Tumoral calcinosis of the foot: An unusual differential diagnosis of calcaneal mass

Introduction Tumoral calcinosis (TC) is a rare disorder characterized by the development of calcified masses within the periarticular soft tissues of large joints. It commonly involves the hip, shoulders, and elbows. TC rarely involves the feet. Case presentation In this report, we describe an unusual case of primary TC of the foot in a 76-year-old female and discuss the pathophysiology, diagnosis, and therapeutic interventions of the condition. Discussion Due to the wide range of conditions mimicking TC, its diagnosis could be challenging. Diagnosis of TC is mainly based on the radiographic findings, the patient's biochemical profile, and the medical history plus differentiating the condition from its mimics. Conclusion TC should be considered in the differential diagnosis of any soft tissue calcification. ©2015 Published by Elsevier Ltd. on behalf of Surgical Associates Ltd

Effect of COVID-19 medications on corrected QT interval and induction of torsade de pointes: Results of a multicenter national survey

Background: There are some data showing that repurposed drugs used for the Coronavirus disease-19 (COVID-19) have potential to increase the risk of QTc prolongation and torsade de pointes (TdP), and these arrhythmic side effects have not been adequately addressed in COVID-19 patients treated with these repurposed medications. Methods: This is the prospective study of 2403 patients hospitalised at 13 hospitals within the COVID-19 epicentres of the Iran. These patients were treated with chloroquine, hydroxychloroquine, lopinavir/ritonavir, atazanavir/ritonavir, oseltamivir, favipiravir and remdesivir alone or in combination with azithromycin. The primary outcome of the study was incidence of critical QTc prolongation, and secondary outcomes were incidences of TdP and death. Results: Of the 2403 patients, 2365 met inclusion criteria. The primary outcome of QTc � 500 ms and �QTc � 60 ms was observed in 11.2 and 17.6 of the patients, respectively. The secondary outcomes of TdP and death were reported in 0.38 and 9.8 of the patients, respectively. The risk of critical QT prolongation increased in the presence of female gender, history of heart failure, treatment with hydroxychloroquine, azithromycin combination therapy, simultaneous furosemide or beta-blocker therapy and acute renal or hepatic dysfunction. However, the risk of TdP was predicted by treatment with lopinavir-ritonavir, simultaneous amiodarone or furosemide administration and hypokalaemia during treatment. Conclusion: This cohort showed significant QTc prolongation with all COVID-19 medications studied, however, life-threatening arrhythmia of TdP occurred rarely. Among the repurposed drugs studied, hydroxychloroquine or lopinavir-ritonavir alone or in combination with azithromycin clearly demonstrated to increase the risk of critical QT prolongation and/or TdP. © 2021 John Wiley & Sons Ltd

A Comparison between the Molecular Identity of Mycoplasma Hominis in ‎Urine Samples of Patients with Urinary Tract Infections and Similar Strains ‎Available in GenBank

BACKGROUND AND OBJECTIVE: Mycoplasmal infections are one of the most important urinary infections. Various studies have applied culture studies and biochemistry to separate the bacteria from the urinary tract. However, it should be noted that molecular and phylogenetic analyses are based on epidemiologic evaluations. The purpose of this study was to determine the molecular identity of Mycoplasma hominis, separated from the urine samples of patients with urinary tract infections in Kerman, Iran and compare the sequences with other strains in GenBank. METHODS: In this cross-sectional study, 5 ml mid-stream urine samples of 50 patients with urinary tract infections were collected. After the specialists confirmed the diagnosis of urinary tract infections in patients via paraclinical tests, segments of 16S rRNA gene were amplified, using specific primers of Mycoplasma hominis via polymerase chain reaction (PCR) technique. After purifying the PCR product, the sequences of bacterial strains were determined. Then, the sequences were aligned and the strains were compared with each other and other strains available in GenBank, using BioEdit software. FINDINGS: Three Mycoplasma hominis strains were separated in this study. The alignment of sequences and comparison with strains available in GenBank did not indicate a significant difference between the strains. Based on phylogenetic analyses in this study and the phylogenetic tree, one of the strains (H6) was highly similar to the strains of GenBank and belonged to the same family. On the other hand, two strains (H11 and H15) were of a different lineage and were completely different from other strains in the present study and those recorded in GenBank. CONCLUSION: In this study, after applying the PCR technique and bacterial separation, the sequences were compared with those in GenBank. All three strains were Mycoplasma hominis, based on 16S rRNA gene sequence

Molecular Identification of Quorum Sensing Genes in Clinical Strains of Pseudomonas aeruginosa and Antibiotic Resistance Profile

BACKGROUND AND OBJECTIVE: The expression of most genes that produce Pseudomonas aeruginosa virulence factors is controlled and regulated by a gene system called quorum sensing (QS) system. Quorum sensing is a cell to cell communication system through small signaling molecules in single-celled organisms. This study aims to investigate the frequency of Pseudomonas aeruginosa lasB, rhlR, rhlI, lasR, lasI, apr and rhlAB genes isolated from clinical samples using multiplex-PCR method and determining the antibiotic resistance profile. METHODS: In this cross-sectional study, 60 clinical isolates of Pseudomonas aeruginosa were collected from patients admitted to Imam Khomeini hospital in Tehran. The antibiotic susceptibility of these isolates against ceftazidime, cefotaxime, amoxicillin, ciprofloxacin, amikacin, gentamicin, imipenem, cefepime, ticarcillin and piperacillin was determined using disk diffusion method. After culturing and final confirmation using biochemical and specific tests, multiplex polymerase chain reaction (Multiplex PCR) was performed to track the intended genes. FINDINGS: In this study, highest susceptibility was observed to be against ciprofloxacin (81.66%) and ceftazidime (65%). Multiplex PCR demonstrated that the frequency of rhlR, lasR and lasI genes was 5%, 48.3% and 60%, respectively, while rhlI, lasB, apr and rhlAB genes could not be identified in any of the strains. CONCLUSION: Resistance to antibiotics is increasing in Pseudomonas aeruginosa, which requires continuous monitoring. QS System plays a key role in pathogenicity of Pseudomonas aeruginosa. Identification of these genes enables us to track and identify this bacterium quickly

Molecular characterization of quinolone resistance genes (qnr) in Salmonella ‎typhimurium isolated from food samples

Salmonellosis is an important disease in animals and human which is caused by different serovars of Salmonella ‎enterica. Serovars Typhimurium is one of the most prevalent sorvars in humans. Quinolones and floroquinolones ‎are the family of extended-spectrum antibiotics which are used in salmonellosis treatment. Qnr genes are the ‎plasmid-mediated quinolones resistance which leads to resistance in Enterobacteiacea. The aim of this study is ‎identification of quinolone resistance genes qnr in Salmonella Typhimurium isolated from food samples. In this ‎study, 60 Salmonella samples isolated from food was collected and confirmed by culture and biochemical tests. ‎Serotyping was done by O and H antisera. Multiplex-PCR‏ ‏‎ was performed to identify qnrA, qnrB and qnrS genes. ‎All of the 60 isolates were confirmed as Salmonella by culture and biochemical tests. The results of serotyping ‎showed all the 60 isolates were belonged to serogroup B and serovar Typhimurium. Multiplex-PCR test showed 5 ‎samples had the qnrB, 4 had the qnrS and 1 harboured qnrA gene. The results of this study shows the presence of ‎qnr genes in Salmonella Typhimurium isolated from food samples which has a specific public health importance. ‎Therefore, there should be sureveillance and montoring programs to prevent this quinolone resistance.

Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation

The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation

Keratoconus progression associated with hormone replacement therapy

Purpose: To report a postmenopausal patient with keratoconus who experienced significant progression after using hormone replacement therapy. Observations: A 51-year-old woman with previously stable keratoconus presented with acute disease progression following hormone replacement therapy in the context of prophylactic hysterectomy and bilateral ovariosalpingectomy. Over a 14-month period after starting hormone therapy, the steepest K increased from 63.7D to 71.5D in the right eye and from 65.8D to 78.1D in the left eye. Conclusions: Hormone replacement therapy may amplify progression of keratoconus

Sequences of mycoplasma hominis in patients with urinary tract infection in a hospital in Kashan, Iran

Mycoplasma hominis is normally found in the urinary tract of human and its role in Urinary Tract Infection (UTI) has been proved. This bacterium causes inflammatory responses and accumulation of leucocytes in urethra. In spite of the presence of the bacteria, the urine culture might be negative. Mycoplasma hominis can be transferred sexually and causes human infertility. The present study was conducted to detect and identify Mycoplasma hominis by molecular methods in urine samples of the patients with UTI, who were referred to our hospital. A total number of 864 urine samples from the patients with UTI were subjected to this study. After routine culture, urine analysis were performed on the samples. The DNA was extracted from the sediments of the urine samples, using phenol and chloroform method. Polymerase Chain Reaction (PCR) was conducted on the extracted DNA to detect the 16S rRNA of Mycoplasma hominis, with the primers; RNAH1 and RNAH2. Based on the results of PCR tests, out of 100 pyuria positive samples, 9 and 1 were infected with Mycoplasma sp. and Mycoplasma hominis, respectively. The sequencing of amplified product of 16S-rRNA revealed a single nucleotide substitution (269 T A), compared with the reference gene of this species. © 2015 Academic Journals Inc

Distinct sources 1 for high-K and adakitic magmatism in SE Iran

Research into Arabia-Eurasia collision zone magmatism in Kerman Province, SE Iran, has largely focused on Late Cenozoic adakitic stocks or domes, with debate around lower crustal or subducted slab origins. Contemporary hawaiite-trachyandesite lava flows have been overlooked. New analyses for domes and lavas from near Dehaj show major and trace element distributions relating to two distinct compositional series. One contains medium-K domes with SiO2 > 60 wt.%, high Sr/Y and La/Yb and generally low MgO, Ni and Cr, showing high-silica adakite affinity. The other series has high-K affinity and includes both lavas and dome samples. The two suites partially mixed in the shallow crust, confirmed by fieldwork and petrography. Isotopically the two suites are indistinguishable, implying a geologically ‘young’ age for the source of the adakites. Given its geochemical signatures and non-relationship with the largely mafic, mantle-derived high-K series, we consider the adakite series to be derived from melting of eclogitized mafic lower crust. The high-K series relates to dehydration melting of mantle peridotite deeper within the ∼220 km thick lithosphere. We also explore adakitic magmas across Iran and their relationship to porphyry copper deposits. At Dehaj and several other Iranian centres, adakites are chemically controlled by garnet as a source or fractionating phase, and are barren, whereas the presence of amphibole as a key phase seems to correlate with Cu mineralisation. This study also shows the need for evidence from multiple datasets to constrain adakite genesis and warns of avoiding sampling bias towards felsic lithologies