Aflatoxins biodetoxification strategies based on probiotic bacteria.

Aflatoxins are secondary metabolites of fungi that are the most dangerous mycotoxin and food safety challenges. Human exposure to mycotoxins occurs directly throughout the intake of contaminated agricultural products or indirectly throughout the consumption of products prepared with animal origin or obtained from animals that were fed with contaminated material. For detoxification and reducing threats to public health and the economic damage caused by the aflatoxins in animal and plants food products, different techniques (physical, chemical and biological) has been studied. All of these methods, by modifying and destroying the toxin molecular structure, would inhibit its transfer to the digestive system and could reduce the accessibility of toxins to the target tissue and eliminate it. In terms of the overarching challenges presented by the aflatoxins (AFs) contamination in foods and feeds, there is an urgent need to evolve cost-effective and appropriate strategies to combat this hazard. The review addresses have been noted the pathogenicity of AFs and the plausible mechanism of their-induced toxicity. Furthermore, assessed the AFs degradation using probiotic bacteria of their biological substance, and converting it into non-toxic or less toxic products, as a cost-effective and environmentally friendly strategy of detoxification method for providing appropriate solutions.

Bio-protective effects of Lactobacillus plantarum subsp. plantarum against aflatoxin b1 genotoxicity on human blood lymphocytes: a native probiotic strain isolated from Iranian camel milk.

BACKGROUND AND PURPOSE: Aflatoxin B1 is one of the main poisonous substances in certain kinds of fungi all over the world. The toxin is a serious health threat to humans and livestock, particularly via DNA damage, and induces multiple cancers. Probiotic agents have confirmed positive beneficial effects in DNA protection against various toxic compounds. In this regard, the present study aimed to investigate the bio-protective effects of a native Lactobacillus plantarum subsp. plantarumNIMBB003 strain isolated from Iranian one-humped camel milk against AflatoxinB1 (AFB1)-induced genotoxicity damage, based on the micronucleus test as a genotoxicity monitoring method. MATERIALS AND METHODS: In this study, a human male blood sample was treated and incubated with107, 109, and 1011CFU/mL of viable L. plantarum and IC50 dose ofAFB1alone and in combination. Afterward, assessed the rate of production of the micronucleus in bi-nucleated lymphocytes. It must be noted that a p-value of less than0.05 was considered significantly significant. RESULTS: Based on the findings, the combined treatment of the L. plantarum at 1011 and109CFU/mL dose with 5.33±0.57% of the micronuclei fragments had protective effects and significantly decreased the genotoxicity of AFB1 by 76%. CONCLUSION: According to the findings, it can be concluded that L. plantarum in 109 CFU/mL had high protective potency against AFB1 genotoxicity. Consequently, the use of local, natural, and native protected compounds with antioxidant effects, such as probiotics agents, is one of the objectives of developing a green strategy in macro-management policies for the discovery and production of new medicines and functional foods with protective/therapeutic effects against nutritional and endogenous DNA toxins.

The role of immunohistochemistry expression of COX-2 in differentiating pigmented benign and malignant skin neoplasms.

Background: Skin cancer is one of the most common types of cancer and its annual mortality rate is increasing. The induction enzyme of cyclooxygenase COX-2 causes biosynthesis of prostaglandin and thromboxane during inflammation of the body. Increasing the expression of COX-2 has an important role in the development and progression of malignant epithelial cancers and other types of cancers. Considering the diagnostic status of the marker, this study aimed to evaluate the expression of COX-2 for diagnosis and differentiation of benign skin pigmented neoplastic lesions from malignant melanoma types. Methods: In this diagnostic study, the immunohistochemistry of COX-2 maker in 82 paraffin blocks of pigmented benign and malignant skin neoplasms of patients (49 men; 33 women) and its association with clinicopathological features of the tumor was evaluated. Data were analyzed using chi-squared and t test in SPSS18. Significance level was set at less than 5%. Results: The findings showed that 20 patients (24.3%) had malignant melanoma and 13 had significant COX-2 (3+ High), while COX-2 marker was not detected in other benign and malignant pigmented skin neoplasms (p<0.001). A significant association was found between COX-2 marker and grade (p<0.001), but there was no significant correlation with other clinicopathological tumor criteria. Sensitivity, specificity, PPV and NPV value of the COX-2 marker were 65%, 100%, 89.9%, and 100%, respectively. Conclusion: Because of the high level of COX-2 in malignant melanoma skin marker, it can be used to distinguish benign and malignant neoplastic lesions (SCC and BCC) from melanoma and to provide effective therapeutic strategies through specific COX-2 enzyme inhibitors.

Primary tonsillar tuberculosis: a forgotten clinical identity.

Primary tonsillar tuberculosis is an uncommon entity and a diagnostic challenge. Misdiagnosis can be prevented with early professional para-clinical finding. The true diagnosis is often delayed and infection management depends on recognizing disease patterns and early laboratory documentation. This rare clinical caseation granuloma with positive clinical symptoms, negative results of radiology/laboratory and alone based on histopathological finding without any Mycobacterium particle indicates the role of an accurate laboratory/pathology finding for urgent medical intervention treatment and lifesaving of patients, particularly in immunocompromised group.

Investigation of CCR7 Marker Expression Using Immunohistochemical Method and Its Association with Clinicopathologic Properties in Patients with Breast Cancer.

Background: Breast cancer is one of the most common cancers among women in the world, especially in Iran. There are large numbers of molecular and genomic factors causing breast cancer as well as many markers associated with tumor invasion. Chemokines are small proteins that primarily regulate leukocyte trafficking in the homeostatic conditions and specific immune responses. Chemokine receptor 7 (CCR7) belongs a class A subtype 7-span transmembrane G-protein coupled receptor. CCR7 plays a role in the migration of tumor cells such as immune cells into lymphoid organs through binding to its only two ligands CCL19/CCL21. High expression of this marker has been observed in breast cancer. However, there have been limited and contradictory data in studies conducted on the relationship between the increasing expression of this marker with various clinical and pathological factors. Materials and Methods: This case-control practical study was carried out on total mastectomy samples from 70 patients with breast cancer and tumor-adjacent normal tissue using immunohistochemistry technique to assess the expression of CCR7 marker. The relationship among the marker expression with different clinical and pathological tumor factors such as age, tumor size, microscopic grade, neurovascular invasion, lymph node metastasis and tumor stage were evaluated in all patients. Since the both groups were matched for age, so McNemar test, Chi-square test and Fisher's exact test were used to compare the expression of CCR7 marker in the case and control groups. Conditional logistic regression was employed to compare the effects of other variables regarding the age harmonization. Results: CCR7 expression was observed in 63 (91.4%) out of 70 studied patients and in tumor-adjacent normal tissue of 55 patients (78.6%), while the marker expression intensity in normal tissue was lower than tumoral tissue (P<0.032) There was a significant relationship among the expression of CCR7 marker with disease stage (P<0.001), grade (P<0.035), lymph node metastasis (P<0.003), perineural invasion (P<0.037) and vascular invasion (P<0.01), but no significant relationship was found among CCR7 expression with other tumor clinicopathologic parameters such as age (P>0.19) and tumor size (P>0.105). Conclusion: Increased expression of CCR7 has a significant relationship with disease stage, grade, lymph node metastasis and neurovascular invasion of breast cancer but has no relationship with age of patients and tumor size. Therefore, this biomarker can be utilized as a predictive factor for tumor metastasis and survival of patients.

A comparison of conventional rapid methods in diagnosis of superficial and cutaneous mycoses based on KOH, Chicago sky blue 6B and calcofluor white stains.

BACKGROUND AND OBJECTIVES: Rapid confirmation of dermatomycoses is desirable, as it allows the clinicians to initiate appropriate therapy immediately. In this study, the utility of a novel contrast stain, Chicago sky blue stain, was compared with potassium hydroxide mount and calcofluor white stain to determine the causative fungal elements in the rapid detection method. MATERIALS AND METHODS: In this survey, 189 samples of suspected dermatomycosis infections were assessed in 3 incubation times of 30 minutes, 2 hours, and > 6 hours. RESULTS: Positive cases were shown in Chicago sky blue 6B (55%), calcofluor white (53.4%), and potassium hydroxide (36%), with 30-minute incubation. Positive results increased in other incubation times. Sensitivity, specificity, PPV, NPV and accuracy of Chicago sky blue 6B were 97%, 100%, 100%, 96% and 98% and, for potassium hydroxide, they were 66%, 98%, 97%, 98%, 80% versus CFW, respectively. CONCLUSION: This study provides evidence that the Chicago sky blue 6B stain is a simple, fast and cost-effective method.

Incidence of Neonatal Hyperphenylalaninemia Based on High-performance Liquid Chromatography Confirmatory Technique in Mazandaran Province, Northern Iran (2007-2015).

BACKGROUND: Classic phenylketonuria (PKU) is a metabolic disorder. The purpose of this study was to assess epidemiological factors of PKU phenotypes in a neonatal screening program for Mazandaran, Iran. METHODS: In this descriptive-retrospective study from 2007 to 2015, neonates PKU level was conducted by phenylalanine level based on a biochemical technique by ELISA and then by confirmatory methods high performance liquid chromatography. RESULTS: Of the 407,244 screened newborns (48.7% girls and 51.3% boys), 14 girls and 13 boys were diagnosed definitely from 465 suspicious cases of PKU. The incidence of PKU was 0.66 in 10,000, which was noted in different severity (severe PKU - 1:67,874, mild PKU - 1:45,249, and HPA - 1:33,937). In addition, we did not detect any cases of nonclassic PKU. CONCLUSIONS: Although the consanguineous marriage pattern is a major cause of hyperphenylalaninemia (HPA) particularly in Iranian, there was no significant difference between groups in this study. Now, screening should be executed for all of the family that they have the familial history of PKU in Iran. According to varies actual of prevalence and incidence rate of PKU reported a real patient and taking PKU with mild PKU and HPA, it is recommended, the will provide the PKU reports based on the severity of the disease.

Evaluation of Anti-Toxoplasma gondii Antibodies in Hemodialysis Patients with Chronic Kidney Disease in Sari, Iran.

BACKGROUND: Toxoplasma gondii has worldwide distribution and is one of the most prevalent infectious agents in humans. OBJECTIVES: The aim of this study was to determine the prevalence of anti-Toxoplasma gondii antibodies in hemodialysis patients with chronic kidney disease (CKD) in the hemodialysis unit of Fatemeh Zahra hospital at the Mazandaran University of Medical Sciences in Sari, Iran. METHODS: Seventy-three patients with CKD and 145 healthy volunteers were assessed for anti-Toxoplasma gondii (IgG, IgM, and IgA) antibodies using a conventional ELISA technique. RESULTS: The anti-Toxoplasma gondii IgG antibody was detected in 80.8% of the cases in the patient group, while 31.5% of the cases in the CKD patient group and 31.8% in the control group were found to be positive for the anti-Toxoplasma gondii IgA antibody. All the patients in the CKD group were negative for the anti-Toxoplasma gondii IgM antibody, although 2.76% of the healthy volunteers were found to be positive. The present study suggests that there was no significant difference between the hemodialysis patient group and the healthy volunteers. CONCLUSIONS: The epidemiological data collected in this study could serve as a reference for future studies and may be useful in developing preventive and educational strategies, and consequently reducing healthcare expenditure.

Epidemiology of tinea capitis in northeast Iran: a retrospective analysis from 1998 to 2012.

BACKGROUND: Tinea capitis is a common disease of the pediatric population. This disease typically follows one of several clinical patterns, i.e., scaling, hair loss, and/or inflammatory lesions, which are usually caused predominantly by two dermatophytic genera: Microsporum and Trichophyton. The aim of this study was to investigate tinea capitis and its etiological agents in Sari city of Mazandaran province, Iran. METHODS: We studied the spectrum of tinea capitis by means of a retrospective analysis involving 1745 patients referred to both the Reference Laboratory of Medical Mycology (RLMM) and Bo Ali Sina Hospital at Sari, Iran (1998-2012). Specimens were assessed by standard mycological techniques based on macroscopic and microscopic morphology. RESULTS: Among the patients, 480 (27.5%; 61 males and 39% females) were confirmed through a mycological examination. The peak incidence was in the 5-14 years age group. Endothrix (263 cases; 54.8%) was the most frequent clinical feature by direct exam. The predominant causative agents of tinea capitis were T. tonsurans (186 cases; 38.8%) and T. violaceum (119 cases; 24.8%), followed by T. mentagrophytes (46 cases; 9.6%), T. schoenleinii (28; 5.8%), T. rubrum (20 cases; 4.2%), M. gypseum (15 cases; 3.1%), T. verrucosum (14 cases; 2.9%), and Epidermophyton floccosum (1 cases; 0.2%). CONCLUSION: The present study showed that tinea capitis is mainly due to the anthropophilic species, and the most common species were T. tonsurans and T. violaceum. Owing to the high frequency of anthropophilic species, future studies may be useful in the development of preventive and educational strategies to reduce healthcare expenditure.

First Autochthonous Coinfected Anthrax in an Immunocompetent Patient.

Cutaneous anthrax has a mortality rate of 20% if no antibacterial treatment is applied. The clinical manifestations of cutaneous anthrax are obviously striking, but coinfection may produce atypical lesions and mask the clinical manifestations and proper laboratory diagnosis. Anthrax is known to be more common in the Middle East and Iran is one of the countries in which the zoonotic form of anthrax may still be encountered. We report a case of a 19-years-old male who used to apply Venetian ceruse on his skin. Venetian ceruse (also known as Spirits of Saturn) is an old cosmetic product used for skin whitening traditionally made from sheep's spinal cord. The patient referred to the Referral Laboratory, Mazandaran University of Medical Sciences, Sari, Iran, with atypical dermatosis, pronounced pain, and oedema of the affected tissue. It was confirmed by both conventional and molecular analysis that culture was a mixture of Bacillus anthracis and Trichophyton interdigitale. The patient was initially treated with ceftriaxone (1000 mg/day for two weeks), gentamicin (1.5-2 mg/kg/day), terbinafine (200 mg/week for one month), and 1% clotrimazole cream (5 weeks) two times per day which resulted in gradual improvement. No relapse could be detected after one-year follow-up. Anthrax infection might present a broader spectrum of symptoms than expected by clinicians. These unfamiliar characteristics may lead to delayed diagnosis, inadequate treatment, and higher mortality rate. Clinicians need to be aware of this issue in order to have successful management over this infection.

Onychomycosis in north-East of iran.

BACKGROUND AND OBJECTIVES: Onychomycosis is a common fungal infection which has been conducted in many parts of the world. The aim of this study was to evaluate the epidemiology and to identify the aetiological factors of onychomycosis in Mazandaran province, Iran. MATERIALS AND METHODS: During the period of 10 years (2003-2012) 1100 patients suspected with onychomycosis, referred to the Mycology Laboratory of the Referral Laboratory and Boali Sina Hospital of Mazanadaran University of Medical Sciences, Sari, Iran, were assessed for the presence of onychomycosis with mycological examination based on conventional techniques. RESULTS: Among 1100 subjects (398 males and 702 females, aged 1-88 years) onychomycosis was diagnosed in 625(56.8%) cases. Among cases of onychomycosis, laboratorial confirmation was reached through direct examination with positive cultures in 464 samples (74.3%), while only by positive direct exam in 114 cases (18.2 %) or just positive culture in 47 cases (7.5%). The results of fungal culture revealed Candida spp. isolated in (61.9%) of the cases as the most common agents of onychomycosis while among dermatophytes, Trichophyton mentagrophytes was found in 17.7% followed by T. rubrum (1.7%), Epidermophyton floccosum (0.7%), T. violaceum (0.2%), T. verrucosum (0.2%), T. tonsurans (0.2%) and Microsporum gypseum (0.2%). Among the non-dermatophyte moulds, Aspergillus spp. was the most prevalent species 14.2%. CONCLUSION: The results demonstrated that onychomycosis was diagnosed in 625(56.8%) cases and the most common isolates were Candida spp., followed by dermatophytes and moulds. This epidemiological data collected may be useful in the development of preventive and educational strategies.

Prevalence of resistance to antibiotics according to International Classification of Diseases (ICD-10) in Boo Ali Sina Hospital of Sari, 2011-2012.

INTRODUCTION: One of the issues in health care delivery system is resistance to antibiotics. Many researches were done to show the causes and antibiotics which was resistance. In most researches the methods of classifying and reporting this resistance were made by researcher, so in this research we examined the International Classification of Diseases 10 the edition (ICD-10). METHODS AND MATERIALS: This is a descriptive cross section study; data was collected from laboratory of Boo Ali Sina hospital, during 2011-2012. The check list was designed according the aim of study. Variables were age, bacterial agent, specimen, and antibiotics. The bacteria and resistance were classified with ICD-10. The data were analyzed with SPSS (16) soft ware and the descriptive statistics. RESULTS: Results showed that of the 10198 request for culture and antibiogram, there were 1020(10%) resistance. The specimen were 648 (63.5%) urine, blood 127(12.5%), other secretion 125 (12/3%), sputum 102 (10%), lumbar puncture 8 (0/8%), stool 6 (6/0%) and bone marrow 4 (0.4%). The E coli was the most 413 (40.5%) resistance cause to antibiotics which was coded with B96.2 and the most resistance was to multiple antibiotics 885(86.8%) with the U88 code. CONCLUSION: The results showed that by using the ICD-10 codes, the study of multiple causes and resistance is possible. The routine usage of coding of the ICD-10 would result to an up to date bank of resistance to antibiotics in every hospitals and useful for physicians, other health care, and health administrations.

A study on tinea gladiatorum in young wrestlers and dermatophyte contamination of wrestling mats from Sari, Iran.

OBJECTIVE: To study the prevalence of tinea gladiatorum among young wrestlers and dermatophyte contamination of wrestling mats from Sari city, the capital of Mazandaran, a northern province of Iran. DESIGN: 324 wrestlers (aged 9-20 years) from 7 active clubs in Sari city were examined, and skin scrapings were obtained from 135 wrestlers suspected of having tinea gladiatorum. The scraped skin samples were evaluated with potassium hydroxide. Pleated carpet sterile fragments (5 x 5 cm) were used for to survey of wrestling mat contamination. Sabouraud's dextrose agar with and without chloramphenicole and cyclohexamide was used to culture scrapings and wrestling mat samples. The dermatophytes were identified by routine laboratory techniques. RESULTS: Our study showed that of the 324 wrestlers, 65 (20.1%) had tinea gladiatorum. Most lesions were on the trunk and head. All the wrestling mat samples were positive for dermatophytes. Trichophyton tonsurans was isolated from all the scrapings and wrestling mat samples. CONCLUSION: Considering that several colonies of T tonsurans were isolated from all the wrestling mats and from wrestlers with tinea gladiatorum (as the only dermatophyte species) we think that the contamination of wrestling mats with T tonsurans has a crucial role in the injection of wrestlers.