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Introduction: Epidermolysis bullosa (EB) is a rare inherited genetic skin disorder with severe skin itching and recurrent blisters and erosion. There is no effective and specific therapy for all types of EB. Objectives: The aim of this study was to evaluate a topical formulation of henna (Lawsonia inermis Linnaeus) in the management of wounds and the itching sensation in patients with EB. Methods: This is a pilot single-arm clinical trial. Nine patients with recessive dystrophic EB, with the age range of 5 to 32 years were enrolled in the study. The patients were instructed to apply the topical 1% henna ointment once daily on two erosions and on also two sites with moderate to a severe itching sensation. The total duration of the intervention was 4 weeks with weekly follow-up visits. Patient global impression of improvement, visual analog scale, and clinical global impression of improvement were used for assessing the wound healing process and itching discomfort. Results: There was a significant improvement in the skin symptoms of epidermolysis bullosa including skin redness, itching, burning, and local warmness (P < 0.05). Local pain decreased during the study period, but this was not statistically significant (P < 0.19). One patient reported moderate xerosis of skin after continuous usage. Conclusions: It seems that the topical formulation of henna may be effective in the management of itching, burning, stringing, and cutaneous warmness sensation in patients with EB. Further controlled studies with larger sample sizes are recommended to better evaluate this formulation.
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INTRODUCTION: Health literacy is a set of different skills, including reading, listening, analyzing, deciding, and applying these skills related to health status. Epidermolysis bullosa (EB) is a rare hereditary genetic disease which affects several aspects of the life of patients and their families. The aim of this study was to assess the health literacy of patients with EB in Iran. MATERIALS AND METHODS: Thirty-three patients from Iran with EB, aged above 15 years-old, were enrolled in the study. Iranian Health Literacy Questionnaire, which measures health literacy in five domains including reading, access, perception, assessment, and decision-making skills, was used for collecting the data. SPSS analytical software, version 22, was used for statistical analysis. RESULTS: In total, 19 (57.6%) patients were male and 14 (42.4%) female with an age range of 15-41 years. Nineteen (57.6%) patients had inadequate health literacy in reading skills. One-third of patients had enough health literacy in the realm of access, and two-thirds were excellent in perception. Overall, there was no significant correlation between the level of health literacy with age (P = 0.92), sex (P = 0.55), race (P = 0.58), and educational level (P = 0.51) of the patients. CONCLUSION: The majority of the patients had inadequate health literacy in reading skills while these patients had acceptable health literacy in perception, assessment, and decision-making skills. Improvement of health literacy of these patients should be a priority for health policy makers with the aim of increasing their quality of life and decreasing their personal and social problems.
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BACKGROUND: Temperament is one of the key concepts in traditional Persian medicine (TPM), which is the quality that will be obtained by the reaction between the four elements of water, earth, fire and air, and its property is different from the component property. According to TPM, temperament is influenced by many factors and the bulk of the body is one of these factors. In this study, we aimed at determining the relationship between person's temperament based on the knowledge of TPM and the body mass index (BMI). METHODS: This study is a cross-sectional study that examines the relationship between person's temperament and their BMI. For this purpose, 86 employees (20-40 years) of Shiraz Medical School were selected and their temperaments assessed using Dr. Mojahedi's temperament questionnaire and visitation by a TPM specialist. SPSS 18 was used for statistical analysis. RESULTS: In this study, 86 employees were evaluated including 18 (20.9%) male and 68 (79.1%) female. The mean age of the participants was 32.45±4.93 years old and the mean BMI was 23.75±2.94. Minimum and maximum BMI were related to people with temperament of cold and dry and cool temperament and more with the mean of 20.55±1.90 and 28.13±0.35, where the difference was statistically significant (P=0.0003). BMI in people with a temperament of hot and dry was significantly less than those with cool and wet temperament (P=0.01). CONCLUSION: Based on TPM, people with wet temperament are usually more obese and people with dry temperament are thinner. The results of this study confirm that obese people are cold and wet or have phlegmatic temperament whereas in comparison thin people are drier. This is in-line with the principles of TPM.
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PURPOSE: Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, as an instrument for assessment of educational environments in residency medical clinics. MATERIALS AND METHODS: This study was performed on 180 residents in Shiraz University of Medical Sciences, Shiraz, Iran, in 2014-2015. The questionnaire designers' electronic permission (by email) and the residents' verbal consent were obtained before distributing the questionnaires. The study data were gathered using ACLEEM questionnaire developed by Arnoldo Riquelme in 2013. The data were analyzed using the SPSS statistical software, version 14, and MedCalc® software. Then, the construct validity, including convergent and discriminant validities, of the Persian version of ACLEEM questionnaire was assessed. Its internal consistency was also checked by Cronbach's alpha coefficient. RESULTS: Five team members who were experts in medical education were consulted to test the cultural adaptation, linguistic equivalency, and content validity of the Persian version of the questionnaire. Content validity indexes were >0.9 in all items. In factor analysis of the instrument, the Kaiser-Meyer-Olkin index was 0.928 and Barlett's sphericity test yielded the following results: X2=6,717.551, df =1,225, and P≤0.001. Besides, Cronbach's alpha coefficient of ACLEEM questionnaire was 0.964. Cronbach's alpha coefficients were also >0.80 in all the three domains of the questionnaire. Overall, the Persian version of ACLEEM showed excellent convergent validity and acceptable discriminant validity, except for the clinical training domain. CONCLUSION: According to the results, the Persian version of ACLEEM questionnaire was a valid and reliable instrument for Iranian residents to assess specialized clinics and residency ambulatory settings.
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New-onset diabetes after transplantation (NODAT) is an important complication after solid organ transplantation. NODAT is a polygenic disease and KCNJ11 E23K polymorphism is considered as a diabetes-susceptibility gene. The present study aimed to assess the association between KCNJ11 (rs5219) variants and the risk of developing NODAT after liver transplantation. This study was conducted on 120 liver transplant recipients who had received tacrolimus-based immunosuppressive drugs. The liver transplant recipients were divided into an new onset diabetes mellitus (NODM) and a non-NODM group. The NODAT group consisted of 60 patients who developed diabetes in the first 6 months after transplantation, while the non-NODAT group included 60 patients who remained euglycemic. The patients were genotyped using polymerase chain reaction-restriction fragment length polymorphism and the incidence of NODAT was compared between the two groups. Nongenetic risk factors including donor gender and cold ischemia time, and recipient (MELD score, presence of viral hepatitis, acute rejection and steroid pulse therapy) were also considered. The KCNJ11 KK variant was associated with an increased risk for NODAT with respective odds ratio of 6.03 (95 % confidence interval 2.37-15.4; P < 0.001]. Donor age and male sex, recipient age as well as fasting plasma glucose before transplantation were significantly different between NODAT and non-NODAT groups (P < 0.05). The prednisolone daily dosage was significantly higher in the NODAT group (P = 0.01). These patients received pulse of methyl prednisolone for treatment of acute rejection. This study showed that polymorphisms in KCNJ11 might predispose the patients treated by tacrolimus to development of NODAT after liver transplantation.