Prevalence of Hepatitis D Virus Infection Among Hepatitis B Virus Infected Patients in Qom Province, Center of Iran

Background: Hepatitis D virus (HDV) is a defective RNA virus that depends on the hepatitis B surface antigen (HBsAg) of hepatitis B virus for its replication, developing exclusively in patients with acute or chronic hepatitis B. There are little data regarding the routes of HDV transmission in Iran. The risk factors for HDV infection in Iran are blood transfusion, surgery, family history, Hejamat wet cupping (traditional phlebotomy), tattooing, war injury, dental interventions, and endoscopy.Objectives: We performed this study to determine the prevalence of hepatitis D in the general population of Qom province and the potential risk factors for acquiring HDV.Patients and Methods: This cross-sectional study collected 3690 samples from 7 rural clusters and 116 urban clusters. HBs antigen was measured, and if the test was positive, anti-HDV was measured. Ten teams, each consisting of 2 trained members, were assigned to conduct the sampling and administer the questionnaires. The data were analyzed using SPSS.Results: Forty-eight subjects (1.3%) suffered from hepatitis B, and 1 HBsAg-positive case had HDV infection. The prevalence of hepatitis D infection in Qom Province was 0.03%. The prevalence of hepatitis D infection in HBsAg-positive cases was 2%. Our anti-HDV-positive case had a history of tattooing, surgery, and dental surgery. There was no significant relationship between tattooing, surgery history, or dental surgery and hepatitis D infection.Conclusions: The prevalence of hepatitis D in Qom is the the lowest in Iran, similar to a study in Babol (north of Iran)

Prevalence of Intestinal Parasitic Diseases in the Students of Qom City and Hygiene Status of Their Schools, Iran

Background and Objectives: Parasitic diseases are one of the major hygienic and economic problems in most of the developing countries and dealing with them is one of the most important parts of the national development programs in these countries. In the current study, the prevalence of intestinal parasitic infection, determination of its affecting factors in primary and secondary school students in Qom city, and providing necessary solutions to prevent it, were investigated. Methods: This cross-sectional study was performed on 2410 students (age, 7-14 years) in primary and secondary girls and boys schools in Qom City. Data gathering tool included School Health Assessment Questionnaire and a questionnaire containing demographic data of the students and their parents' education level and occupation. Data were analyzed using Fisher and chi-square tests. The level of significance was set at p<0.05. Results: Of 2140 students, 48.54% were female and the rest were male. The Overall prevalence of parasitic diseases in Qom city was estimated to be 11.99%, which was 12.86% in the primary school students and 10.71% in secondary school students, and was higher in boys compared to girls. The type of parasitic infection in 42.56% of caseswas Entamoeba coli, 37.37% Giardia, 6.23%, Entamoeba histolytica, 4.5% Enterobius vermicularis, and 2.08% Hymenolepis nana. The prevalence of the disease were reported higher in public schools, without health instructors, and extended families. Conclusion: Considering the pathogenic role of parasites in the human and their physical, psychological, social, and economic damages and the importance of fighting them, health education at school level in the use of toilets, lavatory, and drinking water is recommend to prevent the spread of these infections

Evaluation of the prevalence of Aeromonas spp., Campylobacter spp., and Clostridioides difficile in immunocompromised children with diarrhea

Abstract Aim Diarrhea is a common disease in immunocompromised patients and can be associated with greater morbidity and even mortality. Therefore, the present study was designed to determine the prevalence of Aeromonas spp., Campylobacter spp., and C. difficile among immunocompromised children. Methods This study was conducted on 130 stool samples from patients with diarrhea who had defects in the immune system and were referred to Hazrat Masoumeh Children’s Hospital in Qom. Demographic information, clinical symptoms, immune status, and duration of chemotherapy were also recorded for each child. DNAs were extracted from the stool, and then direct PCR assays were done by specific primers for the detection of Aeromonas spp., Campylobacter spp., and toxigenic C. difficile, including tcdA/B and cdtA/B genes. Co-infection in patients was also evaluated. Results 60.8% and 39.2% were male and female, respectively, with a m ± SD age of 56.72 ± 40.49 months. Most cases of immunocompromised states were related to Acute Lymphocytic Leukemia (77.7%) and Non-Hodgkin Lymphoma (14.6%). 93.1% of patients were undergoing chemotherapy during the study. Among patients, most clinical symptoms were related to bloody diarrhea (98.5%) and fever (92.3%). Based on PCR, 14.6, 9.2, and 1.5% were positive for Aeromonas spp., C. difficile, and C. jejuni, respectively. Among the C. difficile-positive cases, the tcdA gene was only detected in one patient. In total, three co-infections were identified, which included Aeromonas spp./C. difficile (tcdA +), C. jejuni/C. difficile, and C. jejuni/Aeromonas spp. Conclusions This is the first study in Iran to investigate the simultaneous prevalence of some pathogens in immunocompromised children with diarrhea. Because Aeromonas spp., Campylobacter spp., and C. difficile are not routinely detected in some laboratories, infections caused by them are underappreciated in the clinic. Our results showed that these pathogens are present in our region and can cause gastroenteritis in children, especially those with underlying diseases. Therefore, increasing the level of hygiene in some areas and controlling bacterial diarrheal diseases should be given more attention by health officials

Stool Antigen Tests for the Detection of Helicobacter Pylori in Children

Objective: Reliable non-invasive methods for detection of Helicobacter Pylori (H. pylori) infection are required to investigate the incidence, transmission, and clearance of infection in childhood. Detecting bacterial antigens in stool offer an alternative noninvasive diagnostic test. However its accuracy in developing countries is not well established. The aim of this study was to evaluate the performance of stool antigen test for H pylori in Iranian children with recurrent abdominal pain necessitating endoscopy. Methods: One hundred three children enrolled in this study. Endoscopy and biopsy was done on all patients providing a criterion standard for validation of the H. pylori stool antigen (HpSA) tests. The presence of H. pylori organisms in stool was determined by an enzyme-linked immunosorbent assay using a commercially available polyclonal antibody. HpSA sensitivity, specificity, and positive and negative likelihood ratios were determined with reference to the results of cultures of gastric biopsy. Findings: Of the 103 children tested 41 (39.8%) and 39 (37.8%) were positive for H. pylori according to the results of cultures of gastric biopsy and HpSA, respectively. The sensitivity, specificity, and positive and negative likelihood ratios of HpSA were found to be 85%, 93%, 89.7%, and 90%, respectively. Conclusion: In this pilot study, a low-cost and rapid diagnostic technique, stool antigen test proved to be highly sensitive and specific for detecting H pylori infection in children with recurrent abdominal pain. Our results are comparable to those reported elsewhere in children and demonstrate that the HpSA test can replace endoscopy and biopsy for detecting H. pylori infection

Unexplained infertility as primary presentation of celiac disease, a case report and literature review

Background: Celiac sprue (gluten sensitive enteropathy) is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility. Case: The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue. Conclusion: Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cur

Combinational immune-cell therapy of natural killer cells and sorafenib for advanced hepatocellular carcinoma: a review

Abstract Background High prevalence of hepatocellular carcinoma (HCC) and typically poor prognosis of this disease that lead to late stage diagnosis when potentially curative therapies are least effective; therefore, development of an effective and systematic treatment is an urgent requirement. Main body In this review, several current treatments for HCC patients and their advantages or disadvantages were summarized. Moreover, various recent preclinical and clinical studies about the performances of “two efficient agents, sorafenib or natural killer (NK) cells”, against HCC cells were investigated. In addition, the focus this review was on the chemo-immunotherapy approach, correlation between sorafenib and NK cells and their effects on the performance of each other for better suppression of HCC. Conclusion It was concluded that combinational therapy with sorafenib and NK cells might improve the outcome of applied therapeutic approaches for HCC patients. Finally, it was also concluded that interaction between sorafenib and NK cells is dose and time dependent, therefore, a careful dose and time optimizing is necessary for development of a combinational immune-cell therapy

A dual H-type tracheoesophageal fistula; why not being repaired simultaneously? A case report and review of literature

Abstract Background H-type Tracheoesophageal Fistula (TEF) is a particular type of congenital esophageal anomalies, in which patients present with non-specific symptoms that can result in delayed diagnosis. Here, we report two pediatric cases with a rarer variant called ‟dual H-type TEFˮ. Case presentation We present two cases of H-type TEF. The first was a 45-day-old boy with feeding problem and cyanosis while feeding, and the second was a three-month-old girl with cough and choking after feeding from the first day of birth. In both cases, two separate TEFs were detected during diagnostic evaluation by flexible bronchoscopy. Both were repaired simultaneously through a cervical incision. The first patient deteriorated 13 days after the surgery, disturbancing in acid-base balance and expired unfortunately. Conclusion Hence, it is necessary to consider the possibility of double TEF in any newly diagnosed H-type TEF