Cutaneous leishmaniasis in suspected patients referred to the center for research and training in skin diseases and Leprosy, Tehran, Iran from 2008 to 2011

Cutaneous leishmaniasis [CL] is a major health problem in many parts of Iran, although diagnosis of CL especially in the endemic area is easy, but treatment and management of the disease is a global dilemma. Diagnosis of CL in non-endemic area is not as simple as in endemic foci. In this study, the status and the proportions of CL induced by Leishmania major and L. tropica among CL suspected patients referred to the Center for Research and Training in Skin Diseases and Leprosy, [CRTSDL] during 2008 to 2011 are described. CL patients with suspected lesions were clinically examined. History of trip to zoonotic CL and/or anthroponotic CL endemic areas and the characteristics of their lesion[s] were recorded. Diagnosis of the lesion was done using direct smear microscopy, culture and conventional polymerase chain reaction [PCR]. A total of 404 [M=256, F=148] patients with 776 lesions were recruited and parasitologically examined. The results showed that 255 of the patients with 613 lesions; patients with lesion[s] induced by L. major=147 [M=63, 43%, F=84, 57%] and lesion[s] induced by L. tropica=108 [M=35, 32%, F=73, 68%]. History of travel to endemic area was not always correlated with isolated Leishmania species. Although travel history to endemic area is an important factor to be considered for diagnosis, but parasitological confirmation is necessary initiation of treatment

Stem cell therapy in treatment of different diseases

Stem cells are undifferentiated cells with the ability of proliferation, regeneration, conversion to differentiated cells and producing various tissues. Stem cells are divided into two categories of embryonic and adult. In another categorization stem cells are divided to Totipotent, Multipotent and Unipotent cells. So far usage of stem cells in treatment of various blood diseases has been studied [such as lymphoblastic leukemia, myeloid leukemia, thalassemia, multiple myeloma and cycle cell anemia]. In this paper the goal is evaluation of cell therapy in treatment of Parkinson's disease, Amyotrophic lateral sclerosis, Alzheimer, Stroke, Spinal Cord Injury, Multiple Sclerosis, Radiation Induced Intestinal Injury, Inflammatory Bowel Disease, Liver Disease, Duchenne Muscular Dystrophy, Diabetes, Heart Disease, Bone Disease, Renal Disease, Chronic Wounds, Graft-Versus-Host Disease, Sepsis and Respiratory diseases. It should be mentioned that some disease that are the target of cell therapy are discussed in this article

[Evaluation of skin pH in normal population and its relationship with age, sex and anatomic location]

Everal studies have been conducted to evaluate skin pH in various diseases, but there are few reports in normal population. The aim of this study was to evaluate skin pH in healthy individuals. Fifty healthy volunteers were enrolled in this study. The subjects were divided by age into 5 groups, i.e., 10-20, 21-30, 31-40, 41-50 and 51-60 years old. In each group, 5 females and 5 males were examined. A pH meter [Courage and Khazaka electronic GmbH, Germany] was used to measure pH in 8 different locations of the body [forehead, cheek, nasolabial fold, neck, forearm, dorsal side of hand, palm and leg]. The mean values for pH in these locations were 5.25, 5.15, 5.06, 4.90, 4.75, 4.80, 4.69, and 4.83 respectively. pH was significantly higher in women [P<0.001]. There was a significant difference between skin pH in different age groups [P=0.002]. The highest and lowest amounts of pH belonged to the forehead [5.26 +/- 0.68] and leg [4.69 +/- 0.40], respectively. Age and sex and location have remarkable effects on skin pH

frequency of skin diseases among Hajj pilgrims in skin clinic of Iran in Saudi Arabia, 1993 and 1999

Skin diseases among pilgrims are considered to be one of the possible health problems. Data supporting this observation are scanty. The aim of this study was to report the most common skin diseases seen in Hajj season. Data regarding skin diseases were collected from piligrims whom were examined and diagnosed clinically at the skin clinics of Iran in Saudi Arabia in 1993 and 1999. During the Hajj season in 1999, 362 patients were seen. The most common groups of diseases were eczemas of different types and related conditions [35.9%], mechanical and thermal injury [17.6%] and infections [16.5%], accounted for more than 70% of cases. During Hajj season in 1993, 560 patients were seen. The most common groups of diseases were infections [19.3%], eczema and related conditions [18.6%] and disorders of skin appendages [16.4%], accounted for bout 54.2% of observed skin diseases. The finding of these most common skin disorders is important in training programmes and delivery of service for care of pilgrims, because they are preventable, easily diagnosed and curable in the majority of patients

frequency of skin allergens in patients with contact dermatitis

Eczema is one of the most widely spread inflammatory skin disorders. Contact dermatitis is an eczematous dermatitis that is produced as a result of contact with a substance in the environment. The substance can act as an irritant or allergen. Every country has allergens particular to itself. Determining the frequency of skin allergens in patients with contact dermatitis in Tehran. In this cross-sectional descriptive study, all the data about the patients with chronic contact dermatitis who were visited in a dermatology clinic in Tehran from the year 1993 to 2003 and patch tested with 23 allergens of European Standard Series [ESS] were analyzed. In this study 222 patients were surveryed. The mean age of the patients was 33.5 Years [SD=13.8]. 66.5% of the patients were females. The most common site of involvement [49%] was their hands. The mean duration of the disease was 54 months [SD=62]. Clinical diagnosis included: 59% allergic contact dermatitis, 24% irritant dermatitis, 10% atopic dermatitis, and 7% other types of dermatitis. One-hundred and forty five [65.3%] of them had at least one positive reaction. The most common allergens were: nickle sulfate 22.6%, cobalt chloride 14.5%, and fragrance mix 13.6%. Nickel was the most common contact allergen among the patients surveyed

Use of 18 and 36 kDa antigens of Mycobacterium leprae for detection of this micro-organism in Iranian leprosy patients by PCR

Mycobacterium leprae is an intracellular micro-organism that is the causative agent of leprosy. This micro-organism has a long division time and does not grow in vitro. For these reasons it is difficult to evaluate the effects of drugs on it. Amongst techniques used for detection of micro-organisms polymerase chain reaction [PCR] is promising. This study was conducted to diagnose lyprosy using two antigens by PCR. In this study by selecting specific M. leprae 36 kDa and 18 kDa antigens, a set of primers were designed for each gene and biopsies from 15 patients were screened for presence of M. leprae by PCR. Specific segments of M. leprae antigens were replicated in 5 patients with these primers. PCR is a relevant and promising method for M.leprae detection in biopsies of leprosy patients and it can be considered as a method of choice for early leprosy detection, especially in high risk groups

[ comparison between the efficacy of intralesional injection of 2% Zinc Sulfate solution with Glucantime in the treatment of acute old world cutaneous Leishmaniasis: a randomized, double-blind, controlled clinical trial]

Several treatment modalities have been used for cutaneous leishmaniasis[CL] with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate [ZnSO4] on Leishmania parasites. To compare the efficacy of intralesional injections of 2% ZnSO4 solution with meglumineantimonate[Glucantime] in the treatment of acute Old World CL. Seventy-two patients with CL with a duration of less than 8 weeks were recruited in a randomized, double-blind, clinical trial in Isfahan province - an area endemic for Leishmania major - after giving written informed consent. They were treated with 6 weekly intralesional injections of either 2% sterile ZnSO4 solution or Glucantime prepared in identical vials. The primary outcome measure was complete re-epithelialization of CL lesions. Among 36 patients with 53 lesions treated with ZnSO4 and 36 patients with 53 lesions treated with Glucantime, 13 patients with 19 lesions and 22 patients with 31 lesions completed the trial, respectively. Inadequacy of treatment was the main reason for drop-out in 12 [33.3%] and 2 [5.5%] patients in ZnSO4 and Glucantime groups, respectively [P < 0.05]. Complete re-epithelialization was observed in 2 [10.5%] and 19 [61.3%] lesions 1 week after the end of treatment in the ZnSO4 and Glucantime groups, respectively [P < 0.05]. A six-week course of weekly intralesional injections of 2% ZnSO4 solution was less effective than Glucantime in the treatment of acute Old World CL

Gram negative bacilli in burns

In a period of nine months, 225 strains of Gram-negative bacilli isolated from burns were identified by a variety of tests in two burn centers in Tehran. The most common species were Pseudomonas aeruginosa, Pseudomonas fluorescens, Escherichia coli, Enterobacter agglomerans, Enterobacter cloacae and Klebsiella pneumoniae. Many strains of acinetobacter spp, providencia spp, proteus spp, serratia spp, and Citrobacter freundii were also isolated. All the strains were tested for sensitivity to bacitracin, carbenicillin colistin, cephalothin, chloramphenicol, gentamicin, kanamycin, lincomycin trimethoprim and tetracycline. The proportion of strains sensitive and resistant to different antibacterial agents varied widely with species of bacteria. Most of the strains except pseudomonas spp were sensitive to few of the antibacterial agents and posed no problem with relation to treatment. Pseudomonas spp. were 100% sensitive to polymyxin B and colistin [polymyxin E] and 90% resistant to gentamicin and carbenicillin