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Biomedical subjects

Yahya Dowlati

Publications and source records attributed to Yahya Dowlati.

15 recordsLinked to original sources
PubMed2006

Imiquimod in combination with meglumine antimoniate for cutaneous leishmaniasis: a randomized assessor-blind controlled trial.

OBJECTIVE: To determine the efficacy and safety of imiquimod in combination with meglumine antimoniate in treating cutaneous leishmaniasis. DESIGN: Prospective, randomized, assessor-blind, parallel-design, placebo-controlled trial. SETTING: Two primary care health clinics. PATIENTS: One hundred nineteen patients (59 patients in the imiquimod group and 60 in the placebo group) were included in the study. INTERVENTIONS: Patients were randomly assigned to receive a combined 4-week course of imiquimod or placebo with meglumine antimoniate treatment (20 mg/kg of pentavalent antimony daily for 2 weeks) in an endemic area of Leishmania tropica. MAIN OUTCOME MEASURES: The primary end point was clinical cure, defined as more than 75% reduction in the size of lesions compared with baseline at week 8. RESULTS: At the end of the 4-week treatment period, clinical cure was similar in both groups (11 patients [18.6%] in the imiquimod-treated group vs 18 patients [30.0%] in the placebo group) (P = .15). Four weeks after the end of treatment, 26 patients (44.1%) and 29 patients (48.3%) in the imiquimod-treated and placebo groups, respectively, were cured (P = .64). Pruritus and burning sensation were reported by 3 patients treated with imiquimod and by no patients treated with placebo. CONCLUSION: This study showed no beneficial effect of combining a 4-week course of treatment with 5% imiquimod cream and a standard course of treatment with meglumine antimoniate in patients with cutaneous leishmaniasis in an endemic area of L tropica. TRIAL REGISTRATION: isrctn.org Identifier:ISRCTN77659407 and Cochrane Skin Group Identifier: CSG Trial No. 32.

Adjuvants, Immunologic↗
PubMed2005

Leishmanization: use of an old method for evaluation of candidate vaccines against leishmaniasis.

To establish the safety and reproducibility of live challenge with Leishmania major, a single frozen stabilate was used in two open, single-arm leishmanization (LZ) trials. A total of 42 inoculations in 28 male adult volunteers were followed until complete healing. Lesions induced by LZ are as diverse as natural infection, but much milder. Total protection was seen in 100% (11/11) of recovered volunteers. LZ used as live challenge to test vaccine candidates reduces the required sample size, is cost effective for surrogate markers studies and will induce protection in the participants who are not protected by candidate vaccines.

Adult↗
PubMed2005

Concepts of patients with alopecia areata about their disease.

BACKGROUND: Alopecia areata (AA) is a common and chronic skin disease with an unknown etiology. It may significantly affect the patient quality of life. This study was designed to evaluate the illness perception in patients with AA. METHODS: A questionnaire consisting of 25 questions about causes, timeline, consequences and control of disease were given to 80 patients with AA attending a skin clinic in Tehran, Iran. The impact of age, gender, duration of disease, education, extent of disease and family history of AA were also assessed. RESULTS: Eighty patients (38 male and 42 female) with a mean age of 27.5 years (SD = 9.3) and disease duration of 7.8 years (SD = 7.7) completed the questionnaire. 76.9% of the patients believed that the role of stress was the cause of disease. 17.1 % believed genetic background to be the main cause, this found to be more frequent in patients with positive family history of AA. More than half of patients believed that their illness had major consequences on their lives and 40% of patients believed that their illness would be likely to be permanent rather than temporary, more in patients with longer duration of disease. Only 57.5% of patients considered their treatments to be effective. CONCLUSION: AA may considerably affect various aspects of patients' lives. The patient knowledge about the causes and course of this disease is limited.

Adolescent↗
PubMed2005

Allergic contact dermatitis in Iran.

The frequency of sensitization to contact allergens varies in different countries because of both genetic and, more importantly, allergen exposure variations. The objective is to determine the frequency of sensitization to contact allergens in Iranian patients with dermatitis. 250 patients with a clinical diagnosis of contact dermatitis and/or atopic dermatitis were evaluated with a 28-allergen screening series recommended by the German Contact Dermatitis Research Group from September 2002 to April 2004 in Tehran, Iran. The patches were applied on the back of the patients, removed after 24 hr and the readings were taken on 24 hr, 48 hr and 72 hr after application. 126 patients (50.4%) showed at least 1 positive reaction, and 23 patients (9.2%) had more than 2 positive reactions. 189 (84.4%) of 224 positive reactions had past and/or present clinical relevance. The 5 most common allergens were nickel sulfate 70 (28.0%), cobalt chloride 32 (12.8%), para-tertiarybutyl phenol formaldehyde resin 20 (8.0%), potassium dichromate 13 (5.2%) and colophony 13 (5.2%). Contact allergy to nickel sulfate was significantly more common in female patients and in patients under 40 years of age (P < 0.05). Nickel sulfate is the most common contact allergen in Iran, mostly affecting women and younger patients probably because of more exposure.

Adolescent↗
PubMed2005

Hair removal using an 800-nm diode laser: comparison at different treatment intervals of 45, 60, and 90 days.

BACKGROUND: Some laser irradiation parameters such as wavelength, fluence, pulse duration, and spot size have been shown to influence the damage of any target inside the skin, however, the role of some patients' factors such as hair growth cycle is still under debate. OBJECTIVE: To determine the association of treatment interval and laser treatment outcome. METHODS: In a retrospective chart review of 176 patients undergoing laser-assisted hair removal with a diode laser 24 patients were selected. All accepted to cease the therapy, and be followed-up for 5 months. At the end of the study the patients were questioned about the efficacy of the treatment as well as the adverse effects. Hair counting was also performed. The adverse effects (pain, blister or erosion, hyperpigmentation, hypopigmentation, and folliculitis) were questioned during the follow-up period. RESULTS: The mean hair reduction was 78.1%, 45.8%, and 28.7% in 45, 60, and 90-day interval groups, respectively (P < 0.0001). CONCLUSION: The treatment interval was related to the treatment outcome in our study.

Adult↗
PubMed2004

What patients with vitiligo believe about their condition.

BACKGROUND: Vitiligo is a common disease with an unknown etiology. It is a chronic disease which causes severe disfigurement, and so may significantly affect a patient's quality of life. This study was designed to evaluate the illness perception and quality of life in patients with vitiligo. PATIENTS AND METHODS: A questionnaire consisting of 25 questions on the causes, timeline, consequences, and control of disease was given to 80 patients with vitiligo attending a private skin clinic in Tehran, Iran, in 1999. The roles of age, sex, duration of disease, education, extent of disease, and family history of vitiligo were assessed. RESULTS: Eighty patients (22 males and 57 females, one not mentioned), with a mean age of 30 years (SD = 11 years) and a disease duration of 7.1 years (SD = 7.8 years), completed the questionnaire; 62.5% of the patients believed that stress played a role in their disease; 31.3% believed that their genetic background played a role in their disease, more so in patients with a positive family history of vitiligo. Almost one-half of patients believed that their illness had major consequences on their lives. One-half of patients believed that their illness was likely to be permanent rather than temporary, more so in patients with a longer duration of disease and a higher level of education. Only 60% of patients considered that their treatments were effective. CONCLUSION: Vitiligo may considerably affect various aspects of patients' lives. The knowledge of patients about the causes and course of their disease is limited.

Adolescent↗
PubMed2004

Laser hair removal: comparison of long-pulsed Nd:YAG, long-pulsed alexandrite, and long-pulsed diode lasers.

BACKGROUND: Advances in laser technology over the past several years have led to the development of numerous lasers for the treatment of unwanted hair. Laser wavelength is a key factor influencing treatment efficacy and complication rates. OBJECTIVE: To compare the efficacy and safety of laser hair removal using three different laser systems. METHODS: A retrospective study of 805 consecutive laser-assisted hair removal treatments, conducted on 75 patients by means of either a long-pulsed Nd:YAG, a long-pulsed alexandrite, or a long-pulsed diode laser is reported. All patients were evaluated at least 3 months after the last treatment, and their present conditions were compared with the 1st-day photographs. RESULTS: The mean hair reduction was 42.4%, 65.6%, and 46.9% in Nd:YAG, alexandrite, and diode lasers, respectively. When the number of treatment sessions was taken into account, the efficacy of alexandrite and diode lasers was not significantly different, whereas both systems were more efficacious than Nd:YAG. Neither of the laser systems showed better results for a particular skin type. The occurrence of side effects was not significantly different between three laser systems. CONCLUSION: Both long-pulsed alexandrite and long-pulsed diode laser systems are effective in the treatment of unwanted hair, and they are more efficacious than Nd:YAG laser.

Face↗
PubMed2003

Assessment of histologic criteria in the diagnosis of mycosis fungoides.

BACKGROUND: The histologic diagnosis of early mycosis fungoides (MF) can be difficult to establish in many instances because the subtle changes observed in patches of MF are also present in many inflammatory dermatoses. METHODS: To assess the frequency and significance of many of these histologic parameters, we retrospectively reviewed 50 slides from patients with documented MF in patch, plaque, and tumor stages. The diagnosis of MF was unequivocally established either by the progression of patients to advanced stages of the disease or by indubitable histologic findings. In the second phase of the study, we compared the histologic parameters observed in 24 patch stage MF patients with those in 24 non-MF patients. The non-MF group were patients whose pathologic pattern was suspicious for MF, but who definitely did not have MF on clinical grounds. The two groups were matched by histologic pattern. Two different observers evaluated the slides and the intensities of 32 histologic parameters were graded on a four-point scale to minimize the subjective variability in the histologic reports. RESULTS: On univariate analysis, the following parameters achieved significance in distinguishing MF from non-MF: Pautrier's microabscesses, haloed lymphocytes, disproportionate epidermotropism, epidermal lymphocytes larger than dermal lymphocytes, hyperconvoluted lymphocytes in the epidermis and dermis, absence of dyskeratosis, and papillary dermal fibrosis. None of these features proved to have additional discriminating power on multivariate analysis. CONCLUSIONS: The efficacy of single histologic features in the diagnosis of early MF is generally poor and, to discriminate MF from its inflammatory simulators, a combination of cytologic and architectural features must be used.

Adolescent↗
PubMed2002

The role of BCG in human immune responses induced by multiple injections of autoclaved Leishmania major as a candidate vaccine against leishmaniasis.

To determine if BCG was required in booster injections for autoclaved Leishmania major (ALM) vaccine, 75 volunteers with no response to leishmanin were injected double-blind and randomly with either ALM+BCG or BCG alone for the first injection and boosted either with ALM+BCG, ALM or BCG alone for the second and third. Addition of BCG to the boosters significantly increased the frequency and the magnitude of leishmanin skin tests (LSTs); however, there was no difference in proliferative and IFN-gamma responses (a month and a year later). Three injections of BCG produced no observable adverse reaction; hence BCG could be used in booster injections to increase the protective potential of this candidate vaccine.

Adolescent↗
PubMedDate not supplied

Intralesional injection of 2% zinc sulfate solution in the treatment of acute old world cutaneous leishmaniasis: a randomized, double-blind, controlled clinical trial.

Several in vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnSO4) on Leishmania parasites. The objective of this study was to compare the efficacy of intralesional injections of 2% ZnSO4 solution with meglumine antimonate (Glucantime) in the treatment of acute Old World cutaneous leishmaniasis (CL). Seventy-two patients with CL lesions less than 8 weeks were recruited in a randomized, double-blind, clinical trial in an area endemic for Leishmania major after giving written informed consent. They were treated with 6 weekly intralesional injections of either drug. 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 < .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 < .05). In conclusion a 6-week course of weekly intralesional injections of 2% ZnSO4 solution was less effective than Glucantime in the treatment of acute Old World CL.

Adolescent↗
PubMedDate not supplied

The role of number of treatments in laser-assisted hair removal using a 755-nm alexandrite laser.

BACKGROUND: It is generally accepted that multiple laser treatments yield more effective clinical results; however, it is not clearly known whether increasing the number of treatments would affect the incidence of adverse effect. The main objective of the study was to assess the role of the number of treatments in the efficacy and safety of laser-assisted hair removal in a relatively dark-skinned population. METHODS: A retrospective study of 313 consecutive laser-assisted hair removal treatments was conducted on a total of 23 patients (22 women, 1 man) with 58 anatomic areas by means of an alexandrite laser. Skin types of III and IV were represented. The long-pulsed alexandrite system (Aphrodite, Quanta system, Italy) was used at a 755-nm wavelength to deliver fluences ranging from 17 to 25 j/cm2 through a 10 mm spot size. The patients were divided into 4 groups according to the number of treatments (group I < or =4, group II = 5, group III = 6, and group IV > or =7 treatments). Digital photographs of the patients were used for hair counting. Adverse effects (hyperpigmentation, hypopigmentation, blister, folliculitis) were questioned. The treatment was defined as successful if there was more than 50% hair reduction and an absence of the adverse effects. RESULTS: There was a positive correlation between hair reduction and number of treatments (r = .402, p < .005). The following side effects were observed: hyperpigmentation (two patients, both in group IV); hypopigmentation (one patient in group IV) and blister (one patient in group IV); folliculitis (two patients in group III and IV). Treatment was successful in 48.3% (28 out of 58) of the treatment sites. The success rate was 25% for < or =4 treatments, and 76%, 58%, and 15% for 5, 6, and > or =7 treatments respectively (p = .002). CONCLUSION: Patients who undergo more treatment sessions achieve a higher rate of hair reduction; although this may be concomitant with an increase in the incidence of adverse effects. The benefit of more laser treatments should be balanced with the risk of occurrence of side effects in each patient.

Adult↗