Publications by authors named "Ahmad-Reza Taheri"

17 Publications

  • Page 1 of 1

Nutritional Intake and Chronicity Associated with the Old World Cutaneous Leishmaniasis: Role of Vitamin A.

Iran J Public Health 2020 Jan;49(1):167-172

Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Old world cutaneous leishmaniasis (CL) is known as a self-healing cutaneous parasitic infection. Host immunity has a fundamental role in the course of this infection. This study was designed to investigate the relationship between nutritional status and vitamin A intake with the clinical course of CL.

Methods: Overall, 250 patients with CL attending a dermatology clinic in Imam Reza Hospital Mashhad, Iran, were enrolled from Apr 2011 to Aug 2012. For data gathering, a semi-quantitative 302-item food frequency questionnaire was utilized. They received routine treatment protocols for leishmaniasis and 1 year of follow-up.

Results: As for the 149 patients who completed the study, a deficiency of macro and micronutrients, particularly vitamin A, was significantly related to a chronic clinical disease course.

Conclusion: Imbalanced or insufficient nutritional intake including vitamin A deficiency, may influence the clinical course of CL.
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January 2020

Evaluation of the oxidant-antioxidant balance, isoprostane and quantitative CRP in patients with cutaneous leishmaniasis.

Microb Pathog 2019 Dec 9;137:103738. Epub 2019 Sep 9.

Department of Clinical Biochemistry, Faculty of Medicine,d Mashhad University of Medical Sciences, Mashhad, Iran; Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Introduction: Cutaneous leishmaniasis is a dermal disease caused by several species of the genus Leishmania. It is an endemic disease with 1.2 million new cases occurring annually and mostly in developing countries. Oxidative stress is a condition of an imbalance in oxidant/antioxidant which may play a role in many different pathologic conditions. For the first time in this study, we introduced isoprostane as a reliable index for oxidative stress in patients suffering from leishmaniasis. We also investigated the possible relation between quantitative CRP and this disease.

Method And Material: We collected 5 ml blood of 30 patients in addition to the same sample of the control healthy group. After applying appropriate methods, the plasma and serum specimens were extracted in order to conduct oxidant-antioxidant balance and CRP tests in serum as well as measuring isoprostane factor in plasma.

Statistical Analysis: We used T-student, ANOVA as well as linear regression to analyze the gathered data with a 0.05 confidence interval in SPSS environment.

Results: The results showed a significant difference between the two groups in terms of the oxidant-antioxidant balance. Also, isoprostane and quantitative CRP levels were substantially higher in patients. There was no significant relationship between the mentioned factors and wound size and number.

Conclusion: Leishmania Amastigotes plays an important role in disturbing the oxidant-antioxidant balance resulting in inflammation and stress in patients. Furthermore, isoprostane was confirmed as a reliable index for evaluating oxidative stress in patients.
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December 2019

Non-Ablative Fractional 1,540-nm Er:Glass Laser in the Treatment of Atrophic Cutaneous Leishmaniasis Scars.

Lasers Surg Med 2020 02 15;52(2):182-187. Epub 2019 Jul 15.

Department of Dermatology, Gonabad University of Medical Sciences, Imam Khomeini Avenue, Medical University of Gonabad, Gonabad, 9691793718, Iran.

Objectives: To evaluate the efficacy of nonablative fractional 1,540 nm laser to treat the atrophic scars caused by the cutaneous leishmaniasis (CL).

Methods: This clinical trial with a pre- and a posttreatment measurement was conducted on patients with atrophic CL scars. The lesions were treated with nonablative fractional 1,540 nm laser. We evaluated the patients initially and then monthly, before each treatment session. The final follow-up was done 6 months after the end of study for all patients. Patient assessment was performed by two physicians using the modified Manchester Scar Scale (MSS) as well as the interpretation of captured digital photographs. Moreover, the patients performed a self-assessment by filling in a researcher-made questionnaire. The data were statistically analyzed by SPSS software. P < 0.05 was considered statistically significant.

Results: Thirty patients with 37 skin lesions participated in the study. The pairwise comparison demonstrated a statistically significant difference between the modified MSS parameters (P < 0.05); however, no significant difference was observed between the modified MSS of the third and fourth (P = 0.82) as well as fourth and fifth (P = 0.636) sessions. The lesions improvement was significant based on the physician's evaluation (P < 0.001). Furthermore, patients' level of satisfaction was significantly increased in all six follow-ups (P < 0.001). No persistent complication was found.

Conclusions: Nonablative fractional 1,540 nm laser is an effective and safe therapeutic choice for atrophic CL, even in darker skins. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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February 2020

Fabrication and characterization of novel bilayer scaffold from nanocellulose based aerogel for skin tissue engineering applications.

Int J Biol Macromol 2019 Sep 18;136:796-803. Epub 2019 Jun 18.

Department of Plastic Surgery, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

The aim of this study was to fabricate a novel bilayer scaffold containing cellulose nanofiber/poly (vinyl) alcohol (CNF/PVA) to evaluate its potential use in skin tissue engineering. Here, the scaffolds were fabricated using a novel one-step freeze-drying technique with two different concentrations of the aforementioned polymers. FE-SEM analysis indicated that the fabricated scaffolds had interconnected pores with two defined pore size in each layer of the bilayer scaffolds that can recapitulate the two layers of the dermis and epidermis of the skin. Lower concentration of polymers causes higher porosity with larger pore size and increased water uptake and decreased mechanical strength. FTIR proved the presence of functional groups and strong hydrogen bonding between the molecules of CNF/PVA and the efficient crosslinking. The MTT assay showed that these nanofibrous scaffolds meet the requirement as a biocompatible material for skin repair. Here, for the first time, we fabricated bilayer scaffold using a novel one-step freeze-drying technique only by controlling the polymer concentration with spending less time and energy.
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September 2019

Digital volumetric measurement of cutaneous leishmaniasis lesions: Blur estimation method.

Indian J Dermatol Venereol Leprol 2017 May-Jun;83(3):307-311

Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Cutaneous leishmaniasis is a common parasitic infestation in Iran. With recent advantages in digital imaging, we have devised a novel non-contact objective method of measuring lesions.

Aim: The aim of the study was to design a software system that analyzes images of cutaneous leishmaniasis lesions, objectively assess and monitor volume.

Methods: A photographic technique along with an image processing algorithm was applied to extract a three-dimensional map of the lesion from a simple two-dimensional picture. This method recovers depth on the basis of blur estimation. A macro lens with a low depth of field was used to blur the objects out of focus. To assess and compare the results, a polymer mold of the corresponding lesion was made and filled with liquid. The volume of liquid corresponded to the volume of the lesion. A total of thirty-seven patients were enrolled, and 48 lesions were analyzed.

Results: The mean volume measured by image processing was 159 μl (range: 8-685 μl), in comparison to an average of 170 μl (range: 6-800 μl) obtained from the molds. This was not significantly different. Statistical analysis by the Pearson correlation test showed a 'very good fit' correlation between these measured volumes (P < 0.001, r = 0.938).

Limitation: The location and height of lesions were two important limitations in implementing this technique. If the lesion location is in the curvature region of body or the lesion height is less than 1 mm or more than 1 cm, this method will lose precision and accuracy.

Conclusion: Image processing with blur estimation technique is an accurate and precise method to measure the volume of lesions in cutaneous leishmaniasis.
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March 2018

The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction.

World J Plast Surg 2016 Sep;5(3):287-292

Department of Plastic Surgery, Tehran University of Medical Sciences, Tehran, Iran.

Background: Surgery, as the main approach in higher stages of gynecomastia, has different techniques regarding the staging of the disease. The more the grade of gynecomastia, the more complicated the used surgical techniques, conventionally. This study assessed the success rate of the simplest surgical technique in higher grades of gynecology as well as the satisfaction rate in patients and surgeon to offer using the technique for higher grades of the disease.

Methods: To evaluate the success and the satisfaction rates of periareolar incision and liposuction among patients with grade II and III gynecomastia, this cross-sectional study was conducted.

Results: The satisfaction rate was the main concern of the present study. The patients had a mean satisfaction score of 8.1±1.396 with the range of 5-10 from total 10 score. The majority of the patients expressed their satisfaction by 9 score. The total mean of physician satisfaction score was 8.36 at all levels.

Conclusion: Like aesthetic reasons which lead individuals to seek solutions for their annoying gynecomastia, aesthetic satisfaction is a prominent concern for people who undergo surgical approach. So, the least surgical scar and complications are absolutely the most area of focus in this regard.
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September 2016

The activity and tissue distribution of thioredoxin reductase in basal cell carcinoma.

J Cancer Res Clin Oncol 2016 Nov 6;142(11):2303-7. Epub 2016 Sep 6.

Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: Basal cell carcinoma (BCC) is the most prevalent cancer worldwide. Different mechanisms are proposed to be involved in its pathogenesis such as oxidative stress. Oxidative stress, which is the consequence of the disruption of redox balance in favor of oxidants, is involved in the initiation or progression of many tumors. Thioredoxin reductase (TrxR) is a key enzyme of the thioredoxin (Trx) system, containing Trx and TrxR and NADPH, which is one of the main cellular oxidoreductases with an essential role in cellular health and survival through providing and maintaining redox balance. Therefore, we aimed to study and compare the activity and tissue distribution of TrxR in tumoral tissue and its healthy margin in patients with BCC.

Methods: After biopsy and taking samples from 18 patients, TrxR activity was measured using a commercial kit and its tissue distribution was assessed immunohistochemically.

Results: Both the activity and tissue distribution of TrxR in tumoral tissues were significantly higher compared to their healthy margins. Regarding the tissue distribution, this significant increase in TrxR in tumoral tissues was documented based on both staining intensity and abundance of positive cells in immunohistochemistry.

Conclusions: Based on these results, it is concluded that TrxR is involved in the pathogenesis of BCC; however, more investigations are required to clarify whether this increase is a consequence of BCC or it is an initiating mechanism.
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November 2016

The Effect of Steri-Strip Dressing on Patients' Satisfaction and Reduction of Ecchymosis in Lower Eyelid, Malar and Cheek Following Rhinoplasty.

World J Plast Surg 2016 Jan;5(1):51-7

Department of Plastic Surgery, Tehran University of Medical Sciences, Tehran, Iran.

Background: Early postoperative edema and ecchymosis are the most common factors to complicate initial patient perceptions about rhinoplasty. The current study was conducted to determine the effects of longer steri-strip tape on patient malar and cheek in terms of ecchymosis control and reduction.

Methods: Through a randomized controlled clinical trial, 64 patients who underwent rhinoplasty were randomly enrolled. One side of the patients' face was randomly selected for different experience of dressing while the main intervention was different length of tape and steri-strip dressing. In one group, the right side and in the rest, the left side of face was applied with steri-stip from the nose to lateral malar and cheek. In the opposite side of the face, steri-strip taping was done from the nose to medical malar and cheek.

Results: The mean area of ecchymosis after rhinoplasty through our trial was 1.55 mm and 2.31 mm, respectively in sides with and without steri-strip which differed significantly. When patients' age and sex were taken into account, the distribution of ecchymosis had no significant difference in this regard.

Conclusion: The present study showed significant reduction in the area of post-rhinoplasty ecchymosis in lower lid, malar and cheek soft tissues as well as the obvious increase in satisfaction rate among intervention side of face in comparison to the control side. But longer steri-strip tape failed to control sub conjunctival bleeding or decrease it.
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January 2016

Ocular Leishmaniasis Treated by Intralesional Amphotericin B.

Middle East Afr J Ophthalmol 2016 Jan-Mar;23(1):153-5

Cutaneous Leishmaniasis Research Center, School of Medicine, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Leishmaniasis is a group of diseases with varied clinical manifestations. Ocular involvement is an unusual presentation of leishmaniasis, and the eyelid is not a common site of cutaneous lesions, likely due to the mobility of the lids. Some case reports of conjunctival involvement are either a contiguous dissemination from lid margin or in the setting of disseminated leishmaniasis in an immunocompromised host. To our knowledge, isolated involvement of the bulbar conjunctiva has not been reported. We present the first case in the literature of a patient with an erythematous fibrovascular lesion in the interpalpebral zone that was clinically diagnosed as pterygium, but recurred at the site of surgical excision. After histopathologic diagnosis, the lesion was treated with intralesional injection of amphotericin B and improved completely within a few weeks. An accurate diagnosis of leishmaniasis in the eye may be challenging in many clinical settings. To our knowledge, an isolated lesion has not been reported in literature. In addition, intralesional injection of amphotericin B is a novel treatment method in this setting.
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August 2016

Ultraviolet B efficacy in improving antileishmanial effects of silver nanoparticles.

Iran J Basic Med Sci 2015 Jul;18(7):677-83

Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Objectives: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by various species of the flagellated protozoan, Leishmania. Regardless of the numerous studies, there are still serious challenges in the treatment of CL. This study aimed at evaluating the influence of a low dose ultraviolet B (UVB) radiation along with silver nanoparticles (AgNPs) on a mouse model of CL induced by Leishmania major.

Materials And Methods: L. major promastigotes (MRHO/IR/75/ER) were extracted from infected mice spleens. Two months after subcutaneous injection of 2×10(6) promastigotes into the footpad of BALB/c mice, when the lesions were developed, the animals were divided into 4 groups including one control group and three study groups: AgNPs, UVB and UVB plus AgNPs. Spleen parasite burden was assessed on day 40 after the first treatment. The data were analyzed by Instat, Elida and SPSS 16 software programs.

Results: The results showed the highest pronounced inhibitory effect in the group receiving AgNPs plus UVB. In addition, a significant difference was obtained between the group receiving AgNPs alone and the one with combinational therapy. The findings on parasite burden showed a significant difference between the control group and other treatment groups.

Conclusion: It could be suggested that UVB in the presence of AgNPs, by inhibiting the spread of CL lesions and reducing the rate of visceral progression of the disease, provides a serious anti-leishmanial effect.
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July 2015

Efficacy of intralesional amphotericin B for the treatment of cutaneous leishmaniasis.

Indian J Dermatol 2014 Nov;59(6):631

Department of Dermatology, Cutaneous Leishmaniasis Research Center, School of Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Antimoniate compounds have been used as gold standard treatment for cutaneous leishmaniasis since many years ago, but with increase in incidence of drug as well as individual contraindications, more attention has been given to alternative treatments.

Aim: The aim of this study was to evaluate the efficacy of intralesional amphotericin B as an alternative treatment for cutaneous leishmaniasis in Mashhad, Iran, during 2007-2009.

Materials And Methods: Non-random sampling from both sexes and without any age limitation of cases eligible for this alternative treatment was done. Size and induration of lesions were measured before beginning and weakly during the treatment. Amphotericin B (2 mg/ml) was injected into lesions weekly for up to 12 weeks and the cases were followed up for the treatment responses, possible side effects and recurrence of the disease.

Results: A total of 93 patients with a mean age of 20.81 ± 15.26 years were included in this study. At the end of 12(th) week, 61.4% of the patients were recovered completely (more than 90% reduction in size and induration), 21.6% had partial remission (60-90% reduction in size and induration), and 17% had less than 60% reduction in size and induration of skin lesions. Injection side effects were insignificant and did not lead to premature discontinuation of treatment in any patients.

Conclusion: Weekly intralesional injection of amphotericin B looks promising, considering the fact that most of the patients in this study were resistant to antimoniates.
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November 2014

Plasma levels of interlukin-4 and Interferon-γ in patients with chronic or healed cutaneous leishmaniasis.

Iran J Basic Med Sci 2014 Mar;17(3):216-9

Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Objective(s): In this study, the serum level of interferon-γ (IFN- γ) and interlukin-4 (IL-4) was evaluated as a marker of Th1 and Th2 immune response that influence the clinical course of cutaneous leishmaniasis .

Materials And Methods: This cross-sectional study was conducted on 44 cases of cutaneous leishmaniasis (21 cases with healed lesions and 23 cases with chronic non-healing lesions. Thirty-two non-infected persons living in the area were considered as controls. Serum levels of IFN- γ and IL-4 were determined using ELISA, and the results along with clinical data were analyzed using SPSS 11.5.

Results: Serum IFN-γ level was not significantly different between various patient groups and control (P=0.27), but the serum level of IL-4 in patient groups was higher than in healthy subjects, and it was higher in patients with non-healed chronic cutaneous leishmaniasis than those with healed lesions (P<0.01).

Conclusion: Serum IL-4 level is a good marker for evaluation of the clinical course of cutaneous leishmaniasis.
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March 2014

Electrophysiologic evaluation of retinal function in patients with psoriasis and vitiligo.

Doc Ophthalmol 2014 Apr 19;128(2):131-6. Epub 2014 Jan 19.

Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: To investigate the relation between psoriasis and vitiligo with the electrophysiologic function of the retinal photoreceptors.

Methods: Patients with psoriasis or vitiligo referred for PUVA therapy were enrolled. Complete eye examination was performed. Patients with any drug or familial history or abnormal eye examination that might affect the retinal function were excluded. Standardized full-field electroretinogram (ERG) elicited with Ganzfeld stimuli using the commercial ERG system (Retiport32; Roland Consult) according to International Society for Clinical Electrophysiology of Vision guidelines was performed. The outcome measures were the difference between the mean rod response, standard combined response, single-flash cone response and 30-Hz flicker wave amplitudes of the patients and normal population.

Results: Seventy-six eyes of 38 patients (vitiligo: 21; psoriasis: 17) and 40 eyes of 20 normal subjects were enrolled in this study. The mean age of patients was 31.3 ± 11.3 years (range 16-54 years). Twenty-two patients (58 %) were female. The mean rod response b-wave, standard combined a- and b-waves, single-flash cone response b-wave and the 30-Hz flicker (N1-P1) amplitudes were significantly lower than the normal population in the same range of age as the study group. There was no significant difference between the patients with vitiligo and those with psoriasis in all wave amplitudes (P = 0.094).

Conclusion: This study showed that overall retinal electrophysiologic function in patients with vitiligo or psoriasis is significantly impaired compared with normal population, independent of age and sex.
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April 2014

Dermoscopic features of cutaneous leishmaniasis.

Int J Dermatol 2013 Nov 22;52(11):1361-6. Epub 2013 Aug 22.

Cutaneous Leishmaniasis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Previous studies have demonstrated that dermoscopy improves accuracy in diagnosing pigmented and non-pigmented tumors. Recently, there has been increasing evidence that dermoscopy can also be useful in the diagnosis of some skin infections.

Objective: We sought to describe the dermoscopic features of cutaneous leishmaniasis.

Method: Dermoscopic examination (using the Derm Lite FOTO, 3Gen) of 144 CL lesions in 82 patients was performed. This study was conducted in the Imam Reza and Ghaem hospitals (Mashhad, Iran) from October 2010 to September 2011.

Results: We observed the following dermoscopic features: generalized erythema (81.9%), white starbursts (60.4%), yellow hue (43.8%), yellow teardrop-like structures (41.7%), central ulcers (59%), hyperkeratosis (33.3%), and milia-like cysts (4.9%). We also observed vascular structures, including dotted vessels (61.1%), hairpin vessels (37.5%), linear irregular vessels (30.6%), comma-shaped vessels (29.9%), glomerular vessels (22.9%), arborizing telangiectasia (10.4%), and corkscrew vessels (4.2%).

Limitations: Biopsy and pathologic evaluation were not performed due to ethical considerations.

Conclusion: Important vascular patterns seen in melanocytic and non-melanocytic tumors were frequently observed in this infection. Dermoscopy may be a promising tool to predict the clinical course in cases of cutaneous leishmaniasis.
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November 2013

Therapeutic effects of acoustic cavitation in the presence of gold nanoparticles on a colon tumor model.

J Ultrasound Med 2013 Mar;32(3):475-83

Research Center and Department of Medical Physics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Objectives: Acoustic cavitation can be fatal to cells and is used to destroy cancerous tumors. The particles in a liquid decrease the ultrasonic intensity threshold needed for onset of cavitation. Bubble generation from intense pulsed light-irradiated gold nanoparticles was investigated as a means of providing nucleation sites for acoustic cavitation in cancer tissues.

Methods: This study was conducted on colon carcinoma tumors in BALB/c mice. The tumor-bearing mice were randomly divided into 7 groups (each containing 15 mice): (1) control, (2) gold nanoparticles, (3) intense pulsed light irradiation, (4) intense pulsed light + gold nanoparticles, (5) ultrasound alone, (6) ultrasound + gold nanoparticles, and (7) intense pulsed light + ultrasound + gold nanoparticles. In the respective groups, gold nanoparticles were injected into tumors. Intense pulsed light and ultrasound irradiation were performed on the tumors 24 hours after injection. Antitumor effects were estimated by evaluation of the relative tumor volume, doubling time, and 5-folding time for tumors after treatment. The cumulative survival fraction of the mice and percentage of the lost tissue volume (treated) were also assessed in different groups.

Results: A significant difference in the average relative tumor volumes 15 days after treatment was found between the intense pulsed light + ultrasound + gold nanoparticle group and the other groups (P < .05). The longest doubling and 5-folding times were observed in the intense pulsed light + ultrasound + gold nanoparticles and ultrasound + gold nanoparticle groups.

Conclusions: Acoustic cavitation in the presence of gold nanoparticles and intense pulsed light has been introduced as a new way for improving therapeutic effects on tumors by reducing the relative tumor volume and increasing the cumulative survival fraction.
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March 2013

Antiparasitic effects of gold nanoparticles with microwave radiation on promastigots and amastigotes of Leishmania major.

Int J Hyperthermia 2013 ;29(1):79-86

Department and Research Centre of Medical Physics, Mashhad University of Medical Sciences, Mashhad.

Purpose: This study aimed to determine the efficacy of thermotherapy in the presence of gold nanoparticles (GNPs) and microwave (MW) radiation at a frequency of 2450 MHz on the survival of Leishmania major promastigotes and amastigotes.

Materials And Methods: L. major promastigotes (strain MRHO/IR/75/ER) were cultured in RPMI-1640 medium supplemented with foetal bovine serum and antibiotic. The promastigotes were incubated with GNPs for 2 h. After washing, thermotherapy was performed by MW irradiation. After 48 h the promastigote survival rate was assessed using Alamar Blue assay. In the second part of the study, after culture and proliferation of J744 cells, the infected macrophages were incubated with the GNPs and were inserted under MW irradiation. After 24 h, the number of amastigotes in the macrophages was determined after Giemsa staining by a light microscope.

Result: Increased exposure time of the microwave to the parasites in the presence of GNPs induced a significant decline in promastigotes survival rate in comparison to similar samples without GNPs. The least survival of amastigotes was also recorded in the groups containing GNPs. The presence of GNPs during MW irradiation was more lethal for promastigotes and amastigotes in comparison to MW alone.

Conclusion: Thermotherapy using MW radiation in the presence of GNPs may be proposed as a new approach to treat leishmaniasis in future studies.
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June 2013

Phacomatosis pigmentokeratotica associated with compound melanocytic nevus of the conjunctiva.

Int J Dermatol 2011 Aug;50(8):994-8

Department of Dermatology, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

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August 2011