AR Firooz; AR Khatami; A Khamesipour; M Nassiri Kashani; MA Nilforoushzadeh; F Behnia; HR Pazoki Toroudi; Y Dowlati
Volume 7, Issue 4 , 2004, , Pages 209-218
Abstract
Background: Several treatment modalities have been used for cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnSO4) on Leishmania parasites. Objective: To compare the efficacy of intralesional injections of 2% ZnSO4 solution ...
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Background: Several treatment modalities have been used for cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnSO4) on Leishmania parasites. Objective: To compare the efficacy of intralesional injections of 2% ZnSO4 solution with meglumine antimonate (Glucantime) in the treatment of acute Old World CL. Patients and Methods: Seventy-two patients with CL with a duration of less than 8 weeks were recruited in a randomized, double-blind, clinical trial in Isfahan province – an area endemic for Leishmania major – after giving written informed consent. They were treated with 6 weekly intralesional injections of either 2% sterile ZnSO4 solution or Glucantime prepared in identical vials. The primary outcome measure was complete re-epithelialization of CL lesions. Results: Among 36 patients with 53 lesions treated with ZnSO4 and 36 patients with 53 lesions treated with Glucantime, 13 patients with 19 lesions and 22 patients with 31 lesions completed the trial, respectively. Inadequacy of treatment was the main reason for drop-out in 12 (33.3%) and 2 (5.5%) patients in ZnSO4 and Glucantime groups, respectively (P<0.05). Complete re-epithelialization was observed in 2 (10.5%) and 19 (61.3%) lesions 1 week after the end of treatment in the ZnSO4 and Glucantime groups, respectively (P<0.05). Conclusion: A six-week course of weekly intralesional injections of 2% ZnSO4 solution was less effective than Glucantime in the treatment of acute Old World CL.
M Mohebali; P Yaghoobi; B Hooshmand; A Khamesipour
Volume 7, Issue 2 , 2004, , Pages 88-94
Abstract
Background: Considering the difficulties, adverse effects and unsuitable response to commonly used drugs; it is essential to find an alternative, particularly local treatment for cutaneous leishmaniasis (CL). Objective: Determination of efficacy of topical paromomycin (Paromo-U ointment) against CL caused ...
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Background: Considering the difficulties, adverse effects and unsuitable response to commonly used drugs; it is essential to find an alternative, particularly local treatment for cutaneous leishmaniasis (CL). Objective: Determination of efficacy of topical paromomycin (Paromo-U ointment) against CL caused by L.major in mouse model. Materials and Methods: Skin lesions were created 1 to 3 months after inoculation of L.major promastigotes to the base of tail of small, white mice (Outbreed). Then the mice were randomly divided to three groups including interventional (Treatment by Paromo-U), control 1 (Treatment by urea) and control 2 (Treatment by distilled water) groups. The mice were treated topically twice a day for 8 weeks. Results: The mean lesion diameter of the lesions prior to treatment in interventional and control groups (Urea and distilled water) were measured 10.9, 5.9 and 6.0 mm respectively and changed to 4.0, 12.7 and 14.3 mm 8 weeks after treatment. No Leishman bodies were observed within the lesions of interventional group, whereas they were seen in all control groups. Conclusion: Paromo-U ointment was effective in the treatment CL caused by L.major in mouse model.
H Mortazavi; A Khamesipour; Z Hallaji; H Bakhshi; A Miramin Mohammadi
Volume 5, Issue 4 , 2002, , Pages 3-9
Abstract
Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) ...
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Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) and Leishmanin skin test (LST) between non-healing and healed patients of CL. Patients and Methods: Fifteen patients with non-healing CL suffering for more than two years, and eight individuals cured from CL were enrolled in this study. The rate of IFN-γ production by peripheral blood mononuclear cells assessed by ELISA and results of LST were compared in both groups. Results: The mean level of the IFN-γ production in non-healing patients and cured individuals were 729 pg/ml, and 4229 pg/ml, respectively (T- test, P<0.01). Four patients in non-healing group had negative LST and all cured patients had positive LST. Conclusion: The low level of the IFN-γ in non-healing patients and high level of IFN-γ in healed individuals are in favour of the lack of TH1 response, which is usually seen in healed patients. Comparing the results of LST between two groups is not conclusive.
SH Hejazi; P Nasrifar; S Jamali; AA Jahangir Nezhad; A Khamesipour
Volume 4, Issue 1 , 2000, , Pages 7-11
Abstract
Background: Isfahan is one of the major foci of cutaneous leishmaniasis in Iran. According to the epidemiological studies, both urban and rural forms have been reported in Isfahan. Accurate identification and characterization of Leishmania is essential for the control of the disease. Several different ...
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Background: Isfahan is one of the major foci of cutaneous leishmaniasis in Iran. According to the epidemiological studies, both urban and rural forms have been reported in Isfahan. Accurate identification and characterization of Leishmania is essential for the control of the disease. Several different molecular techniques for Leishmania identification are developed including use of monoclonal antibodies. Objective: In the present study specific monoclonal antibodies against L.major (T1, T9), L.tropica (T10, T11) and L.donovani (D2) were used to identify and characterize the leishmania parasites isolated from patients with cutaneous leishmaniasis in Isfahan. Patients and Methods: Samples were obtained from borders of lesions suspicious of leishmaniasis in 298 patients, stained with Giemsa and cultured in NNN and RPMI 1640 media supplemented with 10% fetal colf serum. The promastigotes were then purified, counted and used as antigen in ELISA test. Results: Mass production of promastigotes was successful in 120 cases. L.major was identified as the causative agent of the disease in 100 cases and L.tropica in 8 patients. In 12 cases the results were inconclusive as the antigens reacted with either 2 or 3 specific monoclonal antibodies. Conclusion: L.major is the most common cause of leishmaniasis in Isfahan.
AR Gholami; A Khamesipour; A Momeni; T Ghazanfari; MA Nilforoush Zadeh; Z Darajeh; Y Dowlati
Volume 3, Issue 3 , 2000, , Pages 2-6
Abstract
Background: Cutaneous leishmaniasis (CL) is a protozoan disease of the skin caused by a wide range of italic species. The disease is endemic in many countries. It has been recognized as a major public health problem in Iran. Many treatments have been suggested for it but none of them was fully effective. ...
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Background: Cutaneous leishmaniasis (CL) is a protozoan disease of the skin caused by a wide range of italic species. The disease is endemic in many countries. It has been recognized as a major public health problem in Iran. Many treatments have been suggested for it but none of them was fully effective. Objective: The objective of this study was to compare the efficacy of a 5% garlic cream with placebo in CL. Patients and Methods: A double blind, placebo controlled study was performed in Isfahan and Jahrom in 1997 and 1998. 197 patients were randomly selected. Exclusion criteria were: pregnancy, lactation, age less than 5 years and duration of disease more than 100 days. Each patient received garlic cream 5% or placebo for 3 weeks and was followed for another period of 40 days. Results: The study was completed as planned in 171 patients. 96 were treated with garlic 5% cream and 75 with placebo. Complete healing occurred in 18 (18.75%) of garlic group in comparison with 15 (20%) of placebo group. The difference was not significant (P=0.9865). Conclusion: 5% garlic cream was not effective in treatment of cutaneous leishmaniasis. Further studies with higher concentrations or different vehicle are needed.
A Momeni; A Khamesipour; A Bagher Zadeh; M Amin Javaheri
Volume 3, Issue 1 , 1999, , Pages 24-30
Abstract
Background: Cell-mediated immunity (CMI) plays an important role in resistance against leishmaniasis. Leishmanin test (Montenegro skin test) is a method in evaluation of immune system reaction against cutaneous leishmaniasis. The TDR/WHO reference Leishmanin produced by the Pasteur Institute of Iran ...
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Background: Cell-mediated immunity (CMI) plays an important role in resistance against leishmaniasis. Leishmanin test (Montenegro skin test) is a method in evaluation of immune system reaction against cutaneous leishmaniasis. The TDR/WHO reference Leishmanin produced by the Pasteur Institute of Iran is used worldwide. Two other antigens produced by Razi Serum Institute of Iran, Killed Leishmania Major (K.L.M) and Autoclaved Leishmania Major (A.L.M), take advantage of vaccine strains of L.major, and under supervision of WHO, have been investigated as leishmaniasis vaccine. Objective: KLM, ALM and standard Leishmanin as skin test wee compared in this study. Patients and Methods: Fifty patients with cutaneous leishmaniasis were randomly selected. They attended the educational clinics of Isfahan University of Medical Sciences. All 3 antigens were injected intradermally in them and the size of erythema and induration were read and recorded after 48 hours. Data were grouped and analyzed with analysis of variance (ANOVA). Results: There was significant difference between mean of erythema and induration sizes of antigens in two by two comparison. The mean of erythema and induration sizes due to K.L.M were greater than A.L.M, and mean of erythema and induration sizes due to A.L.M were greater than Pasteur Institute reference leishmanin (P<0.0001). Conclusion: Although the mean of erythema and induration sizes due to K.L.M were greater than others, use of A.L.M seems to be more practical compared to. K.L.M, because of simple storage method of A.L.M, and more sensitive than Pasteur Institute reference leishmanin.
