COVID-19 meningitis without pulmonary involvement with positive cerebrospinal fluid PCR.

BACKGROUND: Coronavirus disease 2019 (COVID-19) typically presents with respiratory illness ranging in severity. Neurological complications of the disease remain largely unknown. Herein, we discuss the case of a woman diagnosed with COVID-19 meningitis following two positive cerebrospinal fluid (CSF) RT-PCR assays, and highlight the importance of recognizing the neurological manifestations of the disease. CASE REPORT: The patient was a 49-year-old woman with a history of hypertension who presented with non-specific symptoms (fever, headache, malaise, nausea/vomiting). Chest computed tomography (CT) revealed a lack of pulmonary involvement and oropharyngeal/nasopharyngeal RT-PCR was negative for COVID-19. A lumbar puncture was performed on the third day of admission and the CSF analysis elucidated a viral pattern, but the CSF bacterial culture and RT-PCR assay for herpes simplex virus were both negative. Surprisingly, the CSF RT-PCR for COVID-19 was positive. The diagnosis of COVID-19 meningitis was made and the patient was treated solely with Kaletra® , with a second CSF analysis confirming our unique finding 1 week later. The patient's clinical characteristics improved progressively, and she was discharged in excellent general condition after 21 days. CONCLUSION: In contrast to what was originally believed, the SARS-CoV-2 can cause meningitis in isolation, perhaps by crossing the blood-brain barrier. Hence, it seems essential that physicians maintain a high index of suspicion for neurological involvement among COVID-19 patients, with early CSF analysis and brain imaging sometimes being indicated.

Compressibility in lattice Boltzmann on standard stencils: effects of deviation from reference temperature.

With growing interest in the simulation of compressible flows using the lattice Boltzmann (LB) method, a number of different approaches have been developed. These methods can be classified as pertaining to one of two major categories: (i) solvers relying on high-order stencils recovering the Navier-Stokes-Fourier equations, and (ii) approaches relying on classical first-neighbour stencils for the compressible Navier-Stokes equations coupled to an additional (LB-based or classical) solver for the energy balance equation. In most cases, the latter relies on a thermal Hermite expansion of the continuous equilibrium distribution function (EDF) to allow for compressibility. Even though recovering the correct equation of state at the Euler level, it has been observed that deviations of local flow temperature from the reference can result in instabilities and/or over-dissipation. The aim of the present study is to evaluate the stability domain of different EDFs, different collision models, with and without the correction terms for the third-order moments. The study is first based on a linear von Neumann analysis. The correction term for the space- and time-discretized equations is derived via a Chapman-Enskog analysis and further corroborated through spectral dispersion-dissipation curves. Finally, a number of numerical simulations are performed to illustrate the proposed theoretical study. This article is part of the theme issue 'Fluid dynamics, soft matter and complex systems: recent results and new methods'.

Human toxoplasmosis: a systematic review for genetic diversity of Toxoplasma gondii in clinical samples.

Toxoplasma gondii (T. gondii) as an obligate intracellular protozoan with a worldwide distribution can infect virtually all warm-blooded animals and humans. This study aims to provide a summary of the available data on genotypes of T. gondii in human. Five databases including MEDLINE in PubMed, Scopus, Science Direct, Web of Science and Google Scholar were searched for the T. gondii genotyping in human during 1995-August 2017. Next, we screened all the articles based on the inclusion and exclusion criteria. Overall, 26 studies were eligible regarding genotyping T. gondii in human samples. In clonal genotyping, 167 out of 286 cases (58%) were infected with type II. Genetic characterisation of T. gondii isolates displayed that type II was the most predominant genotype in human with the prevalence of 64.3%, 62.1% and 41.7% in patients with AIDS, congenital and ocular toxoplasmosis, respectively. In ToxoDB genotyping, most individuals were infected with genotypes #9 and #65 (21.2%). Based on these results, genotype profile of T. gondii isolates is different throughout the world. The strains in Asian and African countries are characterised by low genetic diversity, while in North and South America a wide diversity of this parasite is found. In countries without any data (e.g. Australia, Western and Southern Africa and Western Asia), identification of T. gondii genotypes might discover higher genetic diversity.

Safe sex norm questionnaire for female sex workers: development and validation study in Iran.

OBJECTIVES: The aim of the present study was to develop and validate a safe sex norm questionnaire as an appropriate instrument which would be adaptable to the female sex worker (FSW) population. STUDY DESIGN: A mixed method study. METHODS: Appropriate content was prepared through a literature review. Content validation indices were assessed using interviews with content experts and lay experts. A conservative approach was used to assess the inter-rater agreement among the participants about the instrument relevance and clarity. The scale content validity index was computed using the average method. Non-parametric Mokken scale analysis was used for assessing scalability and unidimensionality of the questionnaire in a sample of 170 FSWs in Tehran. To evaluate the reliability and internal consistency of the questionnaire intra-class correlation and Cronbach's alpha were employed. RESULTS: A list of 34 items was finalized, with subscales for actual behavioral norms and for perceived norms. The relevance of the actual and perceived norms subscales in the final questionnaire was higher than 96%; clarity of the subtests was 99% and higher. The comprehensiveness of the actual and perceived norms subscales was 85% for both. Mokken scale analysis showed that the two subscales were distinct constructs, and all items are good indicators for the constructs. CONCLUSION: Our findings support that the safe sex norm questionnaire is a valid and reliable measure that would be useful to harm reduction programs and help effective HIV prevention among female sex workers.

Feeding broilers with thyme essential oil loaded in chitosan nanoparticles: an efficient strategy for successful delivery.

1. The use of chitosan nanoparticles (CNPs) for the entrapment of active components has gained considerable interest in food and pharmaceutical industries due to its mucous adhesiveness, non-toxicity, biocompatibility and biodegradability. 2. This study aimed to investigate the usefulness of feeding encapsulated thyme essential oil (E-TEO) on performance, blood parameters, immunity and ileal microflora in broilers. 3. CNPs were prepared by using ionotropic gelation and structurally characterised by dynamic light scattering; scanning electron microscope and Fourier transform infrared spectroscopy. The encapsulation efficiency percentage of TEO in CNPs and its in vitro release were determined using ultraviolet visible spectroscopy and dialysis method, respectively. 4. An in vivo experiment was conducted with five treatments of five replicates with ten chicks per pen. Dietary treatments consisted of an unsupplemented control diet, or supplemented with chlortetracycline (80 and 50 mg/kg during the starter and grower phase, respectively); CNPs (60 mg/kg); TEO (40 mg/kg diet) or E-TEO (60 mg/kg). 5. Results showed uniform distribution of nanoparticles with roughly spherical morphology, and the size of particles ranged from 30 to 100 nm. It was observed that 68.3% of TEO was encapsulated into CNPs, from which more than 90% was released within the first 96 h. Birds treated with antibiotic and E-TEO showed significantly (P < 0.05) higher body weight gain than the control and the other treatments were intermediate. Compared to the control group, adding of E-TEO into diet significantly (P < 0.05) improved feed conversion ratio at 42 days of age. Feeding birds with E-TEO significantly (P < 0.05) decreased the number of coliform and total aerobic bacteria compared to other treatments. Birds supplemented with E-TEO showed lower heterophile to lymphocyte ratio compared to birds that received TEO. 6. The results suggested that the entrapment of TEO in CNPs and its sustained release promoted broiler performance via the improvement of physiological status and modulating intestinal microbiota and therefore could be used as substitute for antibiotic growth promoter in broiler diets.

Effect of interactions of polymorphisms in the Melanocortin-4 receptor gene with dietary factors on the risk of obesity and Type 2 diabetes: a systematic review.

AIM: To perform a systematic review of the effect of interaction between Melanocortin-4 receptor (MC4R) single nucleotide polymorphisms and diet on the development of obesity and Type 2 diabetes. BACKGROUND: Environmental factors, such as nutrient intakes or feeding behaviours, can modulate the association of polymorphism in the MC4R gene with obesity and Type 2 diabetes mellitus. METHODS: A systematic literature search was conducted in the PubMed, Scopus and Google Scholar databases, with a combination of the following keywords: Diet*, nutr*, melanocortin receptor, melanocortin 4 receptor and MC4R. To assess the quality of observational studies, we used a 12-item quality checklist, derived from the STREGA statement. RESULTS: A total of 14 articles were selected based on the inclusion and exclusion criteria. Consumption of highly salty foods and adherence to a Mediterranean dietary pattern can modulate the association between MC4R polymorphisms and the risk of obesity or Type 2 diabetes. Despite the highly contradictory results of intervention studies, after short-term lifestyle interventions, children with variant alleles of MC4R single nucleotide polymorphisms can lose more body weight, compared with non-carriers, although they may have difficulty in maintaining this weight loss in the long-term. To interpret the results of studies on adults, we need further studies. CONCLUSIONS: The interaction between MC4R genes with dietary factors plays a significant role in the development of obesity or Type 2 diabetes phenotypes. Early detection of MC4R risk alleles in individuals and modification of their diet based on these results could be an efficient strategy to prevent obesity or diabetes in these subgroups.

Developing a conceptual framework and a tool for measuring access to, and use of, medicines at household level (HH-ATM tool).

OBJECTIVE: To develop a valid and reliable tool to evaluate access to, and use of, medicines at household level (HH-ATM tool). STUDY DESIGN: The Behavioral Model of Health Services Use was adapted and used as the conceptual framework for developing the HH-ATM tool. Questionnaires were designed (individual and household) based on the conceptual framework and existing tools, including items that captured the characteristics of predisposing, enabling and need factors; health care behaviours; outcomes and impacts. METHODS: Face validity, content validity and test-retest reliability were assessed using inter-rater agreement, item and scale content validity indices, comprehensiveness indices, and intra-class correlation, kappa and weighted-kappa coefficients. RESULTS: The household and individual questionnaires demonstrated appropriate validity and reliability. The content validity of household questionnaire was favourable, with inter-rater agreement of 86% and 91% for relevance and clarity, respectively. Scale content validity indices for relevance and clarity were 89% and 91%, respectively, and comprehensiveness was scored at 100%. These indices were also favourable for the individual questionnaire, all scoring 94% or higher. CONCLUSION: The questionnaires showed excellent validity and reliability for use in Iran. The HH-ATM tool can be implemented to evaluate access to, and use of, medicines in Farsi-speaking communities, and may be useful in other communities if adapted appropriately.

Effect of high-dose phytase and citric acid, alone or in combination, on growth performance of broilers given diets severely limited in available phosphorus.

1. Two trials were conducted to evaluate the effect of high-dose phytase alone or in combination with citric acid (CA) in the diet severely limited in available phosphorus (P) on performance, plasma P and plasma Ca of broilers from 22 to 42 d of age. 2. In Trial 1, 297 21-d-old female chicks were placed into 27 pens and allocated to 9 maize-soybean meal-based dietary treatments, which were a positive control [PC, 4.23 g/kg non-phytate P (NPP)] and 8 negative control (NC, 1.35 g/kg NPP) groups consisting of two concentrations of CA (0 and 20 g/kg) and 4 concentrations of phytase (0, 1000, 2000 and 4000 U/kg) in a 2 × 4 factorial arrangement. In Trial 2, 192 21-d-old male chicks were placed into 24 pens and allocated to 6 wheat-canola meal-based dietary treatments, which were a PC (4.2 g/kg NPP), a NC (1.68 g/kg NPP) and 4 NC groups consisting of two concentrations of CA (0 and 20 g/kg) and two concentrations of phytase (2000 and 4000 U/kg) in a 2 × 2 factorial arrangement. 3. In both trials, birds fed on the PC had significantly higher average daily gain (ADG), average daily feed intake (ADFI), plasma P and lower feed conversion ratio (FCR) and plasma Ca than those of birds fed on the NC. CA supplementation significantly increased ADG and ADFI. There was a significant interaction between CA and phytase on plasma P where CA improved the effect of phytase on plasma P. In Trial 1, phytase addition improved ADG, ADFI, FCR and plasma Ca linearly. 4. Briefly, this research showed the interaction effect between CA and phytase on plasma P when broilers were fed on diets based on maize-soybean meal or wheat-canola meal. The results showed that CA supplementation lowered the concentration of phytase that is needed in low NPP diets to increase plasma P.

Comparative study of dietary soy phytoestrogens genistein and equol effects on growth parameters and ovarian development in farmed female beluga sturgeon, Huso huso.

Oocyte maturation in fish is a hormonally regulated process. In the light of long-term oocyte maturation in beluga, the aim of this research was to study the estrogenic effects of different concentrations of soy dietary genistein (GE) and equol (EQ) on the growth performance and ovary development in farmed female Huso huso. Fish were fed with concentrations 0 (control), 0.2, 0.4, 0.8 and 1.6 g of EQ and GE per kg of isoproteic (CP 45 %) and isoenergetic (19.5 MJ/kg) diets during a year. Blood samples and ovary biopsies were collected from each fish seasonally. The main results of the present experimentation are that growth performance was not affected significantly both in GE and EQ (P > 0.05). EQ at concentration 0.4 g/kg had more estrogenic effects than other concentrations of EQ and GE in beluga so that 64 % of fish were matured sexually. Some reproductive indices such as oocyte diameter, testosterone (T) and 17ß-estradiol (E2) increased significantly at EQ 0.4 g/kg at the end of experiment (P < 0.05), while 17α-hydroxy progesterone level (17α-OHP) showed no significant changes at all concentrations. Biochemical indices such as calcium, phosphorous and cholesterol increased at GE concentrations, but decreased at EQ concentrations similarly at the end of experiment. There was a negative relationship between plasma phosphorous and alkaline phosphatase enzyme levels. Based on results, EQ at concentration 0.4 g/kg improved oocyte development more than the other concentrations of GE and EQ, and therefore, it can be used as an additive to diets for inducing ovary development in this species.

Asymptotic freedom in the lattice Boltzmann theory.

Asymptotic freedom is a feature of quantum chromodynamics that guarantees its well posedness. We derive an analog of asymptotic freedom enabling unconditional linear stability of lattice Boltzmann simulation of hydrodynamics. We further demonstrate the validity of the derived conditions via the special case of the equilibrium based on entropy maximization, which is shown to be uniquely renormalizable.

Entropic equilibrium for the lattice Boltzmann method: Hydrodynamics and numerical properties.

The entropic lattice Boltzmann framework proposed the construction of the equilibrium by taking into consideration minimization of a discrete entropy functional. The effect of this entropic equilibrium on properties of the resulting solver has been the topic of discussions in the literature. Here we present a rigorous analysis of the hydrodynamics and numerics of the entropic equilibrium. We demonstrate that the entropic equilibrium features unconditional linear stability, in contrast to the conventional polynomial equilibrium. We reveal the mechanisms through which unconditional linear stability is maintained, most notable of which are adaptive propagation velocity of normal modes and the positive-definite nature of the dissipation rates of hydrodynamic eigenmodes. We further present a simple local correction to considerably reduce the deviations in the effective bulk viscosity.

Percutaneous Transhepatic Radiologic Intervention of Biliary Complications following Liver Transplantation: A Single-center Experience.

Background: Biliary complications are the leading cause of morbidity and mortality in patients undergo¬ing Liver Transplantation (LT). Post-biliary transplantation strictures (BSs) are a severe problem with a high risk of graft failure. However, management of these BSs has remained controversial, and consid¬erable variability has been reported in Percutaneous Transhepatic Radiological Interventions (PTRIs) related to broad differences in technical procedures. Objective: This study aimed to evaluate the efficacy of percutaneous treatments in managing post-LT BSs in a center in Shiraz. Methods: PTRIs including balloon dilatation, metallic stent, and internal or internal-external hand-made plastic stent insertion were done for 34 transplanted patients with BSs referring to the Interventional Radiology Unit of Shiraz Namazi Hospital. Technical success rate, patency rates, and complications were evaluated. Results: The. In this study, 31 strictures were successfully treated without any significant difference between the anastomotic and non-anastomotic types of stricture (success rate: 91.2%). Based on the results, 12- , 24-, and 36-month primary patency rates were 90.1%, 84.5%, and 76.8%, respectively. The secondary patency rate was 100% at 12 and 24 months and 93.3% at 36 and 60 months. The rate of minor complica¬tions (mild cholangitis and hemobilia) was 6.4%, and no major complications were detected. Conclusion: According to the findings, PTRI is an effective method for treating anastomotic and non-anas- tomotic strictures with a high success rate and low complications.

Counterfeit medicines: report of a cross-sectional retrospective study in Iran.

OBJECTIVES: To gain insight into the pharmaceutical grey market in Iran by reviewing inspection files of the Special Inspectorate Unit, Deputy Ministry for Food and Drugs, Ministry of Health and Medical Education, and to define the counterfeit pharmaceutical pattern in Iran. STUDY DESIGN: Cross-sectional retrospective study. METHODS: In total, 382 inspection files of pharmaceutical counterfeit cases between 2007 and 2008 were reviewed. A database was constructed in Microsoft Access, and all cases of counterfeit medicines together with the details recorded in the files were entered. A primary list of all items in all files was produced (n = 7910), and this contained 716 different counterfeit medicines. This article reports the analysis of these 716 items and the outcome. Subsequently, the list of items was further filtered, and a final working list of 100 items was selected for further analysis. Drug samples of the working list were collected and checked against a modified version of the 'Checklist for the visual inspection of medicines to identify suspicious drug products' of the US Pharmacopeia Convention, Inc. and recommended by IMPACT (International Medical Products Anti-Counterfeiting Taskforce). Details of items in the working list recorded in the checklist were then entered into the database. Data were analysed using Statistical Package for the Social Sciences Version 12.0 and Microsoft Excel. RESULTS: Of the 716 items, 64.5% were supplements, 10.2% were analgesics, 7.8% were hormones and 3.2% were antihistamines. Unnamed items and/or items of unknown origin accounted for 2.4% of the total. Herbal medicines, drugs used in the central nervous system, gastrointestinal system and genito-urinary systems, and drugs used for cardiovascular disease and diabetes represented 1-2% of items, and other drug groups accounted for <1% of the 716 counterfeit medicines. Drugs used in professional settings accounted for 20% and drugs used in non-professional settings accounted for 15% of the 716 items. Selected items were checked against the World Health Organization's visual checking tool, and the following observations were made: 15.8% showed mismatch between the label and the container, 7.9% showed the incorrect manufacturer's name and address, 82.9% showed existence or a different view of the logo and hologram of the product, and 18.4% used poor-quality paper for the insert. In 73.7% of products checked, the ink of the packaging or inserts was not smudge-proof. CONCLUSION: Results from this study have been utilized by the Deputy Ministry for Food and Drugs in Iran and the outcome was a faster registration and market authorization of supplements compared with other pharmaceutical products. Inter- and intra-section collaboration, active vigilance and conducting educational programs at different levels would reduce the risk of counterfeit medicines and protect public health.

Nanoencapsulation (in vitro and in vivo) as an efficient technology to boost the potential of garlic essential oil as alternatives for antibiotics in broiler nutrition.

The addition of essential oil (EO) as chitosan encapsulated can increase the efficiency of these oils in broiler feeding. Therefore, the objective of the current research was to explore the antibacterial and antioxidant potential of garlic essential oil (GEO) (free vs. nanoencapsulated) and their effects on performance, gene expression of mucin2, microbial, and morphology of intestine in broilers. A total of 900 1-day-old male broilers (Ross 308) were assigned to six dietary treatments (0, 100, and 200 mg/kg free GEO and 0 (contain of chitosan), 100 and 200 mg/kg nanoencapsulated GEO) with a 2 × 3 factorial arrangement based on completely randomized design. Garlic essential oil encapsulation with chitosan significantly enhanced antibacterial and antioxidant parameters. At 100 mg/kg nanoencapsulated GEO had significant (P < 0.01) advantages in improving BW gain (BWG) (22-42 and 0-42) and feed conversion ratio (FCR) (0-42). Maximum feed intake (FI) was also associated with the control group (P < 0.05). Broilers fed on 100 mg/kg of nanoencapsulated GEO showed higher villi length and width relative to other treatments and villi length to crypt depth ratio as well (P < 0.01). The nanoencapsulation process of GEO (P < 0.01) affected the Lactobacilli population in the digesta of ileo-caecum and mucin2 gene expression. In broiler chickens, the tested EO, especially nanoencapsulated type, enhanced more evaluated parameters. Because of its ideal properties, nanoencasulating with chitosan may also be an effective and inexpensive way to protect bioactive compounds and improve GEO effects in broiler chickens.

Importance of miR-UL-148D Expression Pattern in Cytomegalovirus Infected Transplant Patients.

Background: MicroRNAs (miRNAs) are endogenous, 18-22 nucleotide non-coding RNA molecules. Human cytomegalovirus (HCMV) is a ubiquitous and particular herpes virus that encodes miRNAs, which increases gradually in the presence of infection. One of the important viral miRNAs is HCMV-miRUL-148D, which plays a role in establishing and maintaining viral latency. Objective: The current study aimed to evaluate the expression levels of HCMV-miRUL-148D in active and inactive HCMV infected transplant patient groups compared to healthy individuals. Methods: Total RNA was extracted from blood samples of 60 solid organ transplant patients and 30healthy controls. In-house SYBR Green Real-Time PCR evaluated the expression levels of studied miRNAand gene. Results: The expression level of the UL-148D gene was significantly higher in the active HCMV infectedpatients (p=0.001) compared to other groups. While the miRUL-148D expression level significantly increased in the inactive HCMV-infected patients (p<0.001) compared to other groups. Conclusion: Increased miRUL-148D expression level in the inactive HCMV-infected transplant patients indicates the potential role of this miRUL-148D as a biomarker of the HCMV latent stage.

Porous shape memory dental implant by reactive sintering of TiH2-Ni-Urea mixture.

We produced bifurcated bone-like shape memory implant (BL-SMI) with desirable tooth-root fixation capability by compact-sintering of TiH2-Ni-urea mixture. The primary constituents of the porous product were Ni and Ti. We could adjust the pores' shape, size, and interconnectivity for favorite bone ingrowth by using urea as a space holder. Without urea, we obtained an average porosity of 0.30, and a mean void size of 100 µm. With 70 vol % urea, we got 62% interconnected pores of 400 µm average size. Aging allowed us to tune the austenite-martensite transformation temperatures towards the needed body tissue arouse. Differential scanning calorimetry measured the transformation temperatures. Their austenite start, austenite peak, and austenite finish values were As = 4, Ap = 22, and Af = 34 °C, respectively. They retained functional shape recovery and superelastic effect at the body temperature. Mechanical properties, including Young's modulus of the specimens, matched well to maxilla and mandible bone tissue. The measured Young's modulus of the NiTi specimens was as low as 3.5 GPa, which decreased to ∼2.1 GPa with further porosity increase at higher space holder percentages. Superelasticity regime and low Young's modulus of the implant could potentially prevent stress-shielding from the surrounding bone tissues and give rise to secure fixation of the implant into the bone socket. Bending tests showed 0.9 mm recoverable deflection for specimens which assisted immediate self-fixation of the implant into the jaw bone cavity.

A web-based daily care training to improve the quality of life of mothers of children with cerebral palsy: A randomized controlled trial.

BACKGROUND: Mothers of moderately to severely affected children with cerebral palsy (CP) have to spend a long time to take care of their children. This time-consuming responsibility affects their physical and psychosocial health. Therefore, mothers as caregivers are required to receive special training to take care of their children. AIMS: The aim of this study was to evaluate the effectiveness of a developed web-based intervention for daily care training of children with CP on their mothers' quality of life (QOL), anxiety, depression, stress, and their musculoskeletal pain. METHODS AND PROCEDURES: This study was a single blind randomized controlled trial. 91 mothers of children with CP with Gross Motor Function Classification System (GMFCS) levels III, IѴ, and Ѵ, who aged from 4 to 12 years were assigned to the intervention and control groups using block randomization. Mothers in the control group received their routine face to face occupational therapy intervention and mothers in the intervention group received 12 weeks web-based intervention. QOL, depression, anxiety, stress, and pain were measured before and after the intervention in both groups. OUTCOMES AND RESULTS: The results of analysis of covariance showed that after controlling the mean score of pretest of pain, the mean score of post-tests in the intervention and control groups was significantly different (P < 0.05). The mean scores of physical health and total QOL scores of post-tests in the intervention group were significantly higher than the control group with controlling pretest scores. CONCLUSIONS AND IMPLICATIONS: Designed web-based intervention affects the caregivers' QOL and pain significantly. This intervention can be used to provide daily care training for mothers of children with CP.

Cryptococcus and cryptococcosis in Iran during 1969-2019: A systematic review and meta-analysis.

OBJECTIVE: Limited data are available on the epidemiology and etiology of cryptococcal infections in the Middle East. We aimed to conduct the systematic review and meta-analysis to summarize the epidemiological data on prevalence of Cryptococcus species complexes in trees and their surroundings, bird guano and secretions, animals, and highlight the reported episodes of cryptococcosis in Iran. MATERIALS AND METHODS: Twelve databases, including PubMed, Science Direct, Scopus, Proquest, Google Scholar, Embase, and the ISI Web of Science, as well as the national databases, from January 1969 to October 2019 were searched. Furthermore, gray literature (e.g., thesis, congress abstracts) was evaluated using Iran Doc and www.thesis. RESEARCH: ac.ir. Search process was accomplished on English or Persian language articles using the following keywords: "Cryptococcus", "Cryptococcosis", "invasive fungal infection", "Humans", "Birds", "Pigeon", "Animals", "Tree", "Eucalyptus", and "Iran", both alone and in combination. RESULTS: Overall 36 studies were eligible regarding Cryptococcus and cryptococcosis in Iran. The total prevalence rates of Cryptococcus species in the tree was 4.7% (95% CI: 2.3-7.8), and in bird guano was 20.4% (95% CI: 10.7-32.2). Cryptococcosis in animal, and human were 1.7% (95% CI: 0.01-5.1), and 2.8% (95% CI: 0.7v6.1), respectively. The highest prevalence of Cryptococcus in the trees (14.6%), and bird guano (89.4%) in Khorasan, animals (8.9%) in Chaharmahal and Bakhtiari, and human (4.4%) in Mazandaran provinces were reported. CONCLUSIONS: Given the significant risk of Cryptococcus species for susceptible humans, mainly HIV-infected patients, it seems quite necessary to adopt concrete preventive strategies to pinpoint the environmental habitats of this yeast.

Donors' Quality of Life after Living Donor Liver Transplantation: Shiraz Organ Transplant Center Experience.

BACKGROUND: Probable effects of living donor liver transplantation on the wellbeing of the donor and psychological difficulties are necessary to be understood. OBJECTIVE: To assess the quality of life of living donors after liver donation. METHODS: 140 living donors who underwent hepatectomy between 2012 and July 2015 were enrolled in this study. Donors were asked to complete the Short Form 36-question Health Survey (SF-36) through face to face or by telephone interview. RESULTS: The mean±SD age of donors at transplantation was 32.1±7.3 years; 83 (59.3%) of donors were female. 134 (95.7%) were married. The mean±SD BMI was 23.8±3.5 (kg/m2). "Mother-to-child" was the most frequent relationship (n=79, 56.4%). 22 (15.7%) complications were reported by participants. The mean±SD score of Physical Component Summary and Mental Component Summary were 48.8±14.6 and 50.1±6.9, respectively. CONCLUSION: Most living donors sustain a near average quality of life post-donation. It seems that living donation does not negatively affect the quality of life.

Association between Interleukin-21, 23 and 27 Expression and Protein Level with Cytomegalovirus Infection in Liver Transplant Recipients.

BACKGROUND: Cytokines have regulatory crosstalk with CMV infection leading to manage of post-liver transplantation virus-related outcomes. OBJECTIVE: To investigate the link between IL-21, IL-23 and IL-27 mRNA and protein level with active CMV infection, which was evaluated in reactivated and non-reactivated liver transplant recipients. METHODS: Two groups of liver transplant recipients were enrolled in this study-54 without and 15 with active CMV infection. 3 EDTA-treated blood samples were taken on day 1, 4, and 7 post-liver transplantation. Plasma and buffy coats of all samples were separated. All samples were analyzed for CMV reactivation using antigenemia technique. The separated plasma of positive samples was used for viral DNA extraction and protein evaluation. For evaluating the mRNA expression level by real-time PCR, RNA extraction and cDNA synthesis were done for all samples. Also, the protein level of studied genes was estimated by ELISA. RESULTS: The expression level of IL-21, IL-23A and IL-27A cytokine genes was increased in CMV reactivated liver transplant recipients in comparison with CMV non-reactivated ones; IL-27A expression pattern was significant (p=0.001) at all sampling times. IL-21 significantly increased on the 2nd and 3rd (p=0.028 and 0.01, respectively) sampling days in CMV reactivated compared with non-reactivated patients. The expression level of IL-23A cytokine significantly increased on the 3rd (p=0.017) sampling day in CMV reactivated compared with non-reactivated liver transplant recipients. CONCLUSION: Elevation in the expression level of IL-21, IL-23A and IL-27A mRNA and protein level in CMV reactivated patients emphasized on the antiviral role of these cytokines in CMV reactivated liver transplant recipients.