A novel multi-peptide subunit vaccine admixed with AddaVax adjuvant produces significant immunogenicity and protection against Proteus mirabilis urinary tract infection in mice model

Abstract Proteus mirabilis is a common pathogen in urinary tract infections (UTIs). There is no vaccine against P. mirabilis, thus a novel multi-peptide vaccine of MrpA, UcaA and Pta factors of P. mirabilis we designed and a mice model was used to evaluate its efficacy in combination with AddaVax adjuvant. According to the bioinformatics studies, 7 fragments of MrpA (31–75, 112–146), UcaA (68–117, 132–156) and Pta (210–265, 340–400, 496–570) with B and T cell epitope regions were selected for fusion construction. Mice subcutaneously vaccinated with the fusion MrpA.Pta.UcaA induced a significant increase in serum and mucosal IgG and IgA responses. The fusion also showed a significant induction in cellular responses (Th1 and Th2). The addition of AddaVax to fusion and the mixture of MrpA, UcaA, and Pta (MUP) improved the humoral and cellular responses, especially the IgG2a and IFN-γ (Th1 responses) levels. Fusion with and without AddaVax and MUP + AddaVax could maintain significant humoral responses until 6 months after the first vaccine dose. All vaccine combinations with and without adjuvant showed high effectiveness in the protection of the bladder and kidney against experimental UTI; this could be attributed to the significant humoral and cellular responses. The present study suggests that the AddaVax-based vaccine formulations especially the fusion Pta.MrpA.UcaA admixed with AddaVax as potential vaccine candidates for protection against P. mirabilis. Furthermore, AddaVax could be considered as an effective adjuvant in designing other vaccines against UTI pathogens. Keywords UTI Proteus mirabilis AddaVax Multi-peptide vaccine Immune responses

Successful Pregnancy and Delivery after Uterine Rupture in Previous Pregnancy: A Case Report

BACKGROUND AND OBJECTIVE: Uterine rupture in all layers is not only a serious complication of pregnancy but is also associated with maternal and fetal mortality. The usual treatment for uterine rupture is termination of pregnancy, and hysterectomy is necessary in most cases. Successful repair of uterine rupture in all layers is not only uncommon but successful subsequent pregnancy is quite rare. A successful pregnancy is reported in a woman with a history of complete uterine rupture due to intramural pregnancy. CASE REPORT: A 28 – year – old pregnant woman, gravida 4, with a history of two abortions, and one delivery (stillbirth) was admitted to the high-risk pregnancy unit of Ayatollah Rouhani Hospital (Babol, Iran). She had a history of rupture of all layers of the uterus following intramural pregnancy in her third pregnancy, and at that time, she had undergone laparotomy and repair of the uterus. In the fourth pregnancy, due to the history of uterine rupture, she was under prenatal care in high-risk pregnancy unit, and after the onset of contractions at 36 weeks and 2 days, emergency cesarean section was performed for the patient, and the neonate was born with 10/10 APGAR score and a weight of 3000 grams. CONCLUSION: In women who become pregnant after a history of rupture of all layers of the uterus and after the repair of uterine, prenatal and fetal care should be done carefully and cesarean section should be performed immediately after the onset of labor contractions

The Predictive Role of Preoperative Leukocytosis, Anemia and Thrombocytosis with the Severity of Epithelial Ovarian Tumors

BACKGROUND AND OBJECTIVE: Ovarian cancer is the sixth common cancer among women in the world. Preoperative blood cell count can be a biomarker that predicts the severity of different types of cancer and determine the type of surgery. Therefore, the present study was conducted to determine the predictive role of the three blood markers of anemia, leukocytosis and thrombocytosis in the stage and grade of epithelial ovarian cancer before the operation. METHODS: In this cross-sectional study, the data of 60 patients with epithelial ovarian cancer were evaluated. Demographic data, hemoglobin, white blood cell count and platelets were statistically compared based on the stage of disease and the grade of mass differentiation as good, moderate and undifferentiated. FINDINGS: 61.1% of patients with thrombocytosis were in stage 3 and 33.3% of patients with leukocytosis were in stage 2 (p≤0.05), while 20.5% of the patients with anemia were in stage 3 (p>0.05). Moreover, 52.4% of patients with leukocytosis and 61.1% of patients with thrombocytosis had grade 3 tumor (p≤0.05), but only 34.1% of patients with anemia were in this group (p>0.05). Based on the evaluation of the ROC curve, cut-off point of the white blood cell was calculated to be 9050/ml with a sensitivity of 64% and specificity of 65% and platelet count was calculated to be 266000/ml with a sensitivity of 88% and specificity of 53%. CONCLUSION: Based on the results of this study, preoperative leukocytosis and thrombocytosis were correlated with stage and grade of epithelial ovarian cancer and had a predictive role

The Risk Factors for Ectopic Pregnancy

BACKGROUND AND OBJECTIVE: Ectopic pregnancy is a common complication and one of the causes of pregnancy-related deaths. Considering the increased prevalence of ectopic pregnancy in recent years and the increased risk factors such as assisted reproductive treatment, the present study was conducted to investigate the risk factors for ectopic pregnancy in Babol, northern Iran. METHODS: This case-control study was performed on pregnant women who were admitted with suspicion for ectopic pregnancy or acute abdomen within a 6-year period. Patients diagnosed with ectopic pregnancy were selected in the case group and the control group was selected from among the pregnant women's medical record during the same years. Patients were examined in terms of age, parity, history of abortion, type of contraception, history of ectopic pregnancy, history of pelvic infections, history of cesarean section, infertility treatment, history of smoking, marriages within the family, medical history and underlying disease. FINDINGS: In this study, 201 patients were examined in each group. The mean age for the case group was 29.75±5.6 and for the control group was 28.62±6.4 years. Among the risk factors, assisted reproductive treatment (OR=10.24, p≤0.001), abdominal and pelvic surgery (OR=2.35, p=0.002), infertility (p=6.76, p<0.001), contraceptive pills (OR=0.61, p<0.001) and nulliparity (OR = 1.61, p=0.019) were associated with increased risk of ectopic pregnancy. CONCLUSION: According to the results of this study, the most important risk factors for ectopic pregnancy are the use of hormonal pills to prevent pregnancy and nulliparity, respectively

Inflammatory myofibroblastic tumor of head of pancreas in a 5 Year-Old child

Inflammatory myofibroblastic tumor (IMT) is assumed as a rare benign tumor that can appear in various organs. Since Umiker et al. introduced inflammatory pseudotumors for the first time in 1954, it was found that occurrence in the head of pancreas is very rare (Baião et al., 2019) 1. Differentiating non-neoplastic lesions of pancreas from adenocarcinoma remains a challenge despite advances in diagnostic modalities whereas cystic and solid lesions and some normal anatomic variants can mimic malignancy (Okun and Lewin, 2016 Jan 1) 2. Histologic patterns of IMT can be identified as fibroblastic and myofibroblastic proliferation with inflammatory infiltrate. They are more common in Women and peak of occurrence is between 2 and 16 years of age (Mirshemirani et al., 2011) 3. In head of pancreas the disease can present with obstructive jaundice and the key for diagnosis is having a tissue specimen by means of needle biopsy. Though in all reported cases surgery is suggested as the lone treatment option, its natural history is obscure still and there can be a challenge in its treatment and also the extent of surgery. Here a new case of IMT of head of pancreas is reported. © 202

A possible pathogenic role of Syndecan-1 in the pathogenesis of coronavirus disease 2019 (COVID-19)

A cell-surface heparan proteoglycan called Syndecan-1 (SDC-1) has multiple roles in healthy and pathogenic conditions, including respiratory viral infection. In this study, we explore the dynamic alternation in the levels of SDC-1 in cases with COVID-19. A total of 120 cases definitely diagnosed with COVID-19 were admitted to the Firoozgar Hospital, Tehran, Iran, from December 1, 2020, to January 29, 2021, and included in our study. Also, 58 healthy subjects (HS) were chosen as the control group. Patients were classified into two groups: 1) ICU patients and (63 cases) 2) non-ICU patients (57 cases). The dynamic changes of serum SCD-1, CRP, IL-6, IL-10, IL-18, and Vit D levels a well as the disease activity were investigated in three-time points (T1-T3). Our results indicated that the COVID-19 patients had significantly increased SCD-1, CRP, IL-6, IL-10, and IL-18 levels than in HS, while the Vit D levels in COVID-19 patients were significantly lower than HS. Further analysis demonstrated that the SCD-1, CRP, IL-6, IL-10, and IL-18 levels in ICU patients were significantly higher than in non-ICU patients. Tracking dynamic changes in the above markers indicated that on the day of admission, the SCD-1, CRP, IL-6, IL-10, and IL-18 levels were gradually increased on day 5 (T2) and then gradually decreased on day 10 (T3). ROC curve analysis suggests that markers mentioned above, SDC-1, IL-6, and IL-18 are valuable indicators in evaluating the activity of COVID-19. All in all, it seems that the serum SDC-1 levels alone or combined with other markers might be a good candidate for disease activity monitoring. © 2021 Elsevier B.V

High frequency of SEN virus infection in thalassemic patients and healthy blood donors in Iran

<p>Abstract</p> <p>Background</p> <p>SEN virus is a blood-borne, circular ssDNA virus and possessing nine genotypes (A to I). Among nine genotypes, SENV-D and SENV-H genotypes have the strong link with patients with unknown (none-A to E) hepatitis infections. Infection with blood-borne viruses is the second important cause of death in thalassemic patients. The aim of this study was to determine the frequency of SENV-D and SENV-H genotypes viremia by performing nested-PCR in 120 and 100 sera from healthy blood donors and thalassemic patients in Guilan Province, North of Iran respectively. Also, to explicate a possible role of SEN virus in liver disease and established changes in blood factors, the serum aminotransferases (ALT and AST) and some of the blood factors were measured.</p> <p>Results</p> <p>Frequency of SENV-D, SENV (SENV-H or SENV-D) and co-infection (both SENV-D and SENV-H) viremia was significantly higher among thalassemic patients than healthy individuals. Frequency of SENV-H viremia was significantly higher than SENV-D among healthy individuals. In comparison to SENV-D negative patients, the mean of mean corpuscular hemoglobin was significantly higher in SENV-D positive and co-infection cases (<it>P </it>< 0.05). The means of AST and ALT were significantly higher in thalassemic patients than healthy blood donors, but there were not any significant differences in the means of the liver levels between SENV-positive and -negative individuals in healthy blood donors and thalassemic patients. High nucleotide homology observed among PCR amplicon's sequences in healthy blood donors and thalassemic patients.</p> <p>Conclusions</p> <p>The high rate of co-infection shows that different genotypes of SENV have no negative effects on each other. The high frequency of SENV infection among thalassemic patients suggests blood transfusion as main route of transmission. High frequency of SENV infection in healthy individuals indicates that other routes rather than blood transfusion also are important. Frequency of 90.8% of SENV infection among healthy blood donors as well as high nucleotide homology of sequenced amplicons between two groups can probably suggest that healthy blood donors infected by SENV act partly as a source of SENV transmission to the thalassemic patients. In conclusion, SENV-D isolate in Guilan Province may be having a pathogenic agent for thalassemic patients.</p

Bone mineral density in Iranian adolescents and young adults with β-thalassemia major

The authors investigated the prevalence of low bone mass in patients from Tehran, Iran, with β-thalassemia major (n = 203), aged 10-20 years, and the potential risk factors for osteoporosis in this patient population. Prevalence of osteoporosis was 50.7 in lumbar spine, 10.8 in femur, and 7.9 in both regions with no significant difference between the two genders. The following factors were associated with low BMD: height for age and weight for age below 3rd percentile, delayed puberty or hypogonadism, age when Desferal (for iron chelation) was started, duration of Desferal therapy, and serum zinc. Low serum copper and 25(OH)D were not associated with low BMD. Copyright © Informa Healthcare USA, Inc