Norwegian Scabies in a 70-Year-Old Renal Transplant Recipient: A Case Report

Crusted scabies (CS) is an extremely contagious variant of classical scabies with substantial morbidity and mortality. It is the most prevalent in immunocompromised patients, those with some underlying diseases, and individuals with physical and mental disabilities. Herein, we report a 70-year-old woman who presented with generalized erythema with itchy hyperkeratotic plaques and crusted lesions on her face, hands, between fingers, neck, scalp, abdomen, and legs up to the knees. She was diagnosed with CS and subsequently isolated and treated with ivermectin (200 μg/kg) and 5% permethrin cream. She died a short time after being admitted, and it was due to severe septic shock and cardiac arrest. Immediate isolation and treatment of CS patients is essential to prevent morbidity and mortality. Prompt diagnosis and precise medical management in both patients and healthcare settings is required

A case report of rhino‑facial mucormycosis in a non‑diabetic patient with COVID‑19: a systematic review of literature and current update

Background: COVID-19 disease may be associated with a wide range of bacterial and fungal infections. We report a patient with COVID-19 infection who developed rhino-facial mucormycosis during treatment with corticosteroids. Case presentation: A 59-year-old non-diabetic male patient was admitted with a diagnosis of COVID-19 based on positive RT-PCR and CT of the lungs. Due to sever lung involvement, he was treated with methylprednisolone. The patient was re-admitted to hospital, due to nasal obstruction and left side facial and orbital swelling, several days after discharge. In sinus endoscopic surgery, debridement was performed and the specimens were sent to pathology and mycology laboratories. A nasal biopsy showed wide hyphae without septa. The sequenced PCR product revealed Rhizopus oryzae. Despite all medical and surgical treatment, the patient died. In addition, the characteristics of patients with COVID-19-associated mucormycosis were reviewed in 44 available literatures. In most studies, diabetes mellitus was the most common predisposing factor for mucormycosis. Conclusion: Our report highlights the need for assessing the presence of mucormycosis in patients with COVID-19 and also it shows that physicians should consider the potential for secondary invasive fungal infections in COVID 19case

Effect of Toxocara canis and Toxascaris leonina egg antigens on induction of eosinophilia in animal model

زمینه و هدف: توکسوکاراها و توکساسکاریس انگل روده سگ و گربه می باشند که لارو آن ها باعث ایجاد ائوزینوفیلی در انسان می شود. در این تحقیق به صورت اختصاری تأثیر آنتی ژن های تخم برخی از این انگل ها بر ایجاد ائوزینوفیلی بررسی شده است. روش بررسی: در این مطالعه تجربی تعداد 54 سر موش سوری در شش گروه قرار گرفتند. به گروه های مورد، آنتی ژن تخم توکسوکارا کانیس یا توکساسکاریس لئونینا بدون ادجونت از راه داخل صفاقی و یا همراه با ادجوانت فروندز از راه زیر جلدی تزریق شد. گروه های شاهد هیچ تزریقی دریافت نکردند. هر تزریق سه بار با فاصله زمانی دو هفته تکرار و بعد از هر تزریق، شمارش گلبول های سفید از نمونه های خونی انجام شد. یافته ها: اختلافی بین میانگین گلبول های سفید شامل لنفوسیت ها، ائوزینوفیل ها، نوتروفیل ها، مونوسیت ها و بازوفیل ها در گروه های مورد در مقایسه با گروه های شاهد مشاهده نگردید. نتیجه گیری: بر خلاف لاروها، آنتی ژن های انگل های مورد مطالعه باعث ائوزینوفیلی در موش ها نشدند؛ با این حال تحقیقات بیشتری در این خصوص توصیه می گردد

A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran

OBJECTIVES Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran. METHODS We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied. RESULTS A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals. CONCLUSIONS The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients

Wide Spectrum of Thyroid Function Tests in COVID-19: From Nonthyroidal Illness to Isolated Hyperthyroxinemia

Background: Changes in thyroid function test (TFT) in COVID-19 patients have been reported in several studies. However, some features such as thyrotoxicosis are inconsistent in these studies. In addition, some drugs such as heparin interfere with the free T4 assay. Objectives: This study was designed to examine TFT abnormalities in COVID-19, utilizing direct and indirect methods of free T4 assay. Methods: This prospective cross-sectional study was conducted on 131 hospitalized COVID-19 patients. Serum levels of total T3, TSH, T3RU, and total T4 were measured. The free T4 assay was performed using direct (free T4) and indirect (free thyroxin index or FT4I) methods. The patients were categorized into different TFT groups. The clinical characteristics, laboratory findings, and outcomes were compared between the groups. Results: The frequencies of Nonthyroidal Illness (NTI), subclinical/overt hypothyroidism and subclinical/overt thyrotoxicosis were 51.7, 6.9, and 6.9%, respectively. Besides, 6 and 8.1% of the patients had isolated high free T4 and isolated high FT4I without any other TFT abnormality, respectively. The lymphocyte percent was lower in the subclinical/overt group than in other TFT groups (P = 0.002). Atrial Fibrillation (AF) was found in 37.5% of subclinical/overt thyrotoxicosis patients versus 1.7% in the NTI and nil in the other three groups (P < 0.001). Conclusions: In addition to the reported TFT abnormalities in COVID-19 in previous studies, some new features like isolated hyperthyroxinemia were found in our study. We found a strong association between subclinical/overt thyrotoxicosis and AF. Regarding the high prevalence of AF in hospitalized COVID-19 patients, the thyroid function test is rational in COVID-19 patients with this arrhythmia

Association of weekly or biweekly use of 50.000 IU vitamin D3 with hypervitaminosis D

Since the beginning of COVID-19 pandemic, many Iranian people are taking 50.000 IU of vitamin D3 on the weekly or biweekly bases in order to enhance their immune system function. This cross- sectional study was conducted on the patients of endocrinology clinic to compare 25(OH)D levels of weekly or biweekly consumption with the monthly users of vitamin D3 50,000 IU. The level above 100ng/ml of 25(OH)D was defined as hypervitaminosis D. Totally, 211 patients (108 and 103 patients in monthly and weekly/ biweekly groups, respectively) were studied. In the subgroups of weekly and biweekly users, the rates of hypervitaminosis were 18.9% and 4.5%, respectively. In contrast, only 0.9% of monthly users had hypervitaminosis D. The highest vitamin D value of 185 ng/ml was detected in a patient who consumed 50,000 IU vitamin D3 weekly for 6 years. No hypercalcemia was detected in the patients with hypervitaminosis D

Molecular and Morphological Data Confirmed First Record of Abbreviata kazakhstanica Markov and Paraskiv, 1956 (Spirurida: Physalopteridea) in Iran

Background: The genus Abbreviata (Spirurida: Physalopteridea) currently contains 47 species. Physalopteridae nematodes infect a large number of vertebrates, including mammals, birds, reptiles and amphibians. The current study is a report of the first morphological and molecular identification of A. kazakhstanica (Spirurida: Physalopteridea) in Pseudopus apodus in Iran. Methods: Eleven road-killed P. apodus, were collected from, Iran during 2016-2018. The nematodes were isolated from stomach. After morphological study, the genomic DNA of the parasites was extracted using CTAB method. The DNA was used for PCR amplification of cytochrome c oxidase subunit I (cox1). The PCR products were sequenced, the sequence data were analyzed and multiple alignments were conducted using the Clustal Omega. Results: After detailed microscopic examination, the A. kazakhstanica was identified. The cox1 sequences confirmed the species of helminth. The new sequences of A. kazakhstanica were submitted to GenBank under the accession number MK578751-2. Conclusion: Regarding the limited data on parasitological status of Iranian reptiles, more specific and comprehensive investigations are needed to identify the parasitic fauna Keywords Abbreviata kazakhstanica, Molecular identification, Pseudopus apodus, Physalopteridea, Ira

The worldwide prevalence of intestinal helminthic parasites among food handlers: A systematic review and meta-analysis

Food handlers have a major role in transmission of food-borne parasitic infections including intestinal helminths. The objective of the present study was to assess the global prevalence of intestinal helminthic parasites among food handlers. Multiple databases (PubMed, Scopus, ProQuest, Web of Science, Science Direct and Google Scholar) were searched for literature published from 1990 to 2022. Pooled prevalence was estimated using the meta-package in R (version 3.6.1). One hundred twenty seven articles, including 220,705 individuals, were considered in this study. The global pooled prevalence (95% confidence interval) was 0.115% (0.091% - 0.141%). The highest pooled prevalence was reported from Africa (0.160%, 0.124%–0.210%). The most prevalent helminth was Ascaris lumbricoides (0.062%, 0.047%–0.079%). Moreover, among different countries, Ghana had the highest pooled prevalence (0.496%, 0–1.000%). This study revealed a high prevalence of intestinal helminths among food handlers. Routine parasitological investigation, food safety and personal sanitation training are recommended to prevent intestinal helminths transmitted by food handlers

Molecular identification and phylogenetic analysis of free-living amoeba in the water resources of Arak, Iran

The aim of the present study was to detect free-living amoeba (FLA) in the water resources of Arak, Iran using molecular tools. A total of 154 samples were collected from different water supplies. Molecular analyses, sequencing, and phylogenetic study were conducted to confirm the species and genotypes of FLA. Fisher exact test was used to determine the significance. Of 154 water samples, 19 (12.3%) samples were tested positive for FLA. Three genotypes of Acanthamoeba including T4, subtype D, and T5 were identified among the isolates. The pathogenicity assay showed that the isolate of Acanthamoeba in drinking water was highly pathogenic. Three species of Naegleria, including N. australiensis, N. pagei, and N. gruberi were found among the samples. Six isolates of Vermamoeba were identified as V. vermiformis. Meanwhile, three other species including Vannella sp., Vahlkampfia avara, and Stenamoeba polymorpha were also recovered from the water samples. Statistical analysis showed a significant difference between the various water resources contaminated with FLA. This is the first study to reveal the presence of S. polymorpha in water sources in Iran. According to the findings of the present study, health officials should be beware of potential public health impacts of FLA in water resources