Publications by authors named "Mohammad Ali Nilforoushzadeh"

84 Publications

Transplantation of autologous fat, stromal vascular fraction (SVF) cell and platelet rich plasma (PRP) for cell therapy of atrophic acne scars: Clinical evaluation and biometric assessment.

J Cosmet Dermatol 2021 Jul 6. Epub 2021 Jul 6.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Scarring is an unfortunate result of acne because it causes the psychological and cosmetic problems for the patients. Unfortunately, no single treatment is suitable, and using multiple methods may have a better result. The autologous fat and stromal vascular fraction (SVF) cells and their secretory factors can enhance the angiogenesis, collagen synthesis, and migration of fibroblasts, therefore, regenerate hurt tissues. Moreover, other treatments for acne scarring, like platelet rich plasma (PRP), induce the increase of scare. This study aimed to verify the effectiveness of transplantation of autologous fat, SVF cells, and PRP as cell therapy techniques on atrophic acne scars. This study included into 9 adult patients with atrophic acne scars on face. All patients received the transplantation of autologous fat, stromal vascular fraction (SVF) cells, and PRP. The treatment outcome was measured by biometric assessment (Visioface 1000 D, Colorimeter, multi-probe adapter Cutometer Tewameter, Mexameter, and skin ultrasound imaging system), also the satisfaction of patients was evaluated. The patients were followed 6 months after the treatment. There was a significant improvement in the skin pores, spots, skin lightness and melanin content of skin, skin elasticity and TEWL (trans epidermal water loss) after 6 months of the treatment. Furthermore, denser skin layers were observed both in the epidermis and dermis. Moreover, 66.6 % of patients showed good satisfaction after the treatment. In brief, the transplantation of autologous fat, SVF cells, and PRP is an effective cell therapy for atrophic acne scars.
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http://dx.doi.org/10.1111/jocd.14333DOI Listing
July 2021

Clinical, biometric, and ultrasound assessment of the effects of the autologous fibroblast cells transplantation on nasolabial fold wrinkles.

J Cosmet Dermatol 2021 Apr 27. Epub 2021 Apr 27.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Feeling beautiful and staying young have always been important to the people. Therefore, an extensive body of research has focused on the efforts made to remove the skin problems, especially wrinkles. Fibroblast cells of the skin are the various autologous cells currently used in repairing several wounds, scars, and skin aging. Thus, the present study was conducted to assess the efficacy of the transplantation of the fibroblast cells in eliminating the facial wrinkles using the biometric assessment and to optimize the application of this technique in this treatment.

Methods: The present study was conducted on 22 male and female patients aged between 35 and 60 years old. Samples were collected from the retro-auricular region, and the fibroblast cells were isolated and cultured. Subjects received three injections with autologous fibroblasts at 2-week intervals. The patients were followed up for 6 months, and structural changes in their wrinkles were assessed by the sonography and the VisioFace software, cutometer, tewameter, and colorimeter.

Results: The results obtained using the VisioFace software showed the significant phenotypic changes in the patients after the nasolabial injections (81.42 ± 23.97 vs. 60.91 ± 21.91, p = 0.0001). The results showed a significant increase in the total skin density (13.73 ± 6.30 vs. 26.27 ± 7.93, p = 0.0001), dermis density (11.28 ± 5.21 vs. 31.88 ± 7.96, p = 0.0001), epidermis density (27.68 ± 23.15 vs. 49.21 ± 45.68, p = 0.046), and dermis thickness (798.09 ± 133.51 μm vs. 905.59 ± 240.67 μm, p = 0.036) compared to pre-treatment.

Conclusion: The findings of the study revealed that the injection of autologous fibroblasts can be effective in restoring the aging skin, especially in the nasolabial region, and can be used as a safe rejuvenating strategy.
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http://dx.doi.org/10.1111/jocd.14181DOI Listing
April 2021

Assessing the effectiveness of the combination therapy with fractional Er-YAG laser and platelet-rich plasma in treatment of periorbital dark circles patients: A clinical trial.

J Cosmet Dermatol 2021 Feb 27. Epub 2021 Feb 27.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Numerous therapeutic techniques for periorbital hyperpigmentation have been suggested.

Aim: In this comparative intrapatient study, the effectiveness of combination therapy included fractional Er: YAG laser and autologous platelet-rich plasma (PRP) compared to Er: YAG laser in periorbital hyperpigmentation treatment.

Patients/methods: Thirty-two patients were enrolled. The right periorbital sides of patients received combination of Er: YAG laser and autologous platelet-rich plasma (PRP) and the left side received Er: YAG laser (three sessions with 4 weeks' intervals). PRP was used in two ways included injection and topical. Patients were evaluated by biometric characteristics, patients, and physician assessments. Also, the patient's satisfaction was assessed and side effects were evaluated.

Results: The mexameter results showed that the melanin content in the right side of the periorbital of the patients was significantly decreased compared to left side. Also, significant increase was observed in the skin lightness of the right side in compare to left. The visioface results showed the decrease in the percent change of the color and wrinkle in both sides, but in the right side these changes were significantly more than left side. The patients and physician assessment confirmed the measured results.

Conclusion: Combination of Er: YAG laser and PRP is significantly effective for periorbital hyperpigmentation.
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http://dx.doi.org/10.1111/jocd.14036DOI Listing
February 2021

Comparison of carboxy therapy and fractional Q-switched ND:YAG laser on periorbital dark circles treatment: a clinical trial.

Lasers Med Sci 2021 Feb 27. Epub 2021 Feb 27.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Treatment of the periorbital dark circles (PDCs) is a current challenge, with most treatment methods failing to yield promising results. The effectiveness of two common methods for periorbital dark circle treatment was compared in 28 patients with PDC. The patients were randomly divided into two groups of equal numbers: the first group received carboxy therapy, and the second group fractional 10,64 nm Q-switched Nd:YAG laser. In the carboxy therapy group, the treatment was performed six times, with 1-week intervals between sessions. In the group treated by Nd:YAG laser, the treatment was conducted in four sessions, with 1-month intervals between sessions. The results were evaluated through biometric evaluation, scoring on the visual analog scale (VAS) by both physicians and patients, and patients' satisfaction. Side effects of the treatments were also evaluated. The results showed that both carboxy therapy and Nd:YAG laser are effective in the treatment of periorbital dark circles, but carboxy therapy is significantly more effective. An increase in the skin lightness and a decrease in the melanin content of the periorbital skin was observed in the group receiving carboxy therapy, and these changes were more pronounced in this group compared to the group of Nd:YAG laser. In addition, side effects, such as erythema and post-inflammatory hyperpigmentation, were less in carboxy therapy than in Nd:YAG laser. Furthermore, the procedure was less expensive and easier to perform compared to Nd:YAG laser. Carboxy therapy is significantly more effective than Nd:YAG laser in PDC treatment.Trial registration: IRCT20080901001159N24.
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http://dx.doi.org/10.1007/s10103-021-03274-5DOI Listing
February 2021

Mesenchymal Stem Cell Spheroids Embedded in an Injectable Thermosensitive Hydrogel: An In Situ Drug Formation Platform for Accelerated Wound Healing.

ACS Biomater Sci Eng 2020 09 27;6(9):5096-5109. Epub 2020 Aug 27.

Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.

The ability of mesenchymal stem cells (MSCs) to enhance cutaneous wound healing has been well established. Extensive expansion of cells to reach sufficient cell numbers for regenerating tissues has always limited cell-based therapies. An ingenious solution to address this challenge is to develop a strategy to increase the immunomodulatory effects of MSCs without expanding them. In this study, we employed a simple characteristic of cells. It was observed that an optimized three-dimensional (3D) MSC culture in spheroid forms significantly improved their paracrine effects. An electrospray (ES) encapsulation apparatus was used to encapsulate individual or 3D spheroid MSCs into microscale alginate beads (microbeads). Furthermore, alginate microbeads were embedded in an injectable thermosensitive hydrogel matrix, which gels at skin temperature. The hydrogel fills and seals the wounds cavities, maintains high humidity at the wound area, absorbs exudate, and fixes microbeads, protecting them from direct contact with the harsh wound environment. In vitro investigations revealed that secretion of interleukin 10 (IL-0) and transforming growth factor β1 (TGF-β1) gene was gradually enhanced, providing a delivery platform for prolonged release of bioactive molecules. In vivo study on full-thickness wounds showed granulation and re-epithelialization, only after 7 days. Moreover, increased expression of α-smooth muscle actin (α-SMA) in the first 14 days after treatment ensured wound contraction. Besides, a gradual decrease in α-SMA secretion resulted in reduced scar formation. Well-organized collagen fibrils and high expression of the angiogenesis biomarker CD31 confirmed the promoting effect of the hydrogel on the wound-healing process. The proposed wound-dressing system would potentially be used in scalable and effective cell-based wound therapies.
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http://dx.doi.org/10.1021/acsbiomaterials.0c00988DOI Listing
September 2020

Autologous whole fat injection stimulates hair growth in resistant Androgenetic Alopecia: Report of nine cases.

J Cosmet Dermatol 2020 Dec 23. Epub 2020 Dec 23.

Jordan Dermatology and Hair Transplantation Center, Tehran, Iran.

Background: The changes in morphology of hair follicle and aberrant cycling of hair follicle are the main reasons of the most common forms of hair loss (alopecia). However, existing alopecia treatments do not specifically target these processes.

Aims: Autologous whole fat injection suggests a paradigm shift that may offer alternative therapies that can be used to prevent hair loss. This study aimed to present clinical cases for the treatment of androgenetic alopecia by autologous whole fat injection in the scalp.

Methods: Nine patients with androgenetic alopecia (7 women and 2 men) were enrolled to our study. After lipoaspiration, autologous whole fat was injected into the patient's scalp. Hair regeneration was evaluated by three clinical tests: the pull test, hair quality, and hair density.

Results: For all patients, before and after treatment, the number (density) and diameter of hair were calculated using trichograms. The pull test was also performed. The pictures were obtained before after treatment.

Conclusion: Our results showed that whole fat injection enormously can increase the level of hair growth.
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http://dx.doi.org/10.1111/jocd.13907DOI Listing
December 2020

Efficacy evaluation of Endolift-based Subcision on acne scar treatment.

J Cosmet Dermatol 2020 Dec 21. Epub 2020 Dec 21.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: People with acne scar suffer from destruction to the surface of the skin. Treating acne scars is a challenge that might need several methods.

Aims: Subsection is a method that has been informed to be a useful method in treating rolling acne scars. While Subcision is a valued procedure, its effect is mild to moderate due to its high reappearance rate, and patients' dissatisfaction with some of the side effects such as inflammation after procedure.

Patients/methods: In this pilot study, 9 rolling acne scar patients underwent Subcision with the Endolift (200-nm fiber) and followed up for 3 months. Outcomes were evaluated by 3 dermatologists (Blind). Also, the patients' satisfaction was assessed to compare with dermatologist's opinions.

Results: Our results indicated that Subcision with the Endolift displayed good and very good improvement in about 90% of patient with a good and very good satisfaction in the patients. Photographic data evaluation indicated 100% improvement in scar depth, topography, and total acne scar appearance. The average numbers of lesions before the treatment were 25.5 ± 12.1, and after treatment, it was reduced to 11.4 ± 2.1 (P < .05).

Conclusion: Subcision with the Endolift seems to be a safe and effective method for acne scar treatment. It is done with a single perforation on each side (instead of several perforations), which reduces the pain and scar risk in the patients. Also, Endolift-based Subcision needs fewer surgical sessions and less recovery time with less inflammation and erythema.
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http://dx.doi.org/10.1111/jocd.13876DOI Listing
December 2020

Defining microRNA signatures of hair follicular stem and progenitor cells in healthy and androgenic alopecia patients.

J Dermatol Sci 2021 Jan 6;101(1):49-57. Epub 2020 Nov 6.

Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Electronic address:

Background: The exact pathogenic mechanism causes hair miniaturization during androgenic alopecia (AGA) has not been delineated. Recent evidence has shown a role for non-coding regulatory RNAs, such as microRNAs (miRNAs), in skin and hair disease. There is no reported information about the role of miRNAs in hair epithelial cells of AGA.

Objectives: To investigate the roles of miRNAs affecting AGA in normal and patient's epithelial hair cells.

Methods: Normal follicular stem and progenitor cells, as well as follicular patient's stem cells, were sorted from hair follicles, and a miRNA q-PCR profiling to compare the expression of 748 miRNA (miRs) in sorted cells were performed. Further, we examined the putative functional implication of the most differentially regulated miRNA (miR-324-3p) in differentiation, proliferation and migration of cultured keratinocytes by qRT-PCR, immunofluorescence, and scratch assay. To explore the mechanisms underlying the effects of miR-324-3p, we used specific chemical inhibitors targeting pathways influenced by miR-324-3p.

Result: We provide a comprehensive assessment of the "miRNome" of normal and AGA follicular stem and progenitor cells. Differentially regulated miRNA signatures highlight several miRNA candidates including miRNA-324-3p as mis regulated in patient's stem cells. We find that miR-324-3p promotes differentiation and migration of cultured keratinocytes likely through the regulation of mitogen-activated protein kinase (MAPK) and transforming growth factor (TGF)-β signaling. Importantly, pharmacological inhibition of the TGF-β signaling pathway using Alk5i promotes hair shaft elongation in an organ-culture system.

Conclusion: Together, we offer a platform for understanding miRNA dynamic regulation in follicular stem and progenitor cells in baldness and highlight miR-324-3p as a promising target for its treatment.
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http://dx.doi.org/10.1016/j.jdermsci.2020.11.002DOI Listing
January 2021

Combination therapy of trichloroacetic acid, human autologous fibroblast injection and fibroblast seeded microfibrous collagen scaffold as a novel treatment for osteomyelitis diabetic foot ulcer.

J Diabetes Investig 2021 Jun 23;12(6):1112-1117. Epub 2020 Nov 23.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

A severe complication associated with diabetes is diabetic foot ulcer (DFU). Most patients with DFU require amputation. Although treatment of non-healing diabetic ulcers is challenging, the use of novel therapies can be effective. In this report, we present the case of a woman with type 2 diabetes with DFU-related osteomyelitis, who was treated with a combination therapy of trichloroacetic acid, calcium alginate and foam dressings, human autologous fibroblast injection, and a fibroblast cell-seeded collagen scaffold. The results showed the positive effects of combination therapy on DFU. In the initial treatment, the wound area was measured to be 14 × 7 cm , with a depth of 4 cm. After 6 months, the wound was measured to be 1.5 cm , showing a 90% reduction of the wound area. Overall, this combination therapy was highly effective in the treatment of DFU-related osteomyelitis, and could markedly prevent amputation among DFU patients.
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http://dx.doi.org/10.1111/jdi.13454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169364PMC
June 2021

Maintaining Hair Inductivity in Human Dermal Papilla Cells: A Review of Effective Methods.

Skin Pharmacol Physiol 2020 14;33(5):280-292. Epub 2020 Oct 14.

Department of Regenerative medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.

The dermal papilla comprises mesenchymal cells in hair follicles, which play the main role in regulating hair growth. Maintaining the potential hair inductivity of dermal papilla cells (DPCs) and dermal sheath cells during cell culture is the main factor in in vitro morphogenesis and regeneration of hair follicles. Using common methods for the cultivation of human dermal papilla reduces the maintenance requirements of the inductive capacity of the dermal papilla and the expression of specific dermal papilla biomarkers. Optimizing culture conditions is therefore crucial for DPCs. Moreover, exosomes appear to play a key role in regulating the hair follicle growth through a paracrine mechanism and provide a functional method for treating hair loss. The present review investigated the biology of DPCs, the molecular and cell signaling mechanisms contributing to hair follicle growth in humans, the properties of the dermal papilla, and the effective techniques in maintaining hair inductivity in DPC cultures in humans as well as hair follicle bioengineering.
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http://dx.doi.org/10.1159/000510152DOI Listing
October 2020

Efficacy of allogeneic cord blood platelet gel on wounds of dystrophic epidermolysis bullosa patients after pseudosyndactyly surgery.

Wound Repair Regen 2021 01 19;29(1):134-143. Epub 2020 Oct 19.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Epidermolysis bullosa (EB) is a rare genetic disorder characterized by the formation of blisters and wounds in skin and mucous membranes; it is classified into four types and has various methods of treatment. Management of previous wounds and prevention of formation of new lesions are the most important strategies in the course of therapy to improve patient's quality of life; lack of wound management can lead to further complications such as infection. The current study investigated the therapeutic effects of allogeneic platelet gel (prepared from umbilical cord blood) in a group of children diagnosed with dystrophic epidermolysis bullosa (DEB) eligible for surgical correction of pseudosyndactyly in the hand. The post-surgical clinical outcome in this group was compared with the clinical outcomes of DEB patients receiving the standard treatment (paraffin gauze wound dressing and topical antibiotics) after corrective surgery. The current study results showed an increase in the rate of recovery and promotion of tissue granulation, complete wound healing, and a decrease in pain level and treatment period. The application of cord blood platelet gel topical dressing was not a conventional method of treatment in patients with DEB wounds and blisters. However, the current study results demonstrated that this gel dressing could effectively accelerate epithelialization and healing of the wounds and decrease patients' pain and post-surgical recovery period, which altogether leads to improvements in patients' overall quality of life.
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http://dx.doi.org/10.1111/wrr.12865DOI Listing
January 2021

Biometric changes of skin parameters in using of microneedling fractional radiofrequency for skin tightening and rejuvenation facial.

Skin Res Technol 2020 Nov 25;26(6):859-866. Epub 2020 Jun 25.

Jordan Dermatology and Hair Transplantation Center, Tehran, Iran.

Background: Fractional radiofrequency (RF) has been used for skin rejuvenation and tightening by dermatologists and cosmetic surgeons in recent years.

Methods: Twenty female patients (mean age of 51.9 years) with Fitzpatrick III to VI skin phototypes who desired to undergo skin lift/tightening received six sessions of fractional microneedle RF treatment and were assessed at baseline and then 3 months after the last session for biometric characteristics using a Colorimeter, Visioface 1000D, Tewameter, Cutometer, Mexameter, and Sebumeter and a skin ultrasound imaging system to evaluate the transepidermal water loss (TEWL), skin pores, color, melanin content, erythema, sebaceous content, and thickness and density of the epidermis and dermis. Patient satisfaction with visual analog scale (VAS) was also measured.

Results: The results showed that skin pores and spots decreased significantly. TEWL also decreased significantly (by 18.44%). Meanwhile, skin density increased significantly (R7, by 44.41%). The ultrasonographic assessments showed that both the density and thickness of the dermis and epidermis were increased. The changes in the other parameters were not significant.

Conclusion: FR increases the density and thickness of the dermis and thus also increases the collagen content and decreases skin pores and TEWL.
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http://dx.doi.org/10.1111/srt.12887DOI Listing
November 2020

Impact of the COVID-19 pandemic on the sexual behavior of the population. The vision of the east and the west.

Int Braz J Urol 2020 07;46(suppl.1):104-112

Department of Surgery and Urology Section, University of Catania, Catania, Italy.

The COVID-19 pandemic has radically changed the way of life around the World. The state of alarm has forced the population to stay at home, radically changing both interpersonal and partner relationships; work at home, social distancing, the continued presence of children at home, fear of infection and not being able to physically meet with others have changed most people's sexual habits. We conducted a review by exploring the impact of the COVID-19 pandemic on sexual behavior in the population from three different countries: Iran, Italy and Spain from each country's perspective. The impact of the coronavirus will be very important in the sexual life of the people and we will attend in the next months or years, to some changes in the relationships at all the levels. The pandemic will negatively affect sexual behaviors due to multiple contact restrictions. In the future, we will be able to assess these effects in more detail.
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http://dx.doi.org/10.1590/S1677-5538.IBJU.2020.S116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719991PMC
July 2020

Human Hair Outer Root Sheath Cells and Platelet-Lysis Exosomes Promote Hair Inductivity of Dermal Papilla Cell.

Tissue Eng Regen Med 2020 08 9;17(4):525-536. Epub 2020 Jun 9.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, No. 226, Qods St., Keshavarz Blvd., Tehran, 1416753955, Iran.

Background: Hair loss is a prevalent medical problem in both men and women. Maintaining the potential hair inductivity of dermal papilla cells (DPCs) during cell culture is the main factor in hair follicle morphogenesis and regeneration. The present study was conducted to compare the effects of different concentrations of human hair outer root sheath cell (HHORSC) and platelet lysis (PL) exosomes to maintain hair inductivity of the human dermal papilla cells (hDPCs).

Methods: In this study, hDPCs and HHORSCs were isolated from healthy hair samples. Specific markers of hDPCs (versican, α-SMA) and HHORSCs (K15) were evaluated using flow cytometric and immunocytochemical techniques. The exosomes were isolated from HHORSCs and PL with ultracentrifugation technique. Western blot was used to detect specific markers of HHORSCs and PL exosomes. Particle size and distribution of the exosomes were analyzed by NanoSight dynamic light NanoSight Dynamic Light Scattering. Different methods such as proliferation test (MTS assay), migration test (Transwell assay) were used to evaluate the effects of different concentrations of exosomes (2,550,100 µg/ml) derived from HHORSC and PL on hDPCs. Expression of specific genes in the hair follicle inductivity, including ALP, versican and α-SMA were also evaluated using real time-PCR.

Results: The flow cytometry of the specific cytoplasmic markers of the hDPCs and HHORSCs showed expression of versican (77%), α-SMA (55.2%) and K15 (73.2%). The result of particle size and distribution of the exosomes were analyzed by NanoSight dynamic light NanoSight Dynamic Light Scattering, which revealed the majority of HHORSC and PL exosomes were 30-150 nm. For 100 µg/ml of HHORSC exosomes, the expressions of ALP, versican and α-SMA proteins respectively increased by a factor of 2.1, 1.7and 1.3 compared to those in the control group.

Conclusion: In summary, we applied HHORSC exosomes as a new method to support hair inductivity of dermal papilla cells and improve the outcome for the treatment of hair loss.
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http://dx.doi.org/10.1007/s13770-020-00266-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392975PMC
August 2020

An Open-Label Study of Low-Level Laser Therapy Followed by Autologous Fibroblast Transplantation for Healing Grade 3 Burn Wounds in Diabetic Patients.

J Lasers Med Sci 2019 1;10(Suppl 1):S7-S12. Epub 2019 Dec 1.

Research Centre for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Low-level laser therapy (LLLT) has been used as an effective therapeutic modality since the mid-1960s. Although there have been several clinical studies using LLLT in wound healing, especially diabetic, pressure and venous ulcers, there are few reports of using this technique in burn ulcers. Autologous fibroblast transplantation is a novel treatment for patients with burns or venous ulcers. In this study for the first time, we used LLLT along with autologous fibroblast skin transplantation to treat grade 3 burn ulcers in diabetic patients. This case series describes the successful management of grade 3 burn ulcers in 10 diabetic patients using autologous fibroblast transplantation along with LLLT. After the approval of the Tehran University Ethics Committee (IR.TUMS.REC.1394.1683) and the Iran Registry of Clinical Trials (IRCT2016050226069N3), 10 diabetic patients with 10 grade 3 burn ulcers, who were a candidate for skin graft surgery, entered the study. Donor skin was biopsied using a 3 mm punch. Fibroblasts were extracted and cultured in vitro in the GMP Technique laboratory. The patients were treated using LLLT in 3-4 weeks during the time that fibroblast cultures became ready to use. Laser irradiation was done using red light, 650 nm, 150 mW, 1 J/cm for the bed of the ulcer and infra-red light 808 nm, 200 mW, 6 J/cm for the margins every other day for 10 sessions. The mean wound size before treatment was 16.28 cm . All patients' burn wounds healed completely after 10-12 weeks. We conclude that this method can be used as an effective method for treating large wounds, especially in complicated patients including the diabetics.
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http://dx.doi.org/10.15171/jlms.2019.S2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6983871PMC
December 2019

A comparative study of the efficacy of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy alone and in combination with erbium:YAG laser therapy: tracing and objective measurement of melanin index in macular amyloidosis.

Lasers Med Sci 2020 Jul 8;35(5):1171-1177. Epub 2020 Jan 8.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Macular amyloidosis (MA) is a common form of primary localized cutaneous amyloidosis, characterized by the eruption of brown pigments of the skin with a rippled pattern. MA can be of cosmetic concern for patients, and its treatment is challenging. In this study, we aimed to find new effective approaches for MA treatment. A total of 39 patients with the clinical diagnosis of MA were treated with two types of laser therapy, and the effectiveness of each approach was examined. Fractional Q-switched 10.64 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy was compared with a combination of fractional Q-switched 10.64 nm Nd:YAG laser and long-pulsed fractional erbium:YAG laser therapy. Melanin biometric measurements were performed using a Mexameter, objective image-based evaluation was carried out, and the itching score and patient satisfaction were examined. Mexameter-based analysis showed that both types of laser therapy were effective in the treatment of MA, causing a significant decrease in the amount of melanin in the treated areas (P < 0.05). Also, combination of two types of laser therapy was significantly more effective than one type alone (P < 0.05). The itching score significantly decreased in patients undergoing a combination of laser therapies. Also, a positive correlation was observed between the amount of melanin and degree of itching in the treated areas. Moreover, analysis of patient satisfaction showed that more than 90% of patients had excellent satisfaction with combination laser therapy. The results confirmed the significant positive effects of both fractional Nd:YAG laser alone and in combination with fractional erbium:YAG laser therapy considering the reduction in melanin content; however, combination of two types of laser therapy was more effective than one type alone. Trial registration: IRCT20080901001159N23.
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http://dx.doi.org/10.1007/s10103-020-02954-yDOI Listing
July 2020

The Efficacy of Carbone Dioxide Laser Debridement Along With Low-Level Laser Therapy in Treatment of a Grade 3 Necrotic Burn Ulcer in a Paraplegic Patient (A Case Report).

J Lasers Med Sci 2019 1;10(4):338-341. Epub 2019 Oct 1.

Burn Research center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, Iran.

A deep burn ulcer, especially in areas with sensory-motor dysfunction, is hard to cure. The patient was a 20-year-old paraplegic girl with a grade 3 necrotic burn ulcer for 3 weeks. We used a fractional Co laser along with chemical debridement with trichloroacetic acid (TCA 80%) and low-level laser therapy (LLLT) with a 808 nm infrared laser, 6 J/cm for the necrotic area, and a 650 nm red laser, 2 J/cm for the open wound area. Complete healing occurred after 25 sessions without surgery. Laser debridement along with LLLT and TCA administration may be useful to treat necrotic ulcers without surgery.
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http://dx.doi.org/10.15171/jlms.2019.54DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885911PMC
October 2019

Engineered skin graft with stromal vascular fraction cells encapsulated in fibrin-collagen hydrogel: A clinical study for diabetic wound healing.

J Tissue Eng Regen Med 2020 03 17;14(3):424-440. Epub 2020 Jan 17.

Applied Cell Sciences Department, Kashan University of Medical Science, Kashan, Iran.

Despite the abundance of skin substitutes in the worldwide market, major hurdles in developing more complex tissues include the addition of skin appendages and vascular networks as the most important structure. The aim of this research was a clinical feasibility study of a novel prevascularized skin grafts containing the dermal and epidermal layer using the adipose stromal vascular fraction (SVF)-derived endothelial cell population for vascular network regeneration. Herein, we characterized hydrogel with emphasis on biological compatibility and cell proliferation, migration, and vitality. The therapeutic potential of the prevascularized hydrogel transplanted on five human subjects as an intervention group with diabetic wounds was compared with nonvascularized skin grafts as the control on five patients. Wound planimetric and biometric analysis was performed using a Mann-Whitney nonparametric t-test (p ≤ .05). The fibrin-collagen hydrogel was suitable for skin organotypic cell culture. There was a significant (p ≤ .05) increased in skin thickness and density in the vascular beds of the hypodermis measured with skin scanner compared with that in the control group. No significant macroscopic differences were observed between the intervention and control groups (p ≤ .05). In summary, we report for the first time the use of autologous dermal-epidermal skin grafts with intrinsic vascular plexus in a clinical feasibility study. The preliminary data showed that SVF-based full-thickness skin grafts are safe and accelerate the wound healing process. The next stage of the study is a full-scale randomized clinical trial for the treatment of patients with chronic wounds.
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http://dx.doi.org/10.1002/term.3003DOI Listing
March 2020

The role of Bax in the apoptosis of Leishmania-infected macrophages.

Microb Pathog 2020 Feb 25;139:103892. Epub 2019 Nov 25.

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Skin Disease and Leishmaniasis Research Center, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address:

Background: Leishmania is a protozoan parasite that nests in macrophages and is responsible for the Leishmaniasis disease. In spite of different defense pathways, last strategy of macrophage for killing parasite is apoptosis process. By permeableizing the mitochondrial outer membrane (MOM). As breaching MOM releases apoptogenic factors like cytochrome-c which activate caspases that result in the destruction of the cell. In this review, we summarized the appropriate manuscripts regarding the bax includes, its different types and the effect of bax on the apoptosis of Leishmania and parasite-infected macrophages.

Methods: Information about the role of BAX in the apoptosis of parasite-infected macrophage of recent articles were surveyed by searching computerized bibliographic database PubMed and Google Scholar entering the keywords BAX and leishmaniasis.

Results: The common studies revealed Leishmania use different survival strategies for inhibiting macrophage apoptosis. As Leishmania by preventing homooligomerization or upregulating the anti-apoptotic molecule Bcl-2 can prohibits proteins of host-cell apoptosis such as Bax that is required for mitochondrial permeabilisation during apoptosis.

Conclusion: With regard to the supportive role of bax in apoptosis and the preventive role of Leishmania in its function, it seems that expression of bax gene in parasite by technologies like transgenic or down regulating of anti-apoptotic molecule Bcl-2 by miRNA could be prompted the apoptosis process of infected-macrophages and inhibited extensive spread of Leishmania and the resulting lesions.
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http://dx.doi.org/10.1016/j.micpath.2019.103892DOI Listing
February 2020

Effect of Cedar () topical solution in mild to moderate acne vulgaris: a randomized clinical study.

J Dermatolog Treat 2021 Mar 24;32(2):197-202. Epub 2019 Nov 24.

Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Acne is the most prevalent skin disease in the world and antibiotics as its standard treatments have limited and also adverse effects. Cedar () has medicinal properties like antibacterial activity and is used topically for treatment of some kinds of skin problems in Persian medicine. The aim of this study was to evaluation the efficacy of topical cedar solution of acne vulgaris.

Methods: Eighty patients aged between 15-45 years with mild to moderate acne vulgaris were conducted in this randomized, double blind trial. The participants were allocated to receive the topical cedar solution plus clindamycin 1% or topical placebo plus 1% clindamycin solution for six weeks. Patients were evaluated at the beginning of the study, second, sixth and eighth weeks after intervention for the acne severity index (ASI) and total acne lesions counting (TLC). Data was analyzed by SPSS software with Mann-Whitney test.

Results: From 105 subjects 68 people completed the study (33 persons in cedar group and 35 persons in placebo group). The mean and standard deviation of the age was 26.1 ± 7.5 years and 22 subjects (32.4%) were male. TLC and ASI in the sixth and eighth weeks in cedar group were significantly less than in placebo group ( < 0.001). Topical cedar solution had no serious side effects.

Conclusion: The topical cedar solution plus clindamycin 1% was more effective and safe than placebo plus 1% clindamycin for the treatment of acne vulgaris.
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http://dx.doi.org/10.1080/09546634.2019.1692125DOI Listing
March 2021

Skin regenerative medicine advancements in the Islamic Republic of Iran: a concise review.

Regen Med 2019 11 13;14(11):1047-1056. Epub 2019 Nov 13.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

In the last decade, the Islamic Republic of Iran has witnessed significant improvement and growth in the field of interdisciplinary medicine and in its translation to patients, including the field of cell and stem cell therapy. The main aim of this report is to highlight various advances in regenerative medicine for skin and dermatology using stem cell technology, and its translation to clinic in the past two decades, in Iranian academic centers, clinical institutes and hospitals. While there have been numerous positive advances in clinical outcomes reported in Iran, there is no comparative analytical information on these studies. Here we present a historical overview of the progress and key advancements seen in skin regeneration in this country, review the research frameworks, regulatory approach and pathways and offer perspectives for the future.
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http://dx.doi.org/10.2217/rme-2018-0170DOI Listing
November 2019

Autologous adipose transplantation an effective method to treat alopecia after trauma: a case report.

Clin Cosmet Investig Dermatol 2019 3;12:647-651. Epub 2019 Sep 3.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Finding new therapies for male and female pattern hair loss treatment remains as great interest. The autologous fat grafting technique is a new method, and clinical experience was increased over the past 10-15 years. Adipose tissue is a biologically active and important tissue and can help drive the complex hair growth cycle. Surgeons have previously reported that autologous fat not only have a positive affect for reconstructive volume and esthetics after transplant but can also have positive skin and hair changes post-transplantation. In this study, lipoaspiration of adipose was performed by cannula and scalp injection was done. In this case report, the authors report that scalp injection of adipose tissue has a positive effect on a patient with alopecia after trauma. The findings suggest adipose tissue can be a promising alternative method to treating men and women alopecia.
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http://dx.doi.org/10.2147/CCID.S217203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731992PMC
September 2019

Comparing cannula-based subcision with the common needle method: A clinical trial.

Skin Res Technol 2020 Jan 1;26(1):39-44. Epub 2019 Aug 1.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Of Trial Design: Treatment of depressed acne scars requires multiple modalities. Although needle subcision is a valuable method, it exhibits mild to moderate efficacy in treatment of deep acne scars owing to the high recurrence rate and other side effects. A total of 100 patients with rolling acne scars were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision in two parallel groups, and the effect of cannula subcision instead of needle subcision was evaluated in the treatment of rolling acne scars.

Methods: A total of 100 patients were randomly treated using the standard technique of 18 gauge cannula and 27 gauge needle subcision. The outcomes of these procedures were assessed by three blinded dermatologists and by patients' satisfaction.

Results: Subcision using the cannula showed good and very good improvement in about 83% of patients (n = 50, P < .05) based on dermatologists investigation and almost no side effects were observed in compared with needle subcision. The response rate was significantly different while using cannula subcision.

Conclusion: Cannula subcision appears to be a safe and practical technique that can enhance the efficacy of subcision without considerable complications.
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http://dx.doi.org/10.1111/srt.12761DOI Listing
January 2020

Sambucus ebulus extract stimulates cellular responses in cutaneous leishmaniasis.

Parasite Immunol 2019 01;41(1):e12605

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

This is the first study aiming to determine the therapeutic effects of the Sambucus ebulus aquatic extract as an antileishmanial herbal drug and evaluate the immune responses in Leishmania major major infected BALB/c mice. The antileishmanial activity of S ebulus aquatic extract was evaluated using MTT test as well as parasite rescue and transformation assay. Footpad swelling and parasite load of infected mice were measured by several techniques. The immune responses were evaluated by measuring the levels of IFN-γ, IL-4, nitric oxide and arginase. The results indicated that S. ebulus can significantly decrease L. major promastigotes and amastigotes viability, but it was not toxic to macrophages. The lesion size, parasite burden and the level of ARG decreased in the treated infected mice, while the IFN-γ-to-IL-4 ratio and the level of NO increased significantly. Altogether, the S. ebulus extract is an effective compound for killing Leishmania parasite without excessive toxicity to the host cells and can cure the CL by switching the host immune responses towards Th1 response. Thus, it may be a perfect therapeutic option for CL treatment.
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http://dx.doi.org/10.1111/pim.12605DOI Listing
January 2019

Engineering the niche for hair regeneration - A critical review.

Nanomedicine 2019 01 7;15(1):70-85. Epub 2018 Sep 7.

Bioengineering Research Group, Nanotechnology and Advanced Materials Department, Materials and Energy Research Center (MERC), Tehran, Iran; Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Recent progress in hair follicle regeneration and alopecia treatment necessitates revisiting the concepts and approaches. In this sense, there is a need for shedding light on the clinical and surgical therapies benefitting from nanobiomedicine. From this perspective, this review attempts to recognize requirements upon which new hair therapies are grounded; to underline shortcomings and opportunities associated with recent advanced strategies for hair regeneration; and most critically to look over hair regeneration from nanomaterials and pluripotent stem cell standpoint. It is noteworthy that nanotechnology is able to illuminate a novel path for reprogramming cells and controlled differentiation to achieve the desired performance. Undoubtedly, this strategy needs further advancement and a lot of critical questions have yet to be answered. Herein, we introduce the salient features, the hurdles that must be overcome, the hopes, and practical constraints to engineer stem cell niches for hair follicle regeneration.
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http://dx.doi.org/10.1016/j.nano.2018.08.012DOI Listing
January 2019

Skin care and rejuvenation by cosmeceutical facial mask.

J Cosmet Dermatol 2018 Oct 21;17(5):693-702. Epub 2018 Aug 21.

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Skin health is an important aspect of aesthetics. Dermatologists and scientists try to develop novel methods and materials to fulfill this aim. Facial cosmetics keep skin moist and remove sebum from the skin to maintain proper skin health. The use of suitable cosmetics according to the facial skin type results in healthy skin. Facial masks are the most prevalent cosmetic products utilized for skin rejuvenation. Facial masks are divided into four groups: (a) sheet masks; (b) peel-off masks; (c) rinse-off masks; and (d) hydrogels. Each of these has some advantages for specific skin types based on the ingredients used. The following article presents the available information about the facial mask. Also, we have focused on the facial masks available in the market. Despite several developments in this field, extensive research is required for performing successful and precise clinical trials in the future. Further improvements would enable the researchers to develop new products in this field. In this review, we present the most recent breakthroughs in the field of skin care and rejuvenation by cosmeceutical facial mask. This information is valuable to get the picture of the latest trends and also helpful for clinicians and related manufacturing companies.
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http://dx.doi.org/10.1111/jocd.12730DOI Listing
October 2018

The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia.

Indian J Dermatol Venereol Leprol 2018 Sep-Oct;84(5):547-553

Department of Biostatistics and Epidemiology, Skin Diseases and Leishmaniasis Research Center, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Androgenetic alopecia is the commonest type of alopecia affecting over half of men and women. Low-level light therapy is a new technique for stimulating hair growth in both genders.

Aims: To overcome the shortcomings of previous epidemiological studies and a lack of controlled clinical trials on the subject, this study compared the effectiveness of adding low-level light therapy to minoxidil topical solution in the treatment of androgenetic alopecia in patients presenting to two skin clinics in Isfahan, Iran during 2014-2015.

Materials And Methods: This clinical trial included 50 patients aged 17-45 presenting to Khorshid and Alzahra educational centers and skin diseases research center for androgenetic alopecia during 2014-2015. The patients were randomly divided into a control and a case group. The case group received topical minoxidil 5% solution plus low-level light therapy twice per day. The control group was given the same topical solution and a laser comb system that was turned off to act as a placebo. Changes in patients' hair density and diameter and its overall regrowth as well as their satisfaction with the treatment were assessed at months 0 (baseline), 3, 6, 9 and 12.

Results: The percentage of recovery from androgenetic alopecia and the patients' satisfaction with their treatment were significantly higher in the case group compared to the control group. The patients' mean hair density and diameter were found to be higher in the case group after the intervention compared to the control group.

Limitations: The study limitations included patient compliance, small sample size, patient insight due to novelty of the method and clinical judgement.

Conclusion: As a new method of treatment, low-level light therapy can help improve the percentage of recovery from androgenetic alopecia and increase patients' satisfaction with their treatment.
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http://dx.doi.org/10.4103/ijdvl.IJDVL_1156_16DOI Listing
December 2018

Evaluation of the Effects of Low Level Laser Therapy on the Healing Process After Skin Graft Surgery in Burned Patients (A Randomized Clinical Trial).

J Lasers Med Sci 2018 20;9(2):139-143. Epub 2018 Mar 20.

Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Skin graft is the standard therapeutic technique in patients with deep ulcers, but like every surgical procedure, it may present some complications. Although several modern dressings are available to enhance comfort of donor site, the use of techniques that accelerate wound healing may enhance patient's satisfaction. Low level laser therapy (LLLT) has been used in several medical fields, especially for wound healing, but it may take several months for large ulcers treated with laser to heal completely. Nine patients with bilateral similar grade 3 burn ulcers in both hands or both feet were selected as candidates for split-thickness skin graft (STSG). One side was selected for laser irradiation and the other side as control, randomly. Laser was irradiated every day for 7 days with red 655 nm light, 150 mW, 2 J/cm at the bed of the ulcer and with infra-red 808 nm light, 200 mW for the margins. The rate of wound dehiscence after skin graft surgery was significantly lower in laser treated group in comparison to control group which received only classic dressing (P=0.019). The results showed LLLT to be a safe effective method which improves graft survival and wound healing process and decreases the rate of wound dehiscence in patients with deep burn ulcers.
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http://dx.doi.org/10.15171/jlms.2018.26DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046389PMC
March 2018

Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial.

J Res Pharm Pract 2017 Oct-Dec;6(4):199-205

Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris.

Methods: In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2, and 3 months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit.

Findings: The IPL group showed greater reduction in AGSS ( < 0.001) and TLC ( = 0.005) than the control group. However, the difference in ASI was not significant ( = 0.12). Patients in IPL groups were more satisfied than control group ( < 0.001).

Conclusion: Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind.
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http://dx.doi.org/10.4103/jrpp.JRPP_17_29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787904PMC
February 2018

Percutaneous ethanol injection as a promising and minimally invasive treatment for axillary osmidrosis: Double-blinded randomized controlled trial.

Indian J Dermatol Venereol Leprol 2018 ;84(2):157-162

Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Axillary osmidrosis is a common problem with a strong negative impact on the professional and social quality of life. Several options are available for its treatment. But there are no treatment guidelines. The objective of this study was to evaluate efficacy and safety of percutaneous ethanol injection for treatment of axillary osmidrosis.

Methods: A randomized, double-blind, placebo-controlled clinical trial to assess clinical efficacy and postoperative complications of percutaneous ethanol injection was performed among 60 patients (12-35 years of age) with axillary osmidrosis. The active agent used in the experimental group (n = 30) was sterile 90% ethanol and the placebo used in the control group (n = 30) was sterile normal saline administered in an identical syringe. The results of malodor elimination were graded by the patients as excellent, good, fair, and poor. All patients were followed-up for 10 months.

Results: Malodor elimination was graded as good by 15 (50%) patients treated with percutaneous ethanol injection. A significant difference in the improvement of axillary osmidrosis was found between the experimental and control groups (P < 0.001). The most common post-procedure complication was transient subjective skin stiffness in the experimental group, which regressed spontaneously. There were no serious permanent side effects.

Limitations: Relatively short duration of follow-up; and lack of histopathological evidence of destruction of the apocrine glands after treatment in most patients.

Conclusions: Percutaneous ethanol injection is an effective and safe treatment method for axillary osmidrosis and does not have permanent side effects.
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http://dx.doi.org/10.4103/ijdvl.IJDVL_704_16DOI Listing
August 2018
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