In Iran, pemphigus vulgaris is the most frequent form of pemphigus. Females are more prone to the disease. The incidence of pemphigus in Tehran is approximately 1.6 per 100,000/year, and in Iran 1.0 per 100,000/year. The age of onset was lower than classically reported. Death occurred in 6.2% of the patients. In pemphigus vulgaris, the mucosal and skin form together had a worse prognosis than the other clinical forms.

Findings suggest that massage is an effective alternative intervention, decreasing pain and anxiety during labor and increasing the level of satisfaction. Also, the supportive role of presenting an attendant can positively influence the level of anxiety and satisfaction.

In this topical study the influence of Aloe Vera, on the wound healing process was investigated in 63 male rats with microscopic and cell count methods. On the day of surgery a round wound, of diameter 20 mm, was created on the back of rats necks under sterile conditions. The surgery day was determined as day zero (0). Then the rats were divided randomly into control and experimental groups 1 and 2. Animals in each group were sub-divided to three smaller groups, investigated every 4, 7, and 14 days. From day 0, wound surfaces were covered with gel once daily in experimental group 1 and twice daily, for 12 h interval, in experimental group 2. Each rat received 30 g of the gel. The wound surface and healing were assessed on days 4, 7, and 14, and then a sample from the wound was prepared and investigated microscopically. The results show that the number of neutrophil, macrophage, and fibroblast cells and the wound thickness in the control group were statistically different from the experimental groups. It was found that the wound diameter thickness in the experimental group was greatly lower due to twice administration of gel and the power of wound healing was more than other groups.

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Context:The reported prevalence of chronic obstructive pulmonary disease (COPD) varies among different groups of cardiac surgical patients. Moreover, the prognostic value of preoperative COPD in outcome prediction is controversial.Aims:The present study assessed the morbidity in the different levels of COPD severity and the role of pulmonary function indices in predicting morbidity in patients undergoing coronary artery bypass graft (CABG).Settings and Design:Patients who were candidates for isolated CABG with cardiopulmonary bypass who were recruited for Tehran Heart Center-Coronary Outcome Measurement Study.Methods:Based on spirometry findings, diagnosis of COPD was considered based on Global Initiative for Chronic Obstructive Lung Disease category as forced expiratory volume in 1 s [FEV1]/forced vital capacity <0.7 (absolute value, not the percentage of the predicted). Society of Thoracic Surgeons (STS) definition was used for determining COPD severity and the patients were divided into three groups: Control group (FEV1 >75% predicted), mild (FEV1 60–75% predicted), moderate (FEV1 50–59% predicted), severe (FEV1<50% predicted). The preoperative pulmonary function indices were assessed as predictors, and postoperative morbidity was considered the surgical outcome.Results:This study included 566 consecutive patients. Patients with and without COPD were similar regarding baseline characteristics and clinical data. Hypertension, recent myocardial infarction, and low ejection fraction were higher in patients with different degrees of COPD than the control group while male gender was more frequent in control patients than the others. Restrictive lung disease and current cigarette smoking did not have any significant impact on postoperative complications. We found a borderline P = 0.057 with respect to respiratory failure among different patients of COPD severity so that 14.1% patients in control group, 23.5% in mild, 23.4% in moderate, and 21.9% in severe COPD categories developed respiratory failure after CABG surgery.Conclusion:Among post-CABG complications, patients with different levels of COPD based on STS definition, more frequently developed respiratory failure. This finding may imply the prognostic value of preoperative pulmonary function test for determining COPD severity and postoperative morbidities.

Background A wrong traditional belief persists among people that opium consumption beneficially affects cardiovascular disease and its risk factors. However, no evidence exists regarding the effect of opium consumption or cessation on the long-term risk of major adverse cardio-cerebrovascular events after coronary artery bypass grafting. We therefore aimed to evaluate the effect of persistent opium consumption after surgery on the long-term outcomes of coronary artery bypass grafting. Methods The study population consisted of 28,691 patients (20,924 men, mean age 60.9 years), who underwent coronary artery bypass grafting between 2007 and 2016 at our centre. The patients were stratified into three groups according to the status of opium consumption: never opium consumers ( n = 23,619), persistent postoperative opium consumers ( n = 3636) and enduring postoperative opium withdrawal ( n = 1436). Study endpoints were 5-year mortality and 5-year major adverse cardio-cerebrovascular events, comprising all-cause mortality, acute coronary syndrome, cerebrovascular accident and revascularisation. Results After surgery, 3636 patients continued opium consumption, while 1436 patients persistently avoided opium use. The multivariable survival analysis demonstrated that persistent post-coronary artery bypass grafting opium consumption increased 5-year mortality and 5-year major adverse cardio-cerebrovascular events by 28% (hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.06–1.54; P = 0.009) and 25% (HR 1.25, 95% CI 1.13–1.40; P < 0.0001), respectively. It also increased the 5-year risk of acute coronary syndrome by 34% (sub-distribution HR 1.34, 95% CI 1.16–1.55; P < 0.0001). Conclusions The present data suggest that persistent post-coronary artery bypass grafting opium consumption may significantly increase mortality, major adverse cardio-cerebrovascular events and acute coronary syndrome in the long term. Future studies are needed to confirm our findings.

Background: The exact prevalence and distinct clinical and histological criteria of psoriatic lesions in the oral cavity remain unknown. Although some non-specific lesions are more frequent in psoriatic patients in comparison with healthy people, the incidence and clinical variation of psoriasis are heterogeneous in the literature. Objectives: This study aimed to evaluate the incidence of oral lesions in Iranian patients with psoriasis. Methods: Patients with plaque-type psoriasis were participated in a cross-sectional study. Physicians performed full-body skin examination and assessed extra-cutaneous involvement including oral cavity, nails and articular system. Results: One hundred patients with psoriasis (41 males and 59 females) with the mean age of 43.79 ± 12.52 years were participated in the study. Mucosal changes clinically suggestive of oral psoriasis were detected in none of the cases. We observed nonspecific oral lesions in 48% of the patients including fissured tongue (35%), angular cheilitis (13%), actinic cheilitis (11%), geographic tongue (6%), fibroma (3%) and denture stomatitis (2%). The statistical analyses showed that presentation of oral lesions increases with concomitant cardiovascular disorders or diabetes mellitus, but no relationship between oral lesions and other demographic and clinical data was noted. Conclusions: Although the incidence of true oral psoriasis is rare, non-specific oral lesions may be frequently found in patients with psoriasis. Since both true psoriatic oral lesions and non-specific changes are mostly asymptomatic, routine examination of the oral cavity is necessary in all patients with the diagnosis of psoriasis.