مجله پزشکی بالینی ابن سینا
سال سی‌ام شماره 2 (پیاپی 108، تابستان 1402)

Considering the role of bacteria in causing some forms of acne, in recent years, the use of antibiotics along with other medications has had positive results in acne treatment; therefore, the present study aimed to compare the effect of the combination of topical erythromycin and zinc acetate with topical erythromycin alone in treating mild to moderate acne vulgaris.

In this clinical trial, 76 patients with acne vulgaris who were referred to a specialized skin clinic were selected and randomly assigned into two treatment groups, namely, A (n=39) and B (n=37). Group A was treated with a local solution of erythromycin 4% without zinc acetate, and group B was treated with a combined local solution of erythromycin 4% and zinc acetate 1.2%. The treatment continued twice a day for three months.

In groups, A and B, respectively, the average lesion intensity score before treatment was 21.1 ± 6.5 and 21.9 ± 5.4 (P=0.555), the first month of treatment was 17.0 ± 6.4 and 15.7 ± 5.9 (P=0.578), the second month of treatment 9.1 ± 4.5 and 6.4 ± 3.3 (P=0.014), the third month of treatment 4.0 ± 3.0 and 2.0 ± 3.0 (P=0.001), and the frequency of complete recovery was 38.5 and 64.9%, respectively (P=0.021). In group B, the severity of papules in the second (P=0.002) and third (P=0.001) months of the treatment was significantly lower than in group A.

Based on the obtained results, using a combination of erythromycin 4% with zinc acetate 1.2% as a topical solution is more effective than the topical solution of erythromycin 4% alone in treating acne lesions

Breast cancer is one of the most common cancers and the fifth leading cause of cancer deaths in Iran. The present study aimed to investigate the absorbed dose received by the heart and its relationship with cardiac complications in radiotherapy of patients with left breast cancer using a three-dimensional conformal radiotherapy technique.

A total of 181 women with left breast cancer who received radiotherapy after surgery were included in the study. Dosimetric parameters were obtained using dose-volume histograms for the heart, whole lung, left lung, and clinical target volume. Electrocardiography tests were performed for all patients before and one year after the radiotherapy.

The mean doses of heart, left lung, whole lung, and clinical target volume were 6.3±3.1, 13.3±4.5, 6.9±3.7, and 47.3±6.4 Gray (Gy), respectively. A significant reduction in T-wave amplitude was observed in 57% of patients three months after radiotherapy. T-wave amplitude decreased from 3.03±0.92 mm to 1.56±0.83 mm. The reduction in the T-wave amplitude displayed a significant relationship with the mean dose of the heart (β = 2.653; P= 0.019).

In women with left-sided breast cancer, cardiac complications are frequent, for which electrocardiographic tests can be used for cardiac evaluation after radiotherapy. Based on the obtained results, the most frequent side effect caused by radiotherapy in these patients was an abnormality in T-wave

Breast cancer is the second leading cause of death in women. Prognostic factors for cancer using appropriate statistical models with data structure not only help in choosing a more appropriate treatment method in the short term but can also play a significant role in identifying high-risk patients in the long term. This study aimed to determine the factors associated with survival in breast cancer patients using a Mixture Cure model.

This retrospective cohort study was conducted from 2011 to 2021. A total of 767 breast cancer patients were referred to the Mahdieh Medical Diagnostic Center in Hamadan, Iran. Clinical and demographic information was collected by contacting the individuals through telephone calls. A Mixture Cure model was used to analyze the collected data. Data analysis was performed using smcure in R.4.0.5 software.

Of the 767 breast cancer patients followed up for 10 years, 58(6.7%) individuals died. The mean (standard deviation) age at diagnosis was 49.23(10.85) years. In univariate analysis, clinical and demographic features, including age, first treatment, marital status, disease recurrence, type of pathology, invasion of lymphatic vessels, and in multivariate analysis, first treatment and disease recurrence had a significant association with patient survival (P<0.05).

According to the findings of this study, first treatment and disease recurrence were identified as factors associated with the survival of breast cancer patients. The impact of first treatment and disease recurrence on survival highlights the importance of early diagnosis, appropriate diagnostic and therapeutic services, and improving the quality of life of patients. On the other hand, the relatively high survival rate in patients referred to the Mahdieh Medical Center may indicate the importance of creating such centers for various diseases.

Adults with stuttering show a fear of communication. This study aimed to compare the effectiveness of mindfulness-based stress reduction to that of acceptance and commitment therapy on social anxiety and its dimensions in adults with stuttering.

This study was a semi-experimental type with a pretest-posttest and follow-up design. The statistical population included all stuttering adults aged 18 to 40 who were referred to speech therapy and psychology centers in Isfahan, Iran, in 2022 and 2023. The sample included 45 individuals, divided into two experimental groups and one control group. The subjects’ social anxiety was measured in three stages by administering the Connor social anxiety questionnaire.

The results showed that the experimental methods were effective on the dependent variables in the experimental groups compared to the control group. Regarding the effectiveness of the two experimental methods on physiological symptoms, there was no significant difference. On the other hand, mindfulness-based stress reduction had a more significant effect on fear, avoidance, and the total score of social anxiety compared to acceptance and commitment therapy (P<0.05).

Based on the findings, both mindfulness-based stress reduction, as well as acceptance and commitment therapy are effective in reducing social anxiety and its dimensions among people who stutter.

The association of leptin with psoriasis is currently controversial. The purpose of this study was to evaluate serum leptin levels in patients with psoriasis and its relationship with the severity of the disease.

In this case-control study, serum leptin levels were measured in 40 patients with psoriasis and 40 age- and gender-matched healthy controls by sandwich enzyme-linked immunosorbent assay method. The severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Data were analyzed using SPSS software version 16.

Of 40 patients, 35 (87.5%) had plaque psoriasis, 3 (7.5%) had palmo-plantar, and one of the remaining two patients had erythrodermic psoriasis while the other one had a pustular type. The mean disease severity based on PASI was 10.2 with a range of 0.8 to 39.9. The most common sites of involvement were generalized (27.5%), upper and lower extremities together (20.0%), lower extremities alone (15%), and trunk and lower extremities (15%) in descending order. Leptin was higher in the patient group than the control group (19.2±16.3 ng/ml versus 15.5±16.1 ng/ml) (P=0.227). The correlation between leptin and body mass index was positive and significant in both groups. No significant relationship was found between the severity and duration of disease and leptin.

The findings of this study showed that similar to most studies, serum leptin levels were higher in patients with psoriasis than in healthy subjects, and in obese people, this difference was greater than in normal-weight individuals

The removal of collagen by chemical methods can increase the micro-shear band strength of composite restorations. The present study aimed to investigate the effect of bromelain 25% and trypsin 10% on the micro-shear bond strength of Etch-and-rinse adhesives.

After cutting the chewing surface and exposing the dentin to a diameter of 5mm, the samples were randomly assigned to three equal groups (n=45): in the control group, after etching the adhesive surface, a Single Bond was used. In the other group, after etching, the surface was prepared with bromelain enzyme. In the last group, the trypsin enzyme was used to prepare the surface before applying the adhesive. Thereafter, the cylinders of ES Flow composite were placed on the bond surface. Following that, the micro-shear strength of the samples was calculated in megapascals.

There was a significant difference between the mean of the trypsin group and that of the control group (P=0.001), as well as the bromelain group and the control group (P<0.001).

The preparation of etched dentin by trypsin and bromelain enzyme solutions increased the micro-shear bond strength between composite materials and dental dentin in Etch-and-rinse adhesives.

Appendectomy is one of the most common surgical procedures with various clinical complications affecting wound healing. The type of skin closure is a critical surgical stage to prevent infection and dermal scarring. Therefore, administration of proper skin suturing can lead to complete wound healing and reduction of appendectomy-associated complications. In this regard, the present study was designed to compare the quality of the wound healing process and related complications in Simple Semi-Plastic (SSP) and Continuous Sub-Cuticular (CSC) dermal suturing procedures.

This triple-blind clinical trial study was conducted on 73 appendectomy patients randomly categorized as the cases with SSP (n=38) and CSC (n=35) suturing procedures. Demographic data, wound-associated characteristics (e.g., width of scar, color, odor, patency, necrotic tissue, wound warmth, granulation and epithelialization tissues, volume and color of wound secretion, and color of wound-surrounded tissues) were totally assessed using a pre-designed checklist. Visual Analogue Scale (VAS) index was also used for assessing level of pain. All the collected data were applied on 2nd, 10th, and 30th days post-surgery. The obtained data was analyzed in SPSS software (version 23).

According to the results of the present research, no significant differences were detected in the terms of demographic characteristics, wound-associated complications, healing-related factors, and changes of wound-surrounding tissues between the SSP and CSC groups (P>0.05). The width of scar was significantly higher on the 2nd and the 10th days after suturing in SSP group than CSC group (P<0.05).

Following appendectomy, thinner dermal scars along with better cosmetic outcomes can be obtained through the CSC technique than SSP.

Burn pain during therapeutic procedures causes anxiety in patients. Spiritual health and resilience are factors affecting anxiety. The present study aimed to determine the relationship between spiritual health with resilience and wound pain anxiety in burn patients.

In this cross-sectional study, 213 patients were selected by random sampling method. Demographic information, Polotzin and Ellison's spiritual health questionnaire, Connor-Davidson Resilience Scale, and Burns Specific Pain Anxiety Scale were used to collect data. T-tests and one-way analysis of variance were used to analyze the collected data. Data analysis was performed using SPSS software (version 21).

The findings showed that most patients were male (62.91%) with an average age of 38.21 ± 12.72. The average scores of spiritual health, wound pain anxiety, and resilience were 73.63 ± 21.20, 52.83 ± 16.18, and 58.24 ± 13.51, respectively. Although a significant relationship was found between spiritual health and resilience and between resilience and wound pain anxiety, no significant relationship was seen between spiritual health and wound pain anxiety.

Burn patients suffer a lot of pain during procedures such as dressings. Considering the relationship between spiritual health, burn pain anxiety and resilience, educational workshops are suggested to increase spiritual health, resilience and better tolerance during hospitalization.