Renal, cardiac, neurological, cutaneous and coagulopathic long-term manifestations of COVID-19 after recovery; A review.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the novel global coronavirus disease 2019 (COVID-19) disease outbreak. Its pathogenesis is mostly located in the respiratory tract. However, other organs are also affected. Hence, realising how such a complex disturbance affects patients after recovery is crucial. Regarding the significance of control of COVID-19-related complications after recovery, the current study was designed to review the cellular and molecular mechanisms linking COVID-19 to significant long-term signs including renal and cardiac complications, cutaneous and neurological manifestations, as well as blood coagulation disorders. This virus can directly influence on the cells through Angiotensin converting enzyme 2 (ACE-2) to induce cytokine storm. Acute release of Interleukin-1 (IL1), IL6 and plasminogen activator inhibitor 1 (PAI-1) have been related to elevating risk of heart failure. Also, inflammatory cytokines like IL-8 and Tumour necrosis factor-α cause the secretion of von Willebrand factor (VWF) from human endothelial cells and then VWF binds to Neutrophil extracellular traps to induce thrombosis. On the other hand, the virus can damage the blood-brain barrier by increasing its permeability and subsequently enters into the central nervous system and the systemic circulation. Furthermore, SARS-induced ACE2-deficiency decreases [des-Arg9]-bradykinin (desArg9-BK) degradation in kidneys to induce inflammation, thrombotic problems, fibrosis and necrosis. Notably, the angiotensin II-angiotensin II type 1 receptor binding causes an increase in aldosterone and mineralocorticoid receptors on the surface of dendritic cells cells, leading to recalling macrophage and monocyte into inflammatory sites of skin. In conclusions, all the pathways play a key role in the pathogenesis of these disturbances. Nevertheless, more investigations are necessary to determine more pathogenetic mechanisms of the virus.

Bacteriophage as a Novel Therapeutic Weapon for Killing Colistin-Resistant Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Bacteria.

Colistin-resistant multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) bacteria are highly lethal and many researchers have tried hard to combat these microorganisms around the world. Infections caused by these bacteria are resistant to the last resort of antibiotic therapy and have posed a major challenge in clinical and public health. Since the production of new antibiotics is very expensive and also very slow compared to the increasing rate of antibiotic resistance, researchers are suggesting the use of natural substances with high antibacterial potential. Bacteriophages are one of the most effective therapeutic measures that are known to exist for use for incurable and highly resistant infections. Phages are highly taken into consideration due to the lack of side effects, potential spread to various body organs, distinct modes of action from antibiotics, and proliferation at the site of infection. Although the effects of phages on MDR and XDR bacteria have been demonstrated in various studies, only a few have investigated the effect of phage therapy on colistin-resistant isolates. Therefore, in this review, we discuss the problems caused by colistin-resistant MDR and XDR bacteria in the clinics, explain the different mechanisms associated with colistin resistance, introduce bacteriophage therapy as a powerful remedy, and finally present new studies that have used bacteriophages against colistin-resistant isolates.

The occurrence of cystic echinococcosis in slaughtered livestock in Jahrom, south of Iran.

Cystic echincoccosis (CE) is a major medical and veterinary concern in the world, especially in Iran. Domestic intermediate hosts are an important reservoir for the disease spread. The purpose of this study was to determine the prevalence of CE in slaughtered livestock in Jahrom, south of Iran. In this cross-sectional study, a total of 3074 animals (2325 (75.63%) goats, 423 (13.76%) sheep, and 326 (10.60%) cattle) were inspected macroscopically for CE. In this regard, a questionnaire about the age, sex, infected organ, number of cysts, and cyst fertility was accomplished for each animal. Moreover, PCR was applied by using the cytochrome c oxidase I (COX1) and NADH dehydrogenase subunit 1 (nad1) fragments of parasite mitochondrial genomes on some positive samples. Prevalence of CE in sheep, cattle, and goats was 11.34% (48/423), 11.04% (36/326), and 2.79% (65/2325), respectively. In all livestock, CE was more common in females than males. Moreover, the highest infection rate was observed in the age group of more than 72 months. Considering the fertility of cysts, the ratio of the number of fertile cysts to total cysts in sheep and goats were 83.3% (40/48) and 80% (52/65), respectively. All hydatid cysts were infertile in cattle. With regard to the location of the cyst on internal organs, the most were observed in the lungs and liver. Regarding the intensity of infection, 1-5, 6-9 and ≥ 10 cysts were detected in 78.52% (117/149), 6.71% (10/149) and 10.73% (16/149) of infected livestock, respectively. In all livestock, hydatid cyst with a diameter of 1-5 cm was the most frequent with 71.81% (107/149). All 149 cyst samples were subjected to PCR. Among them, a total of 18 samples (six samples of each animal) were prepared for sequencing. G6 was the most dominant. According to the results of present study and the relatively high prevalence of CE in slaughtered livestock in Jahrom, health policy makers, health authorities, and experts should make effective approach in this regard, and implement careful inspections.

Occurrence of microsporidia spp. infection in children with diarrhea in southern Iran.

Microsporidia spp. are recognized emerging zoonotic microorganisms in immunocompromised and immunocompetent populations. Therefore, we conducted a study to investigate the occurrence, sociodemographic and risk factors of microsporidia spp. infection using microscopic and molecular techniques in children with diarrhea in Jahrom city (Fars province, southern Iran). Stool samples were gathered from 395 children aged ≤ 14 years between January 2017 and January 2018. Next, a questionnaire includes the age, sex, living area, immune system status, breast milk consumption, contact with animals, and type of water source was completed for all children. For microscopic assessment, modified acid-fast trichrome staining was applied for detection of microsporidia spores. Furthermore, DNA extraction and PCR were accomplished for all samples. A total of 15 (3.79%; 95% confidence interval [CI] 2.14-6.19) and 8 (2.02%; 95% CI 0.88-3.95) samples were positive for microsporidia infection by microscopic and molecular techniques, respectively. Although none of the sociodemographic and risk factors were significant (p value > 0.05), the prevalence of this infection was higher in some variables (e.g., rurality, contact with animals and well water consumption). Three random samples were sequenced that all isolates belonged to Enterocytozoon bieneusi. Cognizance of microsporidia occurrence, risk factors, and disease disorders for the health specialists, physicians, children's families are important for appropriately control the infection.

Prevalence of Intestinal Parasitic Infections Among Diarrheic Patients from Ahvaz, Southwestern Iran.

BACKGROUND: Intestinal parasitic infections are among the most common infections in humans, particularly in resource-poor communities. Gastrointestinal parasites, specially protozoa, can lead to diarrhea, malabsorption, and anemia. The majority of parasitic diarrhea is caused by Entamoeba histolytica, Giardia duodenalis, and Cryptosporidium spp. The present study aimed to evaluate the prevalence of intestinal parasites among diarrheic patients referred to the Shahid Rajaee Polyclinic, Ahvaz, southwestern Iran. METHODS: A cross-sectional study was conducted to determine the prevalence of intestinal parasites among 250 diarrheic patients using direct smear, formalin-ether concentration, Ziehl-Neelsen and trichrome staining. RESULTS: The results indicated that 34.4% (86/250) of the patients were infected with pathogenic parasites. Giardia duodenalis with an occurrence of 18.8% (47/250) and Cryptosporidium spp. with a frequency of 2.8% (7/250) had the highest and lowest infection rates, respectively. Blastocystis hominis with a frequency of 15.2% (38/250) showed the highest prevalence rate after G. duodenalis. Entamoeba histolytica/dispar was observed in 3 (1.2%) of diarrheic patients. The age group 1-10 years old was the most frequently infected group (27.9%). We could not find a significant association between the source of drinking water and intestinal parasitic infections (p= 0.912). CONCLUSION: This study demonstrated that G. duodenalis was the predominant parasite found among the patients. The results revealed that intestinal parasites were one of the main health problems in the region.