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Article
Therapeutic Evaluation of Spironolactone and Finasteride in the Treatment of Acne Vulgaris

Author: Khalifa E. Sharquie
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 206-210
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Antiandrogens have been developed to treat acne; spironolactone, an androgen receptor blocker, and finasteride, 5 alpha reductase inhibitor, are two antiandrogens that can be used to treat acne vulgaris.OBJECTIVES:To evaluate the effectiveness and safety of spironolactone , finasteride, and combination of both drugs in the treatment of acne vulgaris.PATIENTS&METHODS:This single blinded uncontrolled clinical therapeutic trial was done in the Department of Dermatology and Venereology – Baghdad Teaching Hospital- in a period from December 2004 to October 2006.The patients were classified according to the number of inflammatory lesions as having mild, moderate and severe acne. Severe acne was excluded from the study. History & close examination were performed to all patients regarding all points related to the disease. Sixty-nine patients with acne were divided into three groups and were instructed to take the following drugs for two months; group A: spironolactone 100 mg/day, group B: finasteride 5 mg/day, and group C: combination of both drugs.The clinical assessment was done by counting the number of inflammatory lesions every two weeks for two months, recording any local or systemic side effects, & comparison between the number of inflammatory lesions before and after treatment was done.RESULTS:Sixty patients had completed this work, whose mean± SD of their ages of the three groups totally was 18.8 ± 2.3 years and for group A, group B, and group C as follow : 19 ± 2.6, 19.3 ± 1.9, and 18.1 ± 2.4 respectively, with 20 patients in each group.Spironolactone was statistically significant in reducing the number of inflammatory lesions, finasteride was beneficial but did not reach a statistically significant level as spironolactone, and combination of both drugs was more effective in the treatment of acne vulgaris than spironolactone alone but did not reach a statistically significant level.CONCLUSION:Spironolactone is a good alternative drug to be used in patients with acne singly or in combination therapy with finasteride.


Article
Serum Trace Elements (Zinc, Copper and Magnesium) Status in Iraqi Patients with Acne Vulgaris :( Case- Controlled Study)

Authors: Ali Y. Majid --- Zainab N. H. Anbar --- Basil OM Saleh
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2011 Volume: 20 Issue: 2 Pages: 44-49
Publisher: Baghdad University جامعة بغداد

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Abstract

Recently on the dermatological fields, the serum levels and the roles of Zn, Cu and Mg have been studied especially in acne vulgaris, but the results were controversial. The aim of the present study is to investigate a relationship between the severity of acne and the serum levels of zinc (Zn), copper (Cu) and magnesium (Mg) and to demonstrate the status of serum levels of zinc, copper, and magnesium in Iraqi male patients with acne vulgaris and to compare it with those of healthy controls.This case controlled study was conducted in the Department of Dermatology and Venerology and in the Poisoning Consultation Center of Baghdad Teaching Hospital between May 2009 to January 2010. Forty- five male patients with acne vulgaris, their ages ranged from 18-30 (21.82±3.77) years and 45 healthy male subjects as controls, their ages ranged from 18-30 (22.18±3.85) years were included in this study. Patients were subdivided into three groups according to the severity of their acne; mild acne group (n=15), moderate (n=15) and severe acne group (n=15). Investigations included serum estimation of Zn, Cu and Mg in both patient and control groups.The data obtained from this study showed that the (mean±SD) values of serum levels of Zn was significantly decreased in severe acne group compared with controls, mild and moderate type of acne group (P< 0.05). Serum Mg concentration was significantly lower in severe acne group compared with mild and moderate acne group (P< 0.05). With regard to serum Cu, there were no significant differences among groups of patients with acne vulgaris.This study revealed a significant association between serum levels of either Zn or Mg with the severity of acne.

أن مستوى وأھمیة الخارصین والنحاس والمغنیسیوم في مصول المرضى المصابین بالأمراض الجلدیة, وخاصة مرض حبالشباب تم دراستھ ولكن النتائج كانت متباینة.أن ھدف ھذه الدراسة ھو تقییم مستوى العناصر المعدنیة(الخارصین, النحاس, المغنیسیوم)في مصول الذكور العراقیین المصابین بمرض حب الشباب والذكور الأصحاء ودراسة العلاقة بین مستوى ھذه العناصر وشدة حبالشباب.لقد تم أجراء ھذه الدراسة في قسم الأمراض الجلدیة و التناسلیة والمركز الاستشاري للسموم في مستشفى بغداد التعلیمي للفترة٤٥ ذكر مصاب بحب الشباب تتراوح أعمارھم بین ( ١8 30 سنة), المعدل . ٢ ولغایة كانون الثاني ٢٠١٠ ٠٠ من أیار ٩٣,٧٧ ) سنة و ٤٥ ذكر صحیح(مجموعة السیطرة) بنفس الفئة العمریة ( 18 30 – ٢ +الانحراف المعیاري لأعمارھم ھو ( ١,٨٢٣,٨٥ سنة) تم شمولھم في ھذه الدراسة. أن مجموعة المرضى تم تقسیمھا - سنة), المعدل +الانحراف المعیاري لأعمارھم ھو( ٢٢,18إلى ثلاث فئات حسب شدة حب الشباب: فئة حب الشباب النوع البسیط وعددھم ١٥ , فئة حب الشباب النوع المتوسط وعددھم ١٥ , فئةحب الشباب النوع الشدید وعددھم ١٣ . الفحوص تشمل تحدید مستوى الخارصین, النحاس, والمغنیسیوم ي في مصول الأشخاصالأصحاء والمرضى. أظھرت نتائج الدراسة عدم وجود فرق إحصائي معنوي في مستوى العناصر(الخارصین, النحاس, المغنیسیوم)بین مجموعتي المرضى والأصحاء. لكن, مستوى الخارصین قد أنخفض بمستوى إحصائي معنوي لدى فئة حب الشباب النوع الشدیدكذلك أظھرت الدراسة انخفاض إحصائي .( P< مقارنة مع مجموعة الأصحاء ومجموعة فئة حب الشباب النوع البسیط( 0.05وفي ما یخص .(P< معنوي في مستوى المغنیسیوم لدى فئة حب الشباب النوع الشدید مقارنة مع فئة حب الشباب النوع البسیط( 0.05مستوى النحاس , لایوجد فرق معنوي بین فئات حب الشباب . یمكن الاستنتاج من ھذه الدراسة بأن ھناك علاقة معنویة بین مستوى كلمن الخارصین والمغنیسیوم في مصول المرضى المصابین بحب الشباب مع شدة المرض.

Keywords

Acne vulgaris --- zinc --- copper --- magnesium


Article
Beneficial Effect of Isotretinoin Gel As AdjunctiveTreatment to Oral Azithromycin in the Management of Facial Acne Vulgaris.

Author: Sabeeh A. Al-Mashhadani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 7-10
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Acne is a multifactorial disease with multiple pathogenic factors, hence combination therapies are needed. Combination therapies using agents with complementary mechanisms of action increasingly are recognized as an effective strategy for treating acne.OBJECTIVE:The rationale of utilizing topical retinoids with azithromycin in treating facial acne vulgaris will be highlighted, particularly in relation to improvement.METHODS:A randomized, clinical trial was carried out at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital between April 2007 and August 2008.A total of 48 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and azithromycin plus isotretinoin gel, both groups received Azithromycin for two months. Azithromycin 250 mg was prescribed every day for one month and every other day for the following month. Patients in second group were instructed to apply Isotretinoin gel 0.05% once daily over a 3 months treatment period. The clinical assessment was done by counting the number of inflammatory lesions in three occasions: baseline, two months and three months.RESULT:After two months, both groups showed a statistically significant difference from the baseline in reducing inflammatory lesions and improving acne. Adding topical isotretinoin gel produced a higher percentage of reduction in their lesional counts, but differences between the two groups were not statistically significant. After three months, regression in the percentage of reduction of the lesional count from 57.7% to 32.4% in the first group. While in the second group the reduction was maintain in 69.8%.CONCLUSION:Adding topical 0.05 per cent isotretinoin gel to oral azithromycin enhances and maintains the rate of improvement of facial acne vulgaris.


Article
Treatment of Acne Vulgaris With Nigella Sativa Oil Lotion

Author: Nasir Abdul-Ameer Hadi Al-Harchan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 140-144
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Acne vulgaris is the most common chronic inflammatory disease of the skin. Despite the vast array of treatment modalities available for acne, there is considerable dissatisfaction in acne treatment among patients and doctors. Cost limitation, adverse effect or lack of efficacy limit the use of current therapy. Herbs and their extracts have been used for treatment of skin disease for centuries. One of the most popular herbs in our society is Nigella sativa; this plant had diverse clinically useful activity.OBJECTIVE:To use nigella sativa oil as natural plant remedy in the treatment of acne vulgaris.METHODS:This study was conducted in the Department of Dermatology and Venereology in Baghdad Teaching Hospital, Iraq during the period between October 2005 and April 2006. In this single-blind randomly controlled therapeutic study, ninety three patients were enrolled, their ages ranged from 13-23 years. There were 51` females and 42 males. The patients were divided into 2 groups; group A (47 patient) instructed to use nigella sativa oil lotion twice daily for 2 months, while group (46 patient) used a control solution. Acne vulgaris was graded as mild and moderate acne by counting the number of papules and pustules. Statistical analysis was carried out by computer using t-test, f-test, and chi-square when needed.RESULTS:Eighty-one patients completed the study. In group A (43 patients), we noted a significantly reduced mean lesion count of papules and pustules after 2 months of therapy. The response of patients to treatment was good in 58%, moderate in 35% and no response in 7%. The satisfaction of patients with treatment was full in 67%, partial in 28%, and no satisfaction in 5%. In group B (38 patients), the lesions showed no significant reduction after 2 months and the response of patients to treatment was good in 8%, moderate in 34%, and no response in 58%. The satisfaction of patients with treatment in this group was full in 8%, partial in 24%, and no satisfaction in 68%. The mean difference in outcome after 8 weeks between the 2 study groups was statistically significant.CONCLUSION:The nigella sativa oil lotion has proved its efficacy as a topical therapy for acne vulgaris. This is a new natural plant extract, which lacks any side effects


Article
The Antioxidant effect of N-Acetylcysteine and its role in the treatment of patients with Acne vulgaris

Authors: Ahmed S. Sahib2 --- Ahmed R. Abu-Raghif1 --- Haidar Hamid Al-Anbari1
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 1 Issue: 11 Pages: 1390-1395
Publisher: Kerbala University جامعة كربلاء

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Abstract

ackground: Acne vulgaris is one of the most common conditions for which patients seek dermatological care and is a common disorder of the skin that affects individuals of all races and ethnicities. There has been an increasing focus on the extent to which oxidative stress is involved in the pathophysiology of acne. The aim of this study is to investigate the effect of N-acetylcysteine, a well known antioxidant, in the treatment of acne vulgaris.Patients and Methods: This study was carried out on 28 patients of both sexes with age range of 14-30 years who allocated into two groups:Group 1, treated with N-acetylcysteine orally and topical moisturizing cream once daily at bed time for 8 weeks .Group 2: were treated with placebo once daily orally and the same topical moisturizing cream . In addition to 28 healthy people, with age and sex matched group who serve as control group for baseline comparison. Serum malondialdehyde (MDA) and glutathione (GSH) were estimated at baseline and at the end of study after 8 weeks, In addition to clinical follow up.Results: Administration of N-acetylcysteine to patients with acne vulgaris (Group 1), significantly reduce serum MDA level; and increased serum level of GSH after 8 weeks compared to pre-treatment value, also reduce the number of inflammatory lesions by 21.41% and 48.91% after 4weeks and 8 weeks respectively, compared to placebo.Conclusion: The results obtained in this study clearly showed the beneficial effect of using N-acetylcysteine to patients with acne vulgaris and confirmed the role of new strategy in the targeting of pathophysiological changes accompanied with acne by using antioxidant agents.Key words: Acne vulgaris, N-acetylcysteine , antioxidants, oxidative stress.


Article
Assessment of serum testosterone in females with acne vulgaris in Erbil city
تقييم هرمون التستوستيرون في المصل عند الإناث المصابات بحب الشباب في مدينة أربيل

Authors: Fatin Qaraney Fattah --- Yousif Bahaaddin Ahmed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 1 Pages: 1249-1253
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous units, characterized by comedones, papules, pustules and nodules. Acne affects primarily the face, neck, upper trunk. Acne typically begins at puberty and it is often the first sign of increased sex hormone production. In all women with acne the possibility of hyperandrogenic state should be considered. The aim of this study was to determine the relationship between abnormal testosterone level and other virilising signs in young females with acne vulgaris. Methods: This case-control study was carried out from April 2013 to January 2014 in the consultation Department of Dermatology and Venereology at Rizgary Teaching Hospital in Erbil city. Sixty females were considered group A (case group with acne) and 60 females were considered as group B ( control group) without acne. Results: The mean±SD serum testosterone level was significantly higher among patients with acne compared to the control group (0.51 ng/ml ± 0.27 compared to 0.31 ng/ml ± 0.12, P ˂0.05). Irregular cycle was found in 28 cases (46.6%). Conclusion: The study showed presence of a significant association between serum testosterone level and acne vulgaris in female patients.


Article
Comparative study between topical clindamycin solution (1%) versus combination of clindamycin (1%)/adapalene (0.1%) gel in the treatment of mild to moderate acne vulgaris
دراسة مقارنة بين محلول الكليندامايسين الموضعي (1٪) مقابل مزيج من الكليندامايسين (1٪) / أدابالين (0.1٪) هلام في علاج حب الشباب الخفيف إلى المعتدل

Authors: Intiha M. Almosuly --- Tara F. Wali
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 3 Pages: 799-804
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Acne vulgaris is a common skin disorder. Combination therapy with topical retinoid and antibiotic is recognized as an effective treatment of acne vulgaris. The aim of this study was to compare the efficacy and tolerability of topical clindamycin solution as a monotherapy with the combination gel of clindamycin/adapalene for the treatment of mild to moderate acne of the face.Methods: This comparative therapeutic trial was conducted at the out patient department of Dermatology and Venereology at Rizgari Teaching Hospital in Erbil City from November 2008. Hundred patients with mild to moderate acne of the face were enrolled in the study and were divided in to two groups; group I (n=50); apply clindamycin phosphate solution 1%, and group II (n=50); apply a combination gel of clindamycin1% /adapalene 0.1%; once daily at night for 12 weeks.Results: Of 100 patients, 89 patients completed their treatment as per protocol, 45 patients in group I, and 44 patients in group II. At the end of the 12 weeks; the mean percent reductions of noninflammatory, inflammatory, and total lesion count were greater in group II than in group I. A significantly greater reduction of total (P = 0.008), and noninflammatory lesions (P = 0.002) were seen in group II than in group I. Both treatments were well tolerated, and few side effects were reported.Conclusion: This study demonstrates that the combination of topical clindamycin and adapalene is more effective than clindamycin solution alone, and provides faster benefit in treatment of mild to moderate acne.


Article
ACNE VULGARIS: THE PREVALENCE, SEVERITY AND THE ASSOCIATED FACTORS AMONG SECONDARY SCHOOL STUDENTS IN A DISTRICT OF KURDISTAN REGION/ IRAQ
حب الشباب: معدل الانتشار والشدة والعوامل المقترنه بهما

Authors: ZEYAD S. AL-DABBAGH زياد صميم الدباغ --- SAMIM A. AL-DABBAGH صميم أحمد الدباع --- KAMIL R. F. CHALKY كامل جلكي
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2016 Volume: 10 Issue: 1 Pages: 58-68
Publisher: University of Dohuk جامعة دهوك

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Background and objectives: Acne vulgaris is a common dermatological disorder among secondary school students. It is frequently complained by students in our locality without being properly studied. This study aimed to measure the prevalence and severity of acne vulgaris and factors affecting them among secondary school students in a district of Kurdistan Region, Iraq.Methods: A cross sectional design was performed. A multistage random sample of 575 secondary school students of both genders selected from 6988 students in Amedi district/ Duhok Governorate. All Students were clinically examined and interviewed for data collection regarding socio- demographic variables of age, gender, ethnicity, residence and family income. Also information was collected regarding parental history of acne, self excoriative behavior and make up use among females. Their nutritional status was measured by the body mass index. The severity of acne was assessed by using Global Acne Grading system. Data were collected and analyzed by using the statistical package for social sciences (SPSS version 22).Results: The results revealed prevalence rates of 71.7% and 87.8% by self–reporting and by clinical examination respectively. The mild, moderate and severe forms were found respectively in 90.8%, 9% and 0.2% of students diagnosed with acne vulgaris. Papules and comedones were the most prominent acne lesions. No statistically significant associations were detected between prevalence or severity of acne vulgaris and socio demographic factors of age, gender, ethnicity, residence and body mass index. Family history of acne vulgaris was significantly associated with severity (p <0.05) but not with the prevalence (p>0.5). Conclusions: The study demonstrated a high prevalence of acne vulgaris with substantial genetic role in the severity of the disease.

حب الشباب: معدل الانتشار والشدة والعوامل المقترنه بهما


Article
The frequency of penile acne among Iraqi males with facial acne vulgaris

Author: Husam A. Salman
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 445-447
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Acne vulgaris is a common skin problem. It affects areas of high density of sebaceous glands like the face, chest and back. The penile skin is no exception, also can be affected with acne, however little was written on this subject.
Patients & Methods: This is a clinical epidemiological study conducted at the Department of Dermatology & Venereology- Baghdad Teaching Hospital, during the period between December 2007 and May 2008. Seventy six male patients with facial acne vulgaris were enrolled in the study. A full history includes age, age of onset of facial acne and any penile lesion observed by the patient Examination of the face was done for the severity of acne and grading it into mild, moderate, severe and very severe according to Allen and Smith method. The penis of each patient was examined for the presence of ectopic sebaceous glands and acne.
Results: A total number of 76 patients, their ages ranged between13 - 30 years with mean + 19.033 + 4.609. They were classified into 4 groups according to the grades of severity of acne vulgaris, 23 (30.26%), 20 (26.31%), 18 (23.68%) and 15 (19.73%) corresponding to mild, moderate, severe and very severe respectively. The frequency of ectopic sebaceous glands in these 4 groups were 15(65.21%),14(70%), 12(66.66%) and 9(60%) respectively with a total 65.78 % from all patients with facial acne. The frequency of penile acne in these 4groupswere4 (17.39%),3(15%),3(16.66%) and 2 (13.33%) with a total 15.87 % from all patients with facial acne. There was neither a statistical significant difference in the frequency of penile ectopic sebaceous glands nor of penile acne among the 4 grades of facial acne vulgaris. P value = 0.993 and 0.992 respectively. In all patients the ectopic sebaceous glands and lesions of penile acne were situated in the ventral surface of the penis. Most patients who were aware about penile lesions and afraid from having sexually transmitted disease were those having papules and pustules.Conclusion: Penile ectopic sebaceous glands were a common skin condition and penile acne was not uncommon skin problem among Iraqi males.


Article
Quality of Life Assessment in Iraqi Patients with Acne Vulgaris and Psoriasis

Author: Hayder R Al-Hamamy*, Sarmad Yahya Abood**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 4 Pages: 345-348
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Skin diseases may affect daily lives of individuals and their psychological and social relationships. Appropriate measurement systems are required to evaluate the impact of the disease on the quality of life. The Dermatology Life Quality Index (DLQI) is an important and commonly used dermatology specific quality of life instrument.OBJECTIVE: To assess the quality of life in 2 common dermatological disorders (acne and psoriasis) in Iraqi patients attending dermatological outpatient clinic, Baghdad Teaching Hospital.PATIENTS AND METHODS:A case series study of 400 patients with 2 dermatological diseases (acne and psoriasis); 200 patients for each disease were evaluated. Information related to socio-demographic data and disease severity were recorded and quality of life was assessed by means of the Dermatology Life Quality Index.RESULTS:The DLQI of patients with acne and psoriasis were comparable; 7.71+/-4.64 and 8.52+/-4.48 respectively. In patients with acne the DLQI was significantly affected by higher level of education P=0.002, also in unmarried patients P=0.0001. Increased disease severity also affected DLQI (P=0.003). In patients with psoriasis the only factor which was associated with a higher DLQI was female gender.CONCLUSION:Acne and psoriasis affect significantly the DLQI of patients. DLQI is a good indicator of the impact of the disease on the life of the patient.

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