Enhanced clindamycin delivery using chitosan-coated niosomes to prevent Toxoplasma gondii strain VEG in pregnant mice: an experimental study.

BACKGROUND: Congenital toxoplasmosis occurs when a pregnant woman becomes infected with Toxoplasma gondii (T. gondii) for the first time. Treatment typically involves antimicrobial medications, with spiramycin commonly used to prevent transmission. However, spiramycin's effectiveness is limited due to poor placental penetration. Clindamycin, another antibiotic, can cross the placenta but reaches the fetus at only half the maternal concentration. Encapsulating the drug in chitosan-coated niosomes (Cs-Nio) could enhance its effectiveness by targeting specific organs and ensuring sustained release. To address the challenges of using clindamycin, a niosome-coated chitosan system was investigated for treating congenital toxoplasmosis caused by the VEG strain of T. gondii in an animal model. METHODS: Pregnant mice were infected with VEG strain of T. gondii on the 12th day of pregnancy, followed by treatment with various drugs across six groups. The treatments included chitosan-coated niosomes loaded clindamycin (Cs-Nio-Cli) and other controls. Parasitological evaluations (microscopic examination and real-time PCR), along with histopathological and immunological assessments were conducted to assess treatment efficacy. Finally, statistical analysis was conducted using GraphPad Prism 8.0 and SPSS 26, comparing test and control groups with T test and Mann-Whitney test. A p ≤ 0.05 was considered statistically significant. RESULTS: The study found that treatment with Cs-Nio-Cli significantly reduced the number of T. gondii cysts in the brain and eyes (97.59% and 92.68%, respectively) compared to the negative control group. It also mitigated inflammatory changes, prevented cell death, and reduced vascular cuffs in the brain. In addition, Cs-Nio-Cli treatment decreased bleeding, placental thrombosis, and inflammatory cell infiltration in the placenta while improving eye tissue health by reducing retinal folds and bleeds. Immunologically, nanoclindamycin treatment resulted in lower TNF-α cytokine levels and higher IL-10 levels, indicating an enhanced anti-inflammatory response. CONCLUSIONS: Although Cs-Nio-Cli demonstrates promise in reducing the transmission of congenital toxoplasmosis and mitigating the effects of congenital toxoplasmosis, additional research is necessary to determine the optimal treatment regimens for the complete eradication of the parasite in the fetus.

Vulvovaginitis due to Enterobius vermicularis in a girl and epidemic enterobiasis in her family.

Key Clinical Message: Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by Enterobius vermicularis. All members of her family were also infected by this helminth. Treatment with mebendazole was administered to all family members and it was found that the entire family had been cured. Abstract: Vulvovaginitis, an inflammation of the vulvovaginal mucous membranes, is a common reason for pediatric gynecology consultations. One of the causes of this condition is a parasitic worm known as Enterobius vermicularis (E. vermicularis). In girls, adult worms can infiltrate the vagina and release eggs, leading to the development of vulvovaginitis. Furthermore, these worms have the ability to invade the endometrial cavity too. Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by E. vermicularis. All members of her family were also infected by this parasitic helminth. In the vaginal sample, apart from the eggs, the female adult worm was observed under the microscope. Treatment with mebendazole was administered to all family members, and their progress was followed for a period of 3 weeks, during which it was found that the entire family had been cured. This patient experienced significant improvement in symptoms related to severe anxiety, nervousness, vaginal inflammation, itching, and vulvovaginitis caused by E. vermicularis. To prevent infection by E. vermicularis, it is crucial to disinfect underwear and bed sheets. In kindergartens, the spread of this parasite should not be underestimated, and asymptomatic individuals who have been exposed to infected persons should receive treatment to prevent an epidemic. Maintaining cleanliness and hygiene, especially after using the toilet, is of the most importance, particularly for girls who are more susceptible to E. vermicularis infection. Additionally, it is essential for all family members to be aware of the transmission routes of this parasite.

Investigating intestinal parasitic infections with emphasis on molecular identification of Strongyloides stercoralis and Trichostrongylus colubriformis in north of Iran.

Currently, parasitic infections are one of the important health problems in the world, especially in developing countries. This study aims to investigate intestinal parasites with an emphasis on molecular identification through the analysis of mitochondrial COX1 and ITS2 gene sequences of Strongyloides stercoralis (S. stercoralis) and Trichostrongylus spp. in north of Iran. Five hundred forty stool samples were collected from medical diagnostic laboratories affiliated with Mazandaran University of Medical Sciences in Sari city, north of Iran. First, all the samples were examined using direct smear, formalin-ether sedimentation, and trichrome staining technique. Suspected samples of Strongyloides larvae were cultured in agar plate. Then, DNA was extracted from samples containing Trichostrongylus spp. eggs and Strongyloides larvae. To amplify DNA, PCR was performed and the samples with a sharp band in electrophoresis were sequenced by Sanger method. Overall, the prevalence of parasitic infections in the study population was 5.4%. The highest and the lowest level of infection was observed with Trichostrongylus spp. and S. stercoralis at 3% and 0.2%, respectively. No traces of live Strongyloides larvae were seen in the culture medium of the agar plate. The six isolates obtained from the amplification of the ITS2 gene of Trichostrongylus spp. were sequenced, all of which were Trichostrongylus colubriformis. The sequencing results of COX1 gene indicated S. stercoralis. In the present study, the prevalence of intestinal parasitic infections in north of Iran has relatively decreased that its main reason can be due to the coronavirus epidemic and compliance with health principles. However, the prevalence of Trichostrongylus parasite was relatively high that it requires special attention to apply appropriate control and treatment strategies in this field.

Effects of diverse Types of Toxoplasma gondii on the outcome of Alzheimer's disease in the rat model.

Toxoplasma gondii has lifelong persistence in the brain and its cysts can affect gene expression and change diverse biological functions of neurons. Many studies indicated T. gondii infection as a risk factor for the development of behavioral changes and neurodegenerative diseases such as Alzheimer's disease (AD), although the etiopathogenetic link between them has not been exactly elucidated. The current study aimed to examine the effects of chronic toxoplasmosis infection with Types I, II, and III strains (RH, PRU, and VEG) alone and in combination on cognitive impairments and neuronal death in the Aß1-42-induced rat model of Alzheimer's disease. In the chronic toxoplasmosis phase, Alzheimer's induction was conducted by injecting Aß1-42 oligomers into the rat brain hippocampus. Behavioral tests were conducted 10 days after the AD induction. Real-time PCR was performed to evaluate T. gondii parasite burden by amplification of the B1 gene. Cytokines IL-1ß, TNF-α, and IL-10 were assayed in brain tissue supernatant using ELISA. Also, histopathological examinations were conducted to calculate inflammatory changes and neuronal death in the brain. Our findings showed that chronic toxoplasmosis infection with PRU reduces cognitive disorders, while the RH strain of T. gondii plays a destructive role and aggravates cognitive impairments in AD. Also, infection with a combination of PRU and VEG strains significantly improved spatial learning and memory impairments in Alzheimer's rat model. Histopathological findings also confirmed the results of behavioral tests, so that in AßPRU and AßPRU + VEG groups, neuronal death and infiltration of inflammatory cells were negligible and significantly less than in Alzheimer's and AßRH groups. Our findings indicate that chronic toxoplasmosis infection with PRU strain alone, also in combination with VEG strain can significantly improve cognitive disorders in AD rats, while RH strain plays a destructive role in AD pathogenesis.

The Effects of Deep-Breathing Exercises on Postoperative Sleep Duration and Quality in Patients Undergoing Coronary Artery Bypass Graft (CABG): a Randomized Clinical Trial.

Introduction: Disordered sleep occurs frequently in patients who have undergone coronary bypass graft surgery, and it contributes to increased morbidity, mortality, and resource utilization. The present study aimed to determine the effects of deep-breathing exercises on postoperative sleep duration and quality in patients undergoing coronary artery bypass graft. Methods: This study was a clinical trial. The study sample included 64 patients who were coronary artery bypass graft hospitalized from January 2015 to April 2015 in Qazvin Booali-Sina hospital. The patients were selected by convenient sampling and then the participants were randomly allocated to the intervention and control groups. The baseline and postoperative (day 7) sleep duration and quality metrics were measured. The St Mary's Hospital Sleep Questionnaire was used to evaluate sleep quality in two groups. Results: Baseline night sleep duration was 5.72 (1.63) hours in the control group and 5.58 (1.07) hours in the intervention group. The initial findings showed that the mean of sleep quality score of patients in the intervention and control groups were 19.72 (2.68) and 18.22 (3.81) respectively. These measurements did not decline postoperatively in the intervention group while night sleep duration and quality declined in the control group. Deep breathing exercise program had a significant effect on sleep quality score in the intervention group compared to the control group. Conclusion: The results indicated that deep breathing exercises prevent decline in sleep quality postoperatively. It seems to be a safe method with no side effects for these patients. Furthermore, it is a simple method to implement and does not impose a high cost.

Shear bond strength of orthodontic brackets after acid-etched and erbium-doped yttrium aluminum garnet laser-etched.

BACKGROUND: Laser ablation has been suggested as an alternative method to acid etching; however, previous studies have obtained contrasting results. The purpose of this study was to compare the shear bond strength (SBS) and fracture mode of orthodontic brackets that are bonded to enamel etched with acid and erbium-doped yttrium aluminum garnet (Er:YAG) laser. MATERIALS AND METHODS: In this experimental in vitro study, buccal surfaces of 15 non-carious human premolars were divided into mesial and distal regions. Randomly, one of the regions was etched with 37% phosphoric acid for 15 s and another region irradiated with Er:YAG laser at 100 mJ energy and 20 Hz frequency for 20 s. Stainless steel brackets were then bonded using Transbond XT, following which all the samples were stored in distilled water for 24 h and then subjected to 500 thermal cycles. SBS was tested by a chisel edge, mounted on the crosshead of universal testing machine. After debonding, the teeth were examined under ×10 magnification and adhesive remnant index (ARI) score determined. SBS and ARI scores of the two groups were then compared using t-test and Mann-Whitney U test. Significant level was set at P < 0.05. RESULTS: The mean SBS of the laser group (16.61 ± 7.7 MPa) was not significantly different from that of the acid-etched group (18.86 ± 6.09 MPa) (P = 0.41). There was no significant difference in the ARI scores between two groups (P = 0.08). However, in the laser group, more adhesive remained on the brackets, which is not suitable for orthodontic purposes. CONCLUSION: Laser etching at 100 mJ energy produced bond strength similar to acid etching. Therefore, Er:YAG laser may be an alternative method for conventional acid-etching.

An In-vitro Comparison of Force Loss of Orthodontic Non-Latex Elastics.

OBJECTIVE: The amount and consistency of the applied forces to the tooth are important factors in tooth movements; therefore, the aim of this study was to compare the initial force and the force loss of three brands of elastics in 24 hours. MATERIALS AND METHODS: In this in-vitro study sixty non-latex elastics (3/16 medium) from three companies (Forestadent, Dentaurum and Ortho Technology) were randomly selected. Two static tests were performed, the first in a dry environment to evaluate the initial force and the other performed in a wet environment (artificial saliva) to evaluate the force loss in 24 hours. The Universal testing machine measured the forces after stretching the elastics to three times the lumen diameter. Data were analyzed by repeated measures ANOVA, One-way ANOVA, Tukey-HSD, Paired samples test, and one sample test. RESULTS: The difference between the brands was significant (p=0.002). Force loss was observed in all samples; 4-7.5% force loss occurred after one hour and 19-38% force loss occurred after 24 hours. The average initial force of Forestadent and Ortho Technology was significantly higher than marketed forces (p<0.001), but the initial force of Dentaurum elastics was similar to the marketed force. CONCLUSION: The force loss over 24 hours time period was Forestadent>Dentaurum>Ortho-Technology. According to the initial force and force loss percentage it is suggested to replace the non-latex elastics several times a day.

Effect of bracket bonding with Er: YAG laser on nanomechanical properties of enamel.

BACKGROUND: The aim of this study was to compare the effects of conventional acid etching and laser etching on the nano-mechanical properties of the dental enamel using nano-indentation test. MATERIALS AND METHODS: In this experimental in vitro study, buccal surfaces of 10 premolars were divided into three regions. One of the regions was etched with 37% phosphoric acid and another etched with Er:YAG laser, the third region was not etched. The brackets were bonded to both of etched regions. After thermocycling for 500 cycles, the brackets were removed and the teeth were decoronated from the bracket bonding area. Seven nano-indentations were applied at 1-31 µm depth from the enamel surface in each region. Mean values of the hardness and elastic modulus were analyzed with repeated measures analysis of variance and Tukey HSD tests, using the SPSS software (SPSS Inc., version16.0, Chicago, Il, USA). P < 0.05 was considered as significant. RESULTS: The hardness up to 21 µm in depth and elastic modulus up to 6 µm in depth from the enamel surface for laser-etched enamel had significantly higher values than control enamel and the hardness up to 11 µm in depth and elastic modulus up to 6 µm in depth for acid-etched enamel had significantly lower values than the control enamel. CONCLUSION: The mechanical properties of the enamel were decreased after bracket bonding with conventional acid etching and increased after bonding with Er:YAG laser.

Effects of fluoride release from orthodontic bonding materials on nanomechanical properties of the enamel around orthodontic brackets.

BACKGROUND: The aim of the present study is to evaluate the effects of a fluoride-releasing composite resin bonding material on reducing enamel demineralization underneath and around orthodontic brackets and compare that with a conventional adhesive system. MATERIALS AND METHODS: Buccal surfaces of 10 intact extracted premolar teeth were divided into two parts with nail varnish and stainless steel brackets were randomly bonded by two resin composite systems: (Transbond XT) and (Transbond XT plus Color Change) (3M, Unitek, Monrovia, CA, USA) on two sides of the teeth and then samples were placed in a demineralization solution. It is claimed that the second system has the ability of fluoride release. Elastic modulus and hardness of enamel were measured with nanoindentation test in 6 depths in 1-36 µm from the enamel surface and in 7 regions: Control (intact enamel surface), underneath the brackets and also 50 and 100 µm from the brackets edge. These nanomechanical features were evaluated in different regions and depths using analysis of variance and paired t-test (P < 0.05). RESULTS: Considerable difference can be seen in different depths and regions in terms of hardness and elastic modulus. The region under the bracket with fluoridated adhesive shows similar results with intact enamel, whereas these parameters in fluoride less side show a significant reduction (P < 0.05). CONCLUSION: Results show that use of resin composite bonding system with the ability of fluoride release for bracket bonding, may reduce demineralization of enamel around brackets during orthodontic treatment.

The association between hyperlipidemia and periodontal infection.

BACKGROUND: Periodontitis is a local chronic inflammatory condition of the supporting structures of the teeth resulting from a dental plaque biofilm attached to teeth surfaces. Recent studies have indicated that this oral disease may have effects on systemic health. OBJECTIVES: The aim of the present study was to evaluate the association between periodontitis and hyperlipidemia. PATIENTS AND METHODS: This case-control study was conducted in Iran during March 2011. In this case-control study, levels of serum lipids in 45 subjects with periodontitis were measured and compared with 45 age, gender and body mass index (BMI) matched controls. Data were analyzed using student t-test and chi-square test with P < 0.05 as the limit of significance. RESULTS: Mean values of total cholesterol (CHL) (periodontitis group = 218.11 ± 29.77, control group = 162.31 ± 48.24) and triglycerides (TG) (periodontitis group = 209.77 ± 44.30, control group = 125.60 ± 44.16) were significantly higher in the periodontitis group (P < 0.001). High-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels were higher in the case group, but this difference was not statistically significant. Frequency of pathological values of CHL and TG were significantly higher in cases compared with the controls (P = 0.002 and P = 0.015, respectively). CONCLUSIONS: This study indicates that hyperlipidemia may be associated with periodontal disease in healthy individuals; yet whether periodontitis causes an increase in levels of plasma lipids or whether hyperlipidemia is a risk factor for periodontal infection and cardiovascular disease, it needs further investigations.