Comparative evaluation of amniotic fluid as an alternative to fetal bovine serum in the maintenance of Leishmania major and Toxoplasma gondii.

This study aimed to evaluate the efficacy of amniotic fluid (AF) as an alternative to fetal bovine serum (FBS) in the maintenance of Leishmania major promastigotes and Toxoplasma gondii tachyzoites. AF was collected by an obstetrician using sterile syringes during a cesarean section. The culture medium was supplemented with 5 different concentrations of FBS or AF including 2, 5, 10, 20, and 30%. These concentrations were used to maintain both mentioned parasites. L. major was maintained at temperatures 4 and 24 °C and examined once a week for 4 weeks, while T. gondii was maintained at temperatures 4, 24, and 37 °C and examined at hours 24, 48, 72, and 96. For L. major, at both 4 and 24 °C, we observed no significant difference between FBS and AF on day 7. However, on days 14, 21, and 28, the difference between FBS and AF was significant at both temperatures. For T. gondii, no significant difference was observed between FBS and AF at hour 24 and all temperatures. However, this difference was significant at hours 48, 72, and 96 and all temperatures. According to our results, although FBS had a greater efficacy than AF in the growth of L. major and the survival of T. gondii, the number of promastigotes increased over time in AF-containing medium and the number of tachyzoites reduced slowly with a mild slop. Therefore, AF can be a potential alternative to FBS.

Global status of neglected human Linguatula infection: a systematic review of published case reports.

Human linguatulosis is a rare but highly specialized pentastomid parasitic infection all around the world. The disease is caused by worm-like parasites which share some morphologic features of arthropods and annelids. The life cycle of Linguatula spp. is provided as an example of pentastomid biology. The adult forms of Linguatula spp. are found in the nasal passages and frontal sinuses of dogs and other canids, domestic animals, and humans. Infestation may occur in the viscera, where immature forms develop in the liver, spleen, lungs, eyes, and other organs, or in the nasopharyngeal area. This review includes previous studies on the genus Linguatula in Iran and other countries from 1940 to 2019. Considering a few reports of human infestation, a comprehensive search was performed on both English and Persian databases for publications reporting human cases all around the world. Finally, 30 papers of 62 human cases were included in this study. The mean age of the patients was 25.8 years (varied from 8 to 79 years). Altogether, 41 (66.1%) and 21 (33.9%) of the patients were female and male respectively. The maximum cases (n = 25) were from Sudan. Nasopharynx was the most frequently involved organ in human cases. Our findings offer that physicians should consider the Linguatula infection in patients with complaints like unexpected dysphagia, with coughing, sneezing, and vomiting, after consuming raw/undercooked contaminated ruminant's viscera.

Tropolone alkaloids from Colchicum kurdicum (Bornm.) Stef. (Colchicaceae) as the potent novel antileishmanial compounds; purification, structure elucidation, antileishmanial activities and molecular docking studies.

Natural compounds played an important role for prevention and treatment of the disease as well as are the important compounds for the design of the new bioactive compounds. In this study, eight tropolone alkaloids were isolated from Colchicum kurdicum including colchicoside, 2-demethyl colchicine, 3-demethyl colchicine, demecolcine, colchifoline, N-deacetyl-N-formyl colchicine, colchicine and cornigerine by column and preparative thin layer chromatography. The chemical structures were identified by 1H NMR and 13C NMR spectroscopy. Moreover, the antileishmanial activity on Leishmania major, anti-inflammatory activity, iron chelating activity and toxicity studies including hemolytic activity, brine shrimp toxicity, cytotoxicity and acute toxicity and docking study of all isolated bioactive compounds were evaluated. As result, colchicoside and colchicine had potent leishmanicidal effects and N-deacetyl-N-formyl colchicine and cornigerine had the highest anti-inflammatory effects. All compounds had the significant iron chelating activity. According to toxicity studies, isolated compounds showed the low hemolytic activity and cytotoxicity, high LC50, LC90 and LD50. In the molecular docking study, colchicoside had the high dockscore. According to the study, with future studies all isolated compounds could be used for design the novel antileishmanial drugs.

Molecular Modeling and Structural Stability of Wild-Type and Mutant CYP51 from Leishmania major: In Vitro and In Silico Analysis of a Laboratory Strain.

Cutaneous leishmaniasis is a neglected tropical disease and a major public health in the most countries. Leishmania major is the most common cause of cutaneous leishmaniasis. In the Leishmania parasites, sterol 14α-demethylase (CYP51), which is involved in the biosynthesis of sterols, has been identified as an attractive target for development of new therapeutic agents. In this study, the sequence and structure of CYP51 in a laboratory strain (MRHO/IR/75/ER) of L. major were determined and compared to the wild-type strain. The results showed 19 mutations including seven non-synonymous and 12 synonymous ones in the CYP51 sequence of strain MRHO/IR/75/ER. Importantly, an arginine to lysine substitution at position of 474 resulted in destabilization of CYP51 (ΔΔG = 1.17 kcal/mol) in the laboratory strain; however, when the overall effects of all substitutions were evaluated by 100 ns molecular dynamics simulation, the final structure did not show any significant changes (p-value < 0.05) in stability parameter of the strain MRHO/IR/75/ER compared to the wild-type protein. The energy level for the CYP51 of wild-type and MRHO/IR/75/ER strain were -40,027.1 and -39,706.48 Kcal/mol respectively. The overall Root-mean-square deviation (RMSD) deviation between two proteins was less than 1 Å throughout the simulation and Root-mean-square fluctuation (RMSF) plot also showed no substantial differences between amino acids fluctuation of the both protein. The results also showed that, these mutations were located on the protein periphery that neither interferes with protein folding nor with substrate/inhibitor binding. Therefore, L. major strain MRHO/IR/75/ER is suggested as a suitable laboratory model for studying biological role of CYP51 and inhibitory effects of sterol 14α-demethylase inhibitors.

Depression and health related quality of life in breast cancer patients.

OBJECTIVE: To investigate the prevalence of depression in women with breast cancer and relate it to their health-related quality of life. METHODS: The cross-sectional study was conducted at the Imam Khomeini Hospital in Iran between January and December 2009, and comprised 60 women with breast cancer with a mean age of 43.8 +/- 47.12 years. In order to assess the health-related quality of life, the study used the parameters of the Iranian version of the Functional Assessment of Cancer Therapy for Breast Cancer. To identify expressive symptoms, the Beck Depression Inventory was used. General linear model regression and SPSS 14 were used to analyse the data. RESULTS: Significant differences in the prevalence of depression between treatment types was found. The presence of depression was significantly correlated with poorer overall health-related quality of life and the four subscales of the protocol. The patients reported statistically significant effects of depression in the overall category (p= 0.001). Participants with depression were more likely to have a poorer overall health-related quality of life, the exception being the social/family well-being subscale. CONCLUSIONS: Depression affects health-related quality of life in breast cancer patients. Although further studies are necessary to confirm our findings, but our results emphasise the necessity for better mental health strategies for such patients.

Status of human cystic echinococcosis based on hospital records in Mazandaran Province: A first registry-based evidence.

Background: Human cystic echinococcosis, as an emerging neglected parasitic disease, is caused by tapeworms of the genus Echinococcus spp. Because of the medical and economic importance, this study aims to review the epidemiology and clinical features of hydatidosis in patients admitted to medical and surgical wards in three referral teaching hospitals over 15 years in Mazandaran Province, northern Iran. Methods: Data were collected from hospital records that were accessible via the hospital information system (HIS) between 2005 and 2019 (15 years).The demographic information (age, sex, living area, and occupation), dog contact, number of the cysts, types of organs involved, and history of disease recurrence were assessed. Results: One hundred twenty-one patients with human cystic echinococcosis (CE) were involved in the study, from whom 58 patients (47.93%) were male and 63 (52.07%) were female. The majority of patients were rural residents (64.46%) and also housewife (28.10%). Based on the results, only about 16.53% of the patients had history of close contacts with dogs. The liver was the organ involved in the most cases of CE. There were statistically significant differences between residence, occupation, history of close contacts with dogs, type of organs involved, number of cysts and history of disease recurrence (P < 0.05). Conclusions: Our data provides valuable registry-based information about CE in an endemic region. The data highlights that most patients lived in rural areas and were housewives. Additionally, they had a low rate of disease recurrence but a high rate of close contact with dogs. Moreover, further monitoring on registry-based program and strengthening the HIS in the provincial hospitals in the studied area are required.

Credible Serological Evidence of Latent Toxoplasma Infection Among Women with Primary Infertility: A Ten-Year Registry-Based Study.

BACKGROUND: Some evidence reveled that chronic infection with Toxoplasma gondii (T. gondii) has recently been associated with infertility in human and experimental model. This baseline study aimed to investigate serological evidence of Toxoplasma infection among infertile women who admitted to the in vitro fertilization (IVF) clinic at Imam Khomeini Hospital, Mazandaran province, Sari, northern Iran. SUBJECTS AND METHODS: In this retrospective (descriptive-analytical) study, all infertile women referred to the IVF clinic during 2010-2019 (10 years), constitute the study population. All data including demographic and some related characteristics were collected into a questionnaire and registered at the Iranian National Registry Center for Toxoplasmosis (INRCT) at the Mazandaran University of Medical Sciences, northern Iran. The existence of anti-Toxoplasma antibodies (IgG and IgM) was explored using a commercially available enzyme-linked immune sorbent assay (ELISA) kit (PishtazTeb, Iran), based on the manufacturer's protocol. RESULTS: Of 520 infertile women, anti-T. gondii IgG, IgM and both IgG and IgM antibodies were detected among 342/520 (65.77%), 1/520 (0.19) and 4/520 (0.77) infertile women, respectively. Primary and secondary infertility was detected in 74.56% and 25.44% of IgG seropositive infertile women, respectively. Also, most of the IgG seropositive subjects had no history of abortion, polycystic ovary syndrome (PCO), fibroma, contraceptive use and varicocele in spouse as primary cause of infertility. Furthermore, serum levels of prolactin and antimullerian (AMH) hormones were normal in 81.29 and 80.12% of infertile women with anti- T. gondii IgG, respectively. There was also a statistically significant difference between the seroprevalence of Toxoplasma infection and these variables associated to primary infertility (P < 0.05). CONCLUSION: According to the high prevalence (about two thirds) of chronic T. gondii infection among infertile women, particularly those with a history of abortion and primary infertility, it can be concluded that latent Toxoplasma infection pose a risk to infertile woman in the study area. Therefore, we advise that screening and treatment of Toxoplasma infection among infertile women must be favorably considered.

Iranian Hydatid Disease Registry: Establishment and Implementation of a Neglected Tropical Disease Registry.

BACKGROUND: Cystic echinococcosis (CE) or hydatid disease is a global public health concern which imposes considerable economic costs on the communities in endemic regions. CE surveillance data are not adequately reliable. The present study reports the development and outcomes of a CE registry in Iran. METHODS: Hydatid Registry (HydatidReg) was initially established as a single-center registry in 2014 after the ethical approval of KMU. Following a call from MoHME to promote registry of different diseases and health outcomes, a call for participation was announced and all the Iranian Universities of Medical Sciences were requested to contribute to the registry. Subsequently, a nation-wide registry of hydatid disease was established in 2016. With a global perspective, HydatidReg joined the European Register of Cystic Echinococcosis (ERCE). A data collection form based on minimum dataset was designed and standard operating procedures (SOPs) were prepared to ensure standardized patient enrolment in the registry. A biobank system with two-dimensional barcoding was established along with HydatidReg for management and organization of biological specimens. RESULTS: As of March 2021, a total of 690 patients were enrolled in the registry. HydatidReg registered 362 (17.3%) out of the total 2097 patients enrolled in ERCE. Quality control (QC) of the data demonstrated 91.2% completeness and 80% timeliness. In the biobank, 322 biological specimens from 184 CE patients have been deposited including 70 blood, 96 sera and 156 parasite materials. CONCLUSION: High-quality data in the HydatidReg registry provided opportunities for health professionals to improve quality of care and organize meaningful research.

The Potential Role of the Serotonin Transporter as a Drug Target against Parasitic Infections: A Scoping Review of the Literature.

BACKGROUND: Several in vitro and in vivo biological activities of serotonin, 5- hydroxytryptamine (5-HT), as a bioactive molecule, and its transporter (5-HT-Tr) were evaluated in parasitic infections. OBJECTIVE: Herein, the roles of 5-HT and 5-HTR in helminths and protozoan infections with medical and veterinary importance are reviewed. METHODS: We searched information in 4 main databases and reviewed published literature about the serotonin transporter's role as a promising therapeutic target against pathogenic parasitic infections between 2000 and 2021. RESULTS: Based on recent investigations, 5-HT and 5-HT-Tr play various roles in parasite infections, including biological function, metabolic activity, organism motility, parasite survival, and immune response modulation. Moreover, some of the 5-HT-TR in Schistosoma mansoni showed an excess of favorite substrates for biogenic amine 5-HT compared to their mammalian hosts. Furthermore, the main neuronal protein related to the G protein-coupled receptor (GPCR) was identified in S. mansoni and Echinococcus granulosus, playing main roles in these parasites. In addition, 5-HT increased in toxoplasmosis, giardiasis, and Chagas disease. On the other hand, in Plasmodium spp., different forms of targeted 5-HTR stimulate Ca2+ release, intracellular inositol triphosphate (ITP), cAMP, and protein kinase A (PKA) activity. CONCLUSION: This review summarized the several functional roles of the 5-HT and the importance of the 5-HT-TR as a drug target with minimal harm to the host to fight against helminths and protozoan infections. Hopefully, this review will shed light on research regarding serotonin transporter-based therapies as a potential drug target soon.

Aurothiomalate-Based Drugs as Potentially Novel Agents Against Leishmania major: A Mini Review.

PURPOSE: Leishmaniasis is a major public health problem worldwide in many parts of the world. Current anti-leishmanial drugs have only limited clinical efficacy. Aurothiomalate derivatives are useful for treating rheumatoid arthritis, but have emerged as a promising therapeutic candidate for leishmaniasis. This paper gives a review of the literature about the usefulness of aurothiomalate derivatives against leishmaniasis. METHODS: In this study, we reviewed the proposed mechanisms of action of aurothiomalate and related compounds on the metabolism of L. major and collected data by searching relevant articles. RESULTS: Aurothiomalate-based drugs could be effective against leishmaniasis through two direct and indirect mechanisms: first, cytotoxic effects on parasites via thiomalate's false substrate role in the citric acid cycle against malate; and second, immunosuppressive and anti-inflammatory effects of aurothiomalate derivatives with prostaglandin production inhibitory effects. CONCLUSIONS: The current study documented that aurothiomalate-based drugs could be effective against leishmaniasis through two direct and indirect mechanisms of action. Gold thiomalate as a promising hit should be evaluated against L. major in vitro and in vivo conditions in the future.

Promising Anti-Protozoan Activities of Propolis (Bee Glue) as Natural Product: A Review.

PURPOSE: Propolis (bee glue) is a resinous mixture of different plant exudates that possesses a wide range of biological and antimicrobial activities and has been used as a food supplement and in complementary medicine for centuries. Some researchers have proposed that propolis could be a potential curative compound against microbial agents such as protozoan parasitic infections by different and occasionally unknown mechanisms due to the immunoregulatory function and antioxidant capacity of this natural product. METHODS: In this review, we concentrate on in vitro and in vivo anti-protozoan activities of propolis extracts/fractions in the published literature. RESULTS: In Leishmania, propolis inhibits the proliferation of promastigotes and produces an anti-inflammatory effect via the inhibition of nitric oxide (NO) production. In addition, it increases macrophage activation, TLR-2, TNF-α, IL-4, IL-17 production, and downregulation of IL-12. In Plasmodium and Trypanosoma, propolis inhibits the parasitemia, improving anemia and increasing the IFN-γ, TNF-α, and GM-CSF cytokines levels, most likely due to its strong immunomodulatory activity. Moreover, propolis extract arrests proliferation of T. cruzi, because it has aromatic acids and flavonoids. In toxoplasmosis, propolis increases the specific IgM and IgG titers via decreasing the serum IFN-γ, IL-1, and IL-6 cytokines levels in the rats infected with T. gondii. In Cryptosporidium and Giardia, it decreases oocysts shedding due to phytochemical constituents, particularly phenolic compounds, and increases the number of goblet cells. Propolis inhibits the growth of Blastocystis, possibly by apoptotic mechanisms like metronidazole. Unfortunately, the mechanism action of propolis' anti-Trichomonas and anti-Acanthamoeba is not well-known yet. CONCLUSION: Reviewing the related literature could highlight promising antimicrobial activities of propolis against intracellular and extracellular protozoan parasites; this could shed light on the exploration of more effective drugs for the treatment of protozoan parasitic infections in the near future.

Scientometric Analysis of Global Research on Trichomoniasis in Scopus Database (1922 -2018).

BACKGROUND: Trichomoniasis is a sexually transmitted disease (STD) prevalent in different parts of the world. The present study was designed to evaluate the scientific output and collaboration of researchers worldwide on trichomoniasis. METHODS: In the present scientometric research, all papers conducted on Trichomonas vaginalis (T. vaginalis) published in the time period of 1922 to 2018 were extracted from the Scopus database and evaluated according to the aims of the research, using scientometric software. RESULTS: The results of this search strategy were the retrieval of 12,596 scientific papers authored by a total of 28,822 people during 97 years (1922-2018). Research in this field has encountered success and failure over the years. The first article on trichomoniasis at the Scopus database was published by Musgrave W.E. (1922) in the "Journal of the American Medical Association". Most papers on this subject (352) were published in 2013; and the years 2017 and 2016 are ranked second and third. Researchers from the US Centers for Disease Control and Prevention have the highest number of papers in this field (210). Alderete J.F. with 111 papers is the most active researcher on trichomoniasis in Scopus. Also, researchers from the US ranked the first with 3,236 papers. In Iran, by the end of 2018, 138 papers on trichomoniasis have been registered in Scopus, which accounts for only one percent of the world's science production in this field. DISCUSSION AND CONCLUSION: The results following about one century indicated that the number of publications on T. vaginalis is growing and that there is a high level of collaboration among researchers in this field. Moreover, many countries have collaborated internationally on trichomoniasis research with the US as the leading country.

A Systematic Literature Review of Curcumin with Promising Antileishmanial Activity.

BACKGROUND: Curcumin (CUR) is a bright yellow chemical and it is used as an additive in foods. Recently CUR and its associated bioactive compounds have received much attention in the literature review. The aim of this systematic review is to overview the antileishmanial properties of CUR and its mechanism; perhaps the results of this study will be used for therapeutic and preventive purposes. METHODS: Following the PRISMA guidelines, international databases were systematically searched for studies published until September 2019. Articles related to the subject were selected and included in this systematic review. RESULTS: A total of 15 articles met our eligibility criteria. Then, the effect of CUR and its associated bioactive compounds on Leishmania species was evaluated. In most studies, CUR/derivatives were tested on L. major and in vitro condition. Most investigations were conducted on the promastigote rather than the more relevant intracellular amastigote stage. Our results showed that CUR overcomes the inhibitory effect of nitric oxide (NO) on Leishmania parasites. CONCLUSION: This review indicated that CUR derivatives, instead of CUR alone showed a high potential to serve as an effective herbal drug against leishmaniasis. Moreover, we concluded that the antileishmanial activity of CUR/bioactive compounds is mostly due to increased oxidative stress and apoptosis.

Peganum harmala and Nigella sativa: anti-leishmanial activity against Leishmania major promastigotes and amastigotes: in vitro and ex vivo experiment.

Leishmaniosis is one of the most important vectors borne disease that is endemic in tropical and subtropical areas. There are many approved treatment for different types of leishmaniosis but all are with some adverse side effects that limited its uses. Here, we attempt to evaluate in vitro and ex vivo anti-leishmanial activities of Peganum harmala (P. harmala) and N. sativa (Nigella sativa) on promastigotes and amastigotes of L. major. The plants were extracted by maceration method and prepared in concentrations of 7.8, 3.9, 1.9, and 0.9 µg. L. major were cultured in RPMI-1640 medium alone and in J774 cell line separately. The extracts at different concentrations were assessed against promastigote (in vitro assay) and amastigotes (ex vivo assay) of L. major for 72 h at 22 and 37°C, respectively. In current work, N. sativa at highest concentration (7.8 µg/ml) showed 54.4 and 60% anti-leishmanial activity with IC50 of 5.3 and 3.278 µg/ml, respectively. Also, P. harmala at highest concentration (7.8 µg/ml) showed 68.9 and 58.6% antileishmanial activity with IC50 of 2.4 µg/ml for both of them, respectively. The SI value was 38.22 for N. sativa, 25.9 for P. harmala, 19.4 for Amphotericin B, and 16.33 for Glucantime. The results of our study indicated that N. sativa and P. harmala are effective against L. major promastigotes and amastigotes and could be consider as an alternative treatments for leishmaniosis. Therefore, it is recommended that further studies be performed to confirm the efficacy and evaluate the toxicity of the herbal extracts.

Toxoplasma gondii infection in patients with rheumatoid arthritis and systemic lupus erythematous diseases: serological and molecular evidence.

This study aimed to determine Toxoplasma gondii infection in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients in Mazandaran Province, north of Iran. During April 2019 to February 2020, 305 patients with RA (N=272) and SLE (N=33) diseases are included in this cross-sectional study. The baseline data of patients were collected into a questionnaire. Also, blood sample was taken from each patient in tubes containing k2-EDTA as anticoagulant for serological and molecular analyses. The presence of specific IgG antibody against T. gondii in plasma was explored using ELISA method. DNA was extracted and conventional-PCR method was done using RE primers on buffy coat samples. Anti-Toxoplasma IgG were detected among 105/272 RA (38.6%) and 11/33 (33%) SLE patients (P=0.55). IgG seropositivity was more common in females (95.70%) than in males (4.30%) and in 51-60 years old patients (37.10%) in rural populations (62.07%). Also, seropositivity was higher in patients who kept cats (93.95%). Keeping cats and patient's age were two studied risk factors which had significant relations with T. gondii seropositivity in patients (P<0.05). Overall, T. gondii DNA was found in 60 of 305 (19.7%) of enrolled patients, whether serology positive or negative (P<0.0001). Given the RA and SLE patients can be considered as a risk group for toxoplasmosis, in addition to the serological test, PCR based techniques is recommended for early and accurate detection of recent T. gondii infection.

In vivo anti-leishmanial activity of concocted herbal topical preparation against Leishmania major (MRHO/IR/75/ER).

Cutaneous leishmaniosis (CL) is considered as one of the most important tropical diseases. Herbal therapy is the ideal treatment for CL because of the reduced injection pain, availability, lower cost and non-toxicity effects. The present study aimed to evaluate the in vivo antileishmanial activity of concocted herbal topical preparation (Aloe vera, Perovskia abrotanoides, Nigella sativa, propolis, lavender and olive oil) to evaluate its efficacy against Leishmania major (MRHO/IR/75/ER) in comparison to the gold standard treatment. Following the cause of cutaneous leishmaniosis, the BALB/c mice were divided into three groups, test group (ointment formulation), positive control (Glucantime) and negative control (untreated), respectively, which were treated twice a day for 28 consecutive days. The lesion size and parasite burden were evaluated for in vivo evaluation. The herbal topical ointment was able to significantly decline the lesion progression and reduce parasite burden in mice inoculated with L. major promastigotes in the test group compared with the negative control group (P=<0.001). In mice treated with the formulation, the number of amastigotes significantly decreased (P=<0.001), compared with that in the negative control group. Moreover, comparative features of both treatments showed there was no difference between the herbal-treated and glucantime-treat mice (P=0.63). The herbal topical ointment displayed significant in vivo antileishmanial activities. It may be that using ointment formulation beside other skin repair compounds can be used as an alternative medicine in the treatment and healing of human CL lesions. Further investigations are needed to study the pharmacologic and pharmacokinetics aspects of ointment formulation in the treatment and healing of human CL lesions.

Promising In Vitro Anti-Toxoplasma gondii Effects of Commercial Chitosan.

CDATA[Background: Toxoplasmosis is a disease that results from infection with an obligate intracellular T. gondii parasite, one of the world's most common parasites. Considering the complications of chemical drugs and the need for an appropriate drug combination for treatment of toxoplasmosis and considering the antimicrobial potential of chitosan, as a natural source, this study was aimed to evaluate in vitro activity of commercial chitosan (CC) on T. gondii. METHODS: In this experimental study, the tachyzoites of T. gondii were collected from the peritoneal exudates from infected Balb/c mice. The tachyzoites were diluted in phosphate buffer saline (PBS) solution. Chitosan with low molecular weight was commercially purchased. Then, at concentrations of 10, 50, 100, and 200 µg/mL and after 30, 60, 120, and 180 minutes, the viability of tachyzoites was determined by using trypan blue 0.1%. Anti-T.gondii activity of CC in all concentrations was significantly higher than pyrimethamine as the control group (P=0.05). RESULTS: The concentration of 200 µg/mL of CC had the highest effects and killed 30.5, 52, 59, and 81.5% of tachyzoites after 30, 60, 120, and 180 minutes. Moreover, IC50 values of CC were 515, 171, 12.5, and <10 µg/mL in comparison with pyrimethamine as 58.82 µg/mL for 30, 60, 120, and 180 min of exposure time. CONCLUSION: Our results indicate that chitosan in low molecular weight had potent activity against T. gondii tachyzoites and could be an appropriate candidate for the treatment of at least acute toxoplasmosis, certainly, after complementary in vivo experiments.

Two decades of echinococcosis/hydatidosis research: Bibliometric analysis based on the web of science core collection databases (2000-2019).

Echinococcus granulosus sensu lato and Echinococcus multilocularis are responsible for serious health and economic implications for humans and animals. This study was designed to conduct a bibliometric analysis of global research on echinococcosis/hydatidosis included in the Web of Science Core Collection databases from 2000 to 2019. A total of 7066 relevant articles between 2000 and 2019 were identified. Most articles were published in 2015 (502 articles), 2017 (492 articles) and 2018 (493 articles), with the Veterinary Parasitology journal publishing the largest number of articles (237). Researchers from Xinjiang Medical University, China authored the most articles (388) in the field. Authors Craig, P.S. and Deplazes, P. were the most active in publishing143 and 126 hydatid cyst research papers, respectively. The most echinococcosis/hydatidosis publications originated from Turkey, China and Iran, with 1210, 708 and 531 articles, respectively. The highest levels of research collaboration were evident between China- England, China-France, England-France, China-Australia, and China-Japan. Also, the top researchers in this field had relatively extensive collaborations with each other. Our bibliometric analysis provides a picture of the scientific research into the echinococcosis/hydatidosis field. Further multi-national collaborative research efforts in this field should show promising progress in the future.

A Bibliometric Analysis of Global Research on Lophomonas Spp. in Scopus (1933-2019).

BACKGROUND: This study was designed to analyze the global research on Lophomonas spp. using bibliometric techniques. METHODS: A bibliometric research was carried out using the Scopus database. The analysis unit was the research articles conducted on Lophomonas spp. RESULTS: A total of 56 articles on Lophomonas spp. were indexed in the Scopus throughout 1933-2019 (87 years) with the following information: (A) The first article was published in 1933; (B) 21 different countries contributed in studies related to Lophomonas spp.; (C) China ranked first with 16 publications about Lophomonas spp.; and (D) "Brugerolle, G" and "Beams, H.W." from France and the US participated in 4 articles respectively, as the highest number of publications in the Lophomonas spp. network. DISCUSSION: After 87 years, Lophomonas still remains unknown for many researchers and physicians around the world. Further studies with high quality and international collaboration are urgently needed to determine different epidemiological aspects and the real burden of the mysterious parasite worldwide.

Paroxysmal Tonic Spasm in a Patient with the Sudden Zolpidem Withdrawal: A Case Report.

Zolpidem is an imidazopyridine derivative and a non-benzodiazepine hypnotic drug. There are several case reports of zolpidem abuse or dependence and zolpidem withdrawal. This study reports a case of paroxysmal tonic spasm (PTS) after abrupt withdrawal of high dose zolpidem. The case was a 21-year- old male patient with complaints of acute involuntary and painful spasms of all extremities after the sudden withdrawal of taking supratherapeutic zolpidem. In his medical records, He had the history of insomnia and psychiatric disorder . The patient's symptoms improved with intravenous injection of 10 mg diazepam slowly and zolpidem was tapered gradually. This case report indicates that zolpidem has a dependency and abusage properties. To the best of our knowledge , this is the first report of zolpidem withdrawal with PTS.