Evaluating Chronic Endometritis in Women with Recurrent Implantation Failure and Recurrent Pregnancy Loss by Hysteroscopy and Immunohistochemistry.

STUDY OBJECTIVE: The identification of less invasive methods with acceptable diagnostic value for evaluating intrauterine abnormalities can improve the satisfaction of patients and physicians. Although hysteroscopy plus biopsy has favorable predictive and diagnostic values, limited studies have evaluated its value, and the exact value of this method is not completely understood. The aim of this study was to evaluate the prevalence of chronic endometritis in patients with recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL) by hysteroscopy and immunohistochemistry. DESIGN: A cross-sectional study. SETTING: An infertility clinic at Jundishapur University Hospital, Ahvaz, Iran. PATIENTS: Women with RIF after IVF and RPL. INTERVENTIONS: Hysteroscopy on the third to fifth day after finishing the menstruation cycle and then a biopsy for immunohistochemistry by a specific monoclonal antibody against the CD138 marker. MEASUREMENTS AND MAIN RESULTS: In total, 85 patients with a mean age of 36.08 ± 5.76 years underwent hysteroscopy on the third to fifth day after finishing the menstruation cycle. At the end of hysteroscopy, a biopsy was taken and assessed using immunohistochemistry by a specific monoclonal antibody against the CD138 marker. Immunohistochemical staining findings of >5 plasma cells per 20 high-power fields were considered the gold standard. The prevalence of chronic endometritis (CE) in both groups and the diagnostic value of hysteroscopy were evaluated. All data were analyzed using the Fisher exact test and analysis of variance. The prevalence of RIF-related CE was 23.4% (11); 21.3% (10) of the cases were diagnosed by hysteroscopy. The prevalence of RPL-related CE was 36.8% (14) and 31.6% (12) based on hysteroscopy and immunohistochemistry staining, respectively. Subsequently, 10 patients (RIF/RPL-related CE with a positive hysteroscopic outcome) were selected randomly for in vitro fertilization therapy, and 3 (30%) of them eventually became pregnant. The sensitivity, specificity, and positive and negative predictive values of hysteroscopy in diagnosing CE were 86.36%, 87.30%, 70.37%, and 94.82%, respectively. CONCLUSION: Hysteroscopy is a reliable diagnostic technique in patients with RIF after in vitro fertilization and RPL that can reliably diagnose chronic endometritis.

A novel competitive ELISA for detection of antibodies against bovine viral diarrhea virus infection.

Diagnosis of bovine viral diarrhea (BVD) relies on the detection of antibodies against its viral causing agent, bovine viral diarrhea virus (BVDV). Here, we designed a novel competitive ELISA (cELISA) using the most immunogenic part of BVDV nonstructural protein 3 (NS3), as a single ELISA recombinant antigen, along with a monoclonal antibody to detect antibodies against BVDV in sera of infected animals. Hence, 197 serum samples were tested by this cELISA and the results were compared to the results obtained from virus neutralization test (VNT) as the gold standard method for diagnosis of BVD. McNemar's test indicated that there was no significant difference between the results of this newly designed cELISA and VNT. Meanwhile, kappa coefficients showed that there was a high correlation between these two assays. The relative sensitivity and specificity of cELISA with respect to VNT were 93.90% and 100%, respectively, suggesting that this newly designed cELISA could be a useful diagnostic tool for detection of BVDV infection. Moreover, as NS3 is highly conserved among Pestiviruses and the developed ELISA is a competitive one, it could potentially be applied to detect BVDV infection in other domestic and wildlife species.

A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm.

Evaluating the effect of convalescent plasma (CP) on some cytokine storm indices in severe COVID-19 patients. Totally, 62 patients were randomly assigned into two groups for this clinical trial. Patients in the intervention group received one unit (500 mL) plasma on the admission day plus standard drugs while the controls merely received standard treatments. Eventually, primary and secondary outcomes were evaluated. In the CP group, compared with controls, the mean levels of lymphocytes and IL-10 significantly increased while the levels of IL-6, TNF-α, and IFN-γ decreased (p < 0.05). The length of in-hospital stay, and mortality rate did not significantly reduce in the CP group compared with controls (p > 0.05) while WHO severity scores remarkably improved (p = 0.01), despite the higher frequency of underlying diseases among the CP group (66.7%) vs. controls (33.3%). Although CP has a remarkable immunomodulatory and antiviral potential to improve the cytokine storm and disease severity in COVID-19 patients, it did not considerably affect the mortality rate.

Prevalence of Cryptosporidium species isolated from HIV/AIDS patients in southwest of Iran.

This study aimed to determine the prevalence and species of Cryptosporidium among HIV/AIDS patients in southwest of Iran. Two hundred fifty faecal samples from HIV patients were examined for the presence of Cryptosporidium oocysts using a conventional coproscopic approach. Such oocysts were detected in 18 (7.2%) out of 250 faecal samples. Genomic DNAs from 250 samples were then subjected to a nested-PCR-RFLP technique targeting different loci of 18S rRNA gene for species identification. Out of 250 samples, 27 (10.8%) were positive for different Cryptosporidium spp; Restriction patterns resulting from the digestion of the nested amplicon with restriction endonucleases VspI and SspI showed that C. parvum (70.38%) was the most prevalent species, followed by C. hominis (25.92%) and C. meleagridis (3.7%), respectively. The mean CD4+ T-cell count was 215 cells/µL. There was a strong association between cryptosporidiosis and CD4+ T-cell count (P = 0.000) with the highest prevalence recorded among patients with CD4+ T-cell count < 200 cells/µL. This confirms that there is a low opportunity for this parasite to get established as the patients CD4+ T-cell count increases. Also HIV infection increased the risk of having Cryptosporidium. Our epidemiological findings are useful for any preventive intervention to control disease diffusion.

In vitro antimicrobial activities of metabolites from vaginal Lactobacillus strains against Clostridium perfringens isolated from a woman's vagina.

BACKGROUND: More than 50 different species of bacteria may live in a woman's vagina, with lactobacilli being the predominant microorganism found in healthy adult females. Lactobacilli are relevant as a barrier to infection and are important in the impairment of colonization by pathogens, owing to competitive adherence to adhesion sites in the vaginal epithelium and their capacity to produce antimicrobial compounds. METHODS: The aim of the present study was to demonstrate the inhibitory capability of Lactobacillus metabolites against Clostridium perfringens, an anaerobic Gram-positive bacterium. These bacteria were isolated from vaginal swabs by using culture-dependent approaches, and the bacteriostatic effect of Lactobacillus metabolites, extracted from different isolates, was assessed using a modified E test. RESULTS: Among the 100 vaginal swabs, 59 (59%) samples showed the presence of Lactobacillus strains and only one sample contained C. perfringens. Lactobacillus metabolites demonstrated the significant potency of in vitro activity against C. perfringens, with minimal inhibitory concentration values ranging from 15.6 µg/mL to 31.2 µg/mL. CONCLUSION: This study suggests that women without vaginal Lactobacillus strains may be susceptible to nonindigenous and potentially harmful microorganisms.