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Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, Namazi MR. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles. J Cosmet Dermatol 2024; 23:600-606. [PMID: 37822183 DOI: 10.1111/jocd.16004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles. AIMS In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up. METHODS In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection. RESULTS Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients. CONCLUSION Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required.
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Affiliation(s)
- Farzaneh Akbari
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student research committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Sara Dehghani
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Parvar SY, Mojgani P, Lankarani KB, Poursaeed F, Mohamadi Jahromi LS, Mishra V, Abbasi A, Shahabi S. Barriers and facilitators to reducing low-value care for the management of low back pain in Iran: a qualitative multi-professional study. BMC Public Health 2024; 24:204. [PMID: 38233835 PMCID: PMC10792884 DOI: 10.1186/s12889-023-17597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Low back pain (LBP) is a prevalent musculoskeletal disorder with a wide range of etiologies, ranging from self-limiting conditions to life-threatening diseases. Various modalities are available for the diagnosis and management of patients with LBP. However, many of these health services, known as low-value care (LVC), are unnecessary and impose undue financial costs on patients and health systems. The present study aimed to explore the perceptions of service providers regarding the facilitators and barriers to reducing LVC in the management of LBP in Iran. METHODS This qualitative descriptive study interviewed a total of 20 participants, including neurosurgeons, physiatrists, orthopedists, and physiotherapists, who were selected through purposive and snowball sampling strategies. The collected data were analyzed using the thematic content analysis approach. RESULTS Thirty-nine sub-themes, with 183 citations, were identified as barriers, and 31 sub-themes, with 120 citations, were defined as facilitators. Facilitators and barriers to reducing LVC for LBP, according to the interviewees, were categorized into five themes, including: (1) individual provider characteristics; (2) individual patient characteristics; (3) social context; (4) organizational context; and (5) economic and political context. The ten most commonly cited barriers included unrealistic tariffs, provider-induced demand, patient distrust, insufficient time allocation, a lack of insurance coverage, a lack of a comprehensive referral system, a lack of teamwork, cultural challenges, a lack of awareness, and defensive medicine. Barriers such as adherence to clinical guidelines, improving the referral system, improving the cultural status of patients, and facilitators such as strengthening teamwork, developing an appropriate provider-patient relationship, improving the cultural status of the public, motivating the patients, considering an individualized approach, establishing a desirable payment mechanism, and raising the medical tariffs were most repeatedly stated by participants. CONCLUSION This study has pointed out a great number of barriers and facilitators that shape the provision of LVC in the management of LBP in Iran. Therefore, it is essential for relevant stakeholders to consider these findings in order to de-implement LVC interventions in the process of LBP management.
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Affiliation(s)
- Seyedeh Yasamin Parvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parviz Mojgani
- Iran-Helal Institute of Applied Science and Technology, Tehran, Iran
- Research Center for Emergency and Disaster Resilience, Red Crescent Society of The Islamic Republic of Iran, Tehran, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Poursaeed
- Transitional Doctor of Physical Therapy Program, College of Professional Studies, Northeastern University, Boston, USA
| | - Leila Sadat Mohamadi Jahromi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vinaytosh Mishra
- College of Healthcare Management and Economics, Gulf Medical University, Ajman, UAE
| | - Alireza Abbasi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Parvar SY, Rezvani A, Ghaderpanah R, Hefzosseheh M, Rafiei S, Monabati A. The relation between epidermal growth factor receptor mutations profiles and smoking patterns in patients with lung adenocarcinoma: A cross-sectional study. Health Sci Rep 2023; 6:e1369. [PMID: 37425232 PMCID: PMC10323165 DOI: 10.1002/hsr2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/02/2023] [Accepted: 06/11/2023] [Indexed: 07/11/2023] Open
Abstract
Background Non-small cell lung cancer (NSCLC) accounts for 85% of lung cancer cases, with smoking being a critical risk factor. The identification of NSCLC patients harboring epidermal growth factor receptor (EGFR) mutations, sensitized to tyrosine kinase inhibitors, has revolutionized treatment plans, resulting in improved clinical responses and reduced chemotherapy toxicity. This study aimed to assess the relationship between EGFR mutations and smoking patterns in patients diagnosed with lung adenocarcinoma referred to major pathologic laboratories. Methods This cross-sectional study included 217 NSCLC patients aged above 18 years. Molecular abnormalities of the EGFR gene were analyzed by polymerase chain reaction amplification of exons 18-21 accompanied by Sanger sequencing. Then, the data were analyzed using the SPSS 26 software. Logistic regression analysis, χ 2 test, and Mann-Whitney U test were used to evaluate the relation between EGFR mutations and smoking patterns. Results EGFR mutations were identified in 25.3% of patients, predominantly involving deletion in exon 19 (61.8%). For most of the mutant EGFR patients, the majority were nonsmokers (81.8%), and 52.7% were female patients. Besides, the median duration of smoking was 26 years and the median frequency of smoking was 23 pack-years in the mutant EGFR group, both of which were lower compared to the wild mutant group. Moreover, female gender, current, and heavy smoking were significantly correlated with EGFR mutations based on the univariate logistic regression analysis (p: 0.004, 0.005, and 0.001, respectively). Conclusions Female gender and nonsmoker status were strongly associated with positive EGFR mutations. While guidelines traditionally recommended EGFR testing primarily for female nonsmokers with advanced NSCLC, our study in line with the recently published evidence has shown a significant prevalence of positive EGFR mutations among male patients and smokers. Therefore, routine mutation testing is suggested for all NSCLC patients. Considering the limited access to EGFR testing laboratories in developing countries, the results of such epidemiological surveys can assist oncologists in choosing the most suitable treatment plan.
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Affiliation(s)
| | - Alireza Rezvani
- Department of internal medicine, Autophagy Research CenterShiraz University of Medical ScienceShirazIran
| | - Rezvan Ghaderpanah
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | | | - Shakila Rafiei
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Ahmad Monabati
- Department of PathologyShiraz University of Medical SciencesShirazIran
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Sadeghi Boogar S, Sivandzadeh GR, Sehatpour F, Dadashpour N, Goodarzian MR, Parvar SY. Early cryptococcosis infection in a liver transplant patient: A case report. Clin Case Rep 2023; 11:e7699. [PMID: 37465242 PMCID: PMC10350661 DOI: 10.1002/ccr3.7699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/24/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
Key Clinical Message In order to early diagnose and prevent the infection dissemination in both suspected solid organ donors and recipients after transplantation, pretransplantation screening tests for rare etiologies like Cryptococcus neoformans should be necessitated, as they can affect many vital organs, especially the brain, liver, and lungs. Abstract Cryptococcosis is a systemic fungal infection mainly affecting immunocompromised patients. The infection is occasionally seen in 16-21 months after organ transplantation, while early involvement is uncommon within <30 days posttransplantation. In the present study, we reported an unusual case of cryptococcosis infection 21 days after transplantation, limited to the transplanted liver in a 60-year-old male. Treatment with an antifungal agent showed prompt improvement in his clinical condition.
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Affiliation(s)
| | - Gholam Reza Sivandzadeh
- Gastroentrohepatology Research Center, Department of Internal Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Faezeh Sehatpour
- Department of Internal Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Nazanin Dadashpour
- Department of Internal Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
| | - MReza Goodarzian
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Seyedeh Yasamin Parvar
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
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Mohammadi AA, Goodarzian MR, Parvar SY, Rafiei E, Keshavarz M, Zardosht M. Epidemiology of burn injuries among adult females in southern Iran; a retrospective study from 2007 to 2022. J Burn Care Res 2023:irad086. [PMID: 37325927 DOI: 10.1093/jbcr/irad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Indexed: 06/17/2023]
Abstract
Burn -by flame, flush, scald, electrical, and chemical types- accounts for 5-12% of trauma injuries worldwide. In Iranian studies, females were the main victims of domestic burns with higher mortality and frequencies. This retrospective study evaluates the epidemiology and etiology of burn injuries in females aged 25-64 years between October 2007 to May 2022 in southern Iran. Demographics and burn etiology information were collected by questionnaires at admission. Univariate and multivariate regression analysis was used to determine the relationship between variables and burn mortality. Pearson's Chi-Square and One-way ANOVA tests were utilized to compare different burn etiologies. Of 3212 females with burn injuries, 1499 (46.6%) were included with a mean age of 38.5 ± 10.8 years. Flame (59.7%) and flush (28.9%) were significantly the most common injuries mechanism. Burn was most common in rural areas (53.9%) and indoor settings (62.1%) (P-value < 0.001). 77.9% of the population were under-diploma (P-value < 0.001), and 3.5% were divorced with higher burn-suicide attempts. The mean Total Body Surface Area (TBSA%) was 41.1 ± 28.3%, and the mean Length of Stay (LOS) was 14.5 ± 13.2 days with a 39.1% mortality rate. With univariate and multivariate analysis, TBSA%, indoor places, flame, flush, and urban living were risk factors for burn mortality. Briefly, flame in indoor settings is the most common type of burn injury affecting adult females with lower educational levels living in rural areas. Such epidemiological studies of burns in adult females may be helpful for health policymakers to develop burn prevention programs.
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Affiliation(s)
- Ali Akbar Mohammadi
- Burn and Wound Healing Research Center, Department of Plastic Surgery, Amir-al-Moemenin hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Reza Goodarzian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Elham Rafiei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Keshavarz
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Zardosht
- Burn and Wound Healing Research Center, Department of Plastic Surgery, Amir-al-Moemenin hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Parvar SY, Ghaderpanah R, Naghshzan A. Prevalence of congenital heart disease according to the echocardiography findings in 8145 neonates, multicenter study in southern Iran. Health Sci Rep 2023; 6:e1178. [PMID: 37033389 PMCID: PMC10073012 DOI: 10.1002/hsr2.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Congenital heart disease (CHD), the lethal congenital anomaly in newborns, is multifactorial, with environmental and genetic factors contributing to its occurrence. Although some studies on the prevalence of CHD have been conducted throughout the country, this large‐scale study aims to provide information on the prevalence of various types of CHDs in newborns according to the echocardiography findings. Patients and Methods Over 3 years, 8145 neonates with suspected CHD who underwent echocardiography by a trained pediatric cardiologist were included in this multicenter, cross‐sectional observational study. CHD was categorized into two major groups; cyanotic and acyanotic heart disease. The SPSS version 22 software was used to analyze the data with a significance level set at 0.05. Results Of 8145 neonates who were referred to our centers with CHD symptoms, 6307 were indicated for echocardiography. The mean age of the studied population was 8.5 ± 9.3 days and the male‐to‐female ratio was 2.6, especially in the arterial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) groups. 77.2% of patients had acyanotic heart disease (100 in 1000 neonates) with ASD as the most common one and 9% were diagnosed with cyanotic heart disease (11 in 1000 neonates) with transposition of the great arteries as the most common form and the aortopulmonary window was the rarest form. Conclusion This large prospective, multicenter screening study reported arterial septal defect (85%) and patents with ductus arteriosus (32%) as the most frequent type of CHD. Moreover, the prevalence of male patients was significantly higher. This information would be helpful for health policy makers, stakeholders, and general practitioners in regions where there are no trained pediatric cardiologist fellowships and limited access to echocardiography devices for better management of CHD.
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Affiliation(s)
| | - Rezvan Ghaderpanah
- Student research committeeShiraz University of medical sciencesShirazIran
| | - Amir Naghshzan
- Cardiovascular and Neonatology research centerShiraz University of Medical SciencesShirazIran
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Bagheri Lankarani K, Masoumi SJ, Honarvar B, Mashhadiagha A, Shirvani M, Parvar SY, Karami M. The Revolutionary Impacts of the COVID-19 Pandemic on Mobile Health; Highlights of the Fourth Shiraz International Congress on Mobile Health. J Biomed Phys Eng 2023; 13:203-208. [PMID: 37082544 PMCID: PMC10111106 DOI: 10.31661/jbpe.v0i0.2107-1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/26/2022] [Indexed: 03/13/2023]
Abstract
Mobile health (m-health) is considered an undeniable part of health service delivery, planning, and marketing, which has dramatically changed due to the unique situation caused by the COVID-19 pandemic. The Forth International Congress of Mobile Health, from February 14th to 16th, 2021, in Shiraz, Iran, aimed to provide a venue to exchange ideas, techniques, relevant experiments, and applications with a particular focus on the COVID-19 pandemic impacts. More than 70 experts from different countries in engineering, biomedical sciences, and humanities presented their recent experiences in m-health advancements, particularly in response to the COVID-19 outbreak. In this article, highlights of the most valuable ideas presented at the congress are concisely summarized to give scientists, entrepreneurs, policymakers, and other stakeholders a better understanding of the growing opportunities, and challenges toward the development of m-health.
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Affiliation(s)
| | - Seyed Jalil Masoumi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Honarvar
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirali Mashhadiagha
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Shirvani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh Yasamin Parvar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Karami
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Parvar SY, Amani M, Shafiei M, Rastaghi F, Hosseini SA, Ahramiyanpour N. "The efficacy and adverse effects of treatment options for facial pores: A review article". J Cosmet Dermatol 2023; 22:763-775. [PMID: 36440737 DOI: 10.1111/jocd.15502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/08/2022] [Accepted: 10/26/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Skin pores are enlarged openings of the pilosebaceous follicles that can be affected by age, gender, genetics, exposure to UV light, ethnicity, and sebum secretion. Many treatment modalities reduce facial pores' count and area, including oral and topical medications as well as different wavelengths of lasers. Finding a safe and cost-effective treatment protocol is necessary since facial pores are one of the main reasons for cosmetic complaints. AIM This review compares available treatment options for reducing facial pores' number and area according to the published clinical trials. METHODS A search on PubMed and Google Scholar was performed. Nineteen published clinical trials regarding treatment options for facial pores were included and reviewed based on the authors' clinical experience. RESULTS A total number of 591 cases (83.7% female) aged 18-80 years were included. Three assessment methods including digital imaging, physician assessment, and patient' satisfaction were used in the studies to evaluate the therapeutic efficacy of each modality. Furthermore, combining different modalities increased the efficacy of reducing pores' size and number. Mild, reversible burning and erythema were common side effects. CONCLUSION Multiple sessions and combination therapies improve facial pores' area and number. In young patients, the focus should be on controlling sebum production, while in older patients, the focus should be on rejuvenation in addition to the control of sebum production.
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Affiliation(s)
- Seyedeh Yasamin Parvar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maliheh Amani
- Department of Dermatology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohadeseh Shafiei
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Rastaghi
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Ali Hosseini
- Postdoctoral Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Pathology and Stem cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Farpour HR, Parvar SY, Ahmed F, Hajihosseini A, Ghamari N, Badheeb M, Nikbakht HA. Phenol vs. botulinum toxin A injection for managing lower limb spasticity in adult patients with upper motor lesions: A randomized clinical trial. Journal of Emergency Medicine, Trauma and Acute Care 2023; 2023. [DOI: 10.5339/jemtac.2023.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Affiliation(s)
- Hamid Reza Farpour
- Shiraz Geriatric Research Center, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Azadeh Hajihosseini
- Shiraz Geriatric Research Center, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Ghamari
- Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamed Badheeb
- Department of Internal Medicine, Faculty of Medicine, Hadhramaut University, Hadhramaut, Yemen
| | - Hossein-Ali Nikbakht
- Social Determinates of Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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Parvar SY, Sarasyabi MS, Moslehi MA, Priftis KN, Cutrera R, Chen M, Lili Z, Gonuguntla HK, Joseph T, Alajmi M, Alshammari S, Singh V, Parakh A, Indawati W, Triasih R, Fasseeh N. The characteristics of foreign bodies aspirated by children across different continents: A comparative review. Pediatr Pulmonol 2023; 58:408-424. [PMID: 36373422 DOI: 10.1002/ppul.26242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/05/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Foreign body aspiration (FBA) is a common issue in pediatric emergencies, with regional variations. Various cultures and foods, parents' and physicians' inadequate experience, and lack of bronchoscopy equipment are some attributable factors in the regional variation of FBA. AIM To more accurately represent the demographic characteristics of aspirated foreign bodies (FBs) across various continents, this review attempted to provide organized information based on the reviewed articles. METHODOLOGY A search was conducted in PubMed/PubMed Central, EMBASE, and google scholar. From the 36 included articles, information on age, gender, bronchoscopy type, type of FB, location, history of choking, and time elapsed between aspiration and admission were extracted. RESULTS A total of 14,469 cases were evaluated. According to the findings, children under two accounted for more than 75% of FBAs. Nuts and seeds were the most common FBs in most countries, whereas plastic and metal objects had higher rates in Brazil, and calcified objects were more prevalent in Thailand. The right bronchus was the most frequent location, and rigid bronchoscopy was the most often utilized type of bronchoscope. In addition, a significant percentage of patients were referred to the emergency rooms in the first 12-24 h following the aspiration incident. Moreover, Asian patients reported more choking history, and Europeans had fewer witnesses of FBA. CONCLUSIONS There is a lack of standardized reporting systems and organized guidelines in pediatric FBA. To select the ideal time for endoscopies and create educational programs, a collaboration between experienced researchers, pediatric pulmonologists, radiologists, and otolaryngologists is required.
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Affiliation(s)
| | | | - Mohammad Ashkan Moslehi
- Pediatric Interventional Pulmonology Division, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kostas N Priftis
- Children's Respiratory and Allergy Unit at National and Kapodistrian University of Athens, Zografou, Greece
| | - Renato Cutrera
- Pediatric Respiratory Department, Bambino Gesù Pediatric University Hospital, Rome, Italy
| | - Meng Chen
- Pediatric Interventional Respiratory Division, Qilu Children University Hospital, Shandong University, Jinan, China
| | - Zhong Lili
- Pediatric Respiratory Department, The Children's Medical Center of Hunan Provincial People's Hospital, Hunan University of Medical Sciences, Changsha, Hunan, China
| | - Hari K Gonuguntla
- Division of Interventional Pulmonology, Yashoda Hospitals, Hyderabad, India
| | - Tinku Joseph
- Interventional Pulmonology Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Mohsen Alajmi
- Pediatric Respirology and Interventional Pulmonology, Ahmadi Hospital, Al Ahmadi, Kuwait
| | - Salman Alshammari
- Department of Pediatrics, Pediatric Intensive Care Unit, Adan Hospital, Hadiya, Kuwait
| | - Varinder Singh
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Childrens Hospital, Delhi, India
| | - Ankit Parakh
- Pediatric Respiratory Division, BLK Max Hospital, New Delhi, India
| | - Wahyuni Indawati
- Child Health Department, Respirology Division, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rina Triasih
- Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Dr. Sarjito Hospital, Yogyakarta, Indonesia
| | - Nader Fasseeh
- Respiratory and Allergy Unit, Faculty of Medicine, Alexandria Universty, Alexandria, Egypt
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Pazyar N, Hatami M, Yaghoobi R, Parvar SY, Radmanesh M, Hadibarhaghtalab M. The efficacy of adding topical 5-fluorouracil to micro-needling in the treatment of vitiligo: A randomized controlled trial. J Cosmet Dermatol 2023; 22:1513-1520. [PMID: 36718813 DOI: 10.1111/jocd.15616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/03/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIM Vitiligo is an autoimmune skin disorder characterized by circumscribed depigmented macules and patches caused by the loss of functional melanocytes. Although there is no definitive treatment for vitiligo, several treatment options have been associated with relative satisfactory outcomes. The purpose of this study was to compare the efficacy of micro-needling in conjunction with topical 5-fluorouracil (5-FU) versus topical tacrolimus ointment in treating vitiligo patches. PATIENTS AND METHODS This study included nineteen participants, each of whom received both treatments on two randomly selected vitiligo patches of approximately the same size and location. On one patch, a combination of weekly micro-needling and topical application of 5-FU solution was used every other day, while on the other, 0.1% tacrolimus topical ointment was applied twice daily. The G-score was used to compare treatment outcomes after 3 months. RESULTS The median duration of the disease in our population was 7 years. Six patients (32%) in the micro-needling plus topical 5-FU treated group showed a moderate to excellent response, indicating a significant improvement between both treatments (p-value = 0.019). In contrast, all other patches treated with topical tacrolimus showed poor improvement. Lower extremity and trunk responded more to treatment with micro-needling plus topical 5-FU than upper extremity and acral areas. Moreover, none of those who have had the disease for more than ten years have responded to treatment. Mild erythema, pinpoint bleeding, and irritation were detected only in the micro-needling treated group. CONCLUSION The current study showed that using micro-needling in conjunction with 5-FU could treat vitiligo patients more efficiently than tacrolimus monotherapy. Despite showing moderate to excellent improvement in patches treated with micro-needling and 5-FU, this well-tolerated office-based modality still requires additional research.
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Affiliation(s)
- Nader Pazyar
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hatami
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Yaghoobi
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Mohammad Radmanesh
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Hadibarhaghtalab
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Ghahartars M, Sahaf A, Parvar SY, Ahramiyanpour N. The Efficacy of Cryotherapy and Zinc Gluconate in Management of Anogenital Warts: A Randomized Double-Blind, Split-Side, Placebo-Controlled Trial. Skinmed 2023; 21:21-26. [PMID: 36987822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Anogenital warts are the most common sexually transmitted infection causing economic and psychosocial issues. Efficacy of zinc has been proved in treating nongenital warts, but its role in treating anogenital warts is not clear. This study was conducted to assess whether oral zinc gluconate in combination with cryotherapy effectively treated anogenital warts. A randomized double-blind, split-side, placebo-controlled trial was conducted on 50 patients suffering from genital warts. The patients were treated for 2 months with a combination of four sessions of cryotherapy and oral zinc gluconate versus placebos. Follow-up was performed at every 2 weeks based on the number of warts. The number of genital warts reduced significantly in both groups during treatment with cryotherapy, but no significant differences were observed between treatment with zinc and placebo. Patients in the zinc gluconate group reported significantly higher gastrointestinal adverse effects than those in the placebo group. This indicates that using oral zinc gluconate appeared to have no significant advantage over placebo in treating and reducing the number of genital warts; however, a longer duration of follow-up and pre-intervention serum level of zinc were necessary to evaluate the role of oral zinc therapy. (SKINmed. 2023;21:21-26).
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Affiliation(s)
- Mehdi Ghahartars
- Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Akram Sahaf
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran;
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13
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Pazyar N, Dezfuly MB, Hadibarhaghtalab M, Parvar SY, Molavi SN, Mapar MA, Zeinali M. Intradermal Injection of 100mg Tranexamic Acid Versus Topical 4% Hydroquinone for the Treatment of Melasma: A Randomized, Controlled Trial. J Clin Aesthet Dermatol 2023; 16:35-40. [PMID: 36743976 PMCID: PMC9891212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective Melasma is an acquired and chronic hyperpigmentation disorder associated with a negative impact on patients' quality of life. This study compares the efficacy of 100mg/mL intradermal TA with 4% topical HQ on female patients presenting with melasma lesions. Methods In this randomized double-blind controlled trial, 48 women with melasma were allocated into two groups, treated with either 100mg/mL intradermal TA or topical 4% HQ. The MASI (Melasma Area and Severity Index) score was assessed by paired t-tests and repeated measured ANOVAs. The Dynamic Physician General Assessment (PGA) was also performed by taking photographs with a digital camera. Results The average MASI score for the HQ and TA groups was 7.7 (3.0 SD) and 5.9 (2.5 SD), respectively. In both groups, the MASI decreased significantly after three months of treatment; however, the decrease was not significant between the two groups (P=0.1). All participants developed mild degrees of burning pain in the injection site without serious adverse effects. Limitations First, we only used the MASI score to measure melasma degree. Second, this is a single-center study with a small sample size. Third, the before-after photos were not taken with a high-quality camera. Conclusion The results of our study showed that both TA and continuous HQ significantly reduced the MASI score of patients without any significant differences and serious side effects. Although many treatment modalities are available for melasma, this condition is still challenging for dermatologists with a high recurrence rate after treatment.
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Affiliation(s)
- Nader Pazyar
- Dr. Pazyar is an Assistant Professor with the Department of Dermatology at Imam Khomeini Hospital at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran
| | - Motahareh Babazadeh Dezfuly
- Drs. Dezfuly and Molavi are Assistants of Dermatology with the Department of Dermatology at Imam Khomeini Hospital at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran
| | - Maryam Hadibarhaghtalab
- Dr. Hadibarhaghtalab and Ms. Parvar are with the Molecular Dermatology Research Center at Shiraz University of Medical Sciences in Shiraz, Iran
| | - Seyedeh Yasamin Parvar
- Dr. Hadibarhaghtalab and Ms. Parvar are with the Molecular Dermatology Research Center at Shiraz University of Medical Sciences in Shiraz, Iran.,Ms. Pavar is additionally with the Student Research Committee at Shiraz University of Medical Sciences in Shiraz, Iran
| | - Seyedeh Nasrin Molavi
- Drs. Dezfuly and Molavi are Assistants of Dermatology with the Department of Dermatology at Imam Khomeini Hospital at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran
| | - Mohammad Ali Mapar
- Drs. Mapar and Zeinali are with the Department of Dermatology at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran
| | - Maryam Zeinali
- Drs. Mapar and Zeinali are with the Department of Dermatology at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran
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14
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Ghahartars M, Parvar SY, Samipour L, Hadibarhaghtalab M. Trichoepithelioma presenting as leonine facies in a young female. Skin Health Dis 2022; 3:e177. [PMID: 36751311 PMCID: PMC9892421 DOI: 10.1002/ski2.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 02/05/2023]
Abstract
Trichoepithelioma is a rare benign tumour of the pilosebaceous unit that originates from the hair follicles. Although it rarely results in facial disfigurement, it is thought to be the cause of leonine facies. We discuss a 27-year-old woman who presented with facies Leonine caused by trichoepitheliomas. The first line of treatment for these multiple symmetrical, firm, and round papules or nodules is excisional surgery.
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Affiliation(s)
- Mehdi Ghahartars
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran,Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Leila Samipour
- Department of DermatologySchool of MedicineKerman University of Medical SciencesKermanIran
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15
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Feily A, Nilforoushzadeh MA, Parvar SY, Hadibarhaghtalab M, Gilman C, Seifi V, Hesamzadeh D, Arzhangian MH, Ghahartars M, Lange CS, Ramirez-Fort MK. Platelet-rich plasma and follicular transplantation versus follicular transplantation alone in the treatment of refractory vitiligo: a comparative pilot study. Dermatol Ther 2022; 35:e15577. [PMID: 35535631 DOI: 10.1111/dth.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/19/2022] [Accepted: 05/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Amir Feily
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Student research committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Maryam Hadibarhaghtalab
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Casey Gilman
- Pathology and Physiology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - Vahid Seifi
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Jahrom University of medical Sciences, Department of Dermatology, Jahrom, Iran
| | - Daryoush Hesamzadeh
- Jahrom University of medical Sciences, Department of Dermatology, Jahrom, Iran
| | | | - Mahdi Ghahartars
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Christopher S Lange
- Radiation Oncology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Life Sciences, BioFort®, Guaynabo, Puerto Rico
| | - Marigdalia K Ramirez-Fort
- Department of Life Sciences, BioFort®, Guaynabo, Puerto Rico.,Department of Radiation Oncology, Caribbean Radiation Oncology Center, Bayamon, Puerto Rico
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16
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Pazyar N, Molavi SN, Hosseinpour P, Hadibarhaghtalab M, Parvar SY, Dezfuly MB. Efficacy of intradermal injection of tranexamic acid and ascorbic acid versus tranexamic acid and placebo in the treatment of melasma: A split-face comparative trial. Health Sci Rep 2022; 5:e537. [PMID: 35284654 PMCID: PMC8905661 DOI: 10.1002/hsr2.537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Melasma is a common dermatologic disorder characterized by symmetrical hyperpigmented lesions on the face. Although various therapeutic options are available for melasma, its treatment remains challenging. The present study evaluated the safety and efficacy of intradermal microinjection of tranexamic acid (TA) plus ascorbic acid in treating melasma lesions compared with TA and placebo. Methods From September 2019 to May 2020, 24 patients with symmetrical melasma were enrolled in a prospective, double-blind, split-face, randomized controlled clinical trial. Each patient received 50 mg/ml TA and 50 mg/ml ascorbic acid for one side of the face (A) and 50 mg/ml TA and placebo for the other side (B) every 2 weeks for 12 weeks. The Melasma Area and Severity Index (MASI) score, Physician Global Assessment, and pain were measured at baseline and at 4, 8, 12, and 24 weeks. Statistical analysis was done using SPSS software version 16, and data were reported as mean ± standard deviation or median and interquartile range. χ 2 and Fisher's exact tests were used to test differences between the groups. Results Both groups experienced a significant decrease in MASI scores compared with the baseline. The MASI score was significantly less in the intervention group than the placebo group at the 8th and 12th weeks. However, burning pain was significantly more prominent in the intervention group. Conclusion Intradermal injection of ascorbic acid combined with TA can be beneficial in treating melasma. Currently, there are numerous treatment modalities for melasma. However, the results still vary, and satisfactory outcomes are yet to be reached.
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Affiliation(s)
- Nader Pazyar
- Dermatology DepartmentAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Seyedeh Nasrin Molavi
- Dermatology Department, Emam Hospital, School of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | | | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research CenterShiraz University of Medical SciencesShirazIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
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17
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Parvar SY, Ghamari N, Pezeshkian F, Shahriarirad R. Prevalence of anxiety, depression, stress, and perceived stress and their relation with resilience during the COVID-19 pandemic, a cross-sectional study. Health Sci Rep 2022; 5:e460. [PMID: 35024455 PMCID: PMC8733840 DOI: 10.1002/hsr2.460] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 12/28/2022] Open
Abstract
Background and aims Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID-19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID-19 pandemic among a sample of the general population in Southern Iran. Methods In this cross-sectional web-based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS-21), Perceived Stress Scale (PSS-14), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t-test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience. Results Among a total of 538 participants, the overall prevalence of moderate-to-extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days. Conclusion The occurring COVID-19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID-19 pandemic.
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Affiliation(s)
| | - Narges Ghamari
- Bone and Joint Diseases Research CenterShiraz University of Medical SciencesShirazIran
| | | | - Reza Shahriarirad
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical SciencesShirazIran
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18
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Saki N, Rahimi F, Pezeshkian FS, Parvar SY. Comparison of the efficacy of microneedling versus CO 2 fractional laser to treat striae alba: A randomized clinical trial. Dermatol Ther 2021; 35:e15212. [PMID: 34796595 DOI: 10.1111/dth.15212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
Striae distensae (SD) are common skin conditions that have posed a significant challenge regarding their assessment and treatment. The present study aimed to evaluate the efficacy of microneedling in comparison to fractional CO2 laser therapy. Similar striae were selected and photographed. Each side was randomly assigned to be treated with CO2 fractional laser or microneedling four times at monthly intervals and followed up for 10 months. Outcome measures including the length and width of the largest striae, dermatologist assessed improvement, patients' satisfaction, and visual analog scale (VAS) were assessed. Wilcoxon signed-rank test and Mann-Whitney U test were used to assess the efficacy of treatments. Forty patients with a mean age of 28.1 years were included. The median cross-section of the largest striae decreased significantly in both groups (P-value <0.001), without statistically significant differences between the two groups before and 6 months after treatment. VAS also improved significantly in both groups, and there were no statistically significant differences between the two treatments in all visits. No clinically significant adverse effects were observed. Fractional CO2 laser and microneedling are both efficient treatments to resolve SD. A new light should be shed on the microneedling modality as it is more economical than the other treatment options.
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Affiliation(s)
- Nasrin Saki
- Molecular Dermatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.,Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Rahimi
- Molecular Dermatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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