Lack of beneficial effects of granulocyte colony-stimulating factor in patients with subacute myocardial infarction undergoing late revascularization: a double-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: Early clinical studies have suggested that administration of granulocyte-colony stimulating factor (G-CSF) may improve the clinical condition of patients suffering from myocardial infarction (MI).This prospective, randomized, double-blind, placebo-controlled single-centre trial aims to assess the safety and clinical efficacy of G-CSF administration in patients with subacute MI and impaired LV function undergoing delayed primary percutaneous coronary intervention (PCI). METHODS: A total of 16 patients (13 men, mean age 51 years) with subacute ST-segment elevation MI and a left ventricular (LV) ejection fraction (EF) of less than 45% at baseline who underwent late revascularization, were included in the study. Patients were randomized in a double-blind fashion to receive either G-CSF (at a dose of 10 microg/kg body weight) or placebo for five consecutive days. End points consisted of assessment of safety parameters as well as changes of global and regional myocardial function from baseline until six months following PCI. RESULTS: G-CSF administration resulted in a significant mobilization of different cell populations (four-fold increase in WBC count and a six-fold increase in CD34+ cells). G-CSF treatment was well tolerated in most patients and no major adverse cardiac events or severe G-CSF-related side effects were identified during hospitalization and at follow-up. No significant differences were observed between the G-CSF and placebo groups regarding global and regional myocardial function parameters. CONCLUSION: G-CSF administration is safe, but not effective, in improving impaired LV functional parameters in patients with subacute MI who had an impaired baseline EF of less than 45%.

"Comparison of thyroid volume, TSH, free t4 and the prevalence of thyroid nodules in obese and non-obese subjects and correlation of these parameters with insulin resistance status".

BACKGROUND: To compare thyroid volume, thyroid stimulating hormone (TSH), free t4 and the prevalence of thyroid nodules between obese and non-obese subjects. Also, the association between BMI and insulin resistance status with various parameters of thyroid gland was evaluated. METHODS: Fifty-two patients with obesity and 38 volunteers aged 20-50 years with normal body mass index (BMI), were enrolled in this cross-sectional study. Patients with diabetes, history of thyroid disorders, and patients, who were taking medications that influence their blood glucose or insulin levels or modified thyroid function tests, were excluded. TSH, free t4, insulin and glucose and thyroid sonography were carried out and the results compared between two groups. P<0.05 was considered as significant. RESULTS: Thyroid volume was higher (p<0.001) and free t4 was lower (p<0.001) in patients with obesity but there was no difference in TSH between groups. Prevalence of thyroid nodules was 15.7% and 10.8% in obese and non-obese groups, respectively (p=0.51). Frequency of nodules was significantly higher in insulin resistant than non- insulin resistant subjects (22% vs.2%, p=0.01). BMI was associated with thyroid volume (r=0.44, p<0.001) and free t4 (r=-0.35, p=0.001). HOMA-IR (homeostatic model assessment for insulin resistance) had no correlation with thyroid volume (p=0.38), but associated with free t4 (r=-0.25, p=0.01). CONCLUSION: Free T4 was lower and volume of thyroid was higher in obese subjects, but TSH and frequency of thyroid nodules had no significant difference between obese and non-obese counterparts. Insulin resistant individuals had more nodules but thyroid volume was mainly associated with BMI.

Evaluation of the Common Bed Bug, Cimex lectularius (Insecta: Hemiptera: Cimicidae) Susceptibility to λ-Cyhalothrin, Malathion, and Diazinon in Northeastern Iran.

The common bed bug, Cimex lectularius (Linnaeus 1758), is a nocturnal blood-sucking ectoparasite of humans that is highly prevalent in the northeast of Iran. In recent years, the efficacy of those insecticides that have been frequently used to control bed bugs in Iran has not been studied. Due to frequent complaints about bed bug treatment failures in Mashhad city (northeastern Iran), this study assessed the susceptibility of C. lectularius collected from a student residence hall to Diazinon, Malathion, and λ-cyhalothrin. The desired concentrations of each insecticide were prepared in acetone, and bioassays were performed using insecticide-impregnated filter paper method. The concentration-response data were subjected to POLO-PC software and data were analyzed by the log-probit procedure. The LC50 values of Diazinon and λ-cyhalothrin for examined bed bugs were 1,337.40 and 2,022.36 ppm, respectively. Malathion at the highest concentration (10,000 ppm) did not exhibit any toxicity to examined C. lectularius. Comparing these results to the same previous studies showed that susceptibility of examined bed bugs to these insecticides has been highly decreased. This study revealed an occurrence of insecticide resistance in bed bug populations in northeastern Iran. It also suggests that Malathion, Diazinon, and λ-cyhalothrin are ineffective against bed bugs in this region.

The Golden jackal (Canis aureus) as an indicator animal for Trichinella britovi in Iran.

Nematodes of the genus Trichinella are zoonotic parasites causing trichinellosis. In Iran, these parasites occur in several animal species and rare cases have been recorded in humans. To monitor the epidemiological pattern of these parasites in the Khorasan-e-Razavi province, Northeastern Iran, muscle tissues were collected from the tongues of roadkill animals between 2016 and 2017: 295 stray dogs, one red fox (Vulpes vulpes), 12 golden jackals (Canis aureus), and one wild boar (Sus scrofa). Trichinella spp. larvae were retrieved using the artificial digestion method and identified to the species level by multiplex PCR. Larvae identified as Trichinella britovi were detected in five stray dogs (1.7%) and one golden jackal (8.3%). The results confirm the circulation of T. britovi in animals of the Khorasan-e-Razavi province, as previously documented. A review of the literature on Trichinella spp. in animals in Iran showed that these parasites were previously detected in 20.02% and 0.04% of carnivore and omnivore mammals, respectively, and that golden jackals can be screened as indicator animals for these zoonotic nematodes. Convenient sampling of Trichinella susceptible roadkill animals may provide a suitable method of monitoring the circulation of these parasites within any given region.

Prevalence of Toxoplasma and Echinococcus IgG antibodies in slaughterhouse workers, a serosurvey in Northeast Iran

Cystic echinococcosis and toxoplasmosis are two human parasitic diseases. Butchers and slaughterhouse workers are in close contact with body fluids and tissues of ruminants. To investigate the prevalence of Toxoplasma and Echinococcus IgG antibodies in slaughterhouse workers in Northeast of Iran, Mashhad, 2016. This cross-sectional study was performed on all personnel working at the largest industrial slaughterhouse of Khorasan Province. Serum samples were taken and kept frozen until used. IgG against Echinococcus and Toxoplasma were quantified using commercial ELISA kits. A questionnaire addressing possible risk factors of infection acquisition was filled by participants. Out of 91 male participants, 58.2% were positive for toxoplasmosis, 5.5% were positive for cystic echinococcosis and 3.3% were positive for both. Except using gloves, and gown and boots, other personal protective equipment (PPE) were not completely used by all personnel; mask 38%, tool disinfectants: 12%, face and hand disinfection: 14.3%. There was a high risk of Toxoplasma in slaughterhouse workers, however, such finding was not observed in Echinococcus parasite. Importance of PPE and tool disinfectants to reduce the risk of zoonotic infections in the workplace should be emphasised.

Population Movement and Virus Spreading: HEV Spreading in a Pilgrimage City, Mashhad in Northeast Iran; an Example.

BACKGROUND: Hepatitis E Virus (HEV) infection is a significant public health concern and responsible for large outbreaks of acute hepatitis in poor sanitary and living conditions. OBJECTIVES: To investigate the impact of population movements on virus spreading, a large-scale population-based survey was performed in a pilgrimage- tourism area, the great Mashhad, capital city of Khorasan province. PATIENTS AND METHODS: A cross-sectional study was carried out among 1582 randomly selected individuals from general population of Mashhad, north east of Iran, between May to September 2009. Serum samples were tested for total anti-HEV antibody using a specific enzyme linked immunoassay (ELISA) kit. RESULTS: The prevalence of HEV infection was 14.2% (225/1582) with a maximum of 25.5 % (14/55) in densely populated areas. The highest prevalence was observed in visitant areas (≥ 20%) near the holly shrine with crowded hotels and inns. The differences between these areas and other districts were statistically significant (P < 0.001). The findings indicated that 13.2% (95/718) of males and 15.0% (130/864) of females were HEV positive; this difference is not significant. Seroprevalence increases with age rising , from 12.8% in subjects less than five years to 28.6% in individuals with more than 65 years old. Although, there were no meaningful differences between HEV seropositivity and socio-economic status, Illiterate individuals were significantly at higher risk for infection than educated persons (P < 0.001). CONCLUSIONS: These findings demonstrated that, high prevalence of HEV is related to populated district, which can reach to the highest rate in hotels and inns close to visitants. Traditional sanitation and water supplying systems are the second important factor for the virus transmission. Therefore, it can be concluded that such areas need efficient surveillance systems to prevent the spreading of infectious diseases.