Visceral involvement, most commonly in lymph nodes and in gastrointestinal and pulmonary sites, is reported in 20-50% of cases. 6,7 Pemphigus vulgaris (PV) is a blistering disease of the skin and mucous membranes. Treatment is essential because it carries a risk for infection and fluid or electrolyte disturbances that may be fatal. 8 Pemphigus is managed by a number of agents, some of which are associated with risk for developing KS. 1,2,6-9 The occurrence of aggressive visceral KS in a patient with PV raises serious questions regarding its management because both diseases are life-threatening, and any improvement in one may be undermined by a deterioration in the other.
BACKGROUND: Many normal children have heart murmurs. Most of these murmurs are innocent but diffe... more BACKGROUND: Many normal children have heart murmurs. Most of these murmurs are innocent but differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is important. Some clinicians do not refer the suspected patients to cardiologist due to anxiety-provoking for the family. The aim of this study was to assess the children with heart murmurs who previously their murmurs labeled as an innocent murmur. METHODS: During 18 months, 36 children with heart murmur been labeled as innocent were reassessed prospectively as outpatients by a pediatric cardiologist. FINDINGS: Overall, 8 different type of congenital heart diseases in 36 patients (17 boys, 19 girls) were diagnosed. The mean age of diagnosis of innocent murmur was at 24 months old. The mean age of detection of congenital heart defects in these patients was 43.5 months old. Physicians referred 80% of patients while 75% of these were referred when were visited by other physicians than their fa...
Neonatal lupus erythematous (NLE) is a rare condition presented by lupus dermatitis shortly after... more Neonatal lupus erythematous (NLE) is a rare condition presented by lupus dermatitis shortly after birth or later following sun exposure. Sturge-Weber syndrome (SWS) is also an uncommon congenital condition characterized by extensive capillary malformation and ophthalmic and/or neurologic involvement. Here, we describe the first case of coexistence of NLE and SWS which posed a significant diagnostic challenge to clinicians.
Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder rarely seen in the pediatric p... more Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder rarely seen in the pediatric population. It usually presents as large and tense bullae, predominantly distributed in the acral areas. Herein, we describe a case of childhood BP with an atypical presentation mimicking toxic epidermal necrolysis (TEN). This case shows us that juvenile BP should be considered in the differential diagnosis of TEN in children, particularly if there are unusual features and an intractable course.
Objective Although ventricular septal defect (VSD) is the most common congenital heart disease, i... more Objective Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. Methods This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Findings Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, ...
any normal children have heart murmurs. M ost of these murmurs are innocent but differentiation o... more any normal children have heart murmurs. M ost of these murmurs are innocent but differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is important. Some clinicians do not refer the suspected patients to cardiologist due to anxiety-provoking for the family. The aim of this study was to assess the children with heart murmurs who previously their murmurs labeled as an innocent murmur. Background: During 18 months, 36 children with heart murmur been labeled as innocent were reassessed prospectively as outp atients by a p ediatric cardiologist. Methods: Overall, 8 different type of congenital heart diseases in 36 patients (17 boys, 19 girls) were diagnosed. The mean age of diagnosis of innocent murmur was at 24 months old. The mean age of detection of congenital heart defects in these patients was 43.5 months old. Physicians referred 80% of patients while 75% of these were referred when were visited by other physicians than their family phy...
Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2014
Background: Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug ... more Background: Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The causative drugs and clinical patterns of ACDRs are different in various populations. This study was conducted to identify the clinical patterns, causative drugs and reasons for drug administration in patients hospitalized due to ACDR. Materials and Methods: This retrospective study was carried out in a referral university hospital, Isfahan, Iran. The medical records of all patients who were hospitalized in the Dermatology Department due to ACDRs were reviewed covering an 8-year period between December 2006 and August 2013. Results: A total number of 282 patients with the mean age of 29.48 ± 21.18 years were hospitalized in this time period, of which 61% were females. The most common clinical patterns regarding the final diagnosis were Stevens-Johnson syndrome (SJS) (32%), exanthematous drug eruptions (24.5%) and toxic epidermal necrolysis (TEN) (11%). Anticonvulsants were the...
Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usual... more Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, respectively. Heart murmur ...
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2014
Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The ... more Adverse cutaneous drug reactions (ACDRs) are the most commonly reported adverse drug events. The causative drugs and clinical patterns of ACDRs are different in various populations. This study was conducted to identify the clinical patterns, causative drugs and reasons for drug administration in patients hospitalized due to ACDR. This retrospective study was carried out in a referral university hospital, Isfahan, Iran. The medical records of all patients who were hospitalized in the Dermatology Department due to ACDRs were reviewed covering an 8-year period between December 2006 and August 2013. A total number of 282 patients with the mean age of 29.48 ± 21.18 years were hospitalized in this time period, of which 61% were females. The most common clinical patterns regarding the final diagnosis were Stevens-Johnson syndrome (SJS) (32%), exanthematous drug eruptions (24.5%) and toxic epidermal necrolysis (TEN) (11%). Anticonvulsants were the most frequently implicated drug group (51.8...
Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usual... more Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition. This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis. Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, respectively. Heart murmur ...
Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterize... more Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterized by painful progressive necrosis of the wound margins. Rarely, postoperative pyoderma gangrenosum (PPG) manifests as a severe disturbance of wound healing following surgical interventions. Only rare cases of this complication have been reported after appendectomy. We report a case of PPG in a 29-year-old female after appendectomy. She was successfully treated with oral prednisolone. Postoperative pyoderma gangrenosum should be kept in mind in the differential diagnosis of any postoperative delayed wound healing, because this disease is simply distinguished from a postoperative wound.
No ideal treatment has been established for Striae distensae (SD), particularly in the late phase... more No ideal treatment has been established for Striae distensae (SD), particularly in the late phase (Striae Alba (SA)) .Various types of lasers have been recently proposed as treatment options for SD. This study aims to compare the clinical efficacy of a fractional CO2 laser as well as a combination of fractional CO2 laser and Pulsed dye Laser (PDL) in the treatment of SA. Materials and Methods: Eighty-eight SA lesions in three female patients were included. Lesions on each half of the body were randomly enrolled in each group. Group 1 (n = 44) were treated by Fractional CO2 laser resurfacing and group 2 (n = 44) by a combination of PDL and Fractional CO2 laser, alternately. Digital Photographs were taken and the surface area of each lesion was measured digitally (using the PictZar Digital Planimetry Software) at the baseline and four weeks after treatment. The clinical improvement was assessed by comparison of the pre-and post-treatment photos and the participants' views about their degree of improvement, using a 10-point verbal analog scale (VAS). Results: The mean surface area decreased significantly in both groups after treatment. The mean difference between the pre-and post-treatment surface area was 0.62 ± 053 for group 2 and 0.41 ± 0.43 for group 1 (P-value = 0.03). Mean VAS and dermatologist assessed improvement scale in group 2 (6.68 ± 0.77 and 2.2 ± 0.76 respectively) were significantly higher than those in group 1 (5.45 ± 0.90 and 1.8±0.72 respectively, P-value <0.001 and 0.04 respectively). Conclusion: The combination of PDL and fractional CO2 laser was more effective than fractional CO2 laser alone and could be suggested as a clinical option in the treatment of SA.
Introduction: The current study evaluated the value of red blood cell (RBC) indices and the corre... more Introduction: The current study evaluated the value of red blood cell (RBC) indices and the corresponding cutoff points for β-thalassemia control programs in Iran. Materials and Methods: 1,150 individuals (575 couples) with low RBC indices and normal hemoglobin A2 who had been referred to the Genetic Centre of Isfahan, were tested during pre-marital screening analyses, in the 2 year period, 2006-2008. β-thalassemia mutations were evaluated. Results: β-thalassemia was identified in 67.8% of the cases with both mean corpuscular volume (MCV) less than 78fl and mean corpuscular hemoglobin (MCH) less than 26 pg. However, 4.1% of the individuals with 78≤ MCV≤ 80 tested positive for thalassemia. MCV showed a higher diagnostic reliability than MCH. However, the accompaniment of MCH<26 with MCV<78 increased the risk of thalassemia 35 times. A significant association was found between the prevalence of minor β-thalassemia and educational levels, race and familial relationships. Conclusion: According to the results of this study, it seems that MCV=80fl can be used as a proper cut-off point for the screening of minor β-thalassemia. Although in the present study MCV was found to have a higher diagnostic reliability than MCH, MCH <26 along with MCV are very helpful indices for the counselor physician to estimate the risk of minor β-thalassemia more accurately.
Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic ... more Post inflammatory hyperpigmentation (PIH) is a common problem occurs following many dermatologic diseases and medical interventions. Different modalities including topical agents, lasers and intense pulsed light (IPL) are suggested for treatment of the post-burn PIH. In the current study, we evaluated the efficacy of IPL plus modified Kligman cream (MODIFIED KLIGMAN CREAM) versus MODIFIED KLIGMAN CREAM alone in the treatment of the post-burn PIH. This was a randomized, non-blinded clinical trial. A total of 53 patches of post-burn PIP in 14 patients were randomized to receive either two sessions of IPL plus modified Kligman formula or kligman formula for 2 months. The patients were recommended to apply MODIFIED KLIGMAN CREAM cream for 12 h at night. According to our results, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). In addition, according to physician evaluation, the patients in the MODIFIED KLIGMAN CREAM + IPL group had higher satisfaction as compared with MODIFIED KLIGMAN CREAM alone (P = 0.000) (Mann-Whitney test). No side effects except a little irritation, erythema and exfoliation due to MODIFIED KLIGMAN CREAM cream were seen in the patients. The results of our study showed the better efficacy and faster response of the IPL plus modified Kligman formula versus modified Kligman formula in the treatment of the post-burn PIH. To better determine the efficacy of IPL in treatment of the post-burn PIP, more extensive studies as randomized, double-blinded clinical trial are recommended.
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Papers by Zahra Nikyar