Evaluating perceived threat of skin cancer and preventive measures in South Iranian sailors: A qualitative study.

BACKGROUND: Sailors are exposed to sunlight as their job requires and are, in the long run, more prone to different types of skin cancer. This study aimed to explore sailors' experience of perceived threat and to show protective behaviors against sunlight in the south of Iran. MATERIALS AND METHODS: The present follows a qualitative approach and directed content analysis in 2018-2019 among sailors who were selected purposively through an interview procedure. Finally, 22 sailors and 3 patients with skin cancer with an experience of sailing were interviewed until data satiation occurred. The data were collected through a semi-structured interview based on two constructs, perceived susceptibility and perceived severity of protection motivation theory, and were instantly transcribed and read more than once by the present researcher. Simultaneously, the data were entered into MAXQDA 10 for the primary categorization. RESULTS: Data analysis results were classified into 5 categories and 12 subcategories: protective attempts (change of work time and use of protectives), passivity in self-protection (not showing protective behaviors and not examining skin), inadequate perception of affliction risk (beliefs hindering preventive behaviors and low sensitivity), perceived threat to personal and familial conditions (loss of peace and loss of occupational-familial positions), and threat to health (incurable disease and perceived skin disease). CONCLUSIONS: Awareness of these factors helps planners to choose the best preventive strategies with a focus on correcting beliefs and promoting protective behaviors as well as examining and screening sailors regularly to diagnose skin cancer. Moreover, to develop practical measures of protective strategies against sunlight among sailors, the required steps should be taken. This can help to reduce the rate of work-related risks while exposed to sunlight in this population.

Comparison of Hydrogel Produced by Radiation as Applied at the Research Center (Yazd Branch) With MaxGel and Routine Dressing for Second-Degree Burn Repair in Yazd Burn Hospital.

BACKGROUND: Recently, the radiation application research center for the atomic energy organization of Yazd (Iran) has developed a hydrogel dressing which was evaluated for quality and safety in 2008. Its efficacy for assisting in the wound healing process was approved for animal use, and its use has proven to be more effective than a related Syrian material. OBJECTIVES: We have already confirmed the safety and efficacy of Irgel use on mice (1, 2), so this study was conducted in order to further evaluate its effectiveness on human burn wounds, and to compare its efficacy with MaxGel, another hydrogel. A randomized clinical trial study was conducted to compare the efficacy of hydrogel produced by the radiation application research center (Yazd Branch) with MaxGel and routine dressing on burn repair in the Yazd Burn hospital. MATERIALS AND METHODS: In this study, 90 patients with second-degree burn injuries who were admitted to the Yazd Burn hospital were randomly divided into three equal groups. In the negative control group, the wounds were covered with sterile vaseline gauze followed by double sterile dry gauze and ultimately bandaged. In the test group, the wounds were covered by an Iranian hydrogel sheet (Irgel) instead of vaseline gauze, while in the positive control group, the wounds were covered by MaxGel instead of Irgel. At each visit (every other day), each dressing was renewed by its respective method and the wound area, pain score, and body temperature were recorded. At the beginning and at the end of the first and second week, five milliliters of venous blood were taken from all patients to evaluate hematologic parameters such as peripheral blood cell count, liver function, blood urea nitrogen, and creatinine. RESULTS: Before the intervention, the extent of the burns and pain sensations were quite similar among the different groups, but at the second week, the burn areas and pain scores for the Irgel group were significantly less than those of the normal control and the positive control groups (P < 0.05). CONCLUSIONS: Based on our findings, both gels assist in the process of burn wound healing and pain reduction more effectively as compared with routine dressing. However, Irgel had better effects on wound healing and pain relief than MaxGel, which indicates a better quality of Irgel for this particular kind of treatment.

Anti Leishmanial Effect of Zinc Sulphate on the Viability of Leishmania tropica and L. major Promastigotes.

BACKGROUND: Cutaneous leishmaniasis (CL) is an endemic disease in developing countries. Although pentamidine orantimonite (Glucantime) has been recommended for cutaneous leishmaniasis treatment by the World Health Organization, there are some concerns too such as high cost, side effects, need for frequent injections, and restricted efficacy. Therefore, different methods have been used for CL treatment so far. OBJECTIVES: This study assessed the sensitivity of two parasite agents of cutaneous leishmaniasis: Leishmania major and L. tropica to zinc sulphate in vitro. In the present study, the zinc sulphate effect on urban and rural strains of cutaneous leishmaniasis, viability of old world, in vitro is under investigation. MATERIALS AND METHODS: The design of the present study was experimental (laboratory-trial) based. Iranian endemic species of L. major and L. tropica were appropriately collected, proliferated, and maintained in the standard culture. Afterward, the proper concentrations of zinc sulphate were provided, sterilized, and added to the cultures containing parasites. In different intervals, parasites were counted by two methods: the slide and cell proliferation ELISA. RESULTS: Both parasite species showed sensitivity to zinc sulphate in vitro and in comparison with the control group, their numbers were reduced. Zinc sulphate (in concentrations of 0.5, 1, 2, and 3 percent) was added to the cultures containing parasites, and the total number of the live parasites was counted through the slide method (Neubauer slide) every day up to the fifth day. The results were analyzed and found statistically significant (P < 0.05). In the second phase, the counting process was repeated with the addition of zinc sulphate compound with different concentrations (3, 4, 5, and 6 percent) and live parasite numbers were counted by ELISA method after 24 hours. The findings revealed that all the cultures containing zinc sulphate showed a slower growth in comparison to the control group. The mentioned difference was statistically significant (P < 0.05). CONCLUSIONS: Considering the safety of zinc sulphate compound in comparison with Glucantime, there is a possibility of using it in the treatment of CL caused by both species of L. major and L. tropica. It is obvious that more researches are mandatory both in vivo and in vitro to figure out its daily dosage, proper concentration, time and duration, and possible side effects.

Familial amyloidosis cutis dyschromica: a case report.

Amyloidosis cutis dyschromica (ACD) is a rare form of macular amyloidosis characterized by hypo and hyperpigmented macules. Here we described a 20 year old girl with diffuse hypo and hyperpigmentation since she was four years old. Five other members of her family are also involved. Biopsy of hyperpigmented lesions revealed increase of melanin in the basal layer, pigment incontinence and amorphous eosinophilic masses stained positive with Congo red in the papillary dermis. The histopathologic findings were consistent with amyloidosis cutis dyschromica. Other investigations were normal. Dermatologists should consider amyloidosis cutis dyschromica when visit a patient with diffuse hypo and hyperpigmentation.

Cutaneous malignant melanoma in central iran: a 20-year study.

BACKGROUND: Skin cancers are the most common cancers around the world. Cutaneous malignant melanoma (CMM) is the malignancy of melanocytes that are mainly located in the skin and mucous membranes. OBJECTIVE: This study tried to evaluate the incidence and mean survival time of cutaneous malignant melanoma (CMM) in Yazd, Iran. It seems that the epidemiology and clinical aspects of CMM in Iran are different from those in other parts of the world; also due to the limited and scattered studies there isn't lot in the literature regarding CMM in Iran. MATERIALS AND METHODS: This study used data obtained from the cancer registry center in the province of Yazd for a period of 21 years (1988 - 2008). Population and statistical data were gathered from "National Organization for Civil Registration". Population-based data were analyzed, focusing on the incidence and mean survival time over this 21 year period. RESULTS: The mean incidence rate for CMM in Yazd-Iran between 1988 and 2008 was 0.40 per 100,000 for males and 0.27 per 100,000 for females per year, and the incidence of CMM was relatively constant during this period of time. The mean survival rates for women were better than men (80.5% and 76.3% respectively). CONCLUSIONS: CMM in Yazd is a low-incidence skin tumor that shows a relatively fixed incidence between 1988 and 2008, Higher incidences of CMM were found in sun-exposed areas (especially head and neck areas), with more incidence in men. Skin cancers and CMM incidence in Iran is lower than western countries, most probably due to geographical zone, genetic factors, skin type, society-related customs including clothing styles.

Evaluation of the vascular anatomy in potential living kidney donors with gadolinium-enhanced magnetic resonance angiography: comparison with digital subtraction angiography and intraoperative findings.

BACKGROUND: X-ray contrast arteriography has traditionally been used for pre-operative evaluation in living kidney donors. However, magnetic resonance angiography (MRA) offers a non-invasive alternative, which has been considered to be less accurate. This study was performed to determine whether MRA in the pre-operative investigation of living kidney donors provides sufficient information. METHODS: From December 2005 to December 2007, 173 potential live donors were evaluated in this study. Donors performed digital subtraction angiography (DSA) and those with one or more accessory arteries at least on one side recruited for further evaluation with three-dimensional gadolinium-enhanced MRA. RESULTS: A total of 30 donors constituted the study population. When compared with DSA as the reference method, MRA detected 20 of 36 renal accessory arteries which indicates a sensitivity of 55.6%. The difference between MRA and DSA in identifying accessory renal arteries was significant (p-value <0.001). Considering intraoperative findings as the standard of reference, MRA depicted correctly four of six (66.7%) accessory arteries on the transplanted kidneys. CONCLUSIONS: MRA has the advantage of avoiding exposure to ionizing radiation and is non-invasive. These are important considerations in pre-operative evaluation of a generally healthy donor population. However, MRA provides suboptimal accuracy in detecting small accessory arteries.

Causes of re-hospitalization in different post kidney transplantation periods.

BACKGROUND: Post kidney transplantation Re-admissions are focused because they are costly and cause morbidity, or may end with unsatisfactory endpoints namely graft loss or death. We compared the pattern, outcome and cost of re-admissions in different post-kidney transplantation periods. MATERIAL/METHODS: In a retrospective study, 562 consecutive re-admissions of kidney recipients categorized to early (during first 6 months; n=278); intermediate (6-24 months; n=115); and late (24 months and afterwards, n=169) hospitalizations. Primary outcome measures included hospitalization pattern (cause and length of hospital stay), and secondary outcome measure were assessed (mortality and graft loss during hospitalization) and costs. RESULTS: The causes of rehospitalization were surgical complication (84 percent), infection (51 percent), graft rejection (45 percent), and malignancy (0.6 percent), in early phase, graft rejection (44 percent), infection (42 percent), surgical complication (13 percent), and malignancy (5 percent), in intermediate phase, and graft rejection (45 percent), infection (39 percent), surgical complication (3 percent), and malignancy (0.06 percent), in late phase. So, infections and surgical complications showed a decreasing trend from early to late post transplant phase, while malignancies showed a peak in intermediate phase. The length of hospital stay (12+/-11, 10+/-10, 9+/-7, p=0.001) and hospitalization charges (708+/-36, 468+/-333, 413+/-262 united states Dollars, p=0.035) were significantly higher in the early post transplant phase. Mortality (p=0.755) and graft loss during hospitalization (p=0.246) remained the same in all time intervals. CONCLUSIONS: Early post-kidney transplantation phase, with a higher risk of infections and surgical complications, health care system experience longer and more costly hospitalizations.

Analysis of 15 years of skin cancer in central Iran (Yazd).

Skin cancer incidences over a 15-year period (1987-2001) were studied in Yazd, a hot, dry, desert area in the center of Iran. The mean skin cancer frequency was determined to be 28.6 percent and 1,124 patients were diagnosed with skin cancer during this time period, approximately 11 per 100,000. The most common skin cancer was basal cell carcinoma, accounting for 76.9 percent. Squamous cell carcinoma was diagnosed in 18.1 percent and melanoma in 2.7 percent; 2.3 percent were other uncommon skin cancers. Most cancers were diagnosed in the seventh and eighth decades of life. The face, head, and neck were the sites of 92 percent of skin cancers. The sex ratio was determined to be 1.6 (male/female), similar to other reported populations. However, melanoma was found to be 1.5 times higher in men in this study, in contrast to most studied populations. Skin cancer incidence in Iran is lower than western countries. It is very likely that clothing and body covering customs can account for such differences.

Is ureteral reimplantation necessary during augmentation cystoplasty in patients with neurogenic bladder and vesicoureteral reflux?

PURPOSE: We assessed the outcome of vesicoureteral reflux after augmentation cystoplasty in patients with neurogenic bladder. MATERIALS AND METHODS: Since May 1992, 112 male and 18 female patients with neurogenic bladder have undergone augmentation cystoplasty with a generous detubularized segment of bowel and no effort to correct existing reflux. Patients were treated conservatively at the beginning but the response was unsatisfactory. All patients had various degrees of vesicoureteral reflux (197 refluxing units). Mean age at operation was 21.6 years (range 1.5 to 57). Preoperatively assessment included urinalysis, urine culture, kidney function tests, voiding cystourethrography, urodynamic evaluation, ultrasonography or excretory urography and cystoscopy when indicated. The status of vesicoureteral reflux, renal hydronephrosis and clinical pyelonephritis were studied during an average followup of 44.5 months. RESULTS: Of the 130 patients 111 (85.4%) no longer had reflux, 14 (10.8%) had improvement, 4 (3%) had no change and 1 (0.8%) had worsening reflux. All refluxing units with grades I to III, 105 of 120 with grade IV (87.5%) and 8 of 13 with grade V (61.5%) showed complete cessation of reflux. Renal hydronephrosis improved in 127 renal units (97.7%). In 8 individuals (6.2%) without reflux after cystoplasty episodes of clinical pyelonephritis occurred. CONCLUSIONS: Augmentation cystoplasty without ureteral reimplantation is effective and adequate treatment for high pressure, noncompliant neurogenic bladder when conservative management fails.