Evaluation of Laboratory Findings of Patients with Coronavirus Disease 2019 in Kerman, Iran.

Background & Objective: Since December 2019 in Wuhan, China there is a new form of pneumonia and after expansion in other countries, World Health Organization (WHO) called it Coronavirus Disease 2019 (COVID-19). Since the clinical laboratory findings have played an important role in the progression of the disease, this study aimed to evaluate the laboratory findings in COVID-19 patients (before vaccination). Methods: In this case-control study that was conducted from February to August 2020; the laboratory test status in 101 positive COVID-19 patients was evaluated and compared with 101 healthy individuals. Results: The results of our study showed that 21% of patients had low WBC, 24.75% low RBC, 37.62%, low Hb, 18.81% with low HCT, 29.7%, low Plt, 41.58% had High PT, 71.29% high CRP, 17.82% high urea, 11.88% high CR, 15.84% high LDH, 10.89% low sodium, 14.75% low potassium (K). The quantitative examination of blood factors showed that lymph%, mixed%, PLT, HCT, Hb, and RBC were higher in the control group than in the case group. While Neu%, WBC, PTT, CRP, UREA, LDH, K in the patient group were higher than in the control group. Conclusion: According to the results of the study, it can be concluded that in the clinical treatment of COVID-19 patients, much attention should be paid to the laboratory indicators to identify and intervene early in critically ill patients.

Histopathological Findings of Testicular Tissue Following Cadmium Toxicity in Rats.

BACKGROUND & OBJECTIVE: Reproductive toxicity of cadmium (Cd) as an environmental toxicant has been proved in animals and humans. Exposure to Cd impairs testes organs and can reduce male fertility. The present study was designed to investigate the spectrum of histopathological changes in testicular tissue focusing on Sertoli cells in rats following Cd intoxication. METHODS: In the present experiment, acute testicular toxicity was induced by an intraperitoneal injection of 1.2 mg/kg CdCl2 to the animals in the test group, while the control group received normal saline. After 52 days, the animals were euthanized, and testicular tissue was stained by Hematoxylin and Eosin. In addition, immunohistochemical staining was performed on Sertoli cells for Wilms' Tumor, Melan-A, and CD99 to evaluate histopathological changes. RESULTS: Cd caused significant alterations in seminiferous tubules with varying effects on the patterns of spermatozoa production. These histopathological changes were significantly higher in the Cd group, compared to the control group. CONCLUSION: The Cd-induced stepwise spectrum changes included sloughing, disorganization, hypospermatogenesis, spermatic cell arrest, germ cell hypoplasia, Sertoli cell-only pattern, fibro-hyalinized seminiferous tubules, and calcification. Sertoli cells accumulated and created multinucleated giant cells in the seminiferous tubules during the atrophic process, which could be dependent upon Sertoli cells viability and function.

High resolution melting analysis and detection of Leishmania resistance: the role of multi drug resistance 1 gene.

BACKGROUND: Pentavalent antimonial compounds are currently used to treat leishmaniasis and resistance to these drugs is a serious problem. Multidrug resistance protein is an efflux pump of the cell membrane that expels foreign compounds. This study designed to evaluate the mutations in the multi-drug resistance 1 (MDR1) gene, in biopsy specimens of Leishmania tropica, with high resolution melting (HRM) method. In this experimental study, genomic DNA was extracted from 130 patients with skin leishmaniasis. Then, nucleotide changes were investigated throughout the gene using HRM and sequencing methods. The samples categorized in 5 groups by differences in the melting temperature (Tm). RESULT: The nucleotide changes analysis showed that 61% of the samples of different groups that were unresponsive to drug had mutations in the MDR1 gene, which were also confirmed by the sequencing method. These mutations can be one of the factors responsible for non-responsiveness to the treatment. CONCLUSION: According to the findings, it seems that mutation in MDR1 gene could be responsible for drug resistance to pentavalent antimonial compounds. Furthermore, HRM method can be used to diagnose drug resistance in leishmaniasis. It is also recommended that further studies be done regarding the importance of drug resistance in the leishmania affected patients.

Pathogenesis of COVID-19; Acute Auto-inflammatory Disease (Endotheliopathica & Leukocytoclastica COVIDicus).

BACKGROUND: The pathogenesis of the COVID19 pandemic, that has killed one million nine hundred people and infected more the 90 million until end of 2020, has been studied by many researchers. Here, we try to explain its biological behavior based on our recent autopsy information and review of literature. METHODS: In this study, patients with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) result were considered eligible for enrollment. Histopathological examinations were done on 13 people who were hospitalized in Afzalipour hospital, Kerman, Iran. Clinical and laboratory data were reviewed. Tissue examination was done by light microscopy, immunohistochemistry and electron microscopy. RESULTS: The most frequent co-morbidity in the patients was cardiovascular disease. The common initial symptoms of COVID-19 infection were dyspnea and cough. In all cases, the number of white blood cells was higher than the normal range. Common histopathological findings were variable degrees of vasculitis as degenerative to necrotic changes of endothelium and trafficking of inflammatory cells in the vessel wall with fibrinoid necrosis. Tissue damage included interstitial acute inflammatory cells reaction with degenerative to necrotic changes of the parenchymal cells. CD34 and Factor VIII immunohistochemistry staining showed endothelial cell degeneration to necrosis at the vessel wall and infiltration by inflammatory cells. Electron microscopic features confirmed the degenerative damages in the endothelial cells. CONCLUSION: Our histopathological studies suggest that the main focus of the viral damage is the endothelial cells (endotheliopathica) in involved organs. Also, our findings suggest that degeneration of leukocytes occurs at the site of inflammation and release of cytokines (leukocytoclastica) resulting in a cytokine storm.

Clinical Features, Treatment, Prognosis, and Mortality in Paraquat Poisonings: A Hospital-Based Study in Iran.

OBJECTIVE: The aim of the present study was to evaluate the demographics, clinical characteristics, fatal dose, the efficacy of treatments, and prognosis in paraquat (PQ) poisoning in the Kerman Province of Iran. METHODS: This analytical cross-sectional study was conducted on 126 PQ poisoned patients who were referred to Afzalipour Hospital during 2006-2015. Demographic variables such as age and gender, signs and symptoms of poisoning, the estimated ingested dosage of PQ, and clinical outcome were extracted from medical records. Patients were compared and categorized into two groups considering the outcome: survivors and nonsurvivors. Patients with nonoral exposures, combined drug exposures, PQ exposures more than 24 h before the presentation, and critical underlying diseases were not included in the study. FINDINGS: Our results indicated that the mean dose of PQ used by all patients was 2358 mg, which was reported as 1846 and 2812 mg in females and males, respectively. Moreover, the results showed that the highest mortality rate was in patients with respiratory distress, followed by oral ulceration and excess salivation. In all PQ-poisoned patients, the dose of greater than approximately 2250 mg predicted death with 86.2% specificity and 75.7% sensitivity. CONCLUSION: Based on the results of the present study, the mortality rate in PQ-poisoned patients depended on the dose of poison, blood sugar level, and aspartate transaminase levels. Our results suggest that these parameters have excellent prognostic value for the prediction of mortality.

Oxidative stress in opium users after using lead-adulterated opium: The role of genetic polymorphism.

Use of lead-adulterated opium has become one of the major sources of lead poisoning in Iran. This study was designed to assess clinical effects and oxidative stress and its association with GSTM1, GSTT1, NQO1, and ALAD genes polymorphisms and blood lead level (BLL) in lead-adulterated opium users. The oxidative stress status in 192 opium users with lead poisoning symptoms measured and compared with 102 healthy individuals. Gluthatione S-transferase (GST)-M1 and -T1 genes deletion, NQO1 rs1800566, and δ-aminolevulinic acid dehydratase (ALAD) rs1800435 polymorphisms were determined using PCR and PCR-RFLP. The relation between the polymorphisms, BLL, and oxidative stress parameters were analysed using multivariate linear regressions. The common symptoms of lead toxicity were gastrointestinal and neurologic complications. Oxidative stress was significantly higher in opium addicts and lipid peroxidation significantly correlated with BLL. There was significant association between ALAD rs1800435 and BLL, and the BLL was significantly lower in the patients with ALAD 1-2 genotype. Use of lead-adulterated opium causes high frequency of lead toxicity symptoms, hematological and biochemical abnormalities, and oxidative stress which are associated with BLL. Route of opioid use and the polymorphism of rs1800435 in ALAD gene are the major determinants of BLL in lead-adulterated opium users.

Metastatic Leiomyosarcoma Originating in the Thigh Skeletal Muscle of a Larry Breed Hen.

Leiomyosarcoma is a malignant tumor arising from the smooth muscle of any soft tissue. Occurrence of this tumor in the skeletal muscles is rare. A 6-year-old Larry hen was examined because of lameness in one leg. A firm mass was palpable in its right thigh muscle, and radiographs showed extensive involvement of the surrounding soft tissues. The chicken was euthanatized. At postmortem examination, the primary tumor in the thigh skeletal muscles was firm and pink on its cut surface, and metastatic nodules were observed in the liver, spleen, kidneys, heart, and lungs. On histopathologic examination, the primary mass consisted of elongated spindle cells with eosinophilic cytoplasm and blunt-end nuclei arranged as interwoven bundles. Malignancy of the tumor was determined by the presence of pleomorphism, bizarre cells, and high numbers of mitotic figures. Immunohistochemical staining was positive for vimentin, desmin, and α-smooth muscle actin but negative for myogenin. Leiomyosarcoma was diagnosed based on the histopathologic and immunohistochemical findings. To our knowledge, this is the first report in a fowl of leiomyosarcoma in the skeletal muscle with widespread metastasis to other organs.

Knee joint morphogenesis of the quail (Coturnix japonica) embryo.

Knee joint development and its morphogenetic events have been studied in human, chicken and other animal models and differences have been found in the pattern of the knee joint morphogenesis among the studied species. According to the small number of studies which have focused on the chronology of knee morphogenesis, a "morphogenetic timely pattern" is hard to suggest. Quail is an animal model for which there is no information about knee joint morphogenesis. This study was planned to define the time table of the knee joint structures formation in this bird. For this purpose embryonated Japanese quail eggs were incubated for 3 to 12 days. Embryos were removed from their eggs every twelve hours and staged according to Ainsworth et al. The hind limbs of the embryos at the stages 17 to 41 were dissected and 6 µm thick slides were prepared from their knee region. The time of appearance of menisci, ligaments, articular cavity and other knee joint components were identified in the quail embryo. During quail knee morphogenesis we observed the appearance of a three layered interzone, femorotibial cavitation and long bone ossification earlier than in chicken. A hypothesis is presented on the differential role of the flexor and extensor muscles of the knee joint on embryonic knee development in birds as compared with humans.

High Mortality Rate due to False Gid in a Sheep Herd.

The sheep nasal bot, Oestrus ovis (Diptera: Oestridae), is a cosmopolitan parasite commonly found in sheep and occasionally goats. Rarely a bot will migrate into the sheep brain (false gid). Following the complaint of an animal husbandman about high mortality rate in a sheep herd, the herd was clinically, hematologically, and pathologically examined exactly. Clinical, hematological, and pathological findings were described in the text. Necropsy findings showed heavy infestation with Oestrus ovis larvae. The herd was treated with Ivermectin. After treatment all patients without nervous sings were recovered. Patients with nervous signs did not respond to treatment, but new cases of disease did not occur and the mortality stopped. In the present report, a high mortality rate due to false gid in a sheep herd was described. The prevention and control of the disease are important because of economic losses and the possibility of transmission to the human.