Deliverska E , Kirilova J , Stefanov L (2018). Oral Mucosal Lesions in Patient With Bullous Pemphigoid - A Rare Case and Literature Review. Journal of Diseases, 5(2): 43-49. DOI: 10.18488/journal.99.2018.52.43.49
Bullous pemphigoid /BP/ is a chronic blistering disorder that can affect oral mucosa very rarely. This autoimmune disease typically has a gradual onset and a chronic progressive course with exacerbations and remissions. Against components located in the epithelial basement membrane are formed autoantibodies. It is important to perform an incisional biopsy to establish a definitive diagnosis. Direct immunofluorescent findings are identical in BMMP and BP. Indirect immunofluorescence shows circulating IgG antibodies against the components of basement membrane in the majority of cases with BP but very rarely in patients with BMMP. There is no correlation between antibody titer and disease severity in BP. The aim is to present a very rare case of bullous pemphygoid of oral mucosa histologically proved with immunostaining. We present a patient with clinically identified oral lesion - bullae with clear fluid content in buccal mucosa of maxilla. After the rupture of bullae it left painful, superficial, ulcerated areas of oral mucosa. Hystopathological examination revealed subepithelial blister formation with clean separation of the full thickness of the epithelium from the underlying connective tissue layer. Direct immunofluorescence revealed a continuous linear band of immunoreactants at the basement membrane area. This immune deposit consist mainly IgG and C3, localized in the basement membrane. Conclusion: The treatment depends on the severity of the disease, tendency of progression and the affected areas. Therefore the clinicians should thoroughly examine all mucosal sites in order to make a proper diagnosis. The chronically characteristic of this autoimmune disease can lead to significant morbidity to patients. The adverse effects from long-term use of corticosteroids and immunosuppressives agents can also contribute to morbidity.
Differential Responses to Cognitive Behavioral Therapy and Pharmacotherapy Versus Combined Therapy in Young Adolescents with Depression
Fereshte Shakibai , Maryam Esmaeili , Nooshin Basiri (2018). Differential Responses to Cognitive Behavioral Therapy and Pharmacotherapy Versus Combined Therapy in Young Adolescents with Depression. Journal of Diseases, 5(2): 33-42. DOI: 10.18488/journal.99.2018.52.33.42
Background: Treatment of patients with major depression involves some problems and, an effective therapy, is still a debatable issue. The goal of this review was to provide a comprehensive survey on comparing three methods of Cognitive Behavioral Therapy, pharmacotherapy and combined therapy on treatment of depressed adolescents. Material and methods: this study was a randomized clinical trial with follow- up which was conducted in Isfahan city (2015). The statistical population included 330 middle school students (aged 13- 16 years) who had the criteria of depression disorder. Then 120 girls and boys were selected via cluster sampling. After that, they divided into 4 groups (3 experimental groups and 1 control group). 4 month after finishing the intervention, all groups were followed by the project. The research tool was the children's depression Inventory (CDI). Results: the results showed that all of the 3 experimental groups were significantly effective in the treatment of depression (p<00.1). In the post-test stage, the combination of pharmacotherapy and CBT, pharmacotherapy, CBT respectively were effective (p<00.0). But the findings illustrate that in the follow- up stage cognitive behavioral therapy had a long-term effect in compare to pharmacotherapy. Conclusion: at last the research results show significant efficacy of all three methods, with different priorities effect, at various stages, on improving the criteria for depression in adolescents.
This study contributes to the existing literature to clarify the best therapy for depressive mood in adolescents. This study uses a new estimation methodology for comparative studies. This study originates a new formula for two kinds of therapy. This study is one of the very few studies which have investigated the differentiated responses to different therapies. The paper contributes the first logical analysis that why these therapies can be different. The paper's primary contribution is finding that in which condition we can use 3 different therapy. This study documents the proven sources in the use of various therapeutic approaches.