An HIV-positive woman with massive brain lesion due to toxoplasmosis: A case report

Key Clinical Message

Toxoplasmosis-related huge brain lesions may require decompressive craniectomy and lesion excision to avoid brain damage. In this situation, injectable cotrimoxazole is a better choice for treatment.

Abstract

Toxoplasma gondii is a worldly distributed obligate intracellular protozoa. Toxoplasmosis is a prevalent opportunistic infection in HIV-infected people, but it was rarely recorded prior to the identification of HIV infection. Here, we report a toxoplasmosis brain lesion in an Iranian HIV-positive patient. A 45-year-old woman with a complaint of malaise was referred to the Valiasr Hospital in Arak city. In her past clinical history, the patient had a history of anemia, deep vein thrombosis (DVT), and positive HIV. The patient was informed of the diagnosis of massive brain toxoplasmosis as a definite diagnosis. The patient was then taken to the operating room for a left decompressive craniectomy, during which the ensuing brain lesion was excised. After a few days, she was discharged from the hospital in good condition and without any complications.

Evaluation of clinical and paraclinical findings in patients with reactive arthritis caused by giardiasis: A systematic review

INTRODUCTION

The aim of this study was to systematically review the clinical and paraclinical findings in patients with reactive arthritis (ReA) caused by giardiasis.

METHODS

In this study, papers describing ReA in patients with giardiasis were found after searching in international databases including MEDLINE/PubMed, Web of Science, Scopus, and ScienceDirect up to 2021. Google Scholar was also searched to find more articles.

RESULTS

Finally, 16 studies met the inclusion criteria with reporting 115 patients, ranging in age from 19 months to 49 years. This disease was more reported in children and adolescents than adults. The most frequently involved joints with arthritis were the knee and ankle followed by the hip, wrist, elbow, shoulder, axial skeleton, metatarsophalangeal, and proximal interphalangeal. The most common extra-articular symptoms included diarrhea, allergic symptoms, and abdominal pain.

CONCLUSION

The signs and symptoms of ReA caused by giardiasis can be various, from moderate to severe manifestations. Also, they can be similar to some other diseases, so it is recommended that physicians and specialists have more knowledge about this disease to treat patients with a correct diagnosis.

Post‐ COVID ‐19 splenic infarction in a patient with chronic atrial fibrillation: A case report

We describe splenic infarction (SI), an infrequent condition, in an 82‐year‐old COVID‐19 patient with chronic atrial fibrillation (AF). COVID‐19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID‐19 patients with abdominal pain, especially if a predisposing factor exists.

Clinical Manifestation and Epidemiological Finding of Trichomonas vaginalis Infection in Unusual Areas of Body in Neonates: A Systematic Review

BACKGROUND

This study intends to increase awareness on the clinical and laboratory diagnosis as well as health care of newborns with trichomoniasis from infected mothers, to introduce this organism as a respiratory pathogen with lower prevalence in other areas, and to outline its manifestations and symptoms.

METHODS

All case report articles in English language regarding the presence of T. vaginalisin unusual areas among infants, which were available in Scopus, PubMed, Science Direct, Google scholar, and Web of Science published between 1980 and 2021 were searched and reported by two independent researchers. Titles and abstracts of all articles were reviewed for initial screening.

RESULTS

After searching the articles and evaluating their quality, 9 full text articles were selected. All reported cases were from 8 different cities (4 countries) in the world. In most cases, the parasite was in the respiratory tract, but it was also reported in the brain and urogenital tract. The most common clinical symptom was respiratory distress.

CONCLUSION

Although the possibility of trichomoniasis infection in unusual areas such as genitals is low, according to the reports collected from around the world, this parasite can also be present outside the genitals. Perhaps, reviewing trichomoniasis along with other diagnoses in these cases may lead to early diagnosis and treatment of the affected neonates.

The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis

BACKGROUND

Toxocariasis is a zoonotic parasitic disease caused by Toxocara canis and Toxocara cati in humans. Various types of T. canis are important.

PURPOSE

The current study aimed to investigate the prevalence of Toxocara spp. in pediatrics in the context of a systematic review and meta-analysis.

METHODS

The MEDLINE (PubMed), Web of Sciences, Embase, Google Scholar, Scopus, and Cumulative Index of Nursing and Allied Health databases were searched to identify peer-reviewed studies published between January 2000 and December 2019 that report the prevalence of Toxocara spp. in pediatrics. The evaluation of articles based on the inclusion and exclusion criteria was performed by 2 researchers individually.

RESULTS

The results of 31 relevant studies indicated that the prevalence of Toxocara spp. was 3%-79% in 10,676 cases. The pooled estimate of global prevalence of Toxocara spp. in pediatrics was 30 (95% confidence interval, 22%-37%; I2=99.11%; P=0.00). The prevalence was higher in Asian populations than in European, American, and African populations.

CONCLUSION

Health policymakers should be more attentive to future research and approaches to Toxocara spp. and other zoonotic diseases to improve culture and identify socioeconomically important factors.

Seroprevalence, risk factors, and clinical symptoms of Toxocara spp. infection among children 3-15 years old in northern Iran

The World Health Organization has categorized toxocarosis as a neglected tropical disease despite its significant impact on high-risk groups such as children. This study aimed to investigate the seroprevalence, risk factors, and clinical symptoms of Toxocara spp. infection among children 3-15 years old in northern Iran. A total of 386 children were enrolled in the study. All serum samples were tested for the presence of IgG antibodies against Toxocara spp. infection using an enzyme-linked immunosorbent assay. Moreover, relevant risk factors and clinical symptom data were obtained using questionnaires. Data analysis was performed using the SPSS software version 24. The overall seroprevalence of Toxocara spp. infection was found 2.85 % (11/386). However, Toxocara spp. infection was high for some risk factors, including eating soil (14.3 %), contacting cats (6.7 %), and consuming raw vegetables (3.7 %). However, there were no statistically significant differences regarding the risk factors and socio-demographic characteristics. Considering the clinical symptoms, Toxocara spp. infection was different in children with eosinophilia (20 %), ocular disorders (8.3 %), skin disorders (7.7 %), liver disorders (4.5 %), and stomach ache (4.2 %), although not statistically significant. The results revealed that the seroprevalence of Toxocara spp. infection was relatively low in children in northern Iran. It is suggested to conduct more studies in different parts of Iran to gain a deeper understanding of the toxocarosis seroprevalence and its status in high-risk groups such as children with asthma, hypereosinophilic syndrome, allergic skin disorders, and epilepsy.

Customizing the Protoscolicidal Activity by a Drug Delivery System: Application of Guar Gum in Electrospun Nanofibers

Background

The present study aimed to control mebendazole drug release from ethyl cellulose nanofibers containing guar gum produced by Electrospinning Method (ESM) on mortality of hydatid cyst protoscoleces under laboratory conditions.

Methods

The study was conducted in Arak Islamic Azad University, 2019. After preparation of ethyl cellulose nanofibers containing guar gum with concentrations 10, 250, 50 and 500 ppm with ESM, the uniformity and fineness of nanofibers were investigated by electron microscope. By determining the absorption of nanofibers during 312 h via spectrophotometry method, the amount of drug release was obtained. Then, the mortality of live protoscoleces in-vitro with nanofibers made with different concentrations was studied during 13 days.

Results

Guar gum nanofiber with four concentrations of 10, 50, 250 and 500 ppm had 0.78512, 0.83729, 1.0098 and 1.0633 absorption respectively and showed drug release 42.09%, 39.95%, 33.05% and 30.96% after 312 hours. Therefore, the survival of protoscoleces in the presence of guar gum with four concentrations was zero after 3, 6, 11 and 13 days (P<0.05).

Conclusion

To produce nanofibers carrying the drug for research related to the treatment of hydatid cysts, the electrospinning technique can be considered as a reliable method.

Toxicity and Antiparasitic Efficacy of Essential Oils: Analyses of the Biochemical Compositions and Potencies

Background: Hydatidosis is a common disease of both humans and animals, resulting from infection with the larvae of Echinococcus granulosus tapeworm. The aim of this study was to investigate the antiparasitic (protoscolicidal) activities of three essential oils in vitro. Methods: This study was designed to evaluate the biochemical composition and in vitro antiparasitic effects of Zataria multiflora, Origanum vulgare and Mentha pulegium essential oils. Gas chromatography was performed to identify the main components of the herbal oils. To determine the antiparasitic properties of the essential oils, live protoscoleces from hydatid cysts were exposed to three concentrations of the herbal oils and were incubated at 37°C for 5, 10, 15, 20 or 25 minutes. Results: The biochemical analysis of these oils indicated that carvacrol and thymol were the major compounds of the Zataria oil. Further, carvacrol and thymol in Origanum essential oil and pulegone and piperitone in Mentha oil were the major compounds. The quickest and slowest antiparasitic effect was achieved from Zataria and Origanum (10%) or from Zataria (0.6%), respectively. The statistical analysis showed a significant difference between the mortality rate of protoscoleces exposed to 0.6% and 1% concentrations, respectively, of Zataria and Origanum at the predetermined exposure times (P<0.05). The three concentrations of Mentha had the same significant statistical differences (P<0.05). Conclusion: Essential oils, Zataria multiflora, Origanum vulgare and Mentha pulegium had significant protoscolicidal activities that were dependent on the concentration of the oils and the exposure times.

Cryptosporidium animal species in Iran: a systematic review and meta-analysis

BACKGROUND

Cryptosporidiosis is an acute and short-term infection which can lead to severe diarrhea (intestinal cryptosporidiosis) associated with a persistent cough in the host with immune system defect. This systematic review and meta-analysis was conducted to estimate the prevalence of animal Cryptosporidium species and the corresponding epidemiological aspects in Iran.

METHODS

In this study, all original research articles relating to the animal cryptosporidiosis in Iran were collected from reliable databases using keywords. A meta-analysis was conducted separately for each subgroup, and heterogeneity among the studies was performed using the Q and I2 tests. Furthermore, it should be noticed that the significance level in the statistical analysis with the Comprehensive Meta-analysis software was considered to be less than 0.05. Finally, meta-analysis results were shown in forest plot with a 95% CI.

RESULTS

In total, 4795 studies were included in the initial screening. Duplicated or non-original studies and the ones which did not meet our considered criteria were excluded from the list. Out of the 100 articles included in our first list for the meta-analysis, 40, 16, 13, 10, 9, 7, and 5 were done on cattle and calves, birds, dogs, sheep, rodents, camels, and horses, respectively. The prevalence rate of cryptosporidiosis among the birds, horses, rodents, camels, dogs, cattle, and sheep in Iran was estimated to be 7.5%, 19.5%, 20.8%, 8.4%, 4.9%, 14.4%, and 9.1%, respectively.

CONCLUSION

The different Cryptosporidium species have been found in different regions of Iran. Geographical region, climate, and domestic animals are considered as factors responsible for animal cryptosporidiosis prevalence in the area. Moreover, this parasite is zoonotic which causes disease in animals as well as humans which can result in economic loss.

Clinical manifestation and epidemiological findings of human linguatula serrate infection in Iran: systematic review

The aim of this study was to collect data and provide information on clinical diagnosis of disease, methods of dissemination, prevention and treatment of human linguatuliasis in order to increase people's awareness and health care. In this study case reports of individuals in Iran those infected with the Linguatula serrata were taken from the international databases (e.g., Medline (PubMed), Scopus, Iranmedex, Scientific Information Database, and Irandoc) and reviewed. The review covers the case reports of human tongue worm infection published either in Persian or in English between the years 1980-2018. An individual researcher undertook the bibliographic search and evaluation of articles based on inclusion/exclusion of specific criteria. Cases of infection have been reported in eight provinces of Iran. Dietary habits play the important roles in the transmission of the parasite. Clinical diagnosis was achieved by obtaining a patient's history, then completing a clinical examination of the mentioned patients. Symptoms of infection were mainly observed in the upper respiratory tract in most reports, the patient's status was improved by removing the parasite from the infected organ. Given that viscera of slaughtered livestock plays a significant role in the transmission of this infection to humans, Careful inspection of slaughtered livestock in slaughterhouses and Preventing the slaughter of livestock illegally and unsanitary, outside the slaughterhouse, is important. Accordingly, it is very important to train the employees working in the slaughterhouses and the people who consume these organs.

Serological Study of Fascioliasis Using Indirect ELISA in Gorgan City, Golestan Province, Northern Iran

Background

Fascioliasis is a neglected zoonotic disease, caused by Fasciola species in human and livestock. We aimed to detect the seroprevalence of human fascioliasis Gorgan City, Golestan Province, northern Iran using ELISA method in 2017.

Methods

Overall, 612 serum samples were analyzed. A relevant questionnaire for demographic data was obtained for all cases. An indirect ELISA test was used to detect IgG antibodies against Fasciola in the sera. The data analysis was performed employing SPSS program version 21.

Results

Eleven cases (1.79%) were seropositive for fascioliasis. The seroprevalence of fascioliasis was 1.9% and 1.1% among males and females, respectively. There was no statistically significant association between the fascioliasis and analyzed variables such as sex, age, residence, job, education, etc.

Conclusion

This study was conducted only on the people referring to the Reference Laboratory of Gorgan. It cannot be distributed to the whole city. Thus, due to importance of the disease, finding the seroprevalence of fascioliasis in a comprehensive survey in Golestan Province should be accounted in further studies.

Evaluation of Toxoplasma gondii infection in western Iran: seroepidemiology and risk factors analysis

Background

Toxoplasmosis is a parasitic infectious disease, and Toxoplasma gondii is the causative factor of this intracellular protozoan disease. Due to the lack of information about the rate of T. gondii in general papulation of Markazi Province in Iran, the current study was conducted to determine the prevalence of toxoplasmosis and the related risk factor analysis in the general population of Markazi Province.

Methods

This cross-sectional study was performed within 6 months on individuals who were referred to diagnostic laboratories in Markazi Province. The demographic and background information of the subjects were collected using a questionnaire. Three milliliters of blood samples was collected from the participants under sterile conditions. The sera were separated and evaluated for levels of anti-Toxoplasma IgG antibody using a commercial enzyme-linked immunosorbent assay (ELISA) method. The collected data were analyzed by the SPSS software using descriptive statistics and chi-square test.

Results

Out of 824 people from the general population of Markazi Province who were investigated in this study, 276 (33.5%) had anti-Toxoplasma antibodies in their blood. According to the logistic regression model, gender variables, location, marital status, and having a cat at home do not affect the chances of contracting the parasite. Furthermore, the chance of contracting the parasite in 41- to 50-year-olds is 0.85 times the one in the 20- to 30-year-olds. The prevalence of toxoplasmosis in men and women in Markazi Province was 33% and 34.5%, respectively.

Conclusion

The mean prevalence of T. gondii infection in the age groups of 20-40, and ≥ 40 years was estimated to be 24.7%, and 40.8%, respectively. These rates were significantly lower than the national results (44%, and 55%, respectively). Therefore, regarding to the health authorities, it is necessary to raise the level of awareness of people of the region, especially at-risk groups about the transmittance and prevention methods, and infection risk factors in order to prevent the occurrence of T. gondii infection and reduce the prevalence and incidence of the disease.

Fungal and parasitic contamination of indoor public swimming pools in Arak, Iran

BACKGROUND

Swimming is a popular exercise for different types of people at different ages. Public swimming pools are places where fungal infections can be easily transferred. The purpose of this study is to evaluate the quality of mycological, parasitological, and physicochemical parameters of swimming pools of Arak city.

METHODS

This cross-sectional study was done for 12 months from April 2013 to March 2014 in six indoor active swimming pools of Arak city (A, B, C, D, E, and F). Samples were collected in four seasons, two times/season; each time, two samples were obtained from six specified locations (shallow level pool, deep level pool, dressing rooms, showers, margin of pool walls, and foot-washing sink) from each pool with a total of 576 samples. Physicochemical parameters including water temperature, pH, turbidity, and the residual chlorine were measured on-site. In order to isolate and detect the fungal agents, special filters and culture Sabouraud's dextrose agar, chloramphenicol, and mycosel agar media were applied. Furthermore, non-nutrient agar medium enriched with Escherichia coli was used to detect and to separate the eggs of the worms, cysts, and parasitic protozoa from centrifuges of samples. In order to investigate their sediment, optical microscope and culture media were used.

RESULTS

We found that 456 (79.1%) samples were positive regarding the fungal elements, and 516 fungal species were isolated. The most common isolates were saprophytic species (8.74%), yeast species (25%), and dermatophyte species (2.5%). The most contaminated surfaces were foot-washing sinks and showers. In this study, Acanthamoeba parasites were isolated from one pool only. All the investigated physicochemical parameters of pool water except for the temperature were found to be in the standard range.

CONCLUSIONS

Existence of saprophytic fungi and yeast in pools' water is plausible to be considered as an indicator of water resistance to the detergent agents. This high degree of contamination is due to the huge number of visitors, the complexity of construction, the choice of materials, and the long opening hours. Isolation of dermatophytes and Acanthamoeba parasite from the pools' area and foot-washing sink reveals the important role of the public swimming pools in disease transmission.

Genotyping of Echinococcus granulosus isolates from livestock based on mitochondrial cox1 gene, in the Markazi province, Iran

Hydatidosisis a parasitic disease caused by the larval stage of Echinococcus granulosus with different genotypes, and major complications in vital organs such as liver, lungs and, brain. Also, this parasite can infect animals and cause economic damages. Recently, some investigations indicated that the genetic variation of the parasite affects the antigenic, immunogenic and pathogenic features. Therefore, present study conducted to genotyping of the E. granulosus larva based on mitochondrial cox1 gene in livestock in the endemic areas of Markazi province, Iran. In this study, 49 hydatid cysts samples collected from 36 sheep, 11 goats and 2 cattle from different slaughterhouses of Markazi province in central part of Iran, 2017. The mitochondrial cox1 gene was amplified and genotyping were accomplished using sequence analysis. The sequencing analysis indicated that the main genotype G1 (61%) and G3 (37%) were identified. Also, one of the samples shows similarity with the G2 (2%) genotype. The results showed the statistically significant differences between the genotypes in different livestock (P < 0.05). This study indicated that the main genotypes of E. granulosus in Markazi province are G1 and G3 which are related to dog/sheep strain. Therefore, parasite control in dogs and sheep can reduce the risk of transmission of infection to humans.

A PCR-Based Molecular Detection of Strongyloides stercoralisin Human Stool Samples from Tabriz City, Iran

Strongyloides stercoralis is a nematode causing serious infections in immunocompromised patients. In chronically infected patients, the low parasitic content as well as the resemblance of the larvae to several other species make diagnosis basedonmorphology difficult. In the present study, a PCR-based method targeting the internal transcribed sequence 2 (ITS2) of the rDNA region was examined for the molecular detection of S. stercoralis infection from the stool samples. A total of 1800 patients were included. Three fresh stool samples were collected per patient, and S. stercoralis isolates were identified by the morphological method. A subset of isolates was later used in the PCR-based method as positive controls. Additionally, negative and no-template controls were included. Data analysis was accomplished using an x² test. Ap-value less than 0.05 was considered significant. In total, fivestool samples were found to be infected with S. stercoralis using the morphology method. PCR method detected S. stercoralis DNA target from all of the fiveDNA samples extracted from positive fecal samples. Conclusions: The PCR method used for amplifying a short fragment was successful for diagnosis of S. stercoralis in fecal samples and can be reliable for directly detecting the parasite bypassing morphological method.

An In Vitro Evaluation of Ozonized Organic Extra-Virgin Olive Oil on Giardia Lamblia Cysts

BACKGROUND

Giardia lamblia is a common intestinal parasite that has been reported all over the world.

OBJECTIVES

This study was conducted to evaluate the effect of ozonized organic extra-virgin olive oil on the cyst of G. lamblia.

METHODS

The olive oil was ozonized based on international standards and confirmed by the world health organization (WHO) at various times in a generator. The ozone concentration of olive oil was adjusted at 32, 64, 96, 128, 160 mg/g based on ozone absorption. Giardia lamblia cysts were isolated from heavily infected stool samples and the sucrose gradient flotation technique. Five groups of triple tubes containing Giardia cysts were exposed to olive oil with 32, 64, 96, 128, 160 ozone concentrations, and the sixth and seventh groups were exposed to non-ozonized olive oil and normal saline, respectively. The tubes were placed at room temperature, and every four hours, the mortality of the Giardia cysts was assessed.

RESULTS

The results showed that the first five groups' mortality rate of Giardia cysts reached 100% in 100 hours. An increasing concentration of ozone in olive oil leads to an increase in the mortality rate of Giardia cysts. The results showed a significant difference in the mean time of the mortality in all the groups (P ≤ 0.05). Furthermore, the higher fatality effect of ozonized organic extra-virgin olive oil (Ozonized Olive Oil = OZO) was proved in comparison with metronidazole in vitro.

CONCLUSIONS

We concluded that ozonized organic extra-virgin olive oil was a growth inhibitor of Giardia cysts, and concerning its compatibility with a biological system, it is recommended for further clinical trials.

Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes: Their Frequency, Antimicrobial Patterns, and Association With Infectious Disease in Shahrekord City, Southwest Iran

Background:

A diversity of virulence factors work together to create the pathogenicity of Staphylococcus aureus. These factors include cell surface components that promote adherence to surfaces as well as exoproteins such as Panton-Valentine leukocidin (PVL), encoded by the luk-PV genes, that invade or bypass the immune system and are toxic to the host, thereby enhancing the severity of infections caused by methicillin-resistant Staphylococcus aureus (MRSA).

Objectives:

The aim of this study was to determine the frequency of PVL-positive MRSA strains by real-time PCR and their antibiotic susceptibility patterns by phenotypic test.

Materials and Methods:

In total, 284 Staphylococcus isolates, identified by phenotypic methods from clinical samples of Shahrekord University Hospitals, Shahrekord, Iran, were tested for nuc, mecA, and PVL genes by TaqMan real-time PCR. The antibiotic susceptibility patterns of PVL-containing MRSA strains were determined via the disk diffusion method.

Results:

In total, 196 isolates (69%) were nuc positive (i.e., S. aureus); of those isolates, 96 (49%) were mecA positive (MRSA). Eighteen (18.8%) of the 96 MRSA positive and 3 (3%) of the 100 methicillin-susceptible Staphylococcus aureus (MSSA) strains were PVL positive. PVL-positive MRSA strains were mostly recovered from tracheal specimens. Eight PVL-positive MRSA strains were resistant to all the tested antibiotics except vancomycin. A significant correlation (P = 0.001) was found between the mecA positivity and the presence of luk-PV genes.

Conclusions:

Community acquired (CA)-MRSA is becoming a public health concern in many parts of the world, including Asian countries. The variable prevalence of luk-PV-positive MRSA isolates in different regions and their rather high frequency in pneumonia necessitate the application of rapid diagnostic methods such as real-time PCR to improve treatment effectiveness.

Solitary osteochondroma of the thoracic spine with compressive myelopathy; a rare presentation

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient’s symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma.

Sequence Analysis of the Second Internal Transcribed Spacer (ITS2) Region of rDNA for Species Identification of Trichostrongylus Nematodes Isolated From Domestic Livestock in Iran

BACKGROUND

Infectivity of herbivores with Trichostrongylus nematodes is widespread in many countries, having a major economic impact on breeding, survivability, and productivity of domestic livestock. This study was carried out on Trichostrongylus species isolated from domestic livestock in order to develop an easy-to-perform method for species identification.

METHODS

Trichostrongylus isolates were collected from sheep, goat, cattle, and buffaloes in Khuzestan Province, southwest Iran. Primary species identification was carried out based on morphological characterization of male worms. PCR amplification of ITS2-rDNA region was performed on genomic DNA and the products were sequenced. Phylogenetic analysis of the nucleotide sequence data was conducted employing Bayesian Inference approach. Consequently, a restriction fragment length polymorphism (RFLP) profile was designed to differentiate Trichostrongylus species.

RESULTS

A consensus sequence of 238 nucleotides was deposited in the GenBank for Iranian isolates of Trichostrongylus species including T. colubriformis, T. capricola, T. probolurus and T. vitrinus. The designated RFLP using restriction enzyme TasI could readily differentiate among species having different ITS2 sequence. The molecular analysis was in concordance with morphological findings.

CONCLUSION

Phylogenetic analysis indicated a close relationship among the sequences obtained in this study and reference sequence of relevant species. ITS2-RFLP with TasI is recommended for molecular differentiation of common Trichostrongylus species.

Morphological and morphometrical description of trichostrongylus species isolated from domestic ruminants in khuzestan province, southwest iran

BACKGROUNDS

Genus Trichostrongylus (Nematoda: Trichostrongylidae) is one of the most important zoonotic nematodes with wide geographic distribution in the world. The purpose of the present study was to describe morphological and morphometrical characteristics of male Trichostrongylus species, currently prevalent in domestic ruminants of Khuzestan Province, southwest Iran.

METHODS

Gastro-intestinal organs of 1600 sheep, goats, cattle, and buffalos, slaughtered in Khuzestan Province, southwest Iran, were examined for infectivity with Trichostrongylus species. For examination and measurements of helminthes, Azo-carmine staining was performed, followed by camera lucida drawings of morphological characters and measurements of morphometrical criteria with a calibrated microscope. Using valid nematodes systematic keys, almost all the parasites were identified at the level of species.

RESULTS

Overall, 114 animals were found infected with at least one species of Trichostrongylus. Considering morphological characteristics of male Trichostrongylus, six species were identified including T. colubriformis, T. vitrinus, T. probolorus, T. capricola, T. longispicularis and Trichostrongylus sp.

CONCLUSION

Although, compared to the previous decades, currently Trichostrongylus is much less prevalent in the domestic ruminants of the study area, but still different species occur in these animals.

Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

Introduction

Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations.

Case presentation

A 73-year-old cachectic Asian man (Iranian) presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP) were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement.

Conclusion

Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

Whole body bone scintigraphy in osseous hydatosis: a case report

Hydatid disease is common in many parts of the world, and causes considerable health and economic loss. This disease may develop in almost any part of the body.Bone involvement is often asymptomatic, and its diagnosis is primarily based on radiographic findings. A whole body bone scan is able to show the extent and distribution of lesions.We describe an unusual case of multifocal skeletal hydatosis and also explain the clinical and diagnostic points. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider this disease as a differential diagnosis in cases of multiple abnormal activity in bone scintigraphy especially among people in endemic areas.

Echinococcus granulosus: Lethal effect of low voltage direct electric current on hydatid cyst protoscoleces

We have studied a small scale method for killing hydatid cyst protoscoleces using low voltage direct electric current. After collecting hydatid cysts from infected organs of slaughtered animals, protoscoleces were cultured in four different media: hydatid cyst fluid, RPMI, normal saline, and Tris buffer, respectively. Protoscoleces from each of the above media were then transferred to an electrolysis device through which different electric current densities were applied. For measuring the survival rate of protoscoleces, flame cell movement and eosin staining was used. The results show that the survival rate of protoscoleces in hydatid fluid was dependent on the electric current density and the time of the applied current. Current densities of 62.5 mA/cm2 (11 V), 53.71 mA/cm2 (10 V), and 18.18 mA/cm2 (5 V) after 1, 2, and 3 min, respectively, killed all the parasites in the hydatid fluid. However, a current density of 7 mA/cm2 (9 V) in RPMI medium after 3 min was most effective.