Molecular Characterization of Giardia intestinalis and Cryptosporidium spp. Detected in Humans in Agri, Türkiye.

Background: We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Agri, Türkiye. Methods: This study included 184 patients who applied to Agri-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of ß-giardin gene were used genotype G. intestinalis. Results: Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId sub-type family. The G. intestinalis were identified assemblages A. Conclusion: Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Agri, Türkiye.

Spread of Intestinal Parasites in Patients Presenting with Gastrointestinal Complaints.

Objective: The aim of this study is to determine the prevalence of intestinal parasites in patients admitted to University of Health Sciences Türkiye (UHS) Van Training and Research Hospital. Methods: A total of 300 patients between the ages of 18-90 who applied to UHS Van Training and Research Hospital with gastrointestinal complaints and were referred to the parasitology laboratory between September 2021 and December 2021, and 100 patients without any chronic disease and gastrointestinal complaints in the control group were included in the study. Stool samples taken from patients included in the study and individuals in the control group were analyzed by native-lugol and modified acid-fast staining methods. Results: In the study, intestinal parasites were detected in 41 (13.3%) of 300 patients in the patient group and in seven (7%) of 100 individuals in the control group. The highest rate of Blastocystis species (Blastocystis spp.) (5.7%) was found in the patient group. Entamoeba coli 3%, G. intestinalis 2.7% and Cryptosporidium species (Cryptosporidium spp). 2.3% were found among the other species detected. In addition, a statistically significant correlation was found between the incidence of parasites and abdominal pain (p=0.022) and nausea (p=0.029). Conclusion: As a result; it was concluded that intestinal parasites are still an important health problem in patients with gastrointestinal complaints and intestinal parasites should definitely be considered in this patient group.

A Ruptured Cystic Echinococcosis in the Gallbladder and Intra/Extrahepatic Biliary Tract, Radiological and Surgical Imaging Findings.

Cystic echinococcosis is a common parasitic infestation that can still cause serious complications in endemic areas. Intrabiliary rupture is a well-defined complication, but rupture into the gallbladder is rare. The disease may present with cholecystitis and cholangitis. Clinicians and radiologists working in the emergency room will find the management of the disease much easier if they become familiar with the clinical and radiological findings of the cyst. In this article, a 28-year-old male admitted to the emergency department with acute abdominal pain who was examined for suspected acute cholecystitis and diagnosed with a rupture of the hydatid intra/extrahepatic bile ducts and gallbladder is presented. Our aim is to present the clinical findings and surgical images of the case (ultrasonography, computed tomography, magnetic resonance imaging) and compare them with the literature.

Investigation of the presence of Enterocytozoon bieneusi and Encephalitozoon intestinalis in immunosuppressed patients with diarrhea by IFA and real time PCR methods.

PURPOSE: This study aimed to investigate the frequency of Enterocytozoon bieneusi and Encephalitozoon intestinalis in patients with diarrhea in the immunosuppressed. METHODS: Patients between the ages of 18-85 who applied to different clinics of Mus Bulanik and Bitlis State Hospitals and were referred to the microbiology or parasitology laboratory were selected for this study. A total of 200 individuals, including 88 immunosuppressed with diarrhea patients, 38 immunocompetent with diarrhea patients, 38 immunosuppressed without diarrhea patients, and 36 immunocompetent without diarrhea individuals, were included. Collected stool samples were evaluated using IFA-MAbs and real-time PCR methods to determine the frequency of E.intestinalis and E.bieneusi. RESULTS: E. intestinalis was detected in 59 (29.5%) of 200 samples and E. bieneusi was detected in 46 (23.0%) of them. Mixed infection was detected in 16 (8%) of the positive samples. While there was no statistically significant difference between E. intestinalis positivity and gender, age, diarrhea status and immune system status, a statistically significant relationship was determined between E. bieneusi positivity and diarrhea. When the real-time PCR method was accepted as the gold standard, the sensitivity of the IFA-MAbs method in the diagnosis of E. intestinalis was 94.54%, the specificity was 97.24, the sensitivity in the diagnosis of E. bieneusi was 95.45%, and the specificity was 98.72%. The overall accuracy of the IFA-MAbs method was 96.5% for the diagnosis of E. intestinalis and 98% for the diagnosis of E. bieneusi. CONCLUSIONS: The findings suggest that E. intestinalis and E. bieneusi should be considered in both immunosuppressed and healthy individuals with diarrhea. IFA-MAbs method can be used in addition to the real-time PCR method to diagnose E. intestinalis and E. bieneusi.

Investigation of Giardia spp., Cryptosporidium spp. and Cyclospora cayetanensis in Samples Collected from Different Spring Waters Igdir, Türkiye

OBJECTIVE: In this study, it was aimed to investigate the physical and chemical properties of different spring waters and parasitic factors with different methods. METHODS: This study was carried out on 69 water samples collected from different spring waters in and around Igdir Province in April and June 2021. The samples were analyzed by native-Lugol, modified acid-fast staining, and nested polymerase chain reaction (nPCR). In addition, altitude (meter) and pressure (mmHg) measurements were made at the point where the water samples were taken. RESULTS: One or more parasites were detected in 27.5% of the 69 water samples examined. Only C. cayetanensis was found in 13% of the samples, only Cryptosporidium spp. in 10.1%, only Giardia spp. in 1.4%, only C. cayetanensis and Giardia spp. in 1.4%, only C. cayetanensis, Cryptosporidium spp., and Giardia spp. in 1.4%. Only Giardia spp. cyst (4.3%) was detected by the direct examination method. While C. cayetanensis and Cryptosporidium spp. oocysts were detected in 8.7% and 7.2% of the samples by the modified acid-fast staining method, C. cayetanensis was detected in 15.9% and Cryptosporidium spp. was detected in 11.6% of the samples by nPCR. When the C. cayetanensis and Cryptosporidium spp. positivity rates were compared according to the characteristics of the water, there was no statistical difference between the altitude, salinity, pH, mmHg, and temperature (kelvin) values, but a significant correlation was found between the amount of dissolved oxygen and Cryptosporidium spp. positivity (p=0.047). CONCLUSION: Cryptosporidium spp., C. cayetanensis, and G. intestinalis are important waterborne pathogens that can cause epidemics. It is our belief that in order to reduce the risk of contamination of these parasitic factors with spring waters, public awareness should be raised, infrastructures should be improved, and new water treatment techniques, such as ultraviolet, ozonation and monitoring systems, should be used.

The Importance of Antioxidant Enzymes and Oxidative Stress in Human Fascioliasis

Objective: The aim of this study was to determine the levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), and malondialdehyde (MDA) in the patients infected with Fasciola hepatica and establish whether these parameters differ among the patients with fascioliasis. Methods: The patient group consisted of 140 individuals with F. hepatica seropositive; the control group consisted of 140 healthy individuals who tested negative for this parasite and had no other diseases. The patient group consisted of individuals with no chronic diseases other than fascioliasis; in both the patient and the control groups, the subjects had no unhealthy habits such as smoking and alcohol consumption, etc. The blood samples taken to diagnose fascioliasis were evaluated by the ELISA method. The samples were studied according to the kit procedures for SOD, CAT, GPx and MDA markers. Results: In this study, 43.6% of 140 individuals in the patient group infected with F. hepatica had CAT (p=0.001), 35% had GPx (p=0.001), 12.9% had SOD (p=0.002), 90.7% had MDA (p=0.001). There was found a statistically significant difference between the patient and the control group in terms of the positivity of these four parameters. Conclusion: As a result, a statistically significant relationship was found between the increase in the SOD, GPx, CAT, and MDA levels and fascioliasis. The high rate of MDA revealed that oxidative stress occurred in patients with fascioliasis, resulting in an increased activity of SOD, GPx, and CAT. Amaç: Bu çalismanin amaci, Fasciola hepatica ile enfekte hastalarda süperoksit dismutaz (SOD), glutatyon peroksidaz (GPx), katalaz (CAT) ve malondialdehit (MDA) düzeylerini belirlemek ve fascioliasisli hastalarda bu parametrelerde farklilik meydana gelip gelmedigini ortaya koymaktir. Yöntemler: Hasta grubu, F. hepatica pozitif olan 140 hastadan; kontrol grubu ise bu parazit yönünden negatif bulunan ve baska herhangi bir hastaligi bulunmayan 140 saglikli kisiden olusturuldu. Hasta grubuna fascioliasis disinda herhangi bir kronik hastaligi olmayan ve hem hasta hem de kontrol grubuna sigara, alkol kullanimi olmayan kisiler dahil edildi. Hastalarda fascioliasis pozitifligini belirlemek için alinan kan örnekleri ELISA yöntemi ile çalisildi. Serum SOD, CAT, GPx ve MDA düzeyleri ELISA yöntemi ile degerlendirildi. Bulgular: Bu çalismada F. hepatica ile enfekte hasta grubundaki 140 kisinin %43,6'sinda CAT (p=0,001), %35'inde GPx (p=0,001), %12,9'unda SOD (p=0,002) ve %90,7 MDA pozitifligi saptandi. Bu dört parametrenin pozitifligi açisindan hasta ve kontrol grubu arasinda istatistiksel olarak anlamli fark bulundu (p=0,001). Sonuç: Sonuç olarak SOD, GPx, CAT ve MDA düzeyindeki artis ile fascioliasis arasinda istatistik olarak anlamli bir iliski saptanmistir. Çalismamizda MDA'nin yüksek oranda saptanmis olmasi fascioliasisli hastalarda oksidatif stres olustugunu ve SOD, GPx ve CAT aktivitelerinde artis oldugunu ortaya koymustur.

Molecular Prevalence of Larval Stages of Fasciola hepatica in Lymnaea stagnalis Species Snails in the Vicinity of the Agri Province

Objective: Lymnaea stagnalis known as the great pond snail, is one of the intermediate hosts of Fasciola hepatica, a zoonotic parasite. In this study, it was aimed to determine the larval forms of F. hepatica by polymerase chain reaction (PCR) in L. stagnalis species snails collected from the vicinity of Agri province. Methods: In this study, 150 L. stagnalis snails were collected from the Agri province. The freshwater snails brought to the laboratory were dissected, then their soft tissues were examined under a microscope. DNA extraction was performed on the dissected snails. After DNA extraction, PCR was performed using primers targeting the cytochrome c oxidase subunit 1 gene region. Results: In the microscopic examination, larval forms of F. hepatica could not be detected. However, it was concluded that two (1.3%) L. stagnalis freshwater snails were infected with the larval forms of F. hepatica in the PCR. Conclusion: It was determined that L. stagnalis served as an intermediate host to F. hepatica in the study area.

Genotyping of Echinococcus granulosus Human Isolates Obtained from the Puncture, Aspiration, Injection, and Re-Aspiration (PAIR) Process in Türkiye.

Background: Echinococcus granulosus is spread by the excretion of cystic organs into the environment. The dog is infected via eating the cystic organ. It then contaminates the environment with eggs of E. granulosus, which are infective to humans and animals. We aimed to determine the E. granulosus genotypes that cause infection in humans in the Van region, Türkiye. Methods: Sixty patients between 18 and 100 years of age, who underwent the puncture, aspiration, injection, re-aspiration (PAIR) procedure in the Department of Radiodiognastics of Van Yüzüncü Yil University, Van, Türkiye were included in the study. PAIR fluids were examined microscopically and DNA was isolated from the fluids. After DNA isolation, polymerase chain reaction (PCR) was performed using primers that amplify the E. granulosus NADH dehydrogenase subunit 1 (NAD1) gene region. After sequence analysis of the PCR amplicons, Basic Local Alignment Search Tool (BLAST) was performed. Results: In the microscopic examination, protoscolex or hook was detected in 42 (70%) of the samples. DNA was successfully extracted from all of the cyst fluids containing protoscolex and hook, and the NAD1 gene region was PCR-amplified. After using BLAST, all of the samples were determined to be an E. granulosus sensu stricto G1 genotype. Sequence comparison revealed that four (9.5%) isolate sequences showed single nucleotide polymorphism (SNP). Sequences of isolates with SNP submitted to the GenBank with accession numbers OR565864 to OR565867. Conclusion: E. granulosus s.s. G1 genotype, known as sheep strain, is common in human hydatid disease in the Van region of Türkiye.

Subtyping of Cryptosporidium parvum Obtained from Humans and Calves in Van, Turkey.

Background: We aimed to investigate the prevalence of Cryptosporidium species detected in humans and calves in the Van region of Turkey. Methods: A total of 150 patients, comprising 60 who were immunosup-pressed, 50 who were immunosuppressed and had diarrhea, and 40 who had only diarrhea, were enrolled in this study in the Department of Medical Parasitology, Van Yuzuncu Yil University Faculty of Medicine, Turkey. Stool samples were taken from the rectums of a total of 50 calves that had 30 diarrhea and 20 that did not have diarrhea, from the stables and farms of 10 central villages of Van, Turkey. All samples were analyzed using modified acid-fast staining, immunochromatographic test, and PCR. Cryptosporidium positive samples were also subtyped. Results: Only C. parvum subtypes were detected in all positive samples. C. parvum was detected in 30 (20%) of the 150 human stool samples, while it was detected in 5 (10%) of the 50 samples from the calves. The GP60 gene region was amplified and sent for sequence analysis to identify the C. parvum subtypes. Conclusion: As a result, C. parvum is found to be an active species that caused cryptosporidiosis is in the Van region. IIdA24G1 subtype of C. parvum were found in both human and calf. Therefore, due to the zoonotic feature of the C. parvum IIdA24G1 subtype, it has been shown that the calves in the region are a significant risk for humans.

Investigation of Pneumocystis jirovecii in Lung Cancer Patients with the Nested PCR Method

Objective: Pneumocystis jirovecii (P. jirovecii) is an opportunistic pathogen in humans. Early diagnosis and optimal treatment of patients with P. jirovecii pneumonia (PJP) remains a key priority. This study investigated P. jirovecii in patients with lung cancer using the nested-polymerase chain reaction (PCR) method and examined the relationship between P. jirovecii and clinical findings. Methods: The study included 60 patients with lung cancer and 30 patients without lung cancer. The bronchoalveolar lavage (BAL) fluid samples of these 90 individuals were taken for diagnostic purposes in the University of Health Sciences Turkey, Van Training and Research Hospital, Clinic of Chest Diseases. Patient information was recorded. After DNA isolation from the BAL fluid samples taken from patients, the nested-PCR protocol for amplification of mtLSUrRNA in P. jirovecii was performed. Results: P. jirovecii DNA was detected in 40 (66.67%) of the lung cancer patients included in the study and in six (20%) patients without lung cancer, that is, in 46 (51.11%) patients. The rate of nested-PCR positivity in the lung cancer group was significantly higher than that in the non-lung cancer group (p=0.0001). Additionally, a statistically significant correlation was found between anorexia and weight loss, fever and sputum P. jirovecii positivity in patients with lung cancer (p<0.005). Conclusion: These findings suggest that lung cancer patients should be evaluated for PJP.

Prevalência de la criptosporidiosis en seres humanos y terneros, y detección molecular del Cryptosporidium parvum / Prevalence of cryptosporidiosis in humans and calves and molecular detection of Cryptosporidium parvum

RESUMEN Objetivo. El objetivo de este estudio fue investigar la prevalencia de especies de Cryptosporidium en humanos y terneros en la provincia de Van, Turquía. Materiales y métodos. Se incluyeron en el estudio un total de 150 pacientes, incluidos 50 pacientes en hemodiálisis, 40 pacientes inmunosuprimidos con diarrea, 30 pacientes con diarrea solamente y 30 pacientes inmunocompetentes. Se recolectaron muestras de heces rectales de un total de 50 terneros alojados en establos y granjas en 10 aldeas centrales de Van, Turquía. Resultados. Se detectó Cryptosporidium parvum en el 17.3% de las 150 muestras de heces tomadas de seres humanos. C. parvum se observó en el 20% de los 50 pacientes en hemodiálisis, el 32.5% de los 40 pacientes inmunosuprimidos con diarrea y el 10% de los 30 pacientes con diarrea solamente, mientras que no hubo Cryptosporidium spp. detectado en los pacientes inmunocompetentes. C. parvum se observó en sólo el 6% de los 30 terneros diarreicos. Conclusiones. Claramente se entendio que la Criptosporidiosis fue detectada en una alta tasa en las muestras de los pacientes inmunosuprimidos sin y con sintomas de diarrea, y que además la especie activa que causó la enfermedad fue el agente etiologico Criptosporidium parvum. Por lo tanto, estos dos grupos de pacientes deben ser evaluados en lo que a términos de Criptosporidiosis se refiere.

ABSTRACT Objective. To investigate of the prevalence of Cryptosporidium species in humans and calves in the province of Van, Turkey. Materials and methods. Included in this research were 150 patients, comprising 50 hemodialysis patients, 40 immunosuppressed patients with diarrhea, 30 patients with diarrhea only, and 30 immunocompetent patients. Collected were stool rectal samples from 50 calves that were housed in stables and farms in 10 central villages of Van, Turkey. Results. Cryptosporidium parvum was detected in 17.3% of the 150 human stool samples. C. parvum was observed in 20% of the 50 samples from the hemodialysis patients, 32.5% of the 40 samples from the immunosuppressed patients with diarrhea, and 10% of the 30 samples from patients with diarrhea only, whereas no Cryptosporidium spp. was detected in the samples from the immunocompetent patients. C. parvum was observed in only 6% of the samples from the diarrheic 30 calves. Conclusions. It was clearly understood that cryptosporidiosis was detected at a high rate in the samples from the immunosuppressed patients and those who were immunosuppressed with diarrhea, and that the active and effective species that causes cryptosporidiosis in the Van region is C. parvum. Hence, these patient groups should be evaluated in terms of cryptosporidiosis.

Trends in Naegleria fowleri global research: A bibliometric analysis study.

Naegleria fowleri is one of the most dangerous protozoan agents. This article describes a bibliometric review of the literature on N. fowleri research indexed in WoS during a 51-year period. The VOSviewer visualization methodology was used to conduct a bibliometric study. The data included articles from the Web of Science database, nations, institutions, journals, keywords, co-authorship, co-citations, international collaborations, and citation rates. A total of 1106 articles were retrieved from the Web of Science database. The articles were cited 21,904 times in total (cited 12,138 times without self-citations). The average citation per article was 19.82. The Hirsch index was 63. The leading country according to the number of published articles was the United States of America (USA) (n = 447; 40.416%), followed by Mexico (n = 80; 7.233%), and Australia (n = 63; 5.696%). Other than these top three countries, the publications were from 74 countries globally. Especially after the 2000s, both the number of citations and the number of publications exhibited an increasing trend. The Virginia Commonwealth University (USA) (9.584%), Centers for Disease Control Prevention (USA) (8.770%), and Instituto Politecnico Nacional Mexico (4.069%) were the leading affiliations. Most of the leading affiliations were from the USA and Mexico. In conclusion, a bibliometric evaluation of N. fowleri was performed for the first time. Authors affiliated with institutions in the USA and Mexico have led scientific production on PAM. Efforts should be made to help developing countries with the highest prevalence of N. fowleri to develop scientific research networks with the USA and/or Mexico in order to increase research with interdisciplinary teams.

Investigation of Intestinal and Blood Parasites in People Returning to Turkey with a History of Traveling Abroad During the Pandemic

Objective: To investigate intestinal and blood parasites in people who have a history of traveling abroad during the Coronavirus disease-2019 pandemic and returning to Turkey. Methods: In this study, 104 patients with gastrointestinal system and/or fever complaints who had traveled abroad during the pandemic period and returned to Turkey were included. Parasitic agents were investigated by taking blood and stool samples from the patients. Additionally, urine samples were obtained from patients with hematuria or dysuria with the suspicion of schistosomiasis. A direct microscopic examination, the Crypto-Giardia immunochromatographic test, and ELISA methods were used in the examination of the stool samples. In order to detect Plasmodium species, blood samples were examined by preparing both the rapid diagnostic test and thick drop and thin smear preparations. Results: One or more parasite species were detected in 38 (38.5%) of 104 patients included in the study. While intestinal parasites were detected in 16 (32%) of 50 patients who traveled to Iran and 16 (33.3%) of 48 patients who traveled to Northern Iraq, blood parasites were not found. Schistosoma mansoni was detected in all 5 of the patients with a history of traveling to Sudan. Plasmodium falciparum was detected in 1 patient who traveled to the African continent. Conclusion: It is vital to take precautions to prevent parasitic diseases, such as malaria and schistosomiasis, during travels to African countries. During travels to neighboring countries of Turkey, such as Northern Iraq and Iran, hygiene should be paid attention to, so as to prevent contracting intestinal parasitic diseases. In addition, it was concluded that people who plan to travel abroad should have information about the endemic parasitic diseases of the country that they are going to.

Investigation of the impact of antiparasitic drug moxidectin on the rewarding effects of alcohol.

Alcohol addiction or alcoholism constitutes a significant risk factor worldwide for morbidity and mortality. Moxidectin is a recently approved anthelmintic drug, which also activates the gamma-aminobutyric acid receptors. The objective of the present study was to examine the impact of moxidectin on rewarding effects of ethanol in the conditioned place preference (CPP) model in mice. In separate experiments, mice were administered intraperitoneal (i.p.) injections of moxidectin (5 or 10 mg/kg, i.p.) before a) acquisition of alcohol-induced CPP, b) each extinction session, and c) alcohol-induced reinstatement of CPP. The present experiments provide consistent data about ethanol place preference in mice (2 g/kg, i.p.), with mice in all tests spending significantly more time on the ethanol-paired side. The acquisition of the CPP response to ethanol was prevented by the administration of moxidectin at a dose of 10 mg/kg. Additionally, moxidectin treatment accelerated the extinction of ethanol CPP when given repeatedly during the extinction phase. Ethanol-induced reinstatement of CPP following an extinction phase was inhibited by moxidectin. Ethanol alone and co-administration with moxidectin did not change locomotor activity and motor coordination. In conclusion, we suggest that moxidectin may be a promising therapeutic candidate for prevention of ethanol-induced addiction and relapse as well as detoxification.

Evaluation of Intestinal Parasites and Some Clinical Symptoms in Children with Diarrhea

Objective: This study aimed to determine the frequency of intestinal parasites in children who were presented to health centers with a complaint of diarrhea and to reveal the importance of these parasites. Methods: The study was conducted on children within the age range of 1-16 who were presented to Igdir State Hospital and Private Bulut Hospital between 2020 February-April 2020 with a complaint of diarrhea. A total of 300 children comprising 141 girls and 159 boys were enrolled in the study. The control group was composed of 100 children (girls=50, boys=50) without any chronic disease and diarrhea. Stool samples were evaluated by the native-Lugol method and the modified acid-fast staining method. Results: Intestinal parasite positivity was found in 105 (35%) out of the 300 children in the patient group and in 17 (17%) out of the 100 children in the control group. In terms of parasitic positivity, a statistically significant difference was found between children with diarrhea and the healthy control group (p=0.001). Blastocystis hominis (13%), Cryptosporidium spp. (3%), and Giardia intestinalis (2%) were found in the patient group. Intestinal parasitic positivity was found in 30.2% and 40.4% of the boys and girls in the patient group, respectively, whereas it was found in 14% and 20% of the boys and girls in the control group, respectively. When evaluated statistically according to gender, a significant difference (comparison for boys: p=0.008; comparison for girls: p=0.004) was noted between the patient group and control group for each gender. In terms of the relationship between the frequency of parasites and some living conditions of the patients, a statistically significant relationship was found in the comparison of "whether or not livestock" (p=0.004) and "whether there is a sewerage network" (p=0.002). Additionally, a significant difference was found between parasitic positivity and abdominal pain (p=0.008) and nausea (p=0.003). Conclusion: The present study concludes that children with clinical symptoms, such as diarrhea, abdominal pain, and nausea, should be evaluated for intestinal parasites. Furthermore, it has been understood that intestinal parasites remain an important health problem among the pediatric cohort.

Frequency of Intestinal Parasites in Substance Abusers

Objective: This study was conducted to investigate the frequency of intestinal parasites in substance abusers and to reveal its significance. Methods: The study was conducted in Van Yüzüncü Yil University Medical Faculty Parasitology Research Laboratory and University of Health Sciences Turkey Van Training and Research Hospital between May 2019 and February 2020. The patient group included 150 patients with substance abuse who applied to the Alcohol and Drug Addicted Treatment Center of University of Health Sciences Turkey Van Training and Research Hospital, while the control group included 75 patients who had no chronic illness and did not use cigarettes, alcohol, or drugs. Stool samples were examined using native-Lugol and modified acid-fast staining methods. Results: In this study, one or more intestinal parasites were found in 21.3% of 150 patients who applied to the internal medicine outpatient clinic and had no chronic illness and did not use cigarettes, alcohol, or drugs. There was a statistically significant difference between the two groups in terms of the parasite frequency (p=0.03). In the patient group, Giardia intestinalis was detected in 7.3% (p=0.02), Blastocystis hominis in 6.7%, and Hymenolepis nana in 0.7%. Considering the frequency of parasites in terms of age groups, intestinal parasites were found at a higher rate in the 35 and younger age group (23.8%) than in the 36 and older age group (17.2%). Intestinal parasite positivity was found at the highest rate (23.8%) in those using methamphetamine. Constipation (79.3%) was the most prevalent in parasite-positive substance abusers, followed by diarrhea (23%). Conclusion: This study contributed to the literature by determining the frequency of intestinal parasites in people addicted to substance, and it was revealed that intestinal parasite infections are a negative consequence of substance addiction. Conclusively, our findings revealed that intestinal parasites should be considered in substance abusers. Also, more detailed studies involving more individuals should be conducted to obtain information about intestinal parasite infections.

Phenoloxidase is involved in the immune reaction of Helix lucorum to parasitic infestation by dicrocoeliid trematode.

INTRODUCTION: Phenoloxidases are known to play a role in the immune defences of arthropods and molluscs. In the invertebrates, phenoloxidases mediate three major physiologically important processes: sclerotization, wound healing, and defence reactions. Helix lucorum serve as the first intermediate host for the larval stages of dicrocoeliid trematodes which infects animals as well as human beings. OBJECTIVE: The aim of the study is to investigate the effect of larval forms of dicrocoeliid trematodes to phenoloxidase acitivity in H. lucorum, Linneaus, 1758, in Bitlis, Turkey. The effect of the snail's shell colour to phenoloxidase activity was also investigated. MATERIAL AND METHODS: Land snails (n=200) were collected by hand from their natural habitats during the period May - June 2019 in Bitlis, Turkey. Evaluation of the process was performed by measuring immune reaction of the snails against larval forms of dicrocoeliid trematodes. Phenoloxidase activity assay was carried out using a spectrophotometer device based on 3,4-Dihydroxy-L-phenylalanine (L-dopa) hydrolysis. RESULTS: The natural infection rate of the land snails with the developmental stages of dicrocoeliid trematodes was 20%. Phenoloxidase activity was found to be significantly higher (*p<0.05) in larval forms of dicrocoeliid trematodes infected snails when compared with non-infected snails. No effect of shell colours to phenoloxidase activity was observed. CONCLUSIONS: To the best of the authors' knowledge, this study is the first to report that the phenoloxidase system is involved in the immune reaction of Helix lucorum to parasitic infestation by larval forms of dicrocoeliid trematodes.

Evaluation of seroprevalence and clinical and laboratory findings of patients admitted to health institutions in Gümüshane with suspicion of Crimean-Congo hemorrhagic fever

Background/aim: To determine the seroprevalence and evaluate clinical findings and laboratory results of patients prediagnosed with Crimean-Congo hemorrhagic fever (CCHF) in Gümüshane. Materials and methods: Included in the cross-sectional study were 362 patients (162 female, 200 male) between 0 and 94 years of age, who were followed up after receiving a preliminary diagnosis of CCHF between January 2011 and December 2019. Anamnesis, age, sex, clinical findings, laboratory results, epidemiological and clinical evaluations, severity criteria, risk factor reviews, and a comparison of the suspected negative cases with positive cases were analyzed retrospectively. Patients included in the study were evaluated as RNA- positive by polymerase chain reaction (PCR) or IgM-positive by ELISA. Results: Of the 362 patients admitted to health institutions with a preliminary diagnosis of CCHF, 242 were diagnosed as CCHF- positive (66.9%). Moreover, 196 of those CCHF-positive patients (81%) were admitted to health institutions during the summer months. Statistical analyses revealed a significant relationship between the incidence of CCHF and patients who had been in contact with animals, lived in rural areas, and had engaged in farming and animal husbandry. In addition, fever, headache, diffuse bodily pain, nausea and vomiting, diarrhea, fever of 38 °C or higher, tachycardia, elevated ALT/AST, creatine kinase (CK), and lactate dehydrogenase (LDH) levels, leukopenia, and thrombocytopenia were detected in the CCHF-positive patients. Significant relations were found between this disease and these symptoms. However, there was no significant relationship between the statistical evaluation of the disease and bloody diarrhea, bodily bruises, rash, unconsciousness, gingival bleeding, hypotension, epistaxis, petechiae, splenomegaly, ecchymosis, hematuria, maculopapular rash, gastrointestinal system complaints, anemia, or elevation of the international normalized ratio and activated partial thromboplastin time duration, separately. Conclusion: Of the 362 patients, 66.9% (242) of those who received a preliminary diagnosis of CCHF were indeed CCHF-positive in Gümüshane. It was concluded that CCHF remains an important endemic disease in Gümüshane. In addition, elevated ALT/AST, CK, and LDH levels, leukopenia, and thrombocytopenia in patients presenting with headache, fever, fever of 38 °C or higher, generalized body pain, nausea/vomiting, diarrhea, and tachycardia will play a pivotal role in the preliminary diagnosis of CCHF.

Genetic Diversity of Echinococcus granulosus Isolated from Humans: A Comparative Study in Two Cystic Echinococcosis Endemic Areas, Turkey and Iran.

Cystic echinococcosis (CE) is one of the most important zoonotic parasitic diseases caused by the larval stage of Echinococcus granulosus. Based on molecular studies and DNA sequencing, E. granulosus has been classified into 10 different genotypes (G1 to G10). Two neighboring countries, Turkey and Iran, are considered the two main foci of CE in the Middle East. The current study is aimed at examining the genotype diversity of E. granulosus isolated from human clinical samples in Turkey and Iran. Surgically removed human hydatid cysts were collected from East Azerbaijan and Fars provinces in Iran and Van province in Turkey. After extracting DNA, performing PCR, targeting the cox1 gene, the PCR products were purified from the gel and were sequenced from both directions. The sequences were aligned and compared, using BioEdit and also the BLAST program of GenBank. The maximum likelihood tree was constructed based on the Tamura-Nei model, using the MEGAX software. Phylogenetic analysis showed that the human isolated samples were classified into two major clades: G1 (from Iran and Turkey) and G3 (5 samples from northwestern Iran and one sample from Turkey). The mean and degree of genetic divergence (K2P) between the two major clades, G1 and G3, were 0.2% and 0.7 ± 0.4%, respectively. The findings of the current study revealed that the sheep strain (G1) and the less important strain G3 have major roles in the transmission cycle of CE in two neighboring countries, Iran and Turkey. Therefore, it is necessary to interpose the life cycle of this parasite and reduce the disease burden in livestock and humans by adopting common regional preventive and control policies.

An Oral Myiasis Case Caused by Diptera (Calliphoridae) Larvae in Turkey

The objective of the present study is to present a patient with oral myiasis caused by Calliphoridae larvae. The patient was a 63-year-old male who was transferred from Van Closed Prison to Yüzüncü Yil University, Faculty of Medicine Research and Application Hospital. Five alive larvae localized in different points of gingival region were observed during routine oral cleaning. These larvae belonged to Calliphoridae family. As a result, medical staff should be informed about this infestation and this parasite should be kept in mind especially in risky group of patients and necessary controls should be conducted.