Headache as a Significant Central Nervous System Manifestation of COVID-19 Infection

Dear Editor,In recent years, the world has witnessed the emergence of dangerous respiratory diseases with coronaviruses, including the severe acute respiratory syndrome (SARS) by the SARS-CoV, Middle East respiratory syndrome (MERS) by the MERS-CoV, and coronavirus disease 2019 (COVID-19) by the SARS-CoV-2. The disease now affects most countries in the world. Coronavirus is generally known to cause respiratory disease, but clinical and experimental studies show that this disorder affects several organs including the central nervous system (CNS).1-3The CNS effects of COVID-19 are not well-known owing to being an emerging phenomenon, however, it is worth understanding. The virus enters the cells of the human body using the cellular receptor angiotensin-converting enzyme 2 (ACE2). In a normal condition, this receptor is expressed in very small amounts in the CNS. The virus can be transmitted to the CNS through systemic circulation or across the cribriform plate of the ethmoid bone in the early and secondary stages of COVID-19 infection. Broad spectrum of neurological manifestations such as ageusia, anosmia, headache, sensory disturbances and epilepsy have been observed in some patients. Anosmia and ageusia are common, and can occur in the absence of other clinical features. Unexpectedly, acute cerebrovascular disease due to hyper coagulation state is also emerging as an important complication. Altered level of consciousness and encephalitis are other presentations in patients with COVID-19.4,5 Almost all the articles reviewed focused on macro-and microscopic changes in the lungs, and only a handful of information from other organs and systemic findings were presented. Comprehensive study after autopsy in the brain is very important and more research needs to be done.6-9 A better understanding of the function of coronavirus in the CNS and accurate identification of the damage can help in treatment planning and prognosis of the disease.10,11 In addition, hypoxia may occur in the CNS (hypoxic ischemic encephalopathy) due to respiratory failure. Thrombotic microangiopathy can also occur.12 Hence, it is of paramount importance that in the early and uncomplicated stages of coronavirus infection, the patient’s CNS be examined. There is still insufficient information to provide a complete picture of the pathophysiology of SARS-CoV-2 infection. Careful clinical, diagnostic, and epidemiological studies are needed to help define the manifestations and burden of neurological disease caused by SARS-CoV-2. Precise case definitions must be used to distinguish non-specific complications of severe disease (e.g. hypoxic encephalopathy and critical care neuropathy).4 In light of the above mentioned, further studies on patients with progressive or worsening CNS findings should be performed more carefully to make the undiscovered effects of this virus on the CNS clearer to the world.So far, we have mentioned CNS involvement in general and now we aim to give a brief summary of studies on headache attributed to COVID-19 infection. The reports on the neurological presentations are rising significantly and headache has the lead on the symptom list.Headache associated with systemic infections is usually nonspecific and actually there are no particular distinguishing or characteristic features. It was reported that headache was a frequent symptom in COVID-19 infection and there was an extreme diversity in its characteristics

Species Identification and Molecular Typing of Leishmania Spp. Using Targeting HSP70 Gene in Suspected Patients of Cutaneous Leishmaniasis from Sistan and Baluchestan Province, Southeast Iran

Background: Leishmaniasis is a sand fly-borne disease caused by the protozoan parasites belonging to the genus Leishmania. Because of the preventing and controlling methods, clinical course, prognosis and choice of treatment are differing from species; differentiation of species is critical. The present study was aimed to detect the parasite species using the PCR-RFLP method. Methods: A total of 130 Giemsa-Stained slides from suspected Cutaneous leishmaniasis (CL) patients were examined under a light microscope at×1000. DNA from each slide was extracted PCR method was undertaken with HSP70 genes and the PCR products were digested with a restriction enzyme HaeIII (BsuR1). The study was conducted in the laboratory of Zahedan University of Medical Sciences in the Sistan and Baluchestan Province, southeastern Iran in 2015. Results: From 130 suspected samples, 59 (45.3%) were positive by the microscopic examination, meanwhile 64 (49.2%) were positive by PCR-RFLP, Leishmania species were recognized, and L. tropica was introduced as predominant species in current study. Conclusion: PCR-RFLP is a valuable technique for distinguish of Leishmania species. Furthermore, anthroponotic CL is the dominant cause of CL in Sistan and Baluchestan Province

Risk mapping of malaria in Iran from 2009 to 2018: A GIS-Based survey

Background: Since the issues of public health and the spread of diseases are directly related to the region's geography. We aim to determine malaria incidence, spatial distribution, and hot spots in Iran using the GIS for a decade from 2009 to 2018. Methods: GIS was used to analyze the information acquired from the Ministry of Health and Medical Education in Tehran, Iran, and other associated centers between 2009 and 2018. Subsequently, maps of the disease's spatial distribution were constructed and using ArcGIS 10.5 software, the disease's hotspots in Iran were determined. The disease's variables, such as temperature, relative humidity, normalized difference vegetation index (NDVI), and malaria incidence, were correlated using geographically weighted regression (GWR) analysis in ArcGIS 10.5.  Using descriptive statistics and the chi-square test, data were analyzed using Linear Regression Analysis and SPSS 21 software using descriptive statistics. Sistan and Baluchistan, and the Bushehr provinces were hot spots for Malaria. The geographically weighted regression analysis results showed that in Sistan and Baluchistan and Bushehr, Hormozgan, Fars, Qom, Yazd, Kohgiluyeh and Boyer-Ahmad provinces, the highest correlation between temperature, humidity, vegetation density, and the incidence of Malaria was observed (p-value = 0.019).&nbsp

Spatial modeling of visceral leishmaniasis in Iran from 2010 to 2018

Kala-Azar is the most lethal type of leishmaniasis, sporadic in most parts of Iran and prevalent in some provinces. Using the Geographical Information System (GIS) and satellite data analysis, we intended to assess the disease's incidence in Iran. Methods: Using GIS, data received from the Ministry of Health and Medical Education in Tehran, Iran, and other associated institutions between 2010 and 2018 were evaluated. The disease's geographical distribution maps were then constructed, and the disease's hotspots in Iran were identified using spatial analysis using ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to link disease-influencing variables such as temperature, relative humidity, normalized difference vegetation index (NDVI), and incidence of visceral leishmaniasis. Linear regression analysis, SPSS 21 software descriptive statistics, and chi-square test were used to analyze the data. Results: This study revealed that the provinces of Ardabil, East Azarbaijan, North Khorasan, and Fars were the hot spots of VL. The provinces of Ardabil, East Azarbaijan, North Khorasan, Fars, Bushehr, Semnan, Sistan, Baluchistan, Esfahan, Chaharmahal Bakhtiari, Qom, Golestan, and Kerman had the highest correlation between temperature, vegetation density, and the incidence of Kala Azar, as determined by geographical weighted regression analysis.&nbsp

Seroprevalence of Human Fasciolosis in Pirabad, Lorestan Province, Western Iran

Background: The purpose of this study was to perform seroepidemiological investigation for determining the status of human fasciolosis in Pirabad Village, Lorestan Province, western Iran. Methods: Blood samples were taken from residents of the village including 801 individuals. Sera were separated and stored at -20°C until used. The samples were analyzed using ELISA. Results: Anti-Fasciola antibodies were detected in 6 (0.7%) individuals. Difference between age, sex and drinking or swimming in the surface water with seropositivity to fasciolosis was not significant. Out of 7 shepherds, 1 (14.3%) was seropositive. Due to the small number of shepherds, comprehensive statistical inference in this regard cannot be done. Significant difference was detected between seropositivity to fasciolosis and consuming local freshwater vegetables during the last 6 months (P=0.001). Conclusion: Metacercariae carrying local freshwater plants might be the main source of contamination because consumption of these kinds of vegetables was confirmed by all participants. Awareness of local communities regarding the danger of freshwater plant consumption, through health education programs, will decrease the risk of infection

Tracking the existence of Dioctophyma renale in Parthian Empire of Iran (247 BC-224 AD)

Paleoparasitological investigation in the archeological site of the Caspian Sea littoral revealed the presence of human Dioctophyma renale infection, a ubiquitous kidney-residing helminth of mammals, during the Parthian Empire of Iran (247 BC-224 AD). This study reports the oldest human infection with giant kidney worm in the Middle East, mainly in an area where the infection is reported nowadays. The paucity of records throughout the literature suggests that the same species of parasite occurred with low frequency in the past, as well. The cemetery in the archeological site of Kiasar represented a unique opportunity of studying human and animal parasites of the Parthian Empire in Iran

Retrieving ascarid and taeniid eggs from the biological remains of a Neolithic dog from the late 9th millennium BC in Western Iran

<div><p> BACKGROUND Paleoparasitology reveals the status of parasitic infections in humans and animals in ancient times based on parasitic particles found in biological remains from archaeological excavations. This line of research emerged in Iran in 2013. OBJECTIVE The identification of parasites from Neolithic times is an attractive subject that shows the oldest origins of parasitic infections in a given geographical region. From an archaeological point of view, this archaeological site is well-known for animal domestication and agriculture in ancient Iran. METHODS In this study, soil deposited on the surface and in the pores of a dog pelvic bone was carefully collected and rehydrated using trisodium phosphate solution. FINDINGS The results showed ascarid and taeniid eggs retrieved from the biological remains of a dog excavated at the East Chia Sabz archaeological site, which dates back to the Neolithic period (8100 BC). MAIN CONCLUSION The current findings clearly illustrate the natural circulation of nematode and cestode parasites among dogs at that time. These ancient helminth eggs can also be used to track the oldest parasitic infections in the Iranian plateau and contribute to the paleoparasitological documentation of the Fertile Crescent.</p></div