Monthly TA intradermal injections can be an effective treatment for melasma. Further studies are required to support our results.

No abstract

Background There are some concerns about the effectiveness of the inactivated and vector-based vaccines against SARS-CoV-2 in the real-world settings with the emergence of new mutations, especially variants of concern. Data derived from administrative repositories during mass-vaccination campaigns or programs are of interest to study vaccine effectiveness (VE). Methods Using 4-repository administrative data linkage, we conducted a historical cohort study on a target population of 1,882,148 inhabitants aged at least 18 years residing in Southern Iran. Results We estimated 71.9% [95% CI: 70.7-73.1%], 81.5% [95% CI: 79.5-83.4%], 67.5% [95% CI: 59.5-75.6%], and 86.4% [95% CI: 84.1-88.8%] hospital admission reduction for those who received the full vaccination schedule of BBIBP-CorV (Sinopharm), ChAdOx1-S/nCoV-19 vaccine (AZD1222, Oxford–AstraZeneca), rAd26-rAd5 (Gam-COVID-Vac, Sputnik V), and BIV1-CovIran (COVIran Barekat) vaccines, respectively. A high reduction in mortality – at least 85% – was observed in all age subgroups of fully immunized population. Conclusion The pragmatic implementation of a vaccination plan including all available vaccine options in the Iranian population was associated with a significant reduction in COVID-19 detected infections as well as hospital admissions and deaths associated with COVID-19.

Background and Objective Psoriasis is a common chronic inflammatory skin disorder affecting any age and gender. The clinical presentation of the nail disease depends on the location of the pathology: nail bed or nail matrix. We aimed to compare the therapeutic effects of triamcinolone acetonide iontophoresis (TI) and topical calcipotriol/betamethasone dipropionate in the nail bed and nail matrix involvements of psoriasis using Nail Psoriasis Severity Index (NAPSI). Materials and Methods In the present bilateral comparison clinical trial, sixteen patients with clinical diagnosis of nail psoriasis were enrolled and randomized to receive six monthly TI treatment sessions either on their right or on the left hand target nails and daily application of topical calcipotriol/betamethasone dipropionate for six months on their other hand. Clinical efficacy was evaluated according to target nails NAPSI before and after the treatment. Wilcoxon sign-rank test and repeated measures ANOVA were used to compare the efficacy of the treatments. Results The results did not show any difference between the therapeutic effects of TI and topical calcipotriol/betamethasone dipropionate regarding the nail bed score (P value =  .356), matrix score (P value =  .137), and total NAPSI (P-value =  .098). Conclusion Monthly TI has an equal efficacy compared to daily topical calcipotriol/betamethasone dipropionate. It can be used as a safe, easy, and compliant treatment for nail psoriasis. This study is registered under IRCT2017050233778N1.

Collagenoma is a type of connective tissue nevi, a rare hamartomatous malformation characterized by the predominant proliferation of normal collagen fibers and normal, decreased, or increased elastic fibers. Collagenomas present as multiple or solitary, hereditary or sporadic, asymptomatic, skin-colored papules, nodules, and plaques with variable sizes, and are usually located on the trunk, arm, and back. Here, we report on a 14-year-old boy who presented with an isolated giant collagenoma of the frontal area that dramatically responded to intralesional triamcinolone acetonide.

Background and objective Ivermectin is a known anti‐parasitic agent that has been investigated as an antiviral agent against coronavirus disease 2019 (COVID‐19). This study aimed to evaluate the efficacy of ivermectin in mild COVID‐19 patients. Methods In this multi‐arm randomized clinical trial conducted between 9 April 2021 and 20 May 2021, a total of 393 patients with reverse transcription‐PCR‐confirmed COVID‐19 infection and mild symptoms were enrolled. Subjects were randomized in a 1:1:1 ratio to receive single‐dose ivermectin (12 mg), double‐dose ivermectin (24 mg) or placebo. The primary outcome was need for hospitalization. Results There was no significant difference in the proportion of subjects who required hospitalization between the placebo and single‐dose ivermectin groups (absolute difference in the proportions: −2.3 [95% CI = −8.5, 4.1]) and between the placebo and double‐dose ivermectin groups (absolute difference in the proportions: −3.9 [95% CI = −9.8, 2.2]). The odds of differences in mean change in severity score between single‐dose ivermectin and placebo groups (ORdifference = 1.005 [95% CI: 0.972, 1.040]; p = 0.762) and double‐dose ivermectin and placebo groups (ORdifference = 1.010 [95% CI: 0.974, 1.046]; p = 0.598) were not statistically significant. None of the six adverse events (including mild dermatitis, tachycardia and hypertension) were serious and required extra action. Conclusion Single‐dose and double‐dose ivermectin early treatment were not superior to the placebo in preventing progression to hospitalization and improving clinical course in mild COVID‐19.

ObjectivesEpidemics are anticipated to influence the coverage of health services. We assessed the impact of the COVID-19 pandemic on maternal healthcare indices and care providers’ performance.Setting1801 maternal healthcare centres under the auspices of Shiraz University of Medical Sciences, Shiraz, Southern Iran.ParticipantsApproximately 63 000 pregnant women.Primary and secondary outcome measuresIn this prospective ecological study, interrupted time series analysis was used to model and compare the trend of maternal healthcare indices before and after the COVID-19 pandemic announcement.ResultsThe results showed a significant drop in count of preconception healthcare visits, first routine laboratory tests, first trimester prenatal care, first trimester sonography, prenatal screening for birth defects at weeks 11–13, prenatal care visits at weeks 16–20, second routine laboratory tests, second trimester sonography, prenatal care visits at weeks 24–30, prenatal care visits at weeks 31–34, postpartum care visits at days 10–15 and postpartum care visits at days 30–42 with the start of the COVID-19 pandemic (−50% (95% CI −48.68% to –51.36%), −19.67% (95% CI −22.12% to –17.15%), −25.88% (95% CI −28.46% to –23.21%), −23.84% (95% CI −26.26% to –21.34%), −20.16% (95% CI −23.01% to –17.20%), −18.53% (95% CI −21.25% to –15.71%), −28.63% (95% CI −31.03% to –26.14%), −27.48% (95% CI −30.07% to –24.79%), −31.08% (95% CI −33.43% to –28.61%), −31.84% (95% CI −34.35% to –29.23%), 32.55% (95% CI −35.12% to –29.89%) and −39.28% (95% CI −41.59% to –36.88%), respectively). Nevertheless, the trend in coverage of these services showed recovery in the subsequent months (8.36%, 10.55%, 5.74%, 8.01%, 4.40%, 5.06%, 11.20%, 7.58%, 7.38%, 7.80%, 9.59% and 9.61% per month, respectively).ConclusionsUsing ecological data during the COVID-19 pandemic era, we observed a ‘level change and slope change’ as the major pattern of interruption of maternal healthcare coverage, indicating a possible indirect effect rather than a causative relationship. Such relative predictability might assist with future pandemic planning.

Melasma is an acquired, chronic, and commonly recalcitrant hyper melanosis of the skin due to the hyperactivity of the epidermal melanocytes. It is described as bilateral brown-to-dark macules and patches mostly on sun-exposed areas, predominantly the face. 1,2 Melasma is presumed to be a multifactorial condition, not limited to any race, while being much more common in women, accounting for up to 90% of all cases predominantly with Fitzpatrick's skin phototypes III-V. 1 Since melasma negatively affects the quality of life and selfesteem, 3 much scientific effort has been dedicated, with various treatments being introduced into clinical practice. Topical agentsespecially tyrosinase inhibitors (i.e., hydroquinone (HQ), azelaic acid, and kojic acid)-, broad-spectrum sunscreens, chemical peels, tranexamic acid (TA), and lasers currently make up the front lines