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Search Results: 1 - 10 of 2134 matches for " Alireza Khatami "
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Iranian Journal of Child Neurology , 2012,
Evaluation of diagnostic test accuracy studies
Alireza Khatami
Dermatology and Cosmetic , 2011,
Abstract: "nIn the recent years, advances in different fields of technology have been resulted in a dramatic increase in the diagnostic methods and tests in different branches of clinical medicine with a consequent increase in the number of scientific publications related to the application of those tests and methods in the diagnosis or prevention of diseases. Dermatology is not an exception. Since, evidence-based medicine emphasizes on the appropriate use of the current best clinical research evidence in the diagnosis or treatment of each individual patient acknowledging his/her values, the capability of dermatologists in appraisal and application of the publications, which reports the results of diagnostic test accuracy studies cannot be ignored. In this article, after a brief review on basic issues in diagnostic test accuracy studies, principles of critical appraisal of these studies, from an evidence-based viewpoint, will be discussed. General strategies for evaluation of validity, applicability and quality assessment of a diagnostic test study will be provided.
Dermatology: A Public Health Perspective
Alireza Khatami,Hamed Zartab
Dermatology and Cosmetic , 2011,
Abstract: Dermatology is a branch of medicine which is related to the diagnosis, treatment and prevention of the diseases and disorders that affect the skin and its appendages including hair, nail, sweat glands and mucosal surfaces of mouth and external genitalia. There are about 3000 clinical entities in the field of dermatology, which are very diverse in terms of their etiologies. Although some of these diseases are really prevalent and some others of them have high incidence rates and acknowledging that because of their visibility in many cases they are associated with stress, anxiety and impairment of patients quality of lives, their resultant burden of disease at individual, familial and social levels are usually ignored. Herein, we provide some examples of the adverse public health and health economics effects of different dermatological diseases and disorders in different countries and populations. We also provide some reasons for this negligence and suggest some strategies to tackle this problem.
Brain MRI Findings in Infantile Spasm: Outcome Correlations in a Patient Cohort  [PDF]
Alireza Khatami, Erick Sell, Mohamed Aggag, Elka Miller
Open Journal of Medical Imaging (OJMI) , 2016, DOI: 10.4236/ojmi.2016.63008
Abstract: Background: Infantile spasm is a type of pediatric seizure often associated with a negative prognosis. The aim of this study was to evaluate the role of Magnetic Resonance Imaging (MRI) in categorization and neurodevelopmental outcomes in children with infantile spasm. Materials and Methods: A retrospective study of the clinical charts and MRI findings of infants diagnosed with infantile spasm between December 2007 and February 2014. Results: A total of 26 children (16 males; 1.6/1) were included: 8 of unknown etiology and 18 with a genetic/structural-metabolic causes. Unknown etiology cases revealed normal brain MRI in 5/8 (62.5%). In the genetic/ structural-metabolic group, only 2/18 (11.1%) had normal imaging. Abnormal imaging findings significantly correlated with genetic/structural-metabolic infantile spasm which had unfavorable neurodevelopmental outcome. Conclusion: Neuroimaging conveys substantial information to the further categorization of children with infantile spasm, providing not only relevant information of the underlying cause but also the prediction of the neurodevelopmental outcome.
Safety and Efficacy of Tacrolimus 0.03% Ointment in the Treatment of Atopic Dermatitis: A Randomized, Double-Blind, Placebo Controlled Clinical Trial
Parvin Mansouri,Soheila Hasouri,Alireza Firooz,Alireza Khatami
Dermatology and Cosmetic , 2011,
Abstract: Background and Aim: Atopic dermatitis (AD) is a chronic, relapsing, pruritic skin disease more common in infancy and childhood. Emollients, topical corticosteroids, and avoidance of irritating factors are the mainstay of its treatment, but fear of side effects has limited the use of topical corticosteroids. The objective of this study was to evaluate the safety and efficacy of topical tacrolimus 0.03% ointment in the treatment of AD. Methods: In this randomized, double-blind, clinical trial, 76 patients with AD older than 2 years were randomly allocated in two groups and treated with either tacrolimus 0.03% ointment (Abu-Rayhan Co., Iran) or placebo, twice a day for 6 weeks. Responses to treatment were compared every 2 weeks using SCORAD. Results: Twenty-nine patients in tacrolimus group and 26 in placebo group completed the trial. The reduction in SCORAD after 2 and 4 weeks in tacrolimus group was significantly higher than placebo group (P<0/05). The frequency of treatment-induced pruritus and burning sensation was similar in both groups but erythema was more observed in the placebo group (P<0/05). Conclusion: Tacrolimus 0.03% ointment is more effective than placebo in the treatment of AD. ackground and Aim: Anti-inflammatory and hypo- pigmenting effects of topical tretinoin and alpha-hydroxy acids have been documented. This study was designed to compare the efficacy of 0.05% tretinion cream with 7% alpha-hydroxy acid in the treatment of ephelides. Methods: In this clinical trial 80 patients with ephelides were selected and allocated into two groups. One group was treated with 0.05% tretinoin cream every other night. The other group was treated with 7% alpha-hydroxy acid cream in the same manner. Both groups were treated with antisolar creams and followed every month for 5 months. Results: After 5 months excellent therapeutic response was achieved in 3 (7.5%) of patients who were treated with 0.05% tretinoin cream compared to 8 (20%) in alpha-hydroxy acid cream. Good therapeutic response was observed in 20 (50%) of tretinoin group versus 16 (40%) in alpha-hydroxy acid group. Patient's satisfaction from treatment was consistent with evaluation by dermatologists (P=0.384 and P=0.132). Conclusion: Both 0.05% tretinoin cream and 7% alpha-hydroxy acid cream are equally efficient in the treatment of ephelides.
Bony Lesions in Pediatric Acute Leukemia: Pictorial Essay
Makhtoom Shahnazi,Alireza Khatami,Bibishahin Shamsian,Mastooreh Mehrafarin
Iranian Journal of Radiology , 2012,
Abstract: Acute leukemia is the most common malignancy in childhood, which mainly involves children less than 15 years of age. The growing skeleton is the main site of involvement in children. Leukemic cells proliferate within the massive red bone marrow in children. So besides the pallor, petechia, purpura and ecchymosis in the skin and mucosal surfaces, bone pain and other bony lesions are other manifestations of leukemia.On the other hand, bony lesions are more prevalent in children than adults with no poor prognosis in comparison to patients without bone lesions. These bony lesions may precede other laboratory tests so familiarity with these presentations is very important for earlier diagnosis.In this pictorial essay, we tried to gather the most common bony lesions that may be seen in acute leukemia in different cases admitted to our hospital with general malaise and localized tenderness and discomfort leading us to perform plain X-ray for further evaluation. Finding these bony lesions helps clinicians to reach the diagnosis quickly. These findings include metaphyseal lucent band and erosion, periosteal reaction, small lucent bone lesion and permeative appearance, reduced bone density and collapsed vertebra.
Ultrasonographic measurement of subarachnoid space and frontal horn width in healthy Iranian infants
Iranian Journal of Child Neurology , 2011,
Abstract: Objectiveultrasonography is among the most general evaluating methods for central nervous system (CNS) assessment, especially for detecting extra axial collection via anterior fontanel. There are few studies showing values of this technique in normal developing infants for detection of subarachnoid space width.Association between age and sex and cerebrospinal fluid (CSF) spaces are controversial. Therefore, we conducted this study to evaluate the relationship between subarachnoid space and sex and age in Iranian infants.Material & Methodswe used ultrasonography with a 7.5MHZ linear probe to evaluate 74 healthy infants who were referred to our departments for other reasons. Sinocortical width (SCW), craniocortical width (CCW), interhemispheric width (IHW) and frontal horn width (FHW) were evaluated. Data was collected and analyzed using STAT 9.1 software.ResultsFifty four percent of the patients were male and 45% were female. Mean age of cases was 71 days. Mean SCW was 2.8 ± 1.33 mm (5% and95% were 1.2-5.8). Mean CCW was 2.52±1.37mm (5% and 95% were 1.1 and 5.2mm, respectively) and mean IHW was 4.39±2mm (5% and 95% were 1.7 and 8mm, respectively). Mean FHW was 2.9+/-1.09mm in females and 3.52±1.34mm in males (5% and 95% were 1.4 and 5mm in females & 1.7 and 5.8mm in males, respectively). There was no significant difference in subarachnoid space width between boys and girls except for FHW which was wider in males than females. (P=0.037). All space diameters correlated with age and were wider in older infants.ConclusionAlthough our sample size was rather small for accurate conclusion, we found a normal range which was wider than western countries but similar studies conducted in China. Delayed maturation of arachnoid villi is one of the most important reasons of subarachnoid space widening in infants younger than one year which seems occur later in Iranian infants.
Comparison of efficacy of intralesional injection of meglumine anti-moniate once-weekly with twice-weekly in the treatment of anthroponotic cutaneous leishmaniasis in Mashhad: a randomized clinical trial
Ali Khamesipour,Mohammad Hossein Ghoorchi,Alireza Khatami,Seyed Ebrahim Eskandari
Dermatology and Cosmetic , 2011,
Abstract: Background and Aim: Cutaneous leishmaniasis (CL) is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL (ACL) caused by L. tropica and zoonotic CL (ZCL) caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate (MA) in the treatment of ACL."n"nMethods: This randomised controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of induration."n"nResults: A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12th week after initiation of treatment, complete healing was observed in 38 out of 44 lesions (86.4%) in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days (95% confidence interval [CI]: 32.0-39.9). Complete healing was recorded in 60 out of 69 lesions (86.9%) in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days (95% CI: 20.9-29.1). While no significant difference was observed between the two groups in terms of complete healing rate (P=0.999), time-to-heal was significantly different between the 2 groups (P=0.003)."n"nConclusion: It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions.
Comparison of the efficacy of weekly vs. twice a week intralesional injections of meglumine antimoniate in the treatment of anthroponotic cutaneous leishmaniasis: a randomized clinical trial
Ali Khamesipour,Alireza Khatami,Iraj Sharifi,Mahdie Bahrami
Dermatology and Cosmetic , 2010,
Abstract: "nBackground and Aim: Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime ) is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL)."n"nMethods: This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime and the other group treated with intralesional Glucantime twice a week. Type and size of each lesion (induration, ulcer and scar) were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure."n"nResults: A total of 48 patients completed the study; complete cure was seen in 24 of 27 (89%) patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77%) patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23)."n"nConclusion: It seems that the efficacy of intralesional injections of Glucantime once a week is similar to efficacy of twice a week Glucantime injections.
Dressings Combined with Injection of Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis: A Randomized Controlled Clinical Trial
Alireza Khatami, Rezvan Talaee, Makan Rahshenas, Ali Khamesipour, Pedram Mehryan, Sepideh Tehrani, Yahya Dowlati, Alireza Firooz
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0066123
Abstract: Background Cutaneous leishmaniasis (CL) is a neglected infectious disease and a major health problem in several developing countries. Despite some reasonable explanation for their potential benefits, there is only trace evidence regarding the role of dressings in the treatment of CL. Methods This randomized, assessor-blind, controlled, clinical trial was conducted in an endemic area for CL caused by Leishmania major in Iran to assess the efficacy of administration of weekly intralesional meglumine antimoniate (i.l.MA) either alone or combined with application of a silver or a non-silver polyester dressing on their lesions for 6 weeks. After screening of 241 patients with CL lesions, 83 eligible patients with 158 lesions were randomly allocated in three arms of the study. Eligibility criteria included parasitologically confirmed CL, age of 12 to 60 years; willingness to participate, duration of lesion<3 months, number of lesions<5, largest ulcer diameter<5 cm. Pregnant or lactating women were excluded. The primary outcome was absolute risk reduction (ARR) based on the proportion of complete healing, which was defined as more than 75% reduction in the size of the lesion compared with baseline in each group at the termination of treatment and 1 month later. Findings ARR (95% Confidence Interval [CI]) in i.l.MA versus i.l.MA+non-silver dressing groups was 5.98% (?7.07% to 20.25%), between i.l.MA versus i.l.MA+silver dressing groups was ?0.23% (?13.53% to 14.82%), and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was ?6.21%(?18.28% to 6.52%) after 6 weeks of treatment. ARR (95% CI) in i.l.MA versus i.l.MA+non-silver dressing groups was ?2.22% (?22.12% to 18.10%), between i.l.MA versus i.l.MA+silver dressing groups was 3.64% (?15.36% to 22.82%), and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was 5.86% (?12.86% to 24.31%) 1 month later. Conclusion It could not be demonstrated that the efficacy of i.l.MA was improved by either dressing. Trial Registration Iranian Registry of Clinical Trials (IRCT.ir) IRCT138707201166N2.
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