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Byline: Mohammadreza, Parisa. Hosseinpour, Maryam. Hadibarhaghtalab, Leila. Karami Case Presentation A healthy 35-year-old woman presented with a tender, growing lesion on her trunk since 2 years ago starting with a [...]

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. [ABSTRACT FROM AUTHOR]

Byline: Mohamad. Namazi, Poorya. Neshat, Ahmad. Monabati, Maryam. Hadibarhaghtalab A healthy 33-year-old man presented with a depressed, non-tender soft plaque on his back since 1 year. The lesion measured 0.7 [...]

Background: Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in Iran. The determination of subtype of BCC plays an essential role in the diagnosis, recurrence rate, and outcome of patients. The present study was conducted to investigate the relationship between histopathologic subtypes and demographic data, history of radiation exposure, and past medical history in the Iranian population. Method: This retrospective cross-sectional study evaluated the patients with BCC referred to Faghihi Hospital, Shiraz, Iran from 2012 to 2017. We examined all the patients with definite histologically diagnosed scalp BCC. The prevalence of different subtypes and its association with other variables were compared between the patients with and without chronic radio-dermatitis. A P-value of less than 0.05 was considered to be significant. Results: A total number of 161 patients with a cumulative number of 439 BCC lesions participated in the study. The mean age of the patients was 64.2 (± 12.38) years old. Among the patients, 113 (70.2%) were men and 48 (29.8%) were women. The total prevalence of macro-nodular, micro-nodular, and mixed aggressive was 70.2%, 49.1%, and 41.6%, respectively. Multivariate logistic regression analysis showed that excessive sun exposure increased the chance of developing micronodular and mixed aggressive lesions by 3.21 (P = 0.006) and 4.88 (P < 0.001) times, respectively. Conclusion: BCC was more aggressive in chronic radio-dermatitis patients than that in non-radio-dermatitis patients. Moreover, it was significantly different regarding age, gender, appearance, and job distribution compared with non-radio-dermatitis patients. Thus, we could suggest that BCC in chronic radio-dermatitis should be regarded as a high-risk disease, unless proven otherwise. [ABSTRACT FROM AUTHOR]

The marginal zones of the Caspian Sea and the Persian Gulf have a higher prevalence of thalassemia compared to other regions of Iran. This disease has disabled many people and resulted in increasing health care costs. The aim of this study was to assess the incidence of β-thalassemia (β-thal) and to evaluate the outcome of applied preventive strategies over a 14-year period in Fars Province, Southern Iran. This cross-sectional study comprised all new cases of β-thal recorded during 1997-2011. The data were obtained from the Non-Communicable Diseases Surveillance Department of Shiraz University of Medical Sciences, Shiraz, Iran, and are presented as mean ± standard deviation (SD). The Fars Health Network System screened 840 686 males and females applying for marriage certificates. Among the carriers, 50.5% cancelled their marriages, 42.5% married, and 7.0% did not show up at the clinics. The rate of cancelled marriages has reduced since 2000, when marriage candidates were given the option of prenatal diagnosis. From 2000 to 2011, a total of 3539 married couples were referred for prenatal diagnosis. Of these, 806 fetuses were found to carry thalassemia and 800 aborted. It is impressive to note that while 101 cases of thalassemia were recorded in 1997, this figure was reduced to two cases by 2011. This study has established that an integrated primary health care approach, with good infrastructure for implementing successful strategies, can significantly reduce the incidence of β-thal. [ABSTRACT FROM AUTHOR]

Objectives: Effective assessment of tissue perfusion is highly important during Coronary Artery Bypass Graft (CABG). Mixed venous 02 saturation (Svo2) is one of the best and routinely used markers of tissue perfusion. However, this method is costly and leads to considerable complications. Thus, the present study aimed to determine whether the Svo2 can be substituted with central venous saturation (Scvo2) and if there is any correlation between lactate level and Svo2. Methods: This prospective observational study was conducted on 62 patients scheduled for CABG. After induction and maintenance of anesthesia, blood samples drawn from central venous, pulmonary artery, and radial artery were used to measure Scvo Svo2, and serum lactate level respectively before and after Cardio Pulmonary Bypass (CPB). Pearson's correlation test was used to determine the correlation between Svo2 and Scvo2 as well as between Svo2 and serum lactate level. Besides, P < 0.05 was considered as statistically significant. Results: Overall, 62 Patients, 33 males (53.2%) and 29 females (46.8%) were enrolled into the present study. The most common coexisting illness was hypertension detected in 33 patients (53.2%) followed by hypercholesterolemia in 28 ones (44.4%). In this study, Svo2 was positively correlated with Scvo2 (r = 0.63, P < 0.001). However, no correlation was found between Svo2 and lactate (r = 0.124, P = 0.348). Conclusions: In summary, Scvo2 is considered as the best substitute of Svo2 for detecting tissue hypo perfusion during CPB. Although the lactate level had been considered as an appropriate marker of tissue perfusion and ischemia, it was not correlated to Svo2 during CABG. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and Methods Results Conclusion There is still no certain effective treatment for vitiligo as a common chronic skin disorder characterized by depigmented patches and loss of skin melanocytes.This study evaluates the efficacy of oral silymarin combined with hair follicle transplantation compared to follicle transplantation alone in the treatment of refractory vitiligo.Twenty refractory vitiligo patients were enrolled in this randomized controlled clinical trial, following up for 3 months. One group underwent hair transplantation plus oral silymarin, while the other group underwent follicle transplantation alone. We assessed the progress with Vitiligo Extent Tensity Index (VETI) in both groups and the peri‐follicular pigmentation diameter was estimated monthly. The Friedman test for comparing two groups at the end and the Mann–Whitney test for comparing two groups during each month was used.The mean age was 30.22 (18–59) years, with the male to female ratio of 1:1. The decrease in the VETI and increase in the perifollicular pigmentation was statistically significant between silymarin and another group in monthly follow‐up (p‐value: 0.019, 0.019, and 0.035, respectively). Finally, the re‐pigmentation was notable in silymarin group (p‐value <0.001 vs. 0.029, respectively). In addition, both genders had a significant increase in peri‐follicular re‐pigmentation in the last follow‐up (p‐value: 0.012 and 0.044, respectively); although the improvement was not statistically significant between genders in each month.According to our study, silymarin in combination with hair transplantation could be a potential medical treatment for vitiligo; however, further trials are needed to establish the efficacy of combination therapies. [ABSTRACT FROM AUTHOR]

Background: Genetic diversity in human leukocyte antigen (HLA) alleles across populations is a significant risk factor for drug-induced severe cutaneous adverse reactions (SCARs), e.g., carbamazepine (CBZ)- and lamotrigine (LTG)-induced Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The present study aimed to investigate the frequency of different HLA alleles in Iranian patients with CBZ- and LTG-induced SJS/TEN., Methods: A case-control study was conducted from 2011 to 2018 at various hospitals affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 31 patients receiving anticonvulsant drugs (CZB or LTG) were recruited and divided into two groups. The drug-induced group (n=14) included hospitalized patients due to CBZ- or LTG-induced SJS/TEN. The drug-tolerant group (n=17) included individuals receiving CBZ or LTG for at least three months with no adverse effects. In addition, 46 healthy individuals (control group) were recruited. The frequency of HLA-A, -B, and -DRB1 alleles in patients with CZB- or LTG-induced SJS/TEN was investigated. HLA typing was performed using the allele-specific polymerase chain reaction method. The Chi square test and Fisher's exact test were used to determine a potential association between SJS/TEN and HLA alleles. P<0.05 was considered statistically significant., Results: CBZ- or LTG-induced SJS/TEN was not significantly associated with HLA alleles. However, HLA-DRB1*01 showed a significantly higher frequency in patients with CBZ-induced SJS/TEN than the CBZ-tolerant patients (30% vs. 9%, P=0.07)., Conclusion: Overall, no significant association was found between CBZ- or LTG-induced SJS/TEN and HLA alleles. Further large-scale studies are required to substantiate our findings., Competing Interests: None declared., (Copyright: © Iranian Journal of Medical Sciences.)

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., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2023. Matrix Medical Communications. All rights reserved.)