The first national pediatric immune thrombocytopenia registry in Iran: research protocol and preliminary study results.

BACKGROUND: Disease registries are comprehensive databases that record detailed information on patients diagnosed with specific conditions, providing valuable insights into their diagnosis, treatment, and outcomes. This study aims to describe the pilot phase of the national pediatric Immune Thrombocytopenia(ITP) registry (NPITP) in Iran, serving as the inaugural interpretive report. METHODS: This patient-centered software system was implemented as a national program across multiple pediatric centers in Iran. Several focus groups were conducted to establish a minimum data set (MDS) comprising six main classes, 14 sub-classes, and 187 data elements. Following expert consensus on the final data set, a web-based software tool was developed by the dedicated IT team, accessible online and offline via https://disreg.sbmu.ac.ir/q/ITP.html . The registry included children aged between two months and 18 years with a platelet count below 100 × 109/L, based on predefined inclusion criteria. RESULTS: Within a four-month period, a total of 60 ITP patients were registered, including 41 (68.3%) newly diagnosed cases, 68 (13.6%) persistent cases, and 14 (23.3%) with chronic ITP. The mean age of the registered patients was 55.93 ± 9.72 months. The most frequently observed bleeding symptoms were petechiae (68.3%), purpura (51.6%), and ecchymosis (13.3%). Among the newly diagnosed patients, 20 (33.3%) received intravenous immunoglobulin (IVIG), 17 (28.3%) were treated with prednisolone, and 17 (28.3%) received combined IVIG and steroid therapy. Of all patients, 40 (66.7%) demonstrated a complete response to treatment, while 16 (26.7%) exhibited a partial response. Four patients (6.7%) remained unresponsive to therapy. Treatment-related complications, such as Cushing's syndrome, edema, weight gain, hirsutism, and mood disorders, were reported in 10 patients (16.6%). However, the majority of patients (81.7%) did not experience therapy-related complications. CONCLUSION: The pilot phase of the NPITP registry successfully implemented a web-based software tool for data collection, aiming to enhance the quality of care, facilitate clinical research, and support health service planning in the future.

Development, Characterization, and In Vitro Biological Performance of Amphotericin B and Terbinafine Microemulsions Against Leishmania major.

This study evaluated the effect of microemulsion (ME) containing Amphotericin B (AmB) alone and associated with Terbinafine (Tbf) on Leishmania major (L. major) using in vitro models. The ME formulations of these drugs were formulated and described. After evaluating their cytotoxicity on the J774A1 macrophage (MΦ), their potency against promastigotes and intracellular amastigotes models was evaluated using an in vitro MTT assay and Giemsa stain, respectively. Based on pseudo ternary phase diagrams, unloaded ME, Tbf-loaded ME (ME-Tbf), and, AmB-loaded ME (ME-AmB) with mean droplet sizes 3.4 ± 0.81, 10.05 ± 0.21, and 8.21 ± 0.46 were successfully prepared, respectively. Concerning toxicity, ME-AmB and ME-Tbf indicated lower toxicity on MΦs compared to the free drugs. The ME formulations showed considerably inhibitory effects compared to the free drug forms when the IC50 was examined. The IC50 values of AmB (59.19 ± 1.74 and 36.4 ± 3.2 µg/mL), ME-AmB (7.5 ± 0.9 and 0.8 ± 0.05 µg/mL), Tbf (234.5 ± 9 and 128.8 ± 0.28 µg/mL), ME-Tbf (26.27 ± 0.2 and 11.97 ± 0.6 µg/mL), AmB + Tbf (30.18 and 24.93 µg/mL), and ME-AmB + ME-Tbf (4.79 and 0.37 µg/mL) were estimated after 48 and 72 h, respectively.

Evaluation of the Efficacy of Amphotericin B and Terbinafine Microemulsions and Their Combination on Cutaneous Leishmaniasis and Comparison with the Conventional Drug Form in BALB/c Mice.

Intracellular parasitic protozoa of Leishmania sp. causes leishmaniasis. The restricted access of the drugs to affected cells in the treatment of intracellular infections such as leishmaniasis is frequently hampered. Furthermore, most of today's drugs have limited uses due to some containing toxic compounds, and drug resistance is on the rise. In the present investigation, Amphotericin B (AmB) and Terbinafine (Tbf) were loaded in microemulsion (ME) in combination and alone, and the in vivo efficacy was considered in BALB/c mice infected with Leishmania major (L. major). The wound size at the base of the mouse tail was measured, and real-time PCR was performed to quantify the parasite load after the infection challenge. The study demonstrated that the ME-AmB and ME-Tbf formulations are safe and effective compounds for the treatment of cutaneous leishmaniasis by enhancing the effectiveness of AmB and Tbf in reducing the parasite burden.

Toxoplasma gondii molecular detection and phylogenetic analysis in hemodialysis patients from Khuzestan, Southwest Iran.

BACKGROUND: The diagnosis and genetic characterization of Toxoplasma gondii (T. gondii) infection can make a significant influence to the prevention of the dangerous consequences of toxoplasmosis, particularly in immunocompromised people. OBJECTIVE: The aim of this investigation was to assess the frequency and genotyping of T. gondii in blood samples of patients with hemodialysis. MATERIALS AND METHODS: In the current investigation, a total of 379 blood samples were taken from subjects with hemodialysis who were referred to teaching hospital of Ahvaz in the southwest of Iran. The samples were evaluated using the Nested PCR by targeting the B1 gene, and then, sequencing and phylogenetic tree were constructed. RESULTS: T. gondii DNA was found in 112 (29.55%) of the blood samples by Nested PCR. Amplicons from T. gondii revealed high identity with GenBank sequences. The phylogenetic analysis revealed that all sequences were closely related to Type I of T. gondii. CONCLUSION: Because of the high incidence of toxoplasmosis with type I prevalent in hemodialysis patients, we recommend a systematic screening for toxoplasmosis to carry out for monitoring the possible dissemination of toxoplasmosis during hemodialysis.

Toxoplasma gondii and Toxocara spp. contamination in university area.

Toxoplasma gondii and Toxocara spp. zoonotic infections may cause severe systemic and ocular illness in infected individuals. Cats play a significant role in environmental contamination and the transmission of parasites. The goal of the present study was to investigate the prevalence of Toxoplasma gondii (T. gondii) and Toxocara spp. infection among stray cats at Ahvaz Jundishapur University of Medical Sciences campus. The current descriptive study began with the collection of 170 fresh cat faecal samples from various sites in the Ahvaz Jundishapur University of Medical Sciences area. Sheather's sugar flotation method was applied to all specimens, and parasites were identified and examined microscopically. Next, a nested-PCR assay, sequencing, and real-time PCR with high-resolution melting curve (HRM) analysis were performed. In this study, out of 170 cat faecal samples microscopically evaluated, 8 (4.70%) and 37 (21.76%) were infected with T. gondii oocysts and Toxocara eggs, respectively. Using nested PCR, 8 out of 170 samples (4.70%) were found to be infected with T. gondii. HRM analysis showed that all isolates could be classified into three genetic lineages. Considerable prevalence, exceeding 50% for Toxocara and surpassing 25% for Toxoplasma in certain instances, along with genetic diversity, was observed in the present study. Hence, it is suggested that all individuals, including kindergarten children, students, employees, workers, and pregnant women who are in contact with their surroundings, take the necessary precautions.

Molecular Survey of Leishmania Infection of Sand Flies in Karun County, Southwestern Iran.

Background: Zoonotic cutaneous leishmaniasis (ZCL) is widely distributed in Iran and around the world. Also, Khuzestan Province is an endemic focus of ZCL. This study aims to investigate the natural infection of sand flies with the Leishmania parasite in Karun County. Methods: Sand flies were collected from Jangiyeh, Qaleh Chanan, Kut-e-Navaser, and Ghazavieh in the spring and summer in the year of 2019, by installing 60 sticky paper traps each time (30 traps outdoors and 30 traps indoors). Two hundred female sand flies with different abdominal conditions (empty, blood-fed, semi-gravid, and gravid) were examined for infection rate using the Nested-PCR method. Results: In this study, seven species of sand flies including Phlebotomus papatasi, Ph. alexandri, Ph. sergenti, Ph. caucasicus, Sergentomyia tiberiadis, Se. sintoni, and Se. antennata were reported from Karun County, with a frequency of 79.64%, 16.96%, 1.07%, 0.18%, 0.36%, 1.61%, and 0.18%, respectively. Only eleven specimens of Ph. papatasi were found to be positive for Leishmania major, with an overall infection rate of 7.8%. The infection of Ph. papatasi was specifically reported in blood-fed, gravid, and semi-gravid specimens, with infection rates of 17.02%, 4.35%, and 14.29%, respectively. Conclusion: In this study, the infection of L. major from Ph. papatasi was reported. The results can be used in planning the control of ZCL in the study area.

Adipose-Derived Stem Cells' Secretome Attenuates Lesion Size and Parasite Loading in Leishmaniasis Caused by Leishmania Major in Mice.

Background: Stem cell-derived secretome (SE) released into the extracellular space contributes to tissue repair. The present study aimed to investigate the impact of isolated secretome (SE) from adipose-derived mesenchymal stem cells (ASCs) on Leishmania major (L. major) lesions in BALB/c mice. Methods: This experimental study was conducted at Ahvaz University of Medical Sciences (Ahvaz, Iran) in 2021. Forty female BALB/c mice were infected with stationary phase promastigotes through intradermal injection in the bottom of their tail and randomly divided into four groups (n=10 per group). The mice were given SE (20 mg/mL), either alone or in combination with Glucantime (GC, 20 mg/mL/Kg), meglumine antimoniate (20 mg/mL/Kg) for the GC group, and phosphate-buffered saline (PBS) for the control group. After eight weeks, the lesion size, histopathology, the levels of Interleukin 10 (IL-10), and Interleukin 12 (IL-12) were assessed. For the comparison of values between groups, the parametric one-way ANOVA was used to assess statistical significance. Results: At the end of the experiment, the mice that received SE had smaller lesions (4.56±0.83 mm versus 3.62±0.59 mm, P=0.092), lower levels of IL-10 (66.5±9.7 pg/mL versus 285.4±25.2 pg/mL, P<0.001), and higher levels of IL-12 (152.2±14.2 pg/mL versus 24.2±4.4 pg/mL, P<0.001) than the control. Histopathology findings revealed that mice treated with SE had a lower parasite burden in lesions and spleen than the control group. Conclusion: The current study demonstrated that ADSC-derived SE could protect mice infected with L. major against leishmaniasis.

Toxocara Canis Increases the Potential of Breast Cancer by Reducing the Expression of the P53 Protein.

INTRODUCTION: Breast cancer is considered the most frequent type of cancer in women with high mortality worldwide, and most importantly, it is the second most common cancer. However, some breast cancer-related risk factors remain unknown. So, the current study was designed to evaluate the effect of Toxocara canis on the biomarkers correlated with proliferation, apoptosis, inflammation, and angiogenesis in 4T1 tumor-bearing mice infected with Toxocara canis for the first time. METHODS: Mice were categorized into four groups: A) control, B) treated with 4T1+ Toxocara canis, C) treated with Toxocara canis, and D) treated with 4T1. The expression of Ki-67 and P53 was then evaluated by using the immunohistochemical technique. In addition, the levels of transforming growth factor-ß, Interferon gamma-γ, Interleukin 10, tumor necrosis factor-α and vascular endothelial growth factor as well as anti- Toxocara canis IgG were determined using the enzyme-linked immunosorbent assay method. RESULTS: The expression of Ki-67 was significantly increased in the 4T1+ Toxocara canis group than control and Toxocara canis groups (P < 0.001 and P < 0.001, respectively). Moreover, a significant decrease in P53 was found in the 4T1+ Toxocara canis group than in the control and Toxocara canis groups (P < 0.001 and P < 0.001, respectively). Also, the 4T1+ Toxocara canis group significantly reduced the expression of P53 more than 4T1 tumor-bearing mice (P = 0.005). In addition, the 4T1+ Toxocara canis group had an increasing tumor necrosis factor-α and vascular endothelial growth factor than controls (P = 0.004 and P = 0.002, respectively). Furthermore, a significant reduction in Interleukin 10 was found in the 4T1+ Toxocara canis group than in the control group (P = 0.004). CONCLUSION: Our findings showed that Toxocara canis could probably increase the potential of breast cancer by reducing P53 in 4T1 tumor-bearing mice infected with Toxocara canis more than other groups.

Toxoplasma gondii genotyping in AIDS patients using high resolution melt analysis (HRM analysis) in Khuzestan province, southwest Iran.

Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii, a common protozoan in the Apicomplexa phylum. Several studies in Iran have demonstrated the presence of the parasite in various hosts, but no data on T. gondii genotyping in HIV patients in Khuzestan, Southwest Iran, is available. One hundred of blood samples from AIDS patients were collected and tested by real-time PCR High Resolution Melting analyses for T.gondii detection and genotyping. T. gondii was discovered in 8 out of 100 (8%) AIDS patients with dominant Type I. This study suggest that HRM method demonstrated excellent discriminating ability for T. gondii, and AIDS patients should be tested for Toxoplasma detection and genotyping to prevent parasite pathogenicity.

Iron ore tailings valorization through separate characterization and upgradation of different tailings streams of an Iranian iron ore processing plant.

In iron ore processing plants, different tailing streams are usually transferred to the tailings thickener for partial dewatering and finally transferred to the tailings dam as a single stream. Therefore, the mixing of different tailings streams happens. This way can challenge the process of reprocessing the tailings in the tailings dam since the mixing of different tailings streams causes more complexity in the mineralogical composition as well as the chemical composition of the tailings in the tailings dam. To solve this problem, the idea of separate characterization and separate upgradation of different tailings streams of an iron ore processing plant was carried out and a comparison was made between the results of magnetic upgradation of each tailings streams with the total tailings (i.e., the tailings in the tailings dam, which is a mixture of different tailings streams of the plant). Hence, the different tailings streams of an iron ore processing plant were sampled and characterize for total iron, FeO content, particle size distribution, mineralogical composition by X-ray diffraction (XRD), magnetic behavior by Davis tube tests, and dry solid tonnage rate. The characterization results showed that the iron grade and dominant iron ore mineral vary from one stream to another tailings stream of the iron ore processing plant. For instance, the total iron content of different tailings streams varies in the range of 18.46 to 64.68% and the dominate iron ore mineral in the Cobber tailings was hematite, but in the other tailings streams it was magnetite. The magnetic upgradation of the Cobber and Rougher tailings and also the total tailings were performed separately by the wet magnetic separation at different magnetic field intensities of 2000, 3500, 5000, and 15,000 Gauss. A concentrate with the highest iron grade of 61.79% and yield of 52.15% was produced from magnetic upgradation of the Rougher tailings, but magnetic upgradation of the total tailings produced a concentrate with the iron grade of 37% and yield of 15.2%. A comparison between the magnetic upgradation of the total tailings and the Cobber and Rougher tailings revealed that the upgradation of Rougher tailings results in a concentrate with higher iron grade and yield than the total tailings.

Comparison of Toxoplasmosis in Narcotic Drug-addicted and Healthy Persons in the Southwest of Iran; A Case-control Study.

INTRODUCTION: Toxoplasmosis and narcotic drug addiction are endemic in various regions of Iran. These drugs can provide situations for infections by disrupting the immune system. The current case-control study was designed to determine the prevalence of toxoplasmosis in narcotic drugaddicted persons in comparison with healthy subjects using serology and molecular techniques in the southwest of Iran. METHODS: A total of 201 subjects (including 101 individuals with drug addiction and 100 control participants) were randomly selected. Chronic and acute toxoplasmosis was detected using the enzymelinked immunosorbent assay (ELISA) IgG avidity. T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) were also determined by the ELISA. Moreover, the presence of T. gondii in blood samples was diagnosed using the nested-polymerase chain reaction (Nested-PCR). RESULTS: For T. gondii IgG, 17 (17.0%) of 100 and 39 (38.6%) of 101 cases were diagnosed in the control participants and drug-addicted people, respectively [P=0.001, OR=3.071, CI= (1.591-5.929)]. Moreover, 16 (15.8) and 5 (5.0%) cases were positive for the B1 gene in the drug-addicted patients and controls by the nested-PCR technique, respectively [P=0.019, OR=3.576, CI= (1.257-10.179)]. However, no significant differences were found between the opium (n=64) and crystal methamphetamine (n=37) groups in terms of T. gondii IgG and IgM antibodies and the presence of the parasite in the blood (P>0.05). CONCLUSION: The present results demonstrated that the outbreak of the infection was more frequent in narcotic drug-addicted persons than the controls using serology and molecular techniques.

Toxoplasma and Risk of Spontaneous Abortion: A Meta-Analysis in A Population of Iranian Women.

Toxoplasma gondii is found as an intracellular protozoan parasite in the Apicomplexa phylum that can be transmitted to the fetus and causes miscarriage, infection, and asymptomatic neonatal disease. In the present study, we characterized the seroprevalence rate of anti-Toxoplasma gondii antibodies in a population of Iranian women with a recent a spontaneous abortion. We examined our national and international databases including Irandoc, Magiran, SID, Medlib, Scopus, PubMed, and the Science Direct. The search strategy was carried out by using keywords and MeSH terms. The statistical analysis was performed by STATA 14.2. By using the random effects model and the fixed effects model the statistical analysis was performed while the heterogeneity was ≥75 and ≤50%, respectively. We used the chi-squared test and I2 index to calculate heterogeneity among studies, and for evaluating publication bias, Funnel plots and Egger tests were used. The seroprevalence positive rate of IgG among women who had experienced abortion was observed 32% [95% confidence interval (CI): 20-45%] based on the random-effects model. The seroprevalence positive rate of IgM based on the fixed-effect model and positive IgG rate based on the random-effect model was evaluated 4% (95% CI: 3-6%) and 32% (9% CI: 3-42%) among women immediately after an abortion, respectively. According to the finding of our study, toxoplasmosis can be one of the most significant causes of abortion.

The Worldwide Prevalence of Herpes Simplex Virus Encephalitis and Meningitis: A Systematic Review and Meta-Analysis.

Given the relatively high frequency of central nervous system infections and considerable mor- tality and morbidity reported to be caused by herpes simplex viruses among the other viral agents, having a clear knowledge about their epidemiological profile seems necessary. This systematic review and meta-analysis aimed to determine the relative frequency and preva- lence of herpes simplex encephalitis and meningitis in patients tested for viral etiologies. A comprehensive systematic review was performed in PubMed, Scopus, and Web of Science databases, searching for studies on the prevalence and relative frequency of herpes sim- plex virus 1 and herpes simplex virus 2 encephalitis and meningitis. Seventy-one studies were included. Overall, the prevalence of herpes simplex virus encephalitis among patients tested was 8% (95% confidence interval, 6%-11%; I2 = 98%) and the prevalence of herpes simplex virus meningitis among aseptic patients tested was 4% (95% confidence interval, 3%-7%; I2 = 95%), and a significant difference was observed by region. The results of our subgroup analysis for herpes simplex virus encephalitis revealed a prevalence of 8% for pediatric patients and ado- lescents and 12% for adults. The results for herpes simplex virus meningitis showed a prevalence of 4% for pediatric patients and adolescents and 9% for adults. We observed significant differ- ences in the frequency of herpes simplex virus 1 and herpes simplex virus 2 detection rates by region. Having high rates of missed cases due to inadequate, highly sensitive paraclinical tests performed on patients with suspected viral central nervous system infection is one of the pos- sible factors. More studies are needed to detect the possible flaws in the process of diagnosis in different regions.

Serologic evidence of pertussis infection in vaccinated Iranian children.

BACKGROUND: It seems that the incidence of pertussis-like illnesses is considerably increasing despite the wide coverage of immunization with the whole cell pertussis vaccine. We aimed to investigate the occurrence of pertussis in vaccinated children by measuring anti-pertussis antibodies. METHODS: In this cross-sectional study, blood samples were taken from vaccinated children aged 2, 4, 6, 12, 18, and 72 months. Anti-pertussis IgG and IgA were measured by ELISA. P<0.05 was considered significant. RESULTS: 725 children were enrolled in the study. Geometric mean titers for IgG that showed a slight decease after 2 months of age and increased distinctly in children aged 72 months. The frequency of the individuals whose IgG was above the determined cut-off (derived from mean+2SD) was observed in 1% of the 2, 4, and 6-month-old infants, 6% of the 12 and 18-month-olds and 12% of the 6-year -old children. Positive IgA titers were detected in 5, 9, 6, 23, 11, and 8% of children aged 2, 4, 6, 12, 18, and 72 months, respectively. CONCLUSION: Since a considerable percentage of children had high levels of anti-pertussis IgG antibodies (≥2 SD), positive anti-pertussis IgA, and most importantly an increased level of anti-pertussis IgG geometric mean titer at 6 years of age, further investigations regarding the protection provided by the presently used pertussis vaccine seems necessary.

Toxoplasmosis in Treatment-Resistant Obsessive-Compulsive Disorder Patients.

BACKGROUND AND OBJECTIVES: The current study was done to evaluate the relationship between T. gondii and obsessive-compulsive disorder (OCD) as well as prevalence rate of toxoplasmosis in treatment-resistant patients with OCD in comparison with treatment-sensitive patients with OCD. METHODS: A total of 180 subjects were selected, including 90 patients with OCD and 90 control participants. Immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against T. gondii were measured by the enzyme-linked immunosorbent assay (ELISA) technique. Detection of acute and chronic toxoplasmosis was carried out using the ELISA IgG avidity. In addition, the presence of this parasite in blood was detected using the nested-polymerase chain reaction (PCR) method. RESULTS: Regarding T. gondii IgG antibodies 42 (46.7%) and 17 (18.9%) cases were detected in the patients and controls, respectively (P = 0.000). Also, 16 (17.8%) and 5 (5.6%) cases were positive for B1 gene in patients and controls, respectively (P = 0.018). The antibodies were found to be related to risk of OCD [OR (95% CI) = 3.71 (1.88-7.30); P < 0.001]. Moreover, out of 90 patients, 35 and 55 cases were resistant and sensitive to treatment, respectively, so that 24 (68.6%) out of 35 and 18 (32.7%) out of 55 were positive for the antibodies (P = 0.01) as well as 11 (31.4%) out of 35 and 5 (9.1%) out of 55 were positive for B1 gene (P = 0.010). The antibodies were also associated with risk of resistance to treatment in patients with OCD [OR (95% CI) = 3.81 (1.42-10.17); P = 0.008]. CONCLUSION: Our findings showed that toxoplasmosis was more frequent in patients with OCD than the control group. In addition, prevalence rate of toxoplasmosis in treatment-resistant patients with OCD was significantly more than that in treatment-sensitive patients with OCD.

The in vitro anti-Leishmania Effect of Zingiber officinale Extract on Promastigotes and Amastigotes of Leishmania major and Leishmania tropica

Objective: Recently, the use of pentavalent antimony compounds for Leishmaniasis treatment has been associated with disease recurrence, drug resistance, and severe side effects. Therefore, there is a need to develop alternative treatment strategies. This study investigates the in vitro effects of Zingiber officinale on promastigotes and amastigotes of Leishmania major and Leishmania tropica. Methods: Promastigotes and amastigotes of Leishmania major and Leishmania tropica were cultured and mass-produced in an RPMI1640 medium enriched with other necessary compounds. The MTT colorimetric method and calculating the IC50 value were used to evaluate the anti-leishmania activity of hydroalcoholic extract of Zingiber officinale. Results: The hydroalcoholic extract of Zingiber officinale inhibited the growth of Leishmania major and Leishmania tropica promastigotes in 24, 48, and 72 hours after in vitro incubation. The IC50 of hydroalcoholic extract of Zingiber officinale was 56 µg/mL for Leishmania major and 275 µg/mL for Leishmania tropica promastigotes after 72 hours. The IC50 of hydroalcoholic extract of Zingiber officinale was 75 µg/mL for Leishmania major and 325 µg/mL for Leishmania tropica amastigotes after 72 hours. Conclusion: The results showed that hydroalcoholic extract of Zingiber officinale has cytotoxicity properties, and Leishmania tropica has a higher resistance to hydroalcoholic extract of Zingiber officinale than Leishmania major. Further research is recommended.

Molecular Identification of Free-living Amoebae Isolated from Hospital Water Systems in Southwest Iran.

INTRODUCTION: Free-living amoebae are opportunistic amoebae that usually live freely in various environmental conditions, including warm water and even in water supply network pipes and reservoirs connected to water. In addition to living freely, these protozoa are able to attack the host's body when they enter a human or animal body. Therefore, it is necessary to identify their presence in water resources. So, this study aimed to identify free-living amoebae isolated from water reservoirs of hospitals in southwest Iran. METHODS: A total of 80 water samples were isolated from the hospitals of Ahvaz city, southwest Iran, and their physical and chemical parameters were measured. The samples were then put into non-food agar culture medium and stained using the Wright-Giemsa staining. Finally, the samples were identified by the PCR molecular method. RESULTS: The mean pH and turbidity values were 7.57 ± 0.03 and 3.31 ± 0.26 nephelometric turbidity unit (NTU), respectively. The mean residual chlorine and electrical conductivity were 0.91 ± 0.02 and 1122.39 ± 24.31, respectively. In addition, 9 (11.25%) and 3 (3.75%) samples were contaminated with Acanthamoeba spp. and Naegleria spp., respectively. However, no positive cases of Balamuthia spp. infection were observed. Moreover, two samples were co-infected with Acanthamoeba spp. and Naegleria spp. CONCLUSION: Due to the existence of free-living amoebae in water storage tanks at hospitals, it is necessary to prevent possible contamination with these amoebae and infectious agents by using new methods of disinfection and purification of water resources.

SARS-CoV-2 and HIV co-infection; clinical features, diagnosis, and treatment strategies: A systematic review and meta-analysis.

Background and aim: Coronavirus disease 2019 (COVID-19) in people living with human immunodeficiency virus (HIV) who has a compromised immune system can be associated with more significant risks for severe complications. To date, no comprehensive study has been performed to evaluate HIV in patients with COVID-19. In the present study, we assessed the status of patients co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HIV as a systematic review and meta-analysis. Methods: A systematic literature search strategy was conducted via reviewing original research articles published in Medline, Web of Science, and Embase databases in 2019 and 2020. Statistical analysis was performed using STATA software, version 14.0 (Stata Corporation, College Station, Texas, USA), to report the prevalence of HIV among patients with COVID-19. Case reports/case series were also evaluated as a systematic review. Results: Sixty-three studies (53 case reports/case series and ten prevalence studies) were included in our study. A meta-analysis of prevalence studies showed that HIV infection among patients with COVID-19 was reported in 6 countries (Uganda, China, Iran, USA, Italy, and Spain) with an overall frequency of 1.2% [(95% CI) 0.8-1.7] among 14,424 COVID-19 patients. According to the case reports and case series, 111 patients with HIV have been reported among 113 patients with COVID-19 from 19 countries. Most of the cases were in the USA, China, Italy, and Spain. Conclusion: The small number of SARS-CoV-2-HIV co-infected patients reported in the literature makes it difficult to draw precise conclusions. However, since people with HIV are more likely to develop more severe complications of COVID-19, targeted policies to address this raised risk in the current pandemic should be considered. Our findings highlight the importance of identifying underlying diseases, co-infections, co-morbidities, laboratory findings, and beneficial treatment strategies for HIV patients during the COVID-19 pandemic.

The university students' viewpoints on e-learning system during COVID-19 pandemic: the case of Iran.

The outbreak of COVID-19 closed educational institutions and universities. The aim of this study was to explain the strengths and weaknesses of the e-learning system in Iranian universities of medical sciences in the COVID-19 pandemic. This is a qualitative study that was conducted with students enrolled in Iranian medical universities. Data was collected through an open-ended electronic questionnaire based on the interview guide and was analyzed through content analysis. 122 students from 46 medical universities participated in this study. 122 questionnaires from 46 universities of medical sciences were completed. From a total of 54 codes extracted from the results, seven (strengths/positive experiences) and six (weaknesses/challenges) themes were extracted, each of which had several subsets. E-learning has both visible and hidden layers in terms of advantages and disadvantages. The e-learning system is an essential tool to continue education during the COVID-19 pandemic. Most students believe that e-learning was a great complement to prevent academic failure, but it cannot replicate the same efficiency of face-to-face training.

Comparison of the Detection of Toxocara Spp. in the Soils of Public Parks of Ahvaz (Southwest of Iran) by PCR and Loop-Mediated Isothermal Amplification (LAMP).

INTRODUCTION: The infections caused by Toxocara spp. are considered as one of the most important zoonotic diseases in the world, especially in developing countries. Human toxocariasis, particularly in children, is acquired by playing in public parks. Hence, the aim of the current study was to detect Toxocara spp. in the soils of public parks of the city of Ahvaz, southwest of Iran, using the PCR and loop-mediated isothermal amplification (LAMP) methods. METHODS: In this descriptive cross-sectional study, 260 soil samples were randomly collected from the different public parks of the city of Ahvaz. After performing zinc sulfate (ZnSO4) flotation technique, the DNA samples were extracted from the isolated Toxocara spp. eggs. Lastly, the extracted DNA was used for PCR and LAMP-based molecular detection. RESULTS: Out of 260 specimens, 57 (21.9%) samples were found positive for Toxocara spp., using the PCR method, out of that 38 (14.6%) samples were positive for T. canis and 19 (7.3%) samples were positive for T. cati. Also, out of 260 specimens, 81 (31.1%) cases were positive for Toxocara species, using the LAMP method, among them 51 (19.6%) samples were found positive for T. canis and 30 (11.5%) samples were positive for T. cati. Kappa (κ) coefficient between PCR and LAMP showed a strong agreement (0.766, P-value=0.002). CONCLUSION: The obtained data showed a relatively high outbreak of Toxocara spp. in the public parks' soils of the city, using the PCR and LAMP methods. Since the parasite can cause human toxocariasis, particularly in children; thus, the health authorities of the city of Ahvaz and other similar cities, especially in developing countries, must pay more attention to the hygiene of the public parks' soils.