Treatment options for leishmaniasis.

Leishmaniasis is broadly classified into three types: cutaneous, mucocutaneous and visceral. The visceral form is most dangerous and can result in death. Although leishmaniasis is an ancient disease, its treatment is still challenging. Several drugs, differing in their cost, toxicity, treatment duration and emergence of drug resistance, are used for different types of leishmaniasis. To overcome these limitations, the search for newer drugs and other treatments continues. In this article, we discuss conventional drugs, other treatments, including newer options such as immunotherapy and immunochemotherapy, and future prospects for leishmaniasis treatment.

Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients.

Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro-drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response to topical minoxidil in the treatment of AGA. In the human liver, sulfotransferase activity is significantly inhibited by salicylic acid. Low-dose OTC aspirin (75-81 mg), a derivative of salicylic acid, is used by millions of people daily for the prevention of coronary heart disease and cancer. It is not known whether oral aspirin inhibits sulfotransferase activity in hair follicles, potentially affecting minoxidil response in AGA patients. In the present study, we determined the follicular sulfotransferase enzymatic activity following 14 days of oral aspirin administration. In our cohort of 24 subjects, 50% were initially predicted to be responders to minoxidil. However, following 14 days of aspirin administration, only 27% of the subjects were predicted to respond to topical minoxidil. To the best of our knowledge, this is the first study to report the effect of low-dose daily aspirin use on the efficacy of topical minoxidil.

Lich-gregoir procedure in treatment of the vesicoureteral reflux.

Vesicoureteral reflux is a major problem in childhood affecting 1% of all children. There are various surgical methods for vesicoureteral reflux treatment. Current study evaluates effectiveness and success rate of the Lich-gregoir procedure in treatment of the vesicoureteral reflux. In a descriptive-analytical study, 32 children with 47 reflux unit underwent Lich-gregoir anti-reflux procedure in Imam Reza and Amir-al-Momenin Hospitals, Tabriz between March 2008 and August 2011. Surgery outcome and success rate, sonographic findings and complications rate were recorded in follow-up. Patients mean age was 5.85 +/- 3.81 years. 28.1% were male and 71.9% were female. Reflux was unilateral in 53.1% and bilateral in 46.9%. Vesicoureteral reflux grade I to V was in one, 1, 13, 22 and ten patients, respectively. Voiding Cystourethrogram (VCUG) findings were abnormal in all cases before operation. Surgery success rate in first 6 months was 95.7% and was 100% in 8 months after operation. Hydronephrosis disappeared after operation in all cases. Complication occurred in 2 cases (6.25%) with bilateral reflux including urinary intention and lymphocele. Lich-gregoir anti-reflux procedure technique is accompanied with higher success rate, low complication and hydronephrosis improvement and is an appropriate treatment for vesicoureteral reflux in children.

Comparison of genu varum treating results using open and closed wedge high tibial osteotomy.

High tibial osteotomy methods include open and closed wedge techniques. The study aims at comparing results of osteotomy methods in patients suffering from genu varum deformity. In a cohort study, 32 patients with genu varum deformity (42 knees) were evaluated. They were divided into two groups and matched according to age and gender. The patients were treated with open and closed wedge osteotomy. After surgery, they were followed up and compared for 6 months. Thirty two patients with genu varum deformity (10 cases of bilateral deformity (31.2%) including 25 women (87.2%) and 7 men (21.8%) were studied. Incidence of complications was the same after open and closed wedge osteotomy operation (12.5%). Patients overall satisfaction from open and closed wedge methods was 87.5 and 75%, respectively. There was statistically significant difference between two groups considering operation duration, weight bearing duration and return to routine activities (p < 0.001). There was no difference in other parameters including varus angle correction, Lysholm score Tegner activity as well as Insall Salvati index. This study demonstrated that there is no difference between two osteotomy methods considering patients' clinical outcomes and both methods are successful in final treatment results.

Evaluation of surgical treatment of developmental dysplasia of hip for avascular necrosis of femoral head in children.

Developmental Dysplasia of the Hip (DDH) is a common congenital malformation. Avascular necrosis of femoral head is the major complication of both close and open reduction of the dislocated joint. Aim of this study was to determine the incidence and influencing factors in different types of a vascular necrosis of femoral head, following surgical treatment of developmental dysplasia of hip in 1-7 years patients. In this study, 120 patients aged from 1 to 7 years old with DDH who had been undergone open surgery, entered to the study. All of these patients followed up for at least 1 year. Surgery procedures divided to 4 groups: open reduction, open reduction+salter osteotomy, open reduction+femur shortening and open reduction+salter osteotomy+femur shortening. The presence of Avascular Necrosis (AVN) had been appraised. 27.5% of surgeries performed on male and 72.5 on female patients. 35.0% of DDH cases were unilateral and remaining was bilateral. 36 patients (30%) shows radiologic findings of AVN, although all of them placed at group I of Bucholz-Ogden classification. 40% of group A patients, 25% of group B, 14.3% of group C and 36.4% of group D patients developed this findings. Open reduction of DDH in older children is effective in the management of DDH and if all of the contrivance considered in the surgery, the rate of AVN would be low and mild (at least in short term follow ups).