Publications by authors named "Mohammad Javad Fatemi"

40 Publications

Investigating the Impact of Collagen-Chitosan Derived from on Second-Degree Burn in Rats Model.

Regen Ther 2021 Dec 18;18:12-20. Epub 2021 Mar 18.

Department of Foreign Languages, Tehran University of Medical Sciences, Iran.

Background: The present study focused on burning as one of the main causes of mortality with detrimental economic and social effects in the world. The purpose of this study was to investigate the impact of collagen-chitosan gel extracted from and shrimp skin in the treatment of second degree burn healing among rats.

Materials & Method: To fulfill the purpose of the study, chitosan and collagen were extracted respectively from shrimp and skin waste by the acid-based method and were evaluated by using Pico Tag, SDS-PAGE. The burn wound healing efficiency of marine collagen-chitosan gel was examined in vivo using rats. Three different ratios of collagen and chitosan blend (Col-CH, 1:3, 1:1 and 3:1) were prepared to obtain the most effective Col-CH gel for burn wound healing and were compared to the animals treated with silver sulfadiazine ointment. Healing burn wound was studied by measuring wound surface area with Image J and histopathologic examination was carried out based on the mean of epithelialization, fibroblastic cells, acute and chronic inflammatory cells, angiogenesis, structure collagen and the amount of collagen on days 15 and 25 post-burn.

Results: The results of SDS-PAGE indicated that the extracted collagen was type I and it was composed of two α (α and α) chains. Amino acid analysis showed a much higher glaycin content in extracted collagen which amounted to one-third of the total amino. The wound surface measurement showed a significant reduction in wound size in the group treated with Col-CH (3:1) compared to silver-sulfadiazine treated group on 15th and 25th days. Histopathological findings represented a high score in epithelialization, collagen, collagen structure, fibroblast cell and a decrease in inflammatory cells infiltration in Col-CH (3:1) treated group on 25th day. The most obvious finding of the present study is that chitosan-collagen gel (3:1) represented a better efficacy compared to sulfadiazine in burn wound healing on day 25 post-burn.
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http://dx.doi.org/10.1016/j.reth.2021.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010355PMC
December 2021

The Effect of Education on Primary School Students' Knowledge Regarding Burn Prevention Measures and Actions to Take.

J Burn Care Res 2021 Mar;42(2):220-227

Assistant Professor of General Assistant Surgery, Shahid Motahari Hospital, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Burns injuries are a global concern. Many health specialists develop prevention programs, especially for high-risk groups such as children. This study was designed to investigate the effect of education on knowledge of primary school students about burn prevention and initial actions to take in dealing with burns. This is a quasi-experimental study conducted on primary school students. The sampling was done by cluster method in six boys' and girls' public schools (fourth to sixth grade) in three different regions of Tehran. The collected data included a demographic section and 17 questions for assessing students' awareness about prevention and initial actions in dealing with burns. The training was conducted by two experts who were familiar with the children's education in the schools. The level of the students' knowledge was evaluated by the questionnaire before the intervention, immediately after, and 3 months follow-up. The results showed that the knowledge score in both domains of prevention and initial actions significantly increased immediately and 3 months after training (P < .05). Also, there was a significant relationship between knowledge score in both domains with sex, educational level, and education area after intervention. Education is effective on raising students' knowledge about prevention and initial actions to take after a burn injury. Therefore, it is suggested to repeat educational programs, educate parents and students simultaneously, and use media to change beliefs and attitudes that are rooted in the culture of a society, especially in lower socioeconomic classes.
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http://dx.doi.org/10.1093/jbcr/iraa138DOI Listing
March 2021

Growth retardation among children in southern Iran: a 7-year population based cohort study.

BMC Public Health 2020 Sep 11;20(1):1392. Epub 2020 Sep 11.

Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Growth retardation is a common health problem, which requires early prevention and detection. This study was conducted to define the approximate age at which stunting starts among the Iranian boys and girls.

Method: The second phase of a population-based retrospective cohort nested case-control study on 400 children who were followed from birth to 7 years of age. This study was performed to define the pattern of growth among stunted and normal children and to reveal the age at which stunting starts in each gender.

Results: Of the selected participants, 53% were girls. Also, about 18% of the children registered by the selected health centers were defined as stunted (under the 3rd percentile of the corresponding sex-age NCHS/WHO growth reference). For boys, the height was relatively similar between the two groups until the age of 6 months at which the difference in height between normal and stunted children starts to become significantly large (difference = 0.70 cm, P = 0.04). For girls, height in the two groups is relatively similar until the age of 9 months at which the difference starts to become significantly large (difference = 0.97 cm, P = 0.01). No significant difference in the weight of the girls was observed between the normal and stunted groups during the study period (difference = 283.21 g, P > 0.05). However, boys from the stunted group were lighter since almost the same time that they started to become significantly shorter (difference = 1265.19 g, P = 0.001).

Conclusions: Soon after birth (at about the 6 months of age), the growth pattern of some (stunted) children starts to stumble and divert from normal. The sixth month of age is the age at which mothers start weaning with withdrawing breast milk and start supplementary foods and adult diet. A specially designed study is needed to understand the actual reason for observing such a phenomenon among Iranian children.
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http://dx.doi.org/10.1186/s12889-020-09511-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488575PMC
September 2020

The Comparison of A New Durable Coronaplasty Technique with Norfolk Method for Glans Reconstruction after Phalloplasty.

World J Plast Surg 2020 Jan;9(1):39-43

Department of Plastic and Reconstructive Surgery, St. Fatima Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Phalloplasty is the most amazing reconstructive surgery, and has a vital role in the quality of life of transsexual patients. There are several techniques for glans sculpting, but none of them had long-lasting results. In the present study, a new technique was introduced and compared with Norfolk technique for coronaplasty following phalloplasty.

Methods: In the present randomized controlled study, 40 transgender patients were enrolled from February 2016 to December 2018, at St. Fatima Plastic and Reconstructive Surgery Center. The patients were randomly assigned in two groups including 20 patients with anterolateral thigh flap (ALT)/radial forearm free flap (RFFF) phalloplasty followed with our new coronaplasty technique (group 1) and 20 patients with ALT flap/RFFF phalloplasty followed with Norfolk technique (group 2).

Results: Almost 85% of the patients underwent the surgery with the new technique were satisfied with the outcome of surgery and considered it acceptable within 6-month follow-up, however, only 70% of the patients in Norfolk technique group reported acceptable results, which was significantly lower than the new technique. Similarly, within 12-month follow-up, 80 and 40% of the patients, respectively in new and Norfolk groups reported acceptable results, which was also significantly higher in the new technique.

Conclusion: This new technique showed remarkably better results relative to the usual technique for glans sculpting in transsexual patients. Moreover, it had the ability to be easily applied along with ALT/RFFF flaps in both immediate and delayed situations.
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http://dx.doi.org/10.29252/wjps.9.1.39DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068192PMC
January 2020

A trivalent vaccine consisting of "flagellin A+B and pilin" protects against Pseudomonas aeruginosa infection in a murine burn model.

Microb Pathog 2020 Jan 26;138:103697. Epub 2019 Aug 26.

Burn Research Center, Hazrat Fatima Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Pseudomonas aeruginosa is a common nosocomial pathogen in burn patients, and rapidly achieves antibiotic resistance, and thus, developing an effective vaccine is critically important for combating P. aeruginosa infection. Flagella and pili play important roles in colonization of P. aeruginosa at the burn wound site and its subsequent dissemination to deeper tissue and organs. In the present study, we evaluated protective efficacy of a trivalent vaccine containing flagellins A and B (FlaA + FlaB) + pilin (PilA) in a murine burn model of infection. "FlaA + FlaB + PilA" induced greater protection in P. aeruginosa murine burn model than the single components alone, and it showed broad immune protection against P. aeruginosa strains. Immunization with "FlaA + FlaB + PilA" induced strong opsonophagocytic antibodies and resulted in reduced bacterial loads, systemic IL-12/IL-10 cytokine expression, and increased survival after challenge with three times lethal dose fifty (LD50) of P. eruginosa strains. Moreover, the protective efficacy of "FlaA + FlaB + PilA" vaccination was largely attributed to specific antibodies. Taken together, these data further confirm that the protective effects of "FlaA + FlaB + PilA" vaccine significantly enhance efficacy compared with antibodies against either mono or divalent antigen, and that the former broadens the coverage against P. eruginosa strains that express two of the three antigens.
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http://dx.doi.org/10.1016/j.micpath.2019.103697DOI Listing
January 2020

Comparing the effect of two types of silver nano-crystalline dressings (acticoat and agcoat) in the treatment of full thickness burn wound.

Iran J Microbiol 2018 Dec;10(6):378-384

Pediatrician, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background And Objectives: This study was conducted to compare the effect of acticoat and agcoat dressing (2 types of silver nano-crystalline dressings) in the treatment of burn wounds. Infection is one of the most important causes of death in patients with major burn. Despite using different prevention methods, including prophylaxis antibiotics with broad-spectrum antibiotics, no method has been found to prevent this dangerous complication for burn patients. Topical silver sulfadiazine is one of the best topical antibiotics in infection control of burn wounds, and other forms of AG dressings are also useful. Their advantages are slow releasing, further-half-life, less frequent dressing change, and less pain during replacement.

Materials And Methods: In this study, 30 patients with infected full thickness burn wound were selected. The patients' age range was 18-85 years, with the mean age of 39.7-17.27. Every patient's wound was divided into 2 parts randomly, one part was dressed with agcoat and the other with acticoat. Sampling of the 2 parts was done before dressing and after the third and seventh day of dressing.

Results: The positive outcome of the first day culturing before silver dressing was 80% and 76.7% for agcoat and acticoat, respectively. However, on the third day, it decreased to 30% and 33.3%, respectively. On the seventh day, it further decreased to 20% in both groups, and the percentage of bacterial growth reduction was not significant.

Conclusion: Based on the results of this study, silver agcoat dressing was as effective as acticoat dressing in preventing burn wound infection.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414747PMC
December 2018

A randomized, double-blind, phase I clinical trial of fetal cell-based skin substitutes on healing of donor sites in burn patients.

Burns 2019 06 14;45(4):914-922. Epub 2018 Dec 14.

Burn Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Due to limited graft donor sites in extensive burns, re-harvesting of a single donor area is very common. Given the importance of fetal fibroblasts in accelerating fetal wound healing, fetal cell-based skin substitutes have emerged as a novel therapeutic modality for regenerating damaged skin. In this trial, we aimed to evaluate the safety, feasibility and potential efficacy of application of amniotic membranes seeded with fetal fibroblasts for accelerating donor sites healing in burn patients.

Methods: In this randomized, double-blind, phase I clinical trial, 10 patients with total burn surface area of 10-55% were enrolled. Three equal parts (10×10cm) were selected in donor site of each patient and covered by Vaseline gauze (control group), amniotic membrane (AM group), or amniotic membrane seeded with fetal fibroblasts (AM-F group). Adverse events, pain intensity scores, and wound sizes were recorded on days 4, 8, 11, 14, and 20 post-treatment. Also, histological assessments were done on days 0 and 14 after the surgery.

Results: All patients underwent surgery, and no adverse events occurred during the procedure and follow-up period. Significantly lower pain intensity and higher healing rates were observed in AM-F and AM groups compared to the control group. Moreover, mean complete re-epithelializatin in AM-F and AM groups were 10.1±2.4 and 11.3±2.9 days, showing that the healing process was significantly accelerated compared to the control group with mean closure time of 14.8±1.6 days. Histological assessment showed lower inflammatory cells infiltration in AM-F and AM groups compared to control group.

Conclusions: This study indicated the safety of transplantation of amniotic membrane seeded with fetal fibroblasts for treatment of donor sites in burn patients; however, preliminary assessments showed no benefits for this therapeutic modality over amniotic membrane alone. Thus, to draw accurate conclusions, further trials in larger populations should be conducted.

Level Of Evidence: This study is assigned as level I.
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http://dx.doi.org/10.1016/j.burns.2018.10.016DOI Listing
June 2019

Stunting and its associated factors among 6-7-year-old children in southern Iran: a nested case-control study.

Public Health Nutr 2018 Oct 15:1-8. Epub 2018 Oct 15.

4Center for Health Related Social and Behavioral Sciences Research,Shahroud University of Medical Sciences,Shahroud,Islamic Republic of Iran.

Objective: Height-for-age shorter than 3th percentile or 2 sd below the median of the National Center for Health Statistics/WHO growth reference is known as stunting. The present study aimed to measure the association of several factors with stunting in a cohort born from 2009 to 2010 in Shiraz, Iran.Design/Setting/SubjectsNested case-control study conducted on pre-school children in 2016. Participants were 200 children suffering from stunting (case group) and 200 children with normal height (control group).

Results: Results of multivariable logistic regression analysis suggested a significant relationship (adjusted OR; 95 % CI) between stunting and mother's occupation (employed v. housewife: 3·58; 1·73, 7·39) and chronic diseases (yes v. no: 2·93; 1·25, 6·88). In addition, significant associations were found between family income (30 million Rials: 5·63; 2·46, 12·87), diary consumption (very little v. high: 5·93; 1·74, 20·18) and animal protein in diet (low v. very high: 2·42; 1·13, 5·19) and stunting among children. Also, chance of stunting was inversely associated with birth interval (<2 years v. first child: 3·13; 1·45, 6·76) and duration of exclusive breast-feeding (18-24 months v. formula only or breast-feeding for <18 months: 0·53; 0·30, 0·92).

Conclusions: Mothers being housewife, possibly due to having more time to take care of their children, childhood diseases and consumption of dairy foods are strong and modifiable factors which can positively affect Iranian children's stature. Higher family income is another important factor in stunting but under less parental control.
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http://dx.doi.org/10.1017/S136898001800263XDOI Listing
October 2018

Healing Effects of Dried and Acellular Human Amniotic Membrane and Mepitelas for Coverage of Skin Graft Donor Areas; A Randomized Clinical Trial.

Bull Emerg Trauma 2018 Jul;6(3):195-200

Hazrat Fatima Hospital, Iran University of Medical Sciences, Tehran, Iran.

Objective: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS).

Methods: Twenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled clinical trial conducted in Hazrate Fatemeh hospital (Iran). Patients were randomly assigned in 3 groups of wound dressing; group A by Mepitel, group B AmiCare (Dried amniotic membrane) and group C OcuReg-A (Acellular amniotic membrane). Re-epithelization rate (healing time), pain sensation, scar formation and infection rate were assessed till complete healing was achieved.

Results: Our results showed no significant difference between Amicare, OcuReg-A and Mepitel in the features analyzed by us including: Re-epithelization rate (healing time) value; 0.573, Pain sensation P value: day 4 th: 0.131, day8 th: 0.93 and day 12 th: 0.365, Scar formation value>0.05and Infection rate.

Conclusion: Our findings confirmed the safety and efficacy of AmiCare (dried amniotic membrane) and OcuReg-A (Acellular amniotic membrane) in treatment of split-thickness donor site in comparison with Mepitel as a standard wound dressing. Trial registration number: IRCT201511118177N12.
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http://dx.doi.org/10.29252/beat-060302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078477PMC
July 2018

Immunization with Bivalent Flagellin Protects Mice against Fatal Pneumonia.

J Immunol Res 2017 19;2017:5689709. Epub 2017 Oct 19.

Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

lung infections present a major challenge to healthcare systems worldwide because they are commonly associated with high morbidity and mortality. Here, we demonstrate the protective efficacy of type a and b flagellins (bivalent flagellin) against acute fatal pneumonia in mice. Mice immunized intranasally with a bivalent flagellin vaccine were challenged by different flagellated strains of in an acute pneumonia model. Besides the protective effect of the vaccine, we further measured the host innate and cellular immunity responses. The immunized mice in our study were protected against both strains. Remarkably, active immunization with type a or b flagellin significantly improved survival of mice against heterologous strain compared to flagellin a or b antisera. We also showed that after an intranasal challenge by strain, neutrophils are recruited to the airways of vaccinated mice, and that the bivalent flagellin vaccine was proved to be protective by the generated CD4IL-17 Th17 cells. In conclusion, bivalent flagellin vaccine can confer protection against different strains of in an acute pneumonia mouse model by eliciting effective cellular and humoral immune responses, including increased IL-17 production and improved opsonophagocytic killing.
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http://dx.doi.org/10.1155/2017/5689709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671732PMC
July 2018

Protective Effect of Ginger (Zingiber officinale Roscoe) Extract against Oxidative Stress and Mitochondrial Apoptosis Induced by Interleukin-1β in Cultured Chondrocytes.

Cells Tissues Organs 2017 7;204(5-6):241-250. Epub 2017 Sep 7.

RAZI Drug Research Center, Iran University of Medical Sciences, Tehran, Iran.

Aims: The protective effects of ginger (Zingiber officinale Roscoe) extract on IL-1β-mediated oxidative stress and mitochondrial apoptosis were investigated in C28I2 human chondrocytes.

Methods: The effects of various concentrations of ginger extract on C28I2 human chondrocyte viability were evaluated in order to obtain noncytotoxic concentrations of the drug by methylthiotetrazole assay. The cells were pretreated with 5 and 25 μg/mL ginger extract for 24 h, followed by incubation with IL-1β (10 ng/mL) for 24 h. The effects of ginger extract on IL-1β-induced intracellular reactive oxygen species (ROS) production and lipid peroxidation were examined. The mRNA expressions of antioxidant enzymes including catalase, superoxide dismutase-1, glutathione peroxidase-1, glutathione peroxidase-3, and glutathione peroxidase-4 were evaluated by reverse transcription polymerase chain reaction. The protein expressions of Bax, Bcl-2, and caspase-3 were analyzed by Western blotting.

Results: No cytotoxicity was observed at any concentration of ginger extract in C28I2 cells. Ginger extract pretreatment remarkably increased the gene expression of antioxidant enzymes and reduced the IL-1β-induced elevation of ROS, lipid peroxidation, the Bax/Bcl-2 ratio, and caspase-3 activity.

Conclusions: Ginger extract could considerably reduce IL-1β-induced oxidative stress and consequent mitochondrial apoptosis as the major mechanisms of chondrocyte cell death. These beneficial effects of ginger extract may be due to its antioxidant properties. It may be considered as a natural herbal product to prevent OA-induced cartilage destruction in the clinical setting.
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http://dx.doi.org/10.1159/000479789DOI Listing
July 2018

Body Image Coping Strategies among Aesthetic Surgery Patients in Iran.

World J Plast Surg 2017 May;6(2):159-163

Department of Plastic and Reconstructive Surgery, Burn Research Center, St. Fatima Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Aesthetic surgery procedures have been performed at dramatically increased rates in recent years in Iran. Few researches exist documenting the usage of body image coping strategies and its relationship in seeking surgery.

Methods: The present research examined data from 90 aesthetic surgery participants (30 Subjects each in invasive, minimally-invasive, and control groups). Assessed subjects on body image coping strategies inventory (avoidance, appearance fixing and positive rational acceptance) provided dysfunctional usage of its variables among Iranian clients.

Results: Between the three groups, on variables of body image coping strategies, there was a significant difference. There was a significant difference on avoidance variable in three groups. On positive rational acceptance variable, there was a significant difference for invasive group with minimally-invasive and control groups. No significant difference was found on appearance fixing variable.

Conclusion: The study emphasizes on the role of psychological problems of aesthetic surgery clients that surgeons should be aware of them, which could inhibit the positive effects of aesthetic surgery. These results have implications for pre-surgical assessment along with psychological interventions at first step rather than invasive medical interventions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506349PMC
May 2017

Prevention of Peritendinous Adhesion Formation After the Flexor Tendon Surgery in Rabbits: A Comparative Study Between Use of Local Interferon-α, Interferon-β, and 5-Fluorouracil.

Ann Plast Surg 2018 Feb;80(2):171-175

Background: Peritendinous adhesion is the most common complication after tendon surgery, particularly in zone II of the hand. Prevention of inflammation around the tendon, which develops after trauma and surgery, can decrease the tendon adhesion formation. This study compares the effect of some anti-inflammatory cytokines with 5-fluorouracil (5-FU) on the tensile strength and in prevention of peritendinous adhesion formation.

Methods: Sixteen rabbits were allocated equally into 4 groups. Tendons of the index and ring fingers in zone II of the right hind paw were cut in all animals and then repaired. Interferon (IFN)-α in group 1, 5-FU in group 2, normal saline in group 3, and IFN-β in group 4 were locally applied to the repaired sites. Three weeks later, tensometric and histopathologic evaluations were performed.

Results: The force required for removing the tendon from the sheath was not different between the groups (P = 0.130), but the time required for removal was significantly shorter in 5-FU group (P = 0.049). The strength of repair was not different between the groups in terms of force and time needed for rupture (P = 0.11 and 0.67, respectively). In histopathologic examination, normal architecture of the tendon and peritendon environment was less disturbed in the IFN groups, especially in IFN-β specimens.

Conclusions: Local application of 5-FU significantly reduced peritendinous adhesion. Local IFN-α and IFN-β had no significant effect on the prevention of peritendinous adhesion formation. The strength of the repair was not affected by these cytokines and 5-FU.
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http://dx.doi.org/10.1097/SAP.0000000000001169DOI Listing
February 2018

Effect of Basic Fibroblast Growth Factor on Achilles Tendon Healing in Rabbit.

World J Plast Surg 2017 Jan;6(1):26-32

Department of Plastic Surgery, Burn Research Center, Hazrate Fatemeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Tendon injuries are common and it takes a long time for an injured tendon to heal. Adverse phenomena such as adhesion and rupture are associated with these injuries. Finding a method to reduce the time required for healing which improves the final outcome, will lead to decreased frequency and intensity of adverse consequences. This study was designed to investigate the effects of basic fibroblast growth factor on the healing of the Achilles tendon in rabbits.

Methods: In 10 New Zealand white rabbits, Achilles tendon was cut at the intersection of the distal and middle thirds on both hind legs. One microgram of recombinant basic fibroblast growth factor (bFGF) was injected in the proximal and distal stumps of the cut tendon on the right side (study group). Normal saline of equal volume was injected on the left side in the same way (control group). Then the tendons were repaired with 5/0 nylon using modified Kessler technique. A cast was made to immobilize each leg. On day 42, rabbits were euthanized and both hind legs were amputated. Tensometry and histopathologic examination were done on specimens.

Results: In tensometric studies, more force was required to rupture the repair site in study group. In histopathologic examination, collagen fibers had significantly better orientation and organization in the study group. No difference was noted regarding number of fibroblast and fibrocytes, and degree of angiogenesis in the two groups.

Conclusion: Application of basic fibroblast growth factor at tendon repair site improves the healing process through improvement of collagen fiber orientation and increase in biomechanical resistance.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339606PMC
January 2017

Effects of early versus delayed excision and grafting on the return of the burned hand function.

J Res Med Sci 2016 7;21:109. Epub 2016 Nov 7.

Department of Occupational Therapy, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Despite a general consensus regarding the impacts of early excision and grafting (EE and G) of burned hand on the reducing of treatment cost and hospital stay, there are some controversial issues about its effect on the outcome of hand function. This study conducted to compare the results of the EE and G and delayed skin grafting in deep hand burns regarding the hand functional outcome.

Materials And Methods: This study was conducted from April 2012 to November 2013 in sixty patients with deep thermal burns of the dorsal hand with total body surface area (TBSA) <20% who were admitted to special burn hospital. After standard primary burn care and resuscitation, necessary procedures (EE and G or more conservative treatment) were performed based on the patients' conditions. The patients were placed into early excision (No. =30) and delayed excision group (No. =30). Total active motion (TAM) of fingers, grip strength of the hand and the assessment of disabilities of the arm, shoulder and hand questionnaire, were measured in all patients 6 months after grafting.

Results: The average percentage of TBSA in the EE and G group was more than the delayed excision group (17.34% ±5.12% vs. 15.64% ±5.83%), this difference was not significant ( = 0.23). After 6 months, the average of the TAM and grip strength in the EE and G group was significantly more than that of the delayed group ( < 0.0001 and = 0.019).

Conclusion: The present study showed that EE and G with proper physical therapy and rehabilitation management provides a higher functional outcome in dorsal deep burned hand.
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http://dx.doi.org/10.4103/1735-1995.193501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322686PMC
November 2016

Protective effect of pilin protein with alum+naloxone adjuvant against acute pulmonary Pseudomonas aeruginosa infection.

Biologicals 2016 Sep 11;44(5):367-73. Epub 2016 Jul 11.

Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Pseudomonas aeruginosa is an important opportunistic human pathogen that causes a wide variety of severe nosocomial infections. Type IV pili of P. aeruginosa are made up of polymerized pilin that aids in bacterial adhesion, biofilm formation and twitching motility. The aim of this study was to evaluate the efficacy of alum and naloxone (alum+NLX) as an adjuvant for P. aeruginosa recombinant PilA (r-PilA) as a vaccine candidate in the improvement of humoral and cellular immunity. Primary immunization with r-PilA in combination with alum+NLX followed by two booster shots was sufficient to generate robust cellular and humoral responses, which were Th1 and Th2 type responses consisting of IgG1 and IgG2a subtypes. Analysis of the cytokine response among immunized mice showed an increased production of IL-4, INF-γ and IL-17 by splenocytes upon stimulation by r-PilA. These sera were also able to reduce bacterial load in the lung tissue of challenged mice. The reduction of systemic bacterial spread resulted in increased survival rates in challenged immunized mice. In conclusion, immunization with r-PilA combined with alum+NLX evokes cellular and humoral immune responses, which play an important role in providing protection against acute P. aeruginosa lung infection among immunized mice.
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http://dx.doi.org/10.1016/j.biologicals.2016.06.009DOI Listing
September 2016

Flagellin and pilin immunization against multi-drug resistant Pseudomonas aeruginosa protects mice in the burn wound sepsis model.

Immunol Lett 2016 08 17;176:8-17. Epub 2016 May 17.

Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Burn Research Center, Motahari Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Pseudomonas aeruginosa is a formidable pathogen and a major threat to burn patients. Antimicrobial therapy is often unsuccessful because P. aeruginosa can develop multi-drug resistance; thus, immunotherapy and vaccine can be a rational alternative. Flagella and type IV pili have been identified as important virulence factors in the colonization and pathogenesis of P. aeruginosa in burn wound infections. Immunogenicity and efficacy of mixed recombinant full-length type b flagellin (r-b-flagellin) and recombinant PilA (r-PilA) as candidate vaccines were assessed by measuring humoral and cellular responses, using an experimental burned mouse model. Primary immunization with "r-b-flagellin+r-PilA" followed by two booster shots was sufficient to generate a robust humoral response, which was predominantly a Th2 response consisting mainly of subtype IgG1 and low levels of IgG2a. Analysis of the cytokine response among immunized mice showed an increased production of IL-4, INF-γ and IL-17 by splenocytes upon stimulation by "r-b-flagellin+r-PilA". Opsonophagocytosis assays confirmed the enhanced killing of bacteria by anti "r-b-flagellin+r-PilA" immune sera. These antibodies were also able to reduce bacterial load in the site of original infection into the liver and spleen of challenged mice. The reduction of systemic bacterial spread resulted in an increased survival rate of challenged immunized mice. In conclusion, immunization with "r-b-flagellin+r-PilA" proteins provides a better protective response against P. aeruginosa infection in the burn mouse model.
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http://dx.doi.org/10.1016/j.imlet.2016.04.002DOI Listing
August 2016

Immunogenicity of Pseudomonas aeruginosa recombinant b-type fagellin as a vaccine candidate: Protective efficacy in a murine burn wound sepsis model.

Burns 2016 May 2. Epub 2016 May 2.

Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Pseudomonas aeruginosa (PA) is a formidable opportunistic pathogen among patients with burn wound infections. Antimicrobial therapy is often unsuccessful because PA can develop multi-drug resistance; thus, immunotherapy can be a rational alternative. The goal of this study was to evaluate the immunogenicity recombinant type b flagellin (r-b-flagellin) as a potential vaccine against P. aeruginosa in a mouse model for burn wound sepsis. Primary immunization with r-b-flagellin (10μg) followed by two booster shots was sufficient to generate a robust humoral response, which was predominantly a T helper 2 (Th2) type response consisting mainly of subtype IgG1 and low levels of IgG2a. Analysis of the Th1-Th2 response among immunized mice showed an increased production of IL-4, INF-γ and IL-17 by splenocytes upon stimulation by r-b-flagellin. Opsono-phagocytosis assays confirmed the enhanced killing of bacteria by anti r-b-flagellin immune sera. These antibodies were also able to inhibit motility of P. aeruginosa and afforded protection to immunized mice by reducing bacterial load in the site of original infection into the liver of challenged mice. The reduction of systemic bacterial spread resulted in an increase in the survival rate of challenged immunized mice. In conclusion, immunization of mice with r-b-flagellin protein increased the level of humoral and cellular immune response and led to an efficacious protection against P. aeruginosa infection in the burn mouse model.
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http://dx.doi.org/10.1016/j.burns.2016.03.015DOI Listing
May 2016

Electromyographic studies regarding denervation potentials in skeletal muscles at sites near and distant from the burn in rats.

Neurol Res 2016 Apr 28;38(4):349-51. Epub 2016 Apr 28.

a Burn Research Center , Iran University of Medical Sciences , Tehran , Iran, Republic of Islamic.

Changes in membrane AChRs in skeletal muscles located near or distant from burn injury similar to denervated muscles may make electrodiagnostic features indistinguishable from true neuropathic changes. The aim of this study was to examine electrodiagnostic changes of muscles at sites local and distant from the burn after thermal injuries due to neuromuscular junction dysfunction. A total of 40 adult male rats were randomly allocated to four groups. Rats in group 1 received thermal burn injury over gastrocnemius muscle of one leg and sham burn on the other leg. A 20-25% and 30-35% surface body area burn and also 30-35% surface body area sham burn were produced at distant site from gastrocnemius muscle in group 2, 3 and 4, respectively. To explore any fibrillation potential, the rats underwent serial electromyographic studies of bilateral gastrocnemius muscles over 5 weeks after burn injury. There were no denervation potentials either in muscles at sites distant from 20-25% and 30-35% of total body surface area burns or in muscles beneath the burn. In the present study on rats, thermal burn injury could not make fibrillation potentials in the electrodiagnostic study of muscles located near and distant from the burn site.
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http://dx.doi.org/10.1080/01616412.2015.1105583DOI Listing
April 2016

Tubular Duplication of the Sigmoid Colon with Acute Abdomen: An Adult Case Report.

Indian J Surg 2015 Dec 28;77(Suppl 3):1005-7. Epub 2014 May 28.

Department of Rheumatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Colonic duplication is a rare abnormality, comprising only 6-7 % of all gastrointestinal duplications and usually present during the first decade of life. Tubular duplications of the sigmoid colon are extremely rare and only a few cases have been reported in the literature. In this study, we report the case of a 27-year-old rural man visited our hospital with symptom of repeated episodes of abdominal pain in epigastric region that radiated to right flank and back. An abdominal computed tomography (CT) scan with oral and intravenous contrast revealed an extremely dilated and air-filled loop related to sigmoid colon. An exploratory laparotomy was performed and tubular sigmoid colon duplication was found intraoperatively. The postoperative period was uneventful.
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http://dx.doi.org/10.1007/s12262-014-1110-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775681PMC
December 2015

Blood pressure alterations in burn patients with septic shock under hydro-cortisone treatment.

Iran J Microbiol 2015 Dec;7(6):315-8

Burn Research Center, Iran University Of Medical Sciences, Tehran, Iran.

Background And Objectives: Hydrocortisone is widely used in septic shock cases resistant to fluid and vasopressor therapy. It may result in increased blood pressure and survival. However the efficacy is no established among patients with severe burn and septic shock. Accordingly it was assessed in this study.

Materials And Methods: The patients older than 14 years of age with resistant septic shock were enrolled during one-year period. The hydrocortisone was prescribed 100 mg three times per day and the alterations in systolic and diastolic blood pressures were recorded.

Results: Twenty-nine patients were enrolled including 19 men and 10 women. The mean age was 37 ± 19 years and the mean burn surface area was 60 ± 20. Fourteen patients had positive blood culture. The most common isolated microorganism were Pseudomonas aeuroginosa in 34.6%(10 cases), and then Acinetobacter in 13.8%(4 cases). The infection was from wound in 79% and the remaining 21% had pneumonia. Twenty-one patients had good response to hydrocortisone and the increase in systolic and diastolic blood pressures was significant; but the mortality rate was similar.

Conclusion: Treatment with hydrocortisone would result in increase in systolic and diastolic blood pressure in burn patients with resistant septic shock.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752685PMC
December 2015

Effect of Heparin on Post-Operative Adhesion in Flexor Tendon Surgery of the Hand.

J Hand Microsurg 2015 Dec 26;7(2):244-9. Epub 2015 Aug 26.

Hazrat Fateme Hospital and Burn Research Center, Iran University of Medical Science, Tehran, Iran ; Shahid Motahari Burn Hospital, Iran University of medical sciences (IUMS), Vali-asr Ave., Yasami St., Tehran, 1996714353 Iran.

Flexor tendon laceration is a common hand injury. Timely and correct diagnosis of this defect is an important factor for restoring hand function. Post-operative adhesion is a frequent problem after tendon repair and its prevention is difficult in some types of tendon lacerations. There have been some controversial studies on the positive effect of some materials and substances on prevention of these adhesions. This study aims to evaluate effects of the Heparin in postoperative tendon adhesions. In this clinical trial, 100 patients with laceration of flexor tendons in zone II of the hand were enrolled. The patients were randomly divided into two groups. In the first group, 0.5 cc Heparin (5000 IU/cc) was injected into each tendon ends before tendon repair. In the control group, repair was carried out without any heparin injection. After 3 months the total active range of motion (TAROM), mean extension gap (MEG) and mean flexion gap (MFG) were measured and compared between these two groups. The TAROM and MEGs were not significantly different between two groups; but MFGs were significantly better in Heparin treated group (P < 0.02). However rupture rate was significantly higher in heparin treated group (P = 0.003). Heparin may improve the tendons function and reduce the postoperative adhesions in zone II of the hand; however there is a significant risk of tendon rupture.
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http://dx.doi.org/10.1007/s12593-015-0192-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642480PMC
December 2015

Epidemiological Study of Child Casualties of Landmines and Unexploded Ordnances: A National Study from Iran.

Prehosp Disaster Med 2015 Oct 16;30(5):472-7. Epub 2015 Sep 16.

1Janbazan Medical and Engineering Research Center (JMERC),Tehran,Iran.

Background: Despite landmine-risk education programs and extensive demining activities on the Western border of Iran, landmines and unexploded ordnance (UXOs) still cause civilian and child casualties three decades after the Iraq-Iran war (1980-1988). The objective of this study was to understand the epidemiological patterns and risk factors of injury in child casualties of landmines and UXOs in Western and Southwestern Iran.

Methods: Children who were 18 years old or younger at the time of study and who sustained injuries from landmines and UXOs were identified through a search at the Iranian National Veterans Registry. These children participated in a 5-day gathering. The information on socioeconomic status, health-related issues, quality of life, health care utilization, and clinical profiles concerning the landmine and UXO injuries were collected. The method of data collection consisted of three component surveys: health interview, social survey, and medical examinations. Social surveys and health interviews were conducted in a face-to-face method by utilizing a questionnaire consisting of 39 questions addressing household and individual components, including information on time and type of injuries, physical activity, mental health, and quality of life. A comprehensive team of physicians in different subspecialties evaluated and examined children to assess the current medical and psychiatric conditions and physical activity, and recommended and arranged further medical, rehabilitation, or surgical planning.

Results: Seventy-eight child casualties were identified and participated in the study. The mean age of the participants at the time of study was 16.11 years old (SD=2 years). The mean age of victims at the time of injury was 8.2 years (SD=3.12 years; ranged from 2 to 15 years old). Sixty-seven (85.9%) of the children were male. Provinces of Kurdistan and Kermanshah had the highest number of casualties, with a total number of 54 children (68.3%). Eighty percent of the injuries were caused by landmines, and UXO explosions were reported in 20% of the cases. Overall, 24 children (30%) had received some landmine-risk education before or after the events. Sixty percent of the explosions had happened in the morning between 9:00 am and 12:00 pm. Playing and grazing livestock were the most prevalent activities/reasons at the time of injury, which were reported in 77% of the subjects. Sixty-three percent of incidents had multiple casualties and in only 13 explosions were the children the only victims of the explosion. The most prevalent injuries were amputations in 41 subjects (52.56%), followed by hearing loss in 23 subjects (29.5%). Amputations were more common in upper extremities (62%) than in lower extremities (38%).

Conclusion: Landmines and UXOs comprise a significant safety hazard to the children living in the Western border of Iran decades after the Iraq-Iran War. The large number of injuries and lack of risk training among victims suggest that landmine cleanings and landmine-risk education should be age-specifically targeted and expanded substantially.
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http://dx.doi.org/10.1017/S1049023X15005105DOI Listing
October 2015

The healing effect of nettle extract on second degree burn wounds.

World J Plast Surg 2015 Jan;4(1):23-8

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

Background: Numerous studies were carried out to develop more sophisticated dressings to expedite healing processes and diminish the bacterial burden in burn wounds. This study assessed the healing effect of nettle extract on second degree burns wound in rats in comparison with silver sulfadiazine and vaseline.

Methods: Forty rats were randomly assigned to four equal groups. A deep second-degree burn was created on the back of each rat using a standard burning procedure. The burns were dressed daily with nettle extract in group 1, silver sulfadiazine in group 2, vaseline in group 3 and without any medication in group 4 as control group. The response to treatment was assessed by digital photography during the treatment until day 42. Histological scoring was undertaken for scar tissue samples on days 10 and 42.

Results: A statistically significant difference was observed in group 1 compared with other groups regarding 4 scoring parameters after 10 days. A statistically significant difference was seen for fibrosis parameter after 42 days. In terms of difference of wound surface area, maximal healing was noticed at the same time in nettle group and minimal repair in the control group.

Conclusion: Our findings showed maximal rate of healing in the nettle group. So it may be a suitable substitute for silver sulfadiazine and vaseline when available.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298861PMC
January 2015

Effect of green tea on the second degree burn wounds in rats.

Indian J Plast Surg 2014 Sep-Dec;47(3):370-4

Departments of Plastic and Reconstructive Surgery, Hazrat Fateme Hospital and Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Various studies indicate that the green tea has anti-inflammatory and anti-oxidative properties. Moreover, a few studies have been carried out that demonstrate beneficial effects of green tea on burned patients.

Materials And Methods: In this study, green tea, Vaseline, and silver sulfadiazine dressings were used as first-aid treatment to deep dermal contact burns in rats, compared with a control of nothing. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in four groups. Wound dressing changes were daily. Macroscopic study was performed on days 1, 3, 7, and 14 by using a digital camera and software processing of photos. Microscopic examination was done by pathologic evaluation of skin specimens on day 14.

Results: We observed that green tea usage significantly decreased burn size in comparison to the control group (P = 0.004).

Conclusion: Green tea is effective on healing process of second degree burn wounds.
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http://dx.doi.org/10.4103/0970-0358.146593DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292114PMC
January 2015

Effects of recombinant human erythropoietin on revascularization of full thickness skin grafts in rat.

Iran Red Crescent Med J 2014 May 5;16(5):e8867. Epub 2014 May 5.

Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Background: Autologous skin graft is frequently used in the field of plastic, and reconstructive surgery. The engraftment is dependent upon revascularization and angiogenesis, which can be regulated by different factors. In addition to its hematopoietic effects, erythropoietin is shown to positively affect the wound healing process.

Objectives: We studied effects of human erythropoietin on revascularization of full thickness skin grafts in rat.

Materials And Methods: Forty adult Albino male rats were selected for this study. Full thickness skin graft was performed for them, and the effects of systemic, and localized administration of erythropoietin on vascularization of the graft area were evaluated in four groups as following: inverse group underwent full thickness skin graft; in normal saline group normal saline was injected under the fascia of grafted area for seven days; systemic EPO group received systemic erythropoietin for seven days after the surgery; and in graft EPO group, erythropoietin was injected under the fascia of grafted area after full thickness skin grafting for seven days.

Results: Forty adult Albino male rats (n = 40), with weights ranging from 356 to 469 g (mean 391.5 ± 29.6 g) were included. The vascular densities of central margins were significantly different between inverse group and graft EPO groups (P value = 0.01), and vascular density of central margins of normal saline group and graft EPO groups were significantly different too (P value = 0.04).

Conclusions: EPO can stimulate angiogenesis which has an important role in wound healing. So, local administration of EPO seems to be beneficial in engraftment.
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http://dx.doi.org/10.5812/ircmj.8867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4082527PMC
May 2014

The effect of levamisole on mortality rate among patients with severe burn injuries.

J Res Med Sci 2013 Sep;18(9):795-800

Psychologist, Shahid Lavasani Hospital, Social Security Organization, Tehran, Iran.

Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection.

Materials And Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated.

Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8).

Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872590PMC
September 2013

Electrical injury in construction workers: a special focus on injury with electrical power.

Burns 2014 Mar 29;40(2):300-4. Epub 2013 Jun 29.

Department of General Surgery, Motahari Burn Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Electrical injury in construction workers due to contact with overhead power lines accounts for an important cause of admission at the emergency department. Due to lack of specific treatment options for this type of injury, prevention remains the mainstay of management.

Aims: Our study aimed to demonstrate the characteristics of electrical injury in construction workers among one of the largest Iranian population at a burn care hospital.

Methods: Through a retrospective review of hospital data base, patients with electrical injuries admitted to Motahari hospital in Tehran, Iran between March 2011 and June 2012 were included for analysis. Patients were divided into construction workers and other patients. Primary characteristics and final outcomes were then compared between the 2 study groups.

Results: Of 202 patients included in this study, 105 patients (52%) were construction workers and 97 patients (48%) constituted the remainder. There was significant difference between the 2 groups in terms of mean age, gender, and average burn size. In contrast, mean duration of hospitalization and mortality rate did not differ significantly between the 2 study groups (p>0.05). Contacts with over head power-lines accounted for the most common mechanism of injury. There was significant difference between the 2 groups in terms of place of injury and electrical current power. However, total cost of treatment did not differ significantly between the 2 groups (p>0.05). Frequency of severe complications was higher in construction workers and this group underwent more invasive procedures such as limb amputation and fasciotomy.

Conclusion: The most common mechanism of electrical injuries in construction workers is due to contact with over head high voltage power-lines at workplace. This type of electrical injury is associated with higher use of fasciotomy, flap and limb amputation.
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http://dx.doi.org/10.1016/j.burns.2013.05.019DOI Listing
March 2014

Severity of symptoms of depression among burned patients one week after injury, using Beck Depression Inventory-II (BDI-II).

Burns 2013 Mar 5;39(2):285-90. Epub 2012 Aug 5.

Motahhari Hospital, Tehran University Of Medical Sciences, Tehran, Iran.

Background: This study was done to determine the severity of symptoms of depression in burned patients and to assess the effect of burn related factors on depression.

Materials And Methods: This is a descriptive cross-sectional survey, performed in Burn center, Motahhari hospital, Tehran University of Medical Sciences, Iran. The population of the study included 300 hospitalized patients from April 2010 to May 2011 who were assessed for symptoms of depression one week after burn injury by Beck Depression Inventory-II.

Results: Three hundred subjects (50% female and 50% male) participated in the study. Age ranged from 13 to 75 with the mean of 35.06±12.79 years. 184 (61.3%) had symptoms of depression, 58 (19.3%) of them mild, 52 (17.3%) moderate and 74 (24.7%) severe depression symptoms. There was a significant relationship between symptoms of depression and age, gender, educational level, TBSA%, number of burn sites and amputation (p value<0.05).

Conclusion: The high prevalence of symptoms of depression in burned patients suggests that depression should be screened in such patients and treat if indicated.
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http://dx.doi.org/10.1016/j.burns.2012.07.012DOI Listing
March 2013

First case of disseminated phaeohyphomycosis in an immunocompetent individual due to Alternaria malorum.

Med Mycol 2013 Feb 8;51(2):196-202. Epub 2012 Aug 8.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

A 27-year-old Iranian, previously healthy male presented with sub-cutaneous necrotic lesions with a localized dermatosis affecting the anterior chest, neck and face. These lesions consisted of singular, well-defined verrucous plaques which gradually developed and disseminated over time. The dermatosis was followed by the development of necrotic swollen lesions localized on the hard palate. The patient did not recall any history of trauma or puncture at any of the sites of infection. While histopathological examination of periodic acid-Schiff (PAS) stained material revealed irregular, unbranched, septate hyphae, direct examination (KOH 10%) of lesion samples demonstrated the presence of septate indistinct brownish hyphae. Alternaria malorum was isolated (CBS 126589) and its identity was confirmed by sequencing of the internal transcribed spacer (ITS rDNA). Since the palate lesion reoccurred after 10 years and the patient's condition did not improve with amphotericin B combination therapy, the lesion was surgical excised and he underwent antifungal therapy with amphotericin B and itraconazole. There was no dehiscence or fistula formation or any evidence of relapse of fungal infection during a one year follow-up and the patient was successfully cured. In vitro antifungal susceptibility tests revealed that the MIC values for those antifungals employed in this case were amphotericin B (0.125 μg/ml), fluconazole (32 μg/ml), itraconazole (0.125 μg/ml), voriconazole (1 μg/ml), and posaconazole (0.063 μg/ml). The MECs for caspofungin and anidulafungin were 0.25 μg/ml and 0.016 μg/ml, respectively. However, treatment of A. malorum infections with the latter agents remains to be evaluated.
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http://dx.doi.org/10.3109/13693786.2012.707338DOI Listing
February 2013