مجله دانشکده پزشکی اصفهان
پیاپی 226 (هفته چهارم فروردین 1392)

Acne is a very common skin disease. Scar are seen in 95% of patients with acne. Although numerous treatments have been recommended to cure acne scars, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. In other words, a combination of available methods is required to reach satisfactory results. We compared the effects of fractional carbon dioxide (CO2) laser alone and in combination with subcision. This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011-12. Eligible patients with atrophic acne scars were treated with fractional CO2 laser alone (five sessions with three-week interval) on right side of the face and fractional CO2 laser plus subcision (one session using both followed by four sessions of fractional CO2 laser, all with three-week intervals) on the left side. The subjects were visited one, two, and six months after the treatment. Patient satisfaction rate was analyzed by SPSS20. The average of recovery rate was 54.7% using the combination method and 43.0% using laser alone (P < 0.001). The mean patient satisfaction rate according to visual analogue scale (VAS) score was significantly higher with the combination method than with laser alone (6.6 vs. 5.2; P < 0.001). Bruising was only seen with the combination method and lasted for one week in 57.0% of patients and for two weeks in 43.0%. Erythema was a side effect of both methods. Post-inflammatory pigmentation and hyperpigmentation were only caused by the combination method. None of the patients had persistent side effects after six months. Using a combination of subcision and laser had suitable results regarding scar recovery and satisfaction rate. However, bruising, post-inflammatory pigmentation, and hyperpigmentation were the side effects of this method. In general, subcision plus laser can be beneficial in the treatment of atrophic acne scars.

Ketotifen is a bronchodilator and anti-allergic drug with antagonistic effects on histamine H1 receptors. The present study evaluated the effects of ketotifen on ulcerative colitis induced by acetic acid in rats. Colitis was induced by 2 mL of 4% acetic acid in rats. It was treated with 2 mg/kg/day ketotifen or 1 mg/kg/day dexamethasone from two hours before the induction of colitis until four days after. The rats were sacrificed 24 hours after the last dose and the colon tissue was studied for macroscopic changes (ulcer area and severity and the weight/length ratio of colon), microscopic changes (inflammation severity, inflammation extent, crypt damage, and percent of involvement), and biochemical tests (myeloperoxidase activity, tumor necrosis factor-α, and interleukin-6). Ketotifen caused significant improvement of macroscopic and microscopic signs compared to negative control group. Myeloperoxidase activity in ketotifen and dexamethasone groups was significantly different from that in the negative control group. However, the two mentioned groups had no significant differences with the sham group in terms of myeloperoxidase activity and interleukin-6. Tumor necrosis factor-α decreased similarly in dexamethasone and sham groups. However, the level of this mediator was higher in the ketotifen group than in the dexamethasone group (P < 0.05). Ketotifen caused significant reductions in mucosal damage and the release of inflammatory mediators. No significant differences were seen between ketotifen (2 mg/kg) and dexamethasone (1 mg/kg) in reduction of macroscopic changes, histological test results, myeloperoxidase activity, and interleukin-6. Considering that ketotifen could alleviate the induced ulcerative colitis in rats, it may be a suitable drug for further evaluations in clinical trials on patients with irritable bowel disease.

While hepatitis C virus (HCV) is the major cause of acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma worldwide, no vaccine against this infection has been proved to date. Cellular immune responses play an important role for eradicating persistent viral infections. Among different vaccine strategies, the use of DNA vaccine has been shown to be a promising approach for enhancing cellular immune responses. In spite of their advantages, DNA-based vaccines might induce weaker antibody and cytotoxic T-lymphocyte responses compared to protein immunization. To overcome this obstacle, several methods such as different immunization regimens, fusion of particle forming units [like hepatitis B surface antigen (HBsAg)] and co-expressing cytokines have been tested. The aim of this study was to design, construct, and evaluate an HBsAg-fused core-based DNA vaccine against HCV infection. The HCV core gene was amplified by polymerase chain reaction (PCR) and cloned in BamHI/EcoRV sites of pcDNA3.1 containing HBsAg. The constructed plasmid (pCHCORE) was analyzed by restriction enzyme and sequencing analyses and evaluated for the protein expression in HEK293T cell line by western blot analysis with anti-HBsAg polyclonal antibody. The correctness of the constructed DNA vaccine was shown by restriction enzyme analysis and sequencing. Western blotting results confirmed the expression of HBsAg-HCV fusion protein with an expected molecular weight in HEK239T cell line. In accordance with previous studies, the constructed vector (pCHCORE) compromising the fusion of HBsAg to HCV core in pCDNA3 plasmid might be used as a HCV DNA vaccine (due to proper expression in cell lines) to induce augmented cellular immune responses.

Patients commonly ask pharmacists for the over-the-counter medications when they get different ailments. Assessment of how a pharmacist evaluates a patient's signs and symptoms and his or her approach to treating the patient using over-the-counter medications were the main goals of this study. In this cross-sectional study, the scenarios on cough, diarrhea and Obesity were selected from questionnaires that had been responded by 61 pharmacists. The scenarios were then designed by determining important questions including the key question using appropriate references and the opinions of a panel of experts. Subsequently, a list of all pharmacies in Isfahan (Iran) was obtained and 210 pharmacies were randomly selected. Final analysis was made on 151 visits to 127 community pharmacies. Performance of pharmacists, i.e. the number and type of questions used to come up with a recommendation and the appropriateness of the decision, was assessed both strictly and leniently. Moreover, the length of time spent for counseling and influence of gender and ownership of pharmacists were analyzed. The mean counseling time was 130.2 ± 86.1 and 98.6 ± 72.4 seconds for female and male pharmacists, respectively (P = 0.01). The key questions for cough, diarrhea, and Obesity scenarios were asked by 29 (55%), 45 (87%), and 0 (0%) of pharmacists, respectively. The questions led to 25 (47%), 10 (19%), and 8 (17%) appropriate recommendations according to a lenient evaluation. Despite asking the key questions, the majority of pharmacists do not make appropriate recommendations for cough, diarrhea, and especially Obesity. Incorporating relevant courses in the pharmacy curricula and devoting continuing education seminars to over-the-counter medication usage are suggested to improve pharmacist's performance.

Electrochemotherapy involves the application of chemotherapy followed by local electrical pulse around the tumor to increase drug delivery into tumor cells. Electroporation is used to increase drug absorbance only for medications whose transport is prevented by plasma membrane. Among all available medicines, bleomycin and cisplatin have been widely studied in pre-clinical and clinical trials. In-vitro observations revealed an increase in cytotoxicity of these drugs after the application of electrical pulses. In-vivo studies have suggested tumor electroporation after local or systemic chemotherapy therapy (electrochemotherapy) as an effective antitumor treatment. This method has also been successfully used in treating primary tumors of cats, dogs, and horses. Pre-clinical research on several types of tumor has clarified the parameters resulting to the effective, local control of tumors. In human clinical trials, electrochemotherapy has been an efficient method for treating advanced diseases with accessible malignant tumors of various types.