Association of thyroid function test abnormalities with preeclampsia: a systematic review and meta-analysis.

BACKGROUND: Preeclampsia is a life-threatening disorder during pregnancy and postpartum periods. Preeclampsia can affect the activity of many organs. It is very important because if this disorder is associated with changes in thyroid function, it can affect the results of maternal and fetal tests. Accordingly, the aim of this meta-analysis study was to assess the abnormalities in thyroid function tests in preeclampsia. METHODS: Studies were selected through a systematic search of the MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar databases in 31st August 2021. Also, reference lists of review articles and relevant studies were manual-searched to identify other potentially eligible studies. English studies that compared TSH, T4 and T3 of normal pregnant with preeclamptic women (Known to be normotensive before pregnancy; gestational age 20 week or more; singleton pregnancy; no previous history of thyroid dysfunction) were screened. Data sets were screened for eligibility by two independent reviewers. Articles were assessed by the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS: After reviewing 886 published studies, 63 observational studies were selected and used for this meta-analysis. The study population included 21,528 pregnant women. The findings revealed that TSH (SMD = 1.70, 95%CI: 1.39 to 2.02; p < 0.001) was significantly higher in preeclamptic women. TT4 (SMD = -0.82, 95%CI: -1.16, -0.49; p < 0.001), TT3 (SMD = -0.88, 95%CI: -1.36 to -0.41; p < 0.001) and FT3 (SMD = -0.59, 95%CI: -0.91 to -0.27; p < 0.001) were less in preeclamptic women. There was no statistically significant difference in FT4 between two groups (SMD = 0.002, 95%CI: -0.27 to 0.27; p = .990). The results of publication bias and sensitivity analysis confirmed the reliability and stability of this meta-analysis. The quality of evidence was regarded as moderate, low, and very low for these risk factors according to the GRADE approach. CONCLUSIONS: Findings of this meta-analysis indicated preeclamptic women were more at risk of changes in thyroid function tests. In order to prevent thyroid disorders, it is recommended that thyroid function tests be performed in women with pre-eclampsia.

Cutaneous leishmaniasis in Iran: A systematic review and meta-analysis.

Cutaneous leishmaniasis as a public health concern that attracts many attentions in endemic area. There is no exact estimation of cutaneous leishmaniasis in Iran. This study aimed to assess the exact prevalence of disease and carried out in databases including: Pub Med, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Iran doc, Barakatkns and Scientific Information Database (SID) from 2000 to 2019. Totally 84 studies were eligible to be included in this systematic review and Meta-analysis study. Based on a random effect model the pooled prevalence of leishmaniasis was estimated 45% (95% CI: 39%-51%; I^2 = 99.8%P < 0.001). The highest prevalence of CL was related to Isfahan 66% (53%-78%), Golestan 64% (62%-65%) and Fars province 63% (38%-84%) and the lowest prevalence was estimated in Kermanshah province 4% (4%-5%), Hormozgan 10% (8%-11%), Bushehr 12% (1%-35%) and Kerman 15% (9%-22%) provinces respectively. The lowest prevalence was associated with L. trapica spices 23% (11%-38%) and the highest was associated with L. major spices 32% (21%-45%). The prevalence with both L. trapica and L. major spices was achieved 60% (48%-71%). It is essential for health authorities to take steps to control and prevent the epidemic by rapid treatment of patients, destroying gerbils and promotion of general and health education for the local population.

Assessing quality of health services with the SERVQUAL model in Iran. A systematic review and meta-analysis.

PURPOSE: The five-dimension service quality (SERVQUAL) scale is one of the most common tools for evaluating gaps between clients' perceptions and expectations. This study aimed to assess the quality of health services in Iran through a meta-analysis of all Iranian studies which used the SERVQUAL tool. DATA SOURCES: A systematic literature review has been performed in Web of Science, PubMed, Scopus, Google Scholar, Iran Medex, Magiran and Scientific Information Database. STUDY SELECTION: All relevant English or Persian studies published between January 2009 and April 2016 were have been selected. Papers were considered if they regarded all five dimensions of the SERVQUAL tool for assessing the quality of health care services. DATA EXTRACTION: Two reviewer independently extracted mean and standard deviation of five dimensions and characteristics of studies. The quality of studies included in meta-analysis using STROBE checklist. RESULTS OF DATA SYNTHESIS: Of 315 studies initially identified, 12 were included in our meta-analysis. All analyses were performed in Stata MP v. 14. Patients' perceptions were lower than their expectations (gap = -1.64). Responsibility (-1.22) and reliability (-1.15) had the lowest gaps, and tangibility and empathy (-1.03) had the largest gaps. Except gender, other variables had no significant associations with gaps. Patients in the cities of Arak (-3.47) and Shiraz (-3.02) had the largest gaps. CONCLUSIONS: All dimensions of service quality were negative, which implies that the quality of health services in Iran has not been satisfying to patients and needs to be improved.

Status of babesiosis among domestic herbivores in Iran: a systematic review and meta-analysis.

Babesiosis is a protozoal disease caused by Babesia spp. in mammals and humans worldwide. It is one of the most important tick-borne diseases, which affects livestock productions, reproductions, and accordingly failing economy. In this, systematic review and meta-analysis, study, the prevalence of babesiosis among domestic herbivores in Iran, between 1998 and 2015, was methodically reviewed. Nine databases including five English and four Persian databases were explored. A total of 49 articles, as regards the examination of 13,547 sheep, 1920 goats, 7167 cattle, and 940 horses, corresponding to prevalence of babesiosis from different regions of Iran were gathered for our qualifying criteria. The overall prevalence of babesiosis was expected to be 14% (95% CI 12%, 16%) in domestic herbivores. Our results showed the highest prevalence in Khorasan Razavi (18.6%) and West Azarbaijan (15.2%) and the lowest in Mazandaran (8.8%) and Isfahan provinces (9.6%), respectively. The high prevalence of Babesia infection in herbivores (mostly sheep and goats) confirms the established enzootic situation of babesiosis in Iran, particularly in western and northeastern regions of the country. Our data offered important and updated information on the epidemiology of babesiosis, for the first time, in domestic herbivores in Iran, and will likely be contributing to the expansion of the screening and control strategies to reduce health and economic impacts among farm animals.

Trichomonas vaginalis infection among Iranian general population of women: a systematic review and meta-analysis.

Trichomonas vaginalis (T. vaginalis) is one of the main causes of vaginitis, prostatitis, and cervicitis all over the world. Little information is available regarding the burden of T. vaginalis infection in Iranian women. This systematic review and meta-analysis were carried out to determine the prevalence of T. vaginalis among general population of Iranian women. Data were systematically collected from 1992 to 2012 in Iran on such electronic databases as PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iran medex, Scientific Information Database (SID), Global Health, and LILACS. Additionally, abstracts of national scientific congresses and dissertations were included. A total of 30 articles attempted to examine 70,373 individuals and reported the prevalence of trichomoniasis from different regions of Iran. The overall prevalence rate of trichomoniasis in Iran was estimated to be 8% (95% confidence interval (CI) = 0.07 to 0.09) with the maximum 38.8% (95% CI = 0.036 to 0.042) and the minimum 0.009% (95% CI = 0.008 to 0.010), respectively. Also, it was found that the prevalence in Central provinces is higher than other ones. In all studies, the average of age was 24.5 with the maximum and the minimum of 45 and 22.5 years old, respectively. The present review revealed that infection rate is relatively high among Iranian women, and risk factors such as hygienic situation, behavior and local culture, poor socioeconomic condition, feeble moral considerations, and increase in marriage age must be considered in the management of controlling programs.

The predicting factors of chronic pain among nursing students: a national study in Iran.

BACKGROUND: Nursing students are faced with a variety of challenges that demand effective cognitive and emotional resources. The physical and psychological well-being of the students plays a key part in the public health of the community. Despite the special lifestyle of nursing students, few studies have addressed chronic pain in this population. Accordingly, the present study aims to identify the predictors of chronic pain among nursing students. METHODS: This cross-sectional study was conducted on 1,719 nursing students aged 18-42 years, between February and November 2019. Sampling was carried out in several stages. Data were collected using seven instruments, namely a demographics survey, the characteristics of chronic pain form, Spielberger State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire-9 (PHQ-9), the Bar-on Emotional Quotient Inventory, Academic Satisfaction Scale, and Procidano and Heller Social Support Scale. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors. RESULTS: The average age of the participants was 22.4 ± 2.96 years. The results of univariate analysis showed that gender (P = 0.506), mother's education (P = 0.056, P = 0.278, P = 0.278), father's education (P = 0.817, P = 0.597, P = 0.41), place of residence (P = 0.215), depression (P = 0.501), grade point average (P = 0.488), academic satisfaction (P = 0.183) and chronic pain weren't significantly correlated with chronic pain in nursing students. The results of the multiple logistic regression models showed that chronic pain was positively correlated with age, social support, state anxiety, and trait anxiety (OR = 1.07, 95% CI: 1.02-1.12; OR = 0.95, 95% CI: 0.93-0.97; OR = 1.03, 95% CI: 1.02-1.05; and OR = 1.97, 95% CI: 0.95-1.99; respectively). CONCLUSION: The prevalence of chronic pain was relatively high in these students. In addition, age, social support, and anxiety could be important factors in the development or persistence of chronic pain in nursing students. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as referral for treatment, home medications for pain relief, and outcomes of chronic pain are suggested in future longitudinal studies.

Association study between killer immunoglobulin-like receptor polymorphisms and susceptibility to COVID-19 disease: a systematic review and meta-analysis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a known virus that leads to a respiratory disease called coronavirus disease 19 (COVID-19). Natural killer (NK) cells, as members of innate immunity, possess crucial roles in restricting viral infections, including COVID-19. Their functions and development depend on receiving signals through various receptors, of which killer cell immunoglobulin-like receptors (KIRs) belong to the most effective ones. Different studies investigated the association between KIR gene content and susceptibility to COVID-19. Since previous studies have yielded contradictory results, we designed this meta-analysis study to draw comprehensive conclusions about COVID-19 risk and KIR gene association. According to PRISMA guidelines, a systematic search was performed in the electronic databases to find all studies investigating KIR gene contents in COVID-19 patients before March 2023. Any association between KIR genes and COVID-19 risk was determined by calculating pooled odds ratio (OR) and 95% confidence interval (CI). After applying the inclusion and exclusion criteria, 1673 COVID-19 patients and 1526 healthy controls from eight studies were included in this meta-analysis. As the main results, we observed a positive association between the 2DL3 (OR = 1.48, 95% CI = 1.17-1.88, P < 0.001) and susceptibility to COVID-19 and a negative association between the 2DP1 and the risk for COVID-19 (OR = 0.48, 95% CI = 0.23-0.99, P = 0.049). This meta-analysis demonstrated that KIR2DL3, as a member of iKIRs, might be associated with an increased risk of COVID-19 disease.

High occurrence of Toxoplasma gondii infection among blood donors in Ardabil Province as main focus of zoonotic visceral leishmaniosis, northwestern Iran.

Toxoplasmosis, as cosmopolitan parasitic disease, is considered as one of the transfusion-transmitted parasites. The true burden of Toxoplasma gondii (T. gondii) amongst blood donors remains undisclosed around the world. Since there was no evidence on the prevalence of T. gondii in blood donors in Ardabil Province, as main focus of zoonotic visceral leishmaniosis (ZVL), northwestern Iran, current research was therefore conducted to estimate the seroprevalence of T. gondii and PCR assay among them for the first time. In the present study, 462 plasma samples from asymptomatic blood donors of Ardabil Province, northwestern Iran, were tested for IgM and IgG anti-T. gondii antibodies levels using ELISA test. Moreover, the buffy coat of all seropositive subjects was screened for T. gondii DNA by conventional PCR. Also, the data sheet consisting of characteristic information was registered for all the applicants. Overall, anti-T. gondii antibodies were found in 36% (166/462) of asymptomatic blood donors. Anti-T. gondii IgM and IgG seroprevalence was 1.5% and 32.5%, respectively. Only nine subjects (2%) were found to be positive for both IgM and IgG. Moreover, T. gondii DNA was identified in 18% (30/166) of seropositive donors. The logistic regression analysis showed a significant correlation between T. gondii seropositivity and contact with cats, agricultural activities, history of consumption of undercooked meat and being non-educated (P=0.001). The high prevalence (about one-third) of anti-T. gondii antibodies and possibly active infection using conventional PCR test represents that asymptomatic carriers of T. gondii are quite common in the study areas and pose a potential threat to the blood safety and hemovigilance program.

Evaluation of MASP1, CMPF and U.A serum levels in pre-diabetic subjects in comparison to Normal individuals for early diagnosis of subjects with pre-diabetes, a case-control study.

BACKGROUND: The present study designed to evaluate the Serum levels of CMPF, MASP1 and UA in pre-diabetic subjects was compared to normal subjects. METHODS: This research is a case-control study. We studied 44 pre-diabetics with 44 normal subjects and were evaluated serum concentration of CMPF, Masp1 and U.Ain both groups andfurthermore serum concentration FPG, BUN, Cr, Cho, TG, HDLc, LDLc, AST, ALT, ALP, HbA1c was examined and correlation between of CMPF, Masp1 and U.Aand other parameters was statistically analyzed. RESULTS: Serum levels of MASP1, CMPF, fasting plasma glucose (P < 0.001)and uric acid (P < 0.002) were significantly increased in pre-diabetic subjects. In this study, a significant difference was found between MASP1 and CMPF in pre-diabetic subjects compared to normal subjects (P=0.005, r=0.291). There was also a significant difference between serum levels of MASP1 with HbA1C (P=0.01, r=0.269). CONCLUSION: Serum levels of CMPF, MASP1 and uric acid were increased in pre-diabetic subjects. These parameters can be used as a biomarker for the diagnosis of pre-diabetes.

Heavy metal concentration in classroom dust samples and its relationship with childhood asthma: a study from Islamic Republic of Iran.

BACKGROUND: Classrooms are an important environment for young children as this is where they spend a large part of their time. AIMS: This study was designed to quantify the levels of heavy metals in classroom dusts in Shiraz, a city southwestern Iran. The potential association between heavy metal levels and childhood asthma was also investigated. METHODS: We selected 32 schools for collecting classroom dust samples during September-November 2016. The concentration of 10 heavy metals was measured in these dust samples by optical emission spectrometry. The diagnosis of childhood asthma was made using both the medical chart of each student and examination by an allergist. The data were analysed using SPSS, version 21.0. RESULTS: The concentration of heavy metals in classroom dust samples ranged from 7559 to 53 723.0 mg/kg (mean: 16 945.5 mg/kg) for Fe, 169.0 to 952.0 mg/kg (mean 288.9 mg/kg) for Mn, and 9.0 to 971.0 mg/kg (mean 258.8 mg/kg) for Pb. We found no correlation between heavy metals in classroom dust and childhood asthma. CONCLUSION: In comparison with studies reported elsewhere, the maximum levels of lead in our study were greater. A potential explanation for the lack of correlation with childhood asthma is the large mass of the particles, preventing them from reaching the lower airways. Nevertheless, special attention should be paid to reducing high levels of heavy metals in classroom dust in this area.

Status of Anaplasma spp. infection in domestic ruminants from Iran: A systematic review with meta-analysis.

Anaplasma species are tick-borne pathogens that are obligatory intracellular of ruminants and other mammalians. In this investigation, we systematically reviewed the distribution of anaplasmosis among domestic ruminants in Iran. Five and four English and Persian databases were studied, respectively, based on keywords and throughout 17 years (2001-2017). Thirty-eight articles were included in this systematic review and meta-analysis. Totally, 5093 cattle, 1958 sheep, and 1232 goats corresponding to prevalence of Anaplasma infection from different areas of Iran were examined. The total prevalence of Anaplasma infection was estimated to be 34% (95% CI 27%, 41%) in domestic ruminants. Based on our data, Khozestan (54%) and Khorasan Razavi (46%) provinces were the most prevalent areas in Iran and Kerman (3%) and Hamedan (1%) provinces are the lowest. The highest prevalence of Anaplasma spp. infection was belonged to A. ovis (44%) and the lowest to A. phagocytophilum (1%) with a significant difference among them (p < .001). In addition, the most common diagnostic tests were PCR (54%), microscopy (35%) and ELISA (7%) assays. The high prevalence of ovine and bovine anaplasmosis in Iran, confirms the stability situations of animal anaplasmosis in the studied regions particularly northeastern and southwestern parts of the country. Our data offer valuable and encouraging information as regards the current situation of anaplasmosis in domestic livestock in Iran, which might be useful for active and passive surveillance and preventing plans.

Global prevalence status of avian schistosomes: A systematic review with meta-analysis.

OBJECTIVES: Human cercarial dermatitis (HCD) is a water-borne zoonotic parasitic disease. Cercariae of the avian schistosomes of several genera are frequently recognized as the causative agent of HCD. Various studies have been performed regarding prevalence of bird schistosomes in different regions of the world. So far, no study has gathered and analyzed this data systematically. The aim of this systematic review and meta-analysis study was to determine the prevalence of avian schistosomes worldwide. METHODS: Data were extracted from six available databases for studies published from 1937 to 2017. Generally, 41 studies fulfilled the inclusion criteria and were used for data extraction in this systematic review. Most of studies have been conducted on the family Anatidae. RESULTS: The overall prevalence of avian schistosomes was estimated to be 34.0% (95%CI, 28%-41%) around the world. Furthermore, results displayed that, Allobilharzia visceralis and Trichobilharzia spp. had the highest frequency and their prevalence in the birds was 50.0% (95% CI, 3.0%-97.0%) and 32.0% (95% CI, 21.0%-0.36%), respectively. The results showed that the prevalence of avian schistosomes was 43.0% (95% CI, 29% - 56%) in the US and 38.0% (27.0% -50.0%) in Europe, which were higher than other continents, respectively. CONCLUSIONS: The prevalence of 34% shows that the bird schistosomes are very common zoonotic worms among aquatic birds in the world. Also, this study shows the importance of avian schistosome research when facing animal and human health of the future.

Effect of antioxidant supplements on sperm parameters in infertile male smokers: a single-blinded clinical trial.

INTRODUCTION: Naturally, in human body, there is a balance between free radicals and the antioxidant system. Yet, cigarette consumption in smokers increases free radicals and decreases antioxidants. A vast body of research showed that the ROS level of seminal fluid is reduced using oral antioxidant complements through enhancing the clearing capacity of free radicals. Thus, the present research aimed to explore the effect of vitamin complement consumption on changing male infertility indices among smokers. METHODS: In the present randomized clinical trial which was single-blinded, 50 infertile oligospermic and asthenospermic men participated. They were selected in a randomized convenient sampling method. Before the study began, a semen sample was taken from all participants for analysis. Subsequently, the patients received 30 mg of Q10 coenzyme, 8 mg of zinc, 100 mg of vitamin C, 12 mg of vitamin E, 400 mg of folic acid for a whole duration of 3 months on a daily basis (once a day) and 200 mg of selenium every other day after lunch. A second sample of seminal fluid was taken from patients and semen parameters were compared between the pre- and post-test. The relevant statistical analyses were conducted in SPSS.23. RESULTS: A comparison of pre-test and post-test results revealed that all sperm parameters including the volume, morphology, motion, count and progressive motility were significantly increased after the intervention (p ≥ 005). Moreover, a statistically significant improvement was observed in the pH and concentration of seminal fluid. CONCLUSION: The present research showed that consuming vitamin complements (30 mg of Q10, mg of zinc, 100 mg of vitamin C, 12 mg of vitamin E, 400 mg of folic acid) once a day as well as 200 mg of selenium every other day can effectively improve the qualitative parameters (pH and concentration) and quantitative parameters (volume, motion, morphology, count and progressive motility) in infertile male smokers.

Is the cat an important reservoir host for visceral leishmaniasis? A systematic review with meta-analysis.

In recent years feline leishmanial infections (FLI) have been studied more than ever before in various parts of the world. However, evidence-based knowledge on FLI has remained unavailable. The main objectives of this study were to investigate the status of felines infected by Leishmania spp. worldwide. Data were extracted from 10 available databases over the period of 1982 to 2017. Overall, 78 articles fulfilled the inclusion criteria and were used for data extraction in this systematic review. The overall FLI prevalence by both serological and molecular methods was estimated at 10% (95% CI: 8%-14%). In Italy, both the seroprevalence (24 %) and PCR prevalence (21 %) were found to be higher than in other countries. The most common diagnostic test used was the indirect fluorescent antibody test (38.5%). Studies on mixed-breed felines were more common than those on other breeds, while the most common parasite species was L. infantum (63%). Our findings suggest that cats act as primary and/or secondary reservoir hosts in the transmission of the Leishmania spp. to humans and also to dogs, by sandflies, at least in endemic foci. Moreover, available data confirm the enzootic stability situation of FLI in several countries including some in Europe.

Occupational exposure to extremely low frequency magnetic fields and risk of Alzheimer disease: A systematic review and meta-analysis.

INTRODUCTION: Occupational exposure to extremely low frequency magnetic fields (ELF-MF) occurs in many occupations such as welders, electric utility workers, train drivers and sewing machine operators. There is some evidence suggesting ELF-MF exposure to be a risk factor for Alzheimer's disease (AD). The current study aims at systematically reviewing the literature and conducting a meta-analysis to evaluate the risk of AD amongst workers exposed to ELF-MF. METHODS: Bibliographic databases were searched including PubMed, EMBASE, Cochrane Library, and Web of Science in November 2017. Risk of bias was assessed in the all included studies. Pooled estimates were obtained using random-effects meta-analysis. In addition, sources of heterogeneity between studies and publication bias were explored. RESULTS: In total, 20 articles met the inclusion criteria. The pooled results suggest an increased risk of AD (RR: 1.63; 95% CI: 1.35, 1.96). Higher risk estimates were obtained from case-control studies (OR: 1.80; 95% CI: 1.40, 2.32) than from cohort studies (RR: 1.42; 95% CI: 1.08, 1.87). A moderate to high heterogeneity (I2 = 61.0%) and indication for publication bias (Egger test: p <  0.001) were found. CONCLUSION: The results suggested that occupational exposure to ELF-MF might increase the risk of AD. However, this suggestion should be interpreted with caution given the moderate to high heterogeneity and indication for publication bias.

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis.

BACKGROUND: Aspergillus sensitization (AS) and allergic bronchopulmonary aspergillosis (ABPA) can occur as a cause of permanent lung damage in patients with cystic fibrosis (CF) and non-CF bronchiectasis. OBJECTIVE: The aim of this study was to determine the frequency of AS and ABPA in patients with CF and non-CF bronchiectasis in southwestern Iran. METHODS: This cross-sectional study was conducted on 33 patients with CF and 27 patients with non-CF bronchiectasis from southwestern Iran who were referred to Namazi Hospital affiliated to Shiraz University of Medical Sciences from July 2015 to February 2016. Skin prick test to Aspergillus fumigatus, peripheral blood eosinophil count, total serum IgE, specific IgE and IgG against Aspergillus fumigatus as well as radiologic chest studies were done for each patient. Statistical analysis was done by Mann-Whitney U test, Fisher Exact test, and Kappa weighted in SPSS software version 18. Level of significance was set at p<0.05. RESULTS: Nine patients with CF (27.3%) and one patient with non-CF bronchiectasis (3.7%) had positive skin tests to Aspergillus. There was 81.2% agreement between positive skin test and specific IgE to Aspergillus fumigatus (p<0.001). Three patients with CF (9%) met the diagnostic criteria for ABPA, whereas ABPA was not seen in patients with non-CF bronchiectasis. CONCLUSION: ABPA was low in this study, considering more frequency of AS in patients with cystic fibrosis, clinicians should keep in mind the diagnosis of ABPA for those CF patients that do not respond to usual medical therapy and have positive skin tests to Aspergillus allergens.

Status of theileriosis among herbivores in Iran: A systematic review and meta-analysis.

AIM: Theileriosis is a protozoal disease caused by Theileria spp. mostly in warm-blooded vertebrates worldwide. It is one of the common tick-borne diseases among domestic animals in tropical and sub-tropical regions, which have a variety of unlikable effects on health economy and animal welfare. In the present study, the prevalence of theileriosis among domestic farm animals in Iran was systematically evaluated. METHODS: To identify the related papers, 10 English and Persian databases, including PubMed, Science Direct, Scopus, Web of Science, Medical Subject Headings, Google Scholar, Magiran, Barakatns (formerly Iranmedex), Elm net, and Scientific Information Database, were appraised for articles published throughout 1999-2017. RESULTS: A total of 56 papers, providing the examination of 11,317 cattle, 9394 sheep, 2991 buffaloes, 1504 horses, 600 goats, and 212 donkeys were analyzed, matching for the prevalence of theileriosis from different parts of Iran were permitted for our allowing checklist. The overall prevalence of theileriosis among domestic herbivores was expected to be 19% (95% confidence interval: 15%, 22%). Our findings highlighted the average of the maximum prevalence in Razavi Khorasan (60.4%) and West Azerbaijan (49.1%) and the minimum in Mazandaran (1.1%) and East Azerbaijan provinces (2.2%), respectively. The high prevalence of Theileria infection in the herbivores (mainly sheep) verifies the well-known enzootic episode of theileriosis in Iran, predominantly in northeastern and western parts of the country. CONCLUSION: Our results suggested updated and imperative information on the true burden of theileriosis in Iran. Moreover, it could be supporting the gaps among monitoring, prevention, and control arrangements to improve the health economy, particularly among dairy farm animals.

Promising antileishmanial activity of novel imidazole antifungal drug luliconazole against Leishmania major: In vitro and in silico studies.

OBJECTIVES: Pentavalent antimonials have been used for the treatment of leishmaniasis for over 70 years, however they are limited by their toxicity. Unfortunately, the efficacy of first-line drugs for the treatment of leishmaniasis has decreased and resistance is noticeable. Luliconazole is a new azole with unique effects on fungi that has not yet been tested on Leishmania parasites. METHODS: In this study, the cytotoxicity and antileishmanial activity of luliconazole were evaluated in vitro against promastigotes and intracellular amastigotes of Leishmania major. The docking simulation with the target enzyme, sterol 14α-demethylase (CYP51) was performed using AutoDock 4.2 program. RESULTS: The IC50 (concentration of test compound required for 50% inhibition) against promastigotes revealed that luliconazole (IC50=0.19µM) has greater potency than ketoconazole (KET), meglumine antimoniate (MA) and amphotericin B (AmB) (IC50 values of 135, 538 and 2.52µM, respectively). Against the amastigote stage, luliconazole at a concentration of 0.07µM decreased the mean infection rate and the mean number of amastigotes per macrophage more effectively than MA (P<0.004) and KET (P<0.043), but there was no difference compared with AmB (P>0.05). A docking study of luliconazole with the cytochrome P450 enzyme sterol 14α-demethylase (CYP51) revealed that this azole drug can properly interact with the target enzyme in Leishmania mainly via coordination with heme and multiple hydrophobic interactions. CONCLUSION: These results show the potent activity of luliconazole at extremely low concentrations against L. major. It may therefore be considered as a new candidate for treatment of leishmaniasis in the near future.

Canine visceral leishmaniasis in Iran: A systematic review and meta-analysis.

Visceral leishmaniasis is considered an endemic zoonosis in some parts of Iran and dogs are main reservoirs, which play role in the transmission cycle of human leishmaniasis. This systematic review and meta-analysis was performed to determine the prevalence of canine visceral leishmaniasis (CVL) in Iran. Data were systematically collected from 1982 to 2015 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iran medex and Scientific Information Database (SID). A total of 39 articles concerning dogs, 6 articles on jackals, 4 articles on wolves and 4 articles on foxes, reporting the prevalence of CVL from different regions of Iran fulfilled our eligibility criteria. Totally, 19903 dogs, 151 jackals, 42 wolves and 44 foxes were examined and the overall prevalence rate of CVL in Iran was estimated to be as following: in dogs 16% (95% CI: 13-19%), in jackals 10% (95% CI: 5-15%), in wolves 10% (95% CI: 5-15%) and in foxes 10% (95% CI: 1k19%), respectively. There was a significant difference in infection rate between male and female dogs, the infection in males 9% (95% CI: 8.8-10.5%) was more than females 7% (95% CI: 5.5-7.5%) (p=0.024). Also, the rate of infection was significantly higher in older dogs than younger ones (p<0.047) while in dogs younger than 1year was 12% (95% CI: 6-18%), in 1-2 years 10% (95% CI: 6-14%), in 3-5 years 16% (95% CI: 9-22%) and in those which were over 7 years 31% (95% CI: 19-44%), respectively. Our meta- regression analysis revealed the significant correlation between stray and owned dogs: the infection rate in stray 10% (95% CI: 5-4%) was higher than those owned 6% (95% CI: 3- 8%) (p=0.037). Also, the prevalence of infection in rural dogs 36% (95% CI: -1-72%) is significantly higher than urban dogs, 19% (95% CI:-1-40%) (p=0.013). Although most (81%) of infected dogs had no clinical signs (asymptomatic), meta-regression analysis showed that the infection rate in asymptomatic dogs was 14% (95% CI: 11-18%) and in those with clinical signs 3% (95%CI: 2-4%), and the correlation is statistically significant (p=0.001). The present systematic review and meta-analysis indicates that CVL is common at least in some districts of more than half of provinces of Iran. Further investigation and monitoring will be required to improve the surveillance and control strategies to reduce the incidence of CVL in Iran.

In vitro antileishmanial activity of novel azoles (3-imidazolylflavanones) against promastigote and amastigote stages of Leishmania major.

Leishmaniasis is a protozoan infectious disease widely distributed all around the world. First line drugs including antimoniales are insufficient due to resistance in endemic areas and high toxicity. Azole antifungals like ketoconazole (KCZ) are also used as antileishmanial agents for several decades. In the present study, we evaluated in vitro antileishmanial effects of new azole antifungals namely 3-imidazolylflavanones (IFs) and their oximes (IFOs) against Leishmania major (L. major) parasites. The obtained results showed remarkable effect of our compounds on promastigote and amastigote stages of L. major. In particular, the 4-chloro analog of flavanone (IF-2) and 3-chloro substituted flavanone oxime (IFO-3) with IC50 values ≤8.9µg/mL were 8-fold more potent than KCZ (IC50=72µg/mL) against promastigote form of L. major. In amastigote stage, the compounds IF-2 and IFO-2 decreased the mean number of infected macrophages (MIR) more than KCZ (p<0.005). In addition, compounds IF-1, IF-2, IF-4, IFO-2, IFO-3 and IFO-5 decreased the mean number of amastigotes per macrophages (MNAPM) significantly more than KCZ (p<0.005). All compounds decreased both MIR and MNAPM significantly more than control (p<0.001). Compounds IF-2 and IFO-2 with parasite survival of 7.70% and 20% had the highest inhibition on intracellular amastigotes. Although most of compounds displayed acceptable selectivity index, compound IF-2 had the highest CC50 value (115.4µg/mL) and SI (383.3). We concluded that our new synthetic azoles displaying potent activity against L. major could be considered as new hits for drug development in the field of antileishmanial therapy.