Efficacy and safety of Nd:YAG laser alone compared with combined Nd:YAG laser with intralesional steroid or botulinum toxin A in the treatment of hypertrophic scars.

The aim of this study is to evaluate the efficacy and safety of Nd:YAG laser alone or in combination with intralesional injection of botulinum toxin type A or intralesional injection of steroid in treatment of hypertrophic scars. This study included 45 patients with hypertrophic scars who were randomly divided into three equal groups. All participants received 4 sessions of Nd:YAG laser at 4-week intervals. Immediately after the laser treatment, patients in group II were assigned to intralesional triamcinolone acetonide, and those in group III were assigned to intralesional botulinum toxin type A. All patients were followed up monthly for 3 months after the last session for any recurrence, or side effects. Clinical evaluation of the cases was done by Vancouver Scar Scale. Hypertrophic scars in the three groups showed a significant improvement (p < 0.001) compared with before treatment in all variables (except for pigmentation) and also a significant improvement in pruritus, pain, and patient relief. The highest percentage of improvements was seen in patients treated with Nd:YAG laser combined with intralesional steroid in all variables according to Vancouver Scar Scale. The degree of improvement was negatively correlated with the patients' age. The three treatment modalities were effective, safe with minimal side effects. Nd:YAG laser followed by intralesional injection of Triamcinolone acetonide had the highest percentage of Vancouver Scar Scale reduction. Combination therapy of Nd:YAG laser with intralesional injection of either Triamcinolone acetonide or Botox revealed better results than using Nd:YAG as a single therapeutic modality for HTS.

Buffalo Yogurt Fortified with Eucalyptus (Eucalyptus camaldulensis) and Myrrh (Commiphora Myrrha) Essential Oils: New Insights into the Functional Properties and Extended Shelf Life.

Eucalyptus (Eucalyptus camaldulensis) and Myrrh (Commiphora Myrrha) essential oils (EOs) stand out for their benefits in terms of health and functionality. Buffalo set yogurt enriched with different concentrations of EOs (0.3, 0.6, and 0.9%) were investigated. The effects of addition on sensory, syneresis, antibacterial activity, and bioactive properties (total phenol content and antioxidant activity) of yogurt were studied. The most acceptable organoleptic properties of treated yogurt were those samples treated with Eucalyptus oil. The levels of syneresis were decreased by increasing the concentration of EOs. Moreover, the antioxidant activity, antibacterial activity, and total phenolic content were enhanced by increasing the concentration of EOs. Yogurt with 0.9% Eucalyptus oil showed the highest antioxidant activity and total phenolic content. The same concentration of Eucalyptus oil showed the highest antibacterial activity against S. typhimurium (the inhibition zone was 20.63 mm) then E. coli (the inhibition zone was 19.43 mm). On the other hand, the highest antibacterial effect against L. monocytogene was for Myrrh oil-enriched yogurt by 0.9% and the inhibition zone was 19.21 mm. The obtained results showed that Eucalyptus and Myrrh oils can be applied to yogurt to improve its beneficial properties in terms of physical characteristics and for human health due to their antioxidant activity and phenolic materials.

Antioxidant activity and some quality characteristics of buffalo yoghurt fortified with peanut skin extract powder.

Peanut is an important crop grown worldwide. Peanut skin, the byproduct of peanut processing is a valuable byproduct due to its content of many functional components. Therefore, this study aimed to evaluate the effect of fortification of yoghurt with peanut skin extract powder (PSEP) at 50, 100 and 200 mg/L milk on the antioxidant activity (radical scavenging activity RSA%) and some quality characteristics of the resultant yoghurt during cold storage. The obtained results revealed that total phenolic content of PSEP is 109.46 mg GAE/g while it's radical scavenging activity % reached 90.57%. Fortification of yoghurt with PSEP increased the apparent viscosity, antioxidant activity, and total phenolic, acetaldehyde, and diacetyl contents as compared to control, while the syneresis of fortified yoghurt was reduced. Microbiological analysis showed that fresh control yoghurt had the highest counts of Streptococcus thermophilus and Lactobacillus bulgaricus and decreased at the end of storage in all treatments. Both control and T1 (the low concentration of PSEP) gained the highest acceptability; therefore, it was recommended that fortification of yoghurt with 50 mg of PSEP/L is more preferable than the other concentrations. In addition, it could be considered as a natural antioxidant source in formulating functional yoghurt either in industrial and/or small industrial scale.

Assessment of laser-assisted delivery vs intralesional injection of botulinum toxin A in treatment of hypertrophic scars and keloids.

Keloids and hypertrophic scars could impair the psychological, physical, and cosmetic aspects of the patient's quality of life. Unfortunately, there is no curative treatment available till now. This study aimed to evaluate the efficacy and safety of intralesional vs topical botulinum toxin A combined with Fractional CO2 laser in the treatment of hypertrophic scars and keloids. Twenty patients with Keloids and hypertrophic scars were enrolled in the study. Each scar was divided into two halves, one subjected to intralesional injection of botulinum toxin type A once a month for 4 months and the other was subjected to four sessions of CO2 laser therapy at 1 month interval followed by topical application of botulinum toxin A. Significant improvement was noted in Vancouver Scar Scale in hypertrophic scars in laser group than intralesional botulinum toxin A. In keloid cases, the improvement was significantly higher with intralesional botulinum toxin A. Clinical improvement showed significant negative correlation with scar duration and size. Botulinum toxin A is a promising treatment for hypertrophic scars and keloids. The use of fractional CO2 laser as a mode of delivery enhanced the efficacy of botox in hypertrophic scars.

Insulin resistance and idiopathic infertility: A potential possible link.

Among various health issues, infertility has been always considered as one of the major health problems. Idiopathic infertility is still a matter of debate since the underlying mechanisms stay obscure. Idiopathic infertility is related to expanded chance of metabolic syndrome components, obesity and increased risk of cardiovascular diseases. This study aimed to assess insulin resistance and serum levels of irisin as one of the adipokines in patients with idiopathic infertility. This study included 50 male patients aged 25-50 years old suffering from idiopathic infertility, together with 50 healthy individuals of matched age as controls. Patients showed significantly increased homeostasis model assessment for insulin resistance values than controls. For irisin results, idiopathic infertility patients had significantly decreased values than controls indicating the potential effect of irisin in development of insulin resistance in idiopathic infertility patients.

Prevalence of premature ejaculation and its impact on the quality of life: Results from a sample of Egyptian patients.

Premature ejaculation is the most common sexual dysfunction affecting 25%-40% of males of different age groups, imposing psychological and physical burden and causing relationship problems. Because there is no standard definition of PE, there has been the variability in its prevalence data. Aims of this study were to detect the prevalence of premature ejaculation in a sample of Egyptian population and to assess the effect of premature ejaculation on the patients' quality of life and on the sexual function of their partners. Our results revealed that the prevalence of PE was 26.67%. Also, PE-affected patients and their wives negatively causing dysfunctions in physiological, psychological, cultural and relationship dimensions.

Assessment of macrophage migration inhibitory factor in patients with verruca vulgaris.

BACKGROUND: Common warts are caused by human papillomaviruses (HPVs), they are among the most common cutaneous viral infections. Macrophage migration inhibitory factor (MIF) is an essential contributor in many inflammatory and immune skin diseases. Yet, its role in the pathology of common warts is unclear. OBJECTIVE: To assess MIF levels in lesional and perilesional skin in patients with common warts in comparison to apparently healthy control group with matching age and sex. SUBJECTS AND METHODS: A case-control study performed on 60 patients with common warts (group A) and 30 age and sex matching healthy controls (group B). Two biopsies were taken from each patient in group A; one from the lesion (lesional) and the other one from the skin around the wart (perilesional), while biopsies of controls were taken from matched sites to patients. Measurement of MIF in all groups was done by quantitative ELISA kits. RESULTS: Significant high MIF levels were detected in lesional and perilesional skin biopsies compared to controls (P<0.001). Yet, the difference in MIF levels between lesional and perilesional skin biopsy was non-significant. No significant relations were found between lesional and perilesional MIF levels and clinical characteristics of the studied patients while both lesional and perilesional MIF levels were significantly correlated (rh=0.269, P=0.021). CONCLUSION: The significantly elevated MIF levels in lesional and perilesional skin biopsies compared to controls point to its role in wart progression from HPV infected cells.

Comparative study of the efficacy of Platelet-rich plasma combined with carboxytherapy vs its use with fractional carbon dioxide laser in atrophic acne scars.

BACKGROUND: Acne scars are a major concerning problem to all acne patients affecting their quality of life. Platelet-rich plasma (PRP) and fractional CO2 laser are innovative treatment modalities for acne scars. Carboxytherapy can also be used to improve scar tissue through the increase in collagen deposition and reorganization, and the improvement in skin texture and tone. AIMS: The aim of this work was to compare the efficacy, safety, and complications of the intradermal injection of PRP combined with carboxytherapy and PRP combined with fractional CO2 laser, in the treatment of atrophic acne scars. PATIENTS AND METHODS: Forty patients with atrophic acne scars were divided into 2 groups. Group A included 20 patients and was subjected to three fractional CO2 laser sessions combined with PRP injection. Group B included 20 patients and was subjected to three sessions of carboxytherapy combined with PRP injection. RESULTS: Both fractional CO2 laser and carboxytherapy combined with PRP showed improvement in acne scars and patients' satisfaction but the improvement with fractional CO2 laser was significantly better than carboxytherapy but with more side effects. CONCLUSIONS: Improvement of acne scars was noted in both treatment modalities with obvious higher and statistically significant results in favor of fractional CO2 laser but with more side effects. Carboxytherapy is a promising tool in treatment of acne scars with less complication.

Tumor Necrosis Factor-like Weak Inducer of Apoptosis: A Novel Serum Marker in Patients with Severe Alopecia.

BACKGROUND: Alopecia areata (AA) is a common form of nonscarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifunctional cytokine expressed on various cell types and tissues and acts through binding to its sole receptor factor-inducible 14 (Fn14). TWEAK/Fn14 activation contributes to various pathological processes, including cell proliferation and death, angiogenesis, carcinogenesis, and inflammation. AIM: The aim of this current study was to measure serum levels of TWEAK in patients with AA and to assess the correlation between it and severity of the disease. SUBJECTS AND METHODS: This study included 50 patients who had patchy AA, in addition to 50 apparently healthy controls. Severity of AA was assessed using Severity of Alopecia Tool Score. Serum TWEAK levels in all participants were determined using ELISA technique and were correlated with the severity of the disease. RESULTS: Mean serum levels of TWEAK were significantly higher in AA patients, with a positive significant correlation between serum levels of TWEAK and severity of the disease. CONCLUSION: TWEAK as a novel marker of many autoimmune inflammatory dermatological diseases, could be a promising marker in the diagnosis of AA, and also can be used as a prognostic marker for its severity.

Serum markers for asymptomatic atherosclerosis in Egyptian psoriatic patients: study controlled by Doppler estimation of carotid intima-media thickness.

BACKGROUND: The aim of the study was to measure serum levels of endocan, myeloperoxidase (MPO), pentraxin 3 (PTX3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in psoriatic patients and to study their correlations with carotid intima-media thickness (CIMT) in trial to evaluate predictability of these parameters in diagnosing asymptomatic atherosclerosis (AAS). PATIENTS AND METHODS: Seventy-five psoriasis patients and 75 control subjects underwent complete clinical examination and Doppler estimation of CIMT using thickness of 0.9 mm as cutoff point for diagnosis of AAS. Blood samples were collected for determination of fasting blood glucose, lipid profile and serum C-reactive protein (CRP), endocan, MPO, PTX3 and 1,25(OH)2D3. RESULTS: Estimated blood low-density lipoprotein cholesterol (LDL-c) and serum CRP, PTX3, MPO and endocan levels were significantly higher, while blood high-density lipoprotein cholesterol (HDL-c) and serum 1,25(OH)2D3 levels were significantly lower in patients than in controls. CIMT showed significant positive correlation with disease severity and duration; patients' age; and endocan, MPO, LDL-c, PTX3 and CRP levels, and significant negative correlation with HDL-c and 1,25(OH)2D3 levels. Regression analysis defined high serum endocan and MPO, low serum 1,25(OH)2D3 and increased disease severity as significant predictors of high CIMT. CONCLUSION: Elevated serum levels of endocan and MPO and low 1,25(OH)2D3 levels may underlie the development of psoriasis-related cardiac manifestations. Elevated serum endocan and low 1,25(OH)2D3 levels could be used as early predictors of increased CIMT, which is a pathognomonic feature of AAS.