comparative study of the topical tacrolimus versus topical calcipotriol in / ptients with hand and facial vitiligo

Background and Objectives: Vitiligo is an acquired disease due to progressive lack of performance of melanocytes and appears as ring depigmentated patches and macules. About%2 of people are involved and because of unpleasant appearance, it creates emotional stress on patients .So new and better treatments are needed. This study was conducted to compare effectiveness of topical tacrolimus with topical calcipotriol in pigmentation of vitiligo patients

Materials and Methods:This study was done in double-blind randomized clinical trial on patients facial and hand vitiligo with under%20 involvement of body surface. Patients were categorized in two groups with tacrolimus and calcipotriol treatments and were evaluated and followed up for 12 months

Results: In statistical analysis, there was no significant difference between the effects of both dings on progression of pigmentation, but their on facial vitiligo was better than hand vitiligo [p=0.04].Side effects of treatment in both groups were mild and no serious side effects were reported, but Tacrolimus had significantly minimal side effects rather than Calcipotriol [p=0.02]

Conclusions: In this study,efficacy of topical tacrolimus was better than topical calcipotriol on face and efficacy of calcipotriol was better than tacrolimus on hand vitiligo

Maternal child abuse and its association with maternal anxiety in the socio-cultural context of Iran

The prevalence of parental violence has been an area of major public concern. There are few available data detailing the ways parents and other caregivers discipline children, particularly in low and middle income countries. This study focuses on the prevalence of different types of maternal child abuse and its association with maternal anxiety in the socio-cultural context of Iran. Participants in this cross-sectional study consisted of 562 mothers with the last child aged from 1 month to 12 years old who attended the Amirkola Children's Referral Hospital in Mazandaran Province, Iran, seeking healthcare services for their children. Demographic characteristics of the mothers, their children and reactions to conflicts with children were evaluated by a validated version of Conflict Tactics Scale for Parent and Child. Also, the relationship between maternal anxiety and child abuse was assessed using the Spielberger State-Trait Anxiety Inventory. The association between variables was examined by Pearson correlation coefficient, independent t-test, one-way ANOVA, and multivariate regression. The prevalence of mother-to-child corporal punishment, severe physical abuse and very severe physical abuse were 436 [78%], 260 [46%] and 180 [32%], respectively. Verbal emotional abuse was reported by 506 [90%] participants and nonverbal emotional abuse was reported in 374 [67%] cases. A correlation was observed between child abuse and mothers' age [p=0.02], as well as with the number of children in the family [p=0.03], and the mothers' trait anxiety [p<0.001]. Overall, the assessment of maternal child abuse should be an important focus for evaluation in mothers with anxiety and vice versa, when child abuse is suspected, maternal psychological assessment should be essential.

Non-traditional roles of iranian senior nurse managers in developing the profession: a qualitative study

The traditional roles of managers are insufficient in today's evolving healthcare market. Therefore, they need to improve management practices through playing new roles. So the present study aimed to explore the roles of nurse managers in the context of Iranian health care system. A qualitative content analysis with semi-structured interviews was used in this study. The study settings included the Ministry of Health and Medical Education, Nursing and Midwifery Schools, public hospitals, and Nursing Associations in Tehran, Iran. A purposive sample of twenty six nurse managers was recruited in this study. The main theme found was "socio-political roles", with the five subcategories as roles: "managing boundaries", "integrator", "convincing agent of change", "governance of the profession", and "promotion of the profession". The study indicated by playing socio-political roles nurse mangers gained many advantages for the profession. While studies have focused on the traditional roles of nursing managers, the concept of socio-political roles opens a new field of work. Hence, should be made to pay close attention to the significant roles of nursing managers in the current context of health care. In keeping pace with changes and by enacting their socio-political roles, nursing managers can facilitate the achievement of major professional and healthcare goals.

Comparison of the efficacy of cryotherapy and 0.1% Acnalen gel vs. cryotherapy and placebo in the treatment of actinic keratoses

To compare efficiency of cryotherapy followed by Acnalen gel 0.1% with cryotherapy plus placebo in the treatment of AKs [Actinic Keratosis]. One hundred outpatients who had a clinical diagnosis of actinic keratoses on face or scalp with at least five lesions were enrolled in the study. Patients were randomized into two groups: cryotherapy plus placebo and cryotherapy plus Acnalen 0.1% gel for a period of 100 days. Lesion counts were assessed at baseline, and 40, 70 and 100 days after cryotherapy. Mean baseline number of lesions for cryotherapy plus Acnalen gel group and cryotherapy plus placebo group were 7.54 +/- 3.66 and 7.20 +/- 3.60. In Acnalen group mean number of lesions reduced to 3.44 +/- 2.71[54.79 +/- 3.8%] and in placebo group reduced to 3.68 +/- 2.97 [48.60 +/- 4.5%] [P=0.62]. Our results suggested that cryotherapy and Acnalen 0.1% gel during 100 days cannot be more helpful than cryotherapy alone in the treatment of clinical AKs

Comparison of the efficacy of 0.05% tretinoin with 7% alpha-hydroxy acid cream in the treatment of ephelides: a controlled clinical trial

Anti-inflammatory and hypo-pigmenting effects of topical tretinoin and alpha-hydroxy acids have been documented. This study was designed to compare the efficacy of 0.05% tretinion cream with 7% alpha-hydroxy acid in the treatment of ephelides. In this clinical trial 80 patients with ephelides were selected and allocated into two groups. One group was treated with 0.05% tretinoin cream every other night. The other group was treated with 7% alpha-hydroxy acid cream in the same manner. Both groups were treated with antisolar creams and followed every month for 5 months. After 5 months excellent therapeutic response was achieved in 3 [7.5%] of patients who were treated with 0.05% tretinoin cream compared to 8 [20%] in alpha-hydroxy acid cream. Good therapeutic response was observed in 20 [50%] of tretinoin group versus 16 [40%] in alpha-hydroxy acid group. Patient's satisfaction from treatment was consistent with evaluation by dermatologists [P=0.384 and P=Q.l32]. Both 0.05% tretinoin cream and 7% alpha-hydroxy acid cream are equally efficient in the treatment of ephelides