Striae gravidarum treatment: evaluating non-ablating fractional laser (NAFL) efficacy and safety.

BACKGROUND: Striae gravidarum (SG) is a common pregnancy-related dermatologic problem, for which finding an effective treatment remains a challenge. AIM: To evaluate the safety and efficacy of 1540 nm non-ablative fractional laser (Star lux 500) in the treatment of SG in Iranian women and peruse the relationship between clinical improvement rate and patient characteristics as well as clinical features of striae. METHOD: A prospective before-after study was conducted on 50 patients with SG who received three monthly sessions of 1540 nm non-ablative fractional laser and were followed for 2 months after the last treatment session. Clinical changes were measured using both provider-rated outcome through before/after pictures represented by final clinical score (from 0 to 5) and patient-reported outcome (patient global assessment or PGA). RESULTS: Over the course of the study both final clinical score and PGA increased significantly from week 4 to week 20 (P value: <0.001 and 0.048, respectively). Only modest adverse effects including erythema, edema and hyperpigmentation were noted. CONCLUSION: In conclusion, patients with SG of different type (rubra/alba) or maturity may somehow benefit from treatment with NAFL experiencing minimal transient side effects.Therefore, NAFL may be considered a safe and partially effective treatment option for stretch mark of patients with SG.

Epidemiology of Dermatophytosis in Tehran, Iran: A Ten-year Retrospective Study.

BACKGROUND: Dermatophytosis still remains a major public health concern worldwide, particularly in developing countries. This study was undertaken to determine the etiological and epidemiological factors of dermatophyte infections in Tehran, Iran. METHODS: A total of 1530 patients clinically suspected of cutaneous fungal infections were examined in two hospitals over a period of 10 years (2010-2020). Samples were analyzed using direct microscopic examination and culture. Data regarding age, gender, and clinical manifestations were also recorded. RESULTS: Out of 1530 cases examined, dermatophytes were detected in 493 (32.2%) patients. Of these patients, 288 (58.4%) were males and 205 (41.6%) were females. The most affected age group was the 25-44 years old (31.6%). Tinea corporis (n=134) was the most prevalent type of ringworm, followed by tinea cruris (n=131), tinea pedis (n=90), tinea manuum (n=65), tinea unguium (n=29), tinea faciei (n=20), tinea capitis (n=18), and tinea barbae (n=2). Both tinea cruris (P<0.001) and tinea pedis (P=0.002) had a significant association with male gender. As for etiological agents, Trichophyton mentagrophytes (29.0%) was the most frequent isolate, followed by Trichophyton tonsurans (25.8%), Trichophyton rubrum (25.3%), Epidermophyton floccosum (6.9%), Trichophyton verrucosum (4.9%), Microsporum audouinii (4.5%), Microsporum canis (2.0%), and Trichophyton violaceum (1.6%). CONCLUSION: Dermatophytes are still the prevailing causes of fungal infection of the skin, hair, and nails in Iran. Further studies with larger samples sizes and inclusion of diverse locations would yield more accurate results.

Pulmonary thromboembolism in COVID-19 Patients on CT Pulmonary Angiography - A Single-Centre Retrospective Cohort Study in the United Arab Emirates

PurposeOur aim is to identify the prevalence and distribution of pulmonary thromboembolism in COVID-19 infected patients in our hospital. Materials and MethodsData of all patients with COVID-19 infection either on RT-PCR testing or non-contrast high resolution CT(HRCT) who had CT pulmonary angiography (CTPA) from April to June 2020 were included. 133 patients were initially included in the study, 7 were excluded leaving a total number of 126 patients. ResultsTwenty (15.8%) patients had evidence of pulmonary embolism (PE) on CTPA with mean age of 50 years (ranging 31-85) with 95% males. The mean D-dimer was 5.61mcg/mL among the PE-negative and 14.49 mcg/mL in the PE-positive groups respectively. Among the patients with evidence of pulmonary embolism on CTPA almost half required admission to intensive care unit in comparison to only one-fifth with negative CTPA. One-fourth died among the PE positive group with only 5% died among the PE negative group. There was a 33% reduction in the development of PE in the COVID-19 patients who had received low molecular weight heparin (LMWH) prior to their CTPA study versus those who had not. ConclusionD dimers correlate well with the incidence of pulmonary embolism among COVID-19 patients. Our data suggest that majority of our patients, developed pulmonary embolisms within 5 days into their hospital stay, accounting to almost two thirds of all positive cases diagnosed by CTPA. Those with PE among COVID-19 patients have high chances of ICU admission and mortality. Use of thromboprophylaxis early on might reduce the incidence of PE.

Diagnostic performance of standard and inverted grey-scale CXR in detection of lung lesions in COVID-19 patients. A single institution study in the region of Abu Dhabi.

PurposeTo evaluate diagnostic performance of greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. MethodsIn this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19 th to May 23 rd 2020 in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of greyscale and inverted greyscale chest radiographs (CXR). The images were viewed on high-specification viewing systems using a primary display monitors and compared it to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. ResultsNinety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detection of lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. ConclusionsThe sensitivity of detection of lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans. HighlightsO_LICXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. C_LIO_LIBetter detection of lesions was noted in the inverted grey scale CXR in (20.8%) of cases with positive findings in standard greyscale CXR. C_LIO_LIConventional radiographs can be used as diagnostic tools in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans. C_LI

Laser irradiation on growth of trichophyton rubrum: an in vitro study.

INTRODUCTION: Trichophyton rubrum is one of the most common species of dermatophytes which affects superficial keratinous tissue. It is not especially virulent but it can be responsible for considerable morbidity. Although there are different therapeutic modalities to treat fungal infections, clinicians are searching for alternative treatment because of the various side effects of the present therapeutic methods. As a new procedure, Laser therapy has brought on many advantages in clinical management of dermatophytes. Possible inhibitory potential of laser irradiation on fungal colonies was investigated invitro in this study. METHODS: A total of 240 fungal plates of standard size of trichophyton rubrum colonies that had been cultured from the lesions of different patients at the mycology laboratory, were selected. Each fungal plate was assigned as control or experimental group. Experimental plates were irradiated by a laser system (low power laser or different wavelength of high power laser). The effects of different laser wavelengths and energies on isolated colonies were assessed. After laser irradiation, final size of colonies was measured on the first, the 7th and the 14th day after laser irradiation. RESULTS: Although low power laser irradiation did not have any inhibitory effect on fungal growth, the Q-Switched Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG) laser 532nm at 8j/cm(2), Q-Switched Nd:YAG laser 1064nm at 4j/cm(2) to 8j/cm(2) and Pulsed dye laser 595nm at 8j/cm(2) to 14j/cm(2) significantly inhibited growth of trichophyton rubrum in vitro. CONCLUSION: Q-Switched Nd:YAG 532nm at 8j/cm(2), Q-Switched Nd:YAG laser 1064nm at 4j/cm(2) to 8j/cm(2) and pulsed dye laser (PDL) 595nm at 8j/cm(2) to 14j/cm(2) can be effective to suppress trichophyton rubrum growth.

Lipid profile components and incident cerebrovascular events versus coronary heart disease; the result of 9 years follow-up in Tehran Lipid and Glucose Study.

OBJECTIVE: To assess the effects of lipid component total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and non-HDL-C on risk of stroke events versus coronary heart disease (CHD). METHODS: The study was conducted on 2620 Iranians, aged ≥ 50 years, free from cardiovascular events at baseline (1999-2001). The multivariable hazard ratios (HRs) for stroke/CHD were calculated for 1 mmol/L change in lipid components, using Cox proportional hazard regression. RESULTS: During 9.1 years of follow-up, 73 and 358 cases of stroke and CHD occurred. We found significant interactions between TC and non-HDL-C with gender in risk prediction of stroke. Among women, multivariate adjusted HRs of ischemic stroke were 1.40 (1.08-1.82), 1.66 (0.71-3.86), 2.27 (0.58-8.91), 1.51 (1.06-2.15) and 1.36 (1.024-1.78) for TC, Ln TG, HDL-C, LDL-C and non-HDL-C respectively, while corresponding HRs of ischemic stroke for men were 0.78 (0.55-1.11), 0.71 (0.33-1.51), 1.04 (0.24-4.47), 0.82 (0.56-1.22), 0.78 (0.55-1.11), respectively. We found no interaction between gender and any of the lipids in risk prediction of incident CHD (p > 0.3). All lipid components were independently associated with CHD in whole population. CONCLUSION: The associations of lipid components on ischemic stroke were modified by gender. Only among female population, TC, LDL-C and non-HDL-C were independently associated with increased risk of ischemic stroke. Regarding CHD events, all lipid components were significant predictors.