Context: Ferroptosis is an understudied iron-dependent cell death pathway characterized by lipid peroxidation and has emerged as a critical mediator of virus-induced cytotoxicity and inflammation, particularly in respiratory viral infections. Objectives: This study examined the temporal regulation of ACSL4, a key pro-ferroptotic enzyme. Evidence Acquisition: A549 cells were infected with influenza A/H1N1, influenza A/H3N2, and influenza B viruses and assessed at 24 and 48 hours post-infection (hpi). ACSL4 expression was evaluated using quantitative reverse transcription-polymerase chain reaction, followed by post hoc analysis. Results: ACSL4 expression showed modest changes at 48 hpi in the A/H1N1 and A/H3N2 groups. However, a pronounced upregulation was observed at 24 hpi, particularly in the A/H1N1 group, with a log fold change increase of 1.52 (P = 0.005). The greatest downregulation was observed at 48 hpi in the influenza B group, with a significant log fold change of -4.11. Conclusions: These findings indicate the time-dependent activation of pro-ferroptotic mRNA associated with ferroptosis during influenza virus infection and suggest that ACSL4 may be a mediator of virus-induced cell death and a target for antiviral interventions.
Background: Influenza viruses induce multiple programmed cell death pathways in respiratory epithelial cells. These pathways are associated with host antiviral defense but may also contribute to tissue damage through inflammation and increased disease severity, thereby functioning as a double-edged sword. Apoptosis is a major cell death pathway that regulates the fate of infected cells following viral infection. Objectives: This study evaluated the mRNA expression of BAX, BAK1, and Bcl-2, three key apoptosis-regulating genes, in A549 lung epithelial cells infected with influenza A/H1N1, A/H3N2, and influenza B viruses. Methods: A549 cells were cultured and inoculated with 100 TCID50 of influenza A/H1N1, A/H3N2, and influenza B viruses for 48 hours. Results were compared with those for uninfected control cells. At 48 hours post-infection, RNA extraction (RNJIA, ROJE) and cDNA synthesis were performed, and the mRNA expression levels of BAX, BAK1, and Bcl-2 were assessed using SYBR Green reverse transcription quantitative PCR. All analyses were based on log fold change (logFC). Differential gene expression versus control was evaluated using the Wilcoxon signed-rank test and a one-sample t test, whereas time-dependent changes within each virus group were assessed using the Kruskal-Wallis test and one-way analysis of variance, followed by pairwise post-hoc tests with Benjamini-Hochberg correction. Results: At 48 hours post-infection, BAX expression was significantly upregulated in A/H1N1-infected cells (log fold change = 2.85, P = 0.031). Although A/H3N2 also upregulated BAX expression (log fold change = 2.35, P = 0.061), this change was not significant. Minor downregulation of BAX was observed in influenza B-infected cells (log fold change = -0.26, P = 0.463). BAK1 expression was significantly upregulated in A/H3N2-infected cells (log fold change = 6.20, P = 0.019). A/H1N1-infected cells also showed BAK1 upregulation (log fold change = 2.10, P = 0.431), although this change was not significant, whereas influenza B-infected cells showed significant BAK1 upregulation (log fold change = 6.21, P = 0.025). Bcl-2 was significantly downregulated in all three infected groups (A/H1N1: log fold change = -6.05, P = 0.040; A/H3N2: log fold change = -4.02, P = 0.002; influenza B: log fold change = -0.70, P = 0.032). Conclusions: This experiment demonstrated strain-dependent regulation of apoptosis-related genes in A549 cells following infection with different influenza viruses. Significant upregulation of BAX and BAK1 after A/H1N1 infection, upregulation of BAK1 after A/H3N2 and influenza B infection, and downregulation of Bcl-2 in all infected groups suggest activation of pro-apoptotic signaling. These findings are preliminary transcriptional observations from an in vitro system and may provide insight into mechanisms involved in the regulation of pro-apoptotic genes in the apoptosis pathway.
Background: Human immunodeficiency virus (HIV) is a member of the retroviral family. The virus infects human white blood cells, including macrophages, dendritic cells, and CD4 lymphocytes, thereby weakening the immune system if patients are not appropriately treated with antiviral agents. Subsequently, the disease progresses to acquired immunodeficiency syndrome (AIDS), with clinical manifestations caused by opportunistic microorganisms, including filamentous bacteria and other bacterial and fungal agents. Filamentous bacteria, or actinomycetes, include important environmental and medically relevant species. These bacteria constitute a major component of the oral microbiota, including that of the oropharynx, particularly in periodontal pockets, gingival grooves, tonsil crypts, and dental plaques. Objectives: The primary aim of this study was to isolate and phenotypically and genotypically characterize Actinomycetes from the oral cavity of HIV-infected participants. Methods: In this retrospective cross-sectional study, conducted from March 2022 to August 2023, buccal samples were collected from 200 HIV-infected participants at a university clinic and transported under cold-chain conditions to the microbiology laboratory at Tehran University of Medical Sciences, Tehran, Iran. Samples were cultured on appropriate media, and bacterial isolates were identified using microscopic, biochemical, and molecular assays. The antimicrobial susceptibility of the Actinomycetes was assessed against selected antimicrobials. In addition, the phylogeny of the isolates was analyzed using sequencing and bioinformatics tools. Results: Of 200 oral samples from HIV-infected patients, 19 Actinomycetes strains (9.5%) were isolated, including Streptomyces (n = 6), Nocardia (n = 6; all N. farcinica), Nocardiopsis (n = 6; including two N. alba), and Saccharopolyspora (n = 1) species. Most isolates were multidrug resistant, exhibiting resistance to beta-lactams such as penicillin G and amoxicillin/clavulanic acid, as well as erythromycin, tetracycline, nalidixic acid, and clindamycin. However, the isolates were largely susceptible to other antimicrobials. Conclusions: This study demonstrated a high prevalence of Actinomycetes, particularly Nocardia and Streptomyces spp., among HIV-infected patients. Accurate identification of Actinomycetes and determination of their antimicrobial susceptibility can effectively guide the treatment of oral ulcers, especially in patients infected with antimicrobial-resistant strains.
Background: Amino acids are essential for immune function, and alterations in glycine, serine, and glutamic acid may contribute to neonatal sepsis. Objectives: To compare plasma levels of these amino acids between septic and healthy neonates using targeted metabolomic analysis. Methods: In this case–control study (2021 - 2022), 78 neonates with clinical symptoms of sepsis and 31 healthy controls matched for gestational age and birth weight were enrolled. Infants with metabolic, neurological, or congenital disorders, intrauterine growth restriction, or those receiving total parenteral nutrition were excluded. Amino acid concentrations were measured by liquid chromatography-tandem mass spectrometry (LC/MS/MS) with Multiple Reaction Monitoring (MRM). Results: Mean plasma glycine was 305.7 ± 78 µmol/L in healthy neonates versus 245.8 ± 71 µmol/L in septic neonates (P = 0.002). Serine was 121.9 ± 33 µmol/L in healthy neonates versus 82.0 ± 23 µmol/L in septic neonates (P < 0.001). Glutamic acid was 330.7 ± 91 µmol/L in healthy neonates versus 249.5 ± 84 µmol/L in septic neonates (P < 0.001). One‑way analysis of variance (ANOVA) confirmed significant group differences, with large effect sizes for serine (η² = 0.33) and glutamic acid (η² = 0.21). In multivariable logistic regression, lower serine [odds ratio (OR) = 0.924, 95% confidence interval (CI) 0.875–0.975, P = 0.004] and glutamic acid (OR = 0.992, 95% CI: 0.984 - 1.000, P = 0.046) remained independently associated with sepsis, while glycine was not significant. Conclusions: Serine and glutamic acid were independently associated with sepsis, supporting their potential as candidate biomarkers. Glycine, although reduced in septic neonates, was not independently predictive. These findings highlight the role of amino acid metabolism in neonatal sepsis and support further research into multi‑marker diagnostic approaches.
Background and Objectives: Universal prophylaxis and preemptive therapy are established strategies to prevent cytomegalovirus (CMV) after liver transplantation, yet their real-world comparative performance varies by center and risk mix. Methods: We conducted a single-center retrospective cohort of consecutive adult recipients transplanted from 2013 - 2021 in Mashhad, Iran. Exposure was the CMV-prevention strategy received (universal valganciclovir prophylaxis vs preemptive PCR-based monitoring). Primary outcomes were CMV viremia (PCR-confirmed) and CMV disease (clinical/histologic). Secondary outcomes were late-onset CMV (> 100 days post-transplant), acute rejection, and mortality. Multivariable logistic regression (and Cox proportional hazards where event dates were available) adjusted for calendar era, donor/recipient serostatus (D/R), immunosuppression regimen, monitoring protocol, age, and sex. Results: Among 475 recipients (universal valganciclovir: 170; preemptive monitoring: 305), CMV viremia occurred in 10/170 (5.9%) vs 18/305 (5.9%) (P = 0.993). Among the 28 infected patients, 23 (82.1%) were male. Onset timing was < 1 month in 6 (21.4%), 1 - 3 months in 9 (32.1%), and > 6 months in 13 (46.4%), indicating late-onset (> 3 months) in 22/28 (78.6%) overall. Conclusions: In this cohort, universal prophylaxis and preemptive monitoring showed no significant adjusted differences in CMV infection or disease. Given era effects and center-specific practices, policy selection should consider D/R risk, monitoring logistics, and late-onset CMV risk. Multicenter studies are warranted.
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects a significant proportion of women during their reproductive years. It is characterized by hormonal and metabolic dysregulation. Growing evidence suggests that the microbiota present in ovarian follicular fluid and vaginal secretions may significantly influence reproductive outcomes. Objectives: The primary objective of this study is to investigate and compare the microbiota of ovarian follicular fluid and vaginal secretions in infertile women with PCOS, specifically to analyze compositional differences between patients who achieve clinical pregnancy and those who do not. Methods: In this prospective cohort study, follicular fluid and vaginal swabs were collected from 30 women with PCOS enrolled for intracytoplasmic sperm injection (ICSI) cycle at Mahdiyeh Hospital, Tehran, between September 2023 and August 2024. None of the patients had taken metformin or antibiotics for 3 months prior to oocyte retrieval. Quantitative real-time polymerase chain reaction (RT-PCR) was employed to assess the Lactobacillus group, Bifidobacterium spp., Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis, Mycoplasma hominis, Escherichia coli, Bacteroides group, and Prevotella spp. Also, the number and maturity of eggs, fertilization and cleavage rates, number and quality of transferred embryos, male partner's semen parameters, infertility duration, cause and type of infertility, and transfer cycle details were recorded. GraphPad Prism 10 software was used for statistical analysis of the data. Results: While most bacterial profiles showed no significant differences between pregnant and non-pregnant groups, M. hominis levels in left follicular fluid were significantly higher in the non-pregnant group (P-value: 0.0225). There was no statistically significant difference in the number and maturity of eggs, fertilization and cleavage rates, the number and quality of transferred embryos, male partner's semen parameters, infertility duration, cause and type of infertility, and type of embryo transfer cycle between study groups. Conclusions: This study compared the reproductive microbiota in women with PCOS undergoing ICSI cycles and found significantly higher levels of M. hominis in left-ovary follicular fluid in non-pregnant women. Other bacterial and clinical parameters showed no significant differences. Future larger-scale studies using metagenomic sequencing are warranted to confirm this association and further characterize the follicular microenvironment's role in in vitro fertilization (IVF)/ICSI outcomes.
Background: Demodex mite is the most common ectoparasite in humans. Demodex infestation or demodicosis often remains asymptomatic, but may be a significant causative agent for many dermatological and ophthalmological conditions. Demodex is found in all parts of the human skin, but the majority are on the face. Demodex brevis inhabits the bottom of the sebaceous glands. Demodex folliculorum is found in the meibomian glands, eyebrows, and eyelashes, and can cause blepharitis. Both of them feed on oil for nutrition. Objectives: The main purpose of this cross-sectional descriptive research was to study the prevalence of human demodicosis and related risk factors in Ahvaz County, southwestern Iran (2022-2023). Methods: A total of 225 men and women referring to the Comprehensive Health Center in East Ahvaz were randomly and voluntarily selected. After completing the questionnaire, sampling from four areas of the face (nose, cheeks, chin, and forehead) was performed using the cellophane tape (CTP) and skin pressurization methods to determine Demodex infestation and evaluate associated risk factors. The results of this research were statistically analyzed using SPSS software version 13 and chi-square and Fisher's exact tests at a confidence level of 95%. Results: According to the obtained data, Demodex infestation in the participants of the study was 52.7% in men and 473% in women, and the total detection rate of Demodex was 573%. The prevalence of demodicosis with methods CTP and skin pressurization was 53.8% and 18.2%, respectively. The difference in infestation rates between the two methods was significant. The highest and lowest infestation rates by facial area were in the nose (50.2%) and chin (6.2%), respectively, with a significant difference among facial regions. The study included participants over 20 years of age, with the highest infestation rate among those aged 51 and above (46.5%). A significant difference in infestation rates was observed across age groups. Conclusions: It was concluded that Demodex prevalence increases with age. The CTP is a good sampling method for investigations of demodicosis prevalence.
Background: Detection of drug resistance in multidrug-resistant tuberculosis (MDR-TB) is essential for effective treatment. This retrospective cross-sectional study compared a World Health Organization (WHO)-recommended proportional method with molecular techniques, including polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and real-time polymerase chain reaction (RT-PCR), to assess clofazimine and linezolid resistance in MDR-TB isolates collected between 2024 and 2025 at a national referral center in Tehran, Iran. Objectives: By evaluating phenotypic and genotypic approaches, we aimed to describe resistance patterns and genetic diversity, as well as the value of molecular diagnostics in MDR-TB management. Methods: The study included consecutive clinical and laboratory-confirmed MDR-TB isolates from patients with confirmed first-line drug resistance based on symptoms, specialist examinations, and radiologic findings. Molecular identification used IS6110-based PCR and hsp65 spacer region PCR-RFLP. Drug susceptibility testing (DST) followed the WHO proportional method on Lowenstein-Jensen and Middlebrook media as the phenotypic reference standard. Primers targeted resistance genes rvo678 (clofazimine) and rrl and rplC (linezolid), analyzed by PCR-RFLP and RT-PCR; isolates with indeterminate or missing results were excluded. Results: Mutations were detected in the rvo678 gene (17.2%) and in the rrl or rplC genes (17.2%), associated with resistance to clofazimine and linezolid, respectively. The PCR-RFLP of rvo678 (720 bp) with NlaIII enzyme showed three distinct patterns: Eighty percent had 80/120/520 bp, 6.7% had 80/120/160/520 bp, and 10% had 80/120/190/520 bp. Bsrl enzyme produced uniform 300/400 bp patterns. For rrl (860 bp), Bsrl showed consistent 105/140/250/260 bp patterns; Bbvl revealed 93.3% had a 60/190/290/320/510/530/780 bp pattern, 6.7% lacked the 190 bp fragment. HaeIII enzyme produced 100/770/780 bp in 93.3% and 100/780 bp in 6.7%. The rplC gene (400 bp) was highly conserved. Bbvl enzyme produced a 75/100/290 bp pattern in 933% and a 70/100/290 bp pattern in 6.7%. Despite mutations, only one isolate showed phenotypic resistance to both clofazimine and linezolid, indicating complex resistance mechanisms; no significant genotype-phenotype correlation was observed. Conclusions: Many MDR-TB isolates carried mutations in genes linked to clofazimine and linezolid resistance, but these did not consistently translate into phenotypic resistance, suggesting complex mechanisms. The retrospective design and small single-centre sample limit generalizability. Future studies using whole genome sequencing (WGS) are recommended to clarify discrepancies and improve MDR-TB treatment strategies.
Background: Multidrug-resistant (MDR) Escherichia coli represent a serious public health risk, leading to higher rates of illness, death, and economic costs. The presence of antibiotics in livestock wastewater contributes to the development of resistance among commensal and environmental bacteria, which can diminish the effectiveness of these drugs in treating both humans and animals. Objectives: This research aimed to examine the patterns of antibiotic resistance and the prevalence of qnrS resistance genes. Methods: This cross-sectional study was conducted on 24 active dairy cattle farms in Hamedan, Iran, selected based on the presence of an accessible wastewater discharge point releasing into residential or agricultural areas. A total of 96 wastewater samples were collected from June to December 2023. Inclusion criteria for samples were a minimum volume of 1 liter, collection within the study period, and processing within 24 hours under refrigerated conditions. Eosin methylene blue agar was utilized to isolate E. coli from wastewater samples. The Kirby-Bauer diffusion susceptibility method was employed to assess the antimicrobial susceptibility and resistance patterns of the isolated E. coli strains. DNA amplification was conducted in polymerase chain reaction (PCR) on a thermos-cycler, for 35 cycles, using a master mix and specific primers for the qnrS gene. Results: Over 60% of 40 strains isolated from 96 wastewater samples were found to be resistant against nalidixic acid (NA), ceftazidime, trimethoprim-sulfamethoxazole (SXT), and piperacillin (PRL). The qnrS resistance gene was identified in 15% of the E. coli. Conclusions: The findings of this study reveal that the wastewater in Hamedan is tainted with antibiotic-resistant E. coli, which poses a significant risk to agricultural communities located downstream. This contamination not only threatens public health by fostering antibiotic resistance among microbial populations but also underscores the need for improved wastewater treatment to lower bacterial levels to safe standards before it is utilized in aquaculture and agriculture.
Background and Objectives: Hospital wastewater is a major reservoir for multidrug-resistant (MDR) bacteria, including integron-bearing Staphylococcus aureus. Integrons facilitate the acquisition and dissemination of antimicrobial resistance genes, making their epidemiological characterization essential for infection control. Methods: In this cross-sectional study, conducted over a 15-month period at two teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, a total of 120 methicillin-resistant S. aureus (MRSA) isolates were collected from hospital wastewater, of which 75 (62.5%) were integron-positive S. aureus isolates. The isolates underwent antimicrobial susceptibility testing, integron class determination, and molecular analysis for resistance gene cassettes. Associations between integron classes and antimicrobial resistance profiles were statistically evaluated. Results: Of the isolates examined, 66.6% carried class 1 integrons, 26.7% carried class 2 integrons, and 6.7% harbored both classes. Carriage of class 1 integrons was significantly associated with resistance to amikacin, penicillin, gentamicin, tetracycline, and erythromycin. Class 2 integrons were significantly correlated with resistance to amikacin, tetracycline, and erythromycin. A total of 16 distinct gene cassette arrays were identified. In class 1 integrons, the most prevalent arrays were aadB-aacA4-aadA2 (20%), aadB-catB3 (14%), and aadB-cmIA6 (12%). In class 2 integrons, sate (25%), dhfrAi-sate (20%), and dhfrAi (20%) were most frequent. Multidrug resistance was observed in 94.2% of isolates, with resistance to erythromycin, tetracycline, gentamicin, and amikacin being most common. Conclusions: This study highlights the predominance of class 1 integrons and their diverse gene cassette arrays in S. aureus isolates from hospital wastewater. The significant association between integron carriage and resistance to multiple antibiotics underscores the urgent need for enhanced surveillance and targeted infection control strategies to limit the spread of integronbearing S. aureus within healthcare environments.
Background: Recurrent implantation failure (RIF) presents a major challenge in assisted reproductive technology. Anti-inflammatory cytokines, such as interleukin-10 (IL-10), are essential for proper embryo implantation and the maintenance of pregnancy. Viruses can significantly impact the implantation failure process by disrupting the balanced secretion of both anti-inflammatory and pro-inflammatory cytokines. Objectives: The present study aimed to examine the relationship between IL-10 levels and the presence of human papillomavirus (HPV) and human herpesvirus 6 (HHV-6) genomes in endometrial secretion samples from women with RIF. Methods: This cross-sectional, single-center study was conducted at the Infertility Center of Aban Hospital of Tehran, between September 2021 and March 2022. After obtaining informed consent and confirming the inclusion criteria with a specialist physician, endometrial secretion samples from 20 women with RIF were collected to evaluate IL-10 levels using flow cytometry. Extracted viral DNA was analyzed using nested-polymerase chain reaction (nested-PCR) targeting the L1 gene for HPV and real time polymerase chain reaction (real-time PCR) targeting human herpesvirus 6A (HHV-6A) and human herpesvirus 6B (HHV-6B). Results: The study population age ranged from 32 to 38 years and the mean age was 34.95 ± 2.01 years. The mean duration of infertility among women was 5.9 ± 0.9 years. The range of IL-10 concentration was 1.05 to 13.52 (3.23 ± 3.4) pg/mL. In contrast to no detection of HPV DNA, the HHV-6A genome was detected among 1/20 (5%) of samples. There was no statistically significant difference in IL-10 production between samples with negative and positive results of viral DNA detection (P > 0.05). Conclusions: In this study, consistent with previous reports, low levels of IL-10 concentration were detected in the endometrial secretion samples of women with RIF, which may contribute to a pro-inflammatory uterine environment and hinder successful implantation. The dysregulation of IL-10 observed in our samples was not influenced by uterine HPV and/or HHV-6 infection, suggesting that other pathogens and immune modulators may warrant further investigation.
Background: A major treatment problem is multidrug-resistant (MDR) Pseudomonas aeruginosa, which is often connected to several nosocomial infections. Treating infections brought on by MDR strains with colistin is considered last-line monotherapy. Recent years have shown a concerning rise in colistin resistance, but little is known about its frequency, especially in specific areas. Methods: Clinical isolates of P. aeruginosa were gathered from hospitalized individuals at Hashemi Nejad Hospital in Mashhad, Iran, over a one-year time frame. Isolates designated as MDR underwent confirmatory testing involving ecfX gene-targeted polymerase chain reaction (PCR) and antibiotic susceptibility tests. Then, using the broth microdilution technique, colistin susceptibility was evaluated; minimum inhibitory concentrations (MICs) were calculated following Clinical and Laboratory Standards Institute (CLSI) recommendations. This was a descriptive cross-sectional study. Results: The study comprised 48 MDR isolates altogether from confirmatory tests. All 48 isolates showed 100% resistance to piperacillin-tazobactam, ceftazidime, cefepime, levofloxacin, meropenem, and imipenem, hence verifying their categorization as both MDR and carbapenem-resistant. Based on MIC values >= 4 pg/mL per CLSI criteria, colistin susceptibility tests indicated 9 isolates (18.75%) were colistin-resistant. Conclusions: The results draw attention to the growing colistin resistance in MDR P. aeruginosa isolates, hence stressing the critical requirement of ongoing monitoring and improved antimicrobial stewardship initiatives to reduce the spread of resistance and maintain the efficacy of last-resort antibiotics.
Background: Brucellosis is a zoonotic disease that is very common in the Middle East, particularly in Saudi Arabia, where contact with livestock is high, increasing the risk of transmission. Even though numerous control measures have been implemented, the disease remains a significant public health concern. Objectives: The present study aimed to examine the demographic distribution, clinical features, primary sources of infection, diagnostic methods, and treatment strategies of brucellosis cases to improve understanding of disease management and recurrence prevention. Methods: A retrospective study of 103 confirmed brucellosis cases was conducted over a seven-year period (2015-2022) at King Abdulaziz University Hospital (KAUH), a tertiary care hospital, to identify risk factors, clinical presentations, epidemiological patterns, and outcomes associated with the disease. Results: The majority of the patients with brucellosis were males (66%). Blood culture and serology were found to be positive in 913% and 76.7% of the cases, respectively. The most common source of infection was unpasteurized animal products (47.6%), and the most prevalent complication was spondylitis (11.7%). The main clinical feature was fever (90.3%), and the most common lab finding was anemia (68.9%). Most cases were cured (79.6%), and the relapse rate was only 3.9%. The most used antibiotic protocol for treating brucellosis was doxycycline + rifampicin combination therapy (44.7%). Conclusions: This study emphasizes the importance of continued vigilance, quick diagnosis, and strict adherence to treatment protocols. It also recommends future studies with a diverse population and larger sample size to validate these findings and facilitate better understanding, management, and treatment of brucellosis.
Background: Keratomycosis is a fungal corneal infection that can be vision-threatening and even cause eye discharge. Objectives: This study aimed to investigate and diagnose fungal keratitis in patients suspected of having corneal lesions. Methods: This descriptive cross-sectional study was conducted from fall 2018 to fall 2023 in 94 patients with suspected fungal keratitis at the ophthalmology clinics of Al-Zahra Hospital in Sistan and Baluchestan province. First, corneal scraping samples were prepared from the patients, then direct testing and culture were performed in standard mycological media. Fungal agents were identified based on microscopic and macroscopic features of the colonies. Results: The results of the tests showed that 37 samples (39.36%) out of 94 samples were positive by direct potassium hydroxide (KOH) test and Gram stain, and 32 samples (34.04%) were positive only by culture test. Twenty-five samples (26.60%) were positive simultaneously in both direct KOH-Gram stain and culture tests. The frequency of fungal species was Fusarium spp. (92.6%),Aspergillus species (53%), Penicillium species, and yeasts 1.1%, and 1.1%, respectively. Conclusions: Fungal keratitis can be caused by a variety of fungi if the necessary conditions are provided, such as corneal injury from plant stems and leaves. The negative direct test in the majority of patients emphasizes the importance and necessity of performing a culture of the sample to diagnose keratomycosis.
Background: Hepatitis A virus (HAV) and hepatitis E virus (HEV) are common viral infections worldwide, transmitted via the fecal-oral route. Unfortunately, there is no published data on the seroepidemiology of these two infections in the northwest of Iran. Objectives: This study aims to investigate the seroprevalence of HAV and HEV immunoglobulin G (IgG) antibodies in Ardabil, northwest of Iran. Methods: A cross-sectional study was conducted between 2018 and 2019 using 700 serum samples from family members of a population that was randomly selected. Blood samples were taken, and checldists were completed. The samples were tested using enzyme-linked immunosorbent assay (ELISA) for antibodies to HAV (anti-HAV) and anti-HEV IgG antibodies. The results of the study for both diseases were expressed using descriptive statistics, and the rate of positivity of samples in different age decades was compared analytically. Results: Our results showed that 135 (1930%) and 401(60.30%) out of 700 participants were seropositive for anti-HEV and anti-HAV IgG antibodies, respectively. The results indicate that there is a significant difference in the seroprevalence of hepatitis A and E. Hepatitis A has a significant upward trend starting from the beginning of the third decade, and by the end of the fourth decade, almost 100% of the tested individuals had a history of hepatitis A. On the other hand, hepatitis E shows a significant upward trend beginning in the early fifth decade, indicating that Ardabil experienced a hepatitis E outbreak 40 to 50 years before the study was conducted. Conclusions: The results demonstrate a significant difference in the seroprevalence of hepatitis A and E. These findings suggest that hepatitis A was endemic in Ardabil twenty years ago, but in the last twenty years, the circulation of the virus has decreased significantly. This finding also indicates that hepatitis E is not currently a common problem in the province, but due to the lack of herd immunity, there is a risk of outbreaks due to contamination of water or food sources.
Introduction: Post-streptococcal glomerulonephritis (PSGN) is a classic immune-mediated renal complication that typically arises 1-2 weeks after a streptococcal throat infection. While it is most commonly observed following pharyngitis or skin infections in children, its occurrence in association with deep neck infections, such as retropharyngeal abscess, is extremely rare. Case Presentation: We report a rare case of a 12-year-old boy with type 1 diabetes mellitus (DM1) who presented with edema and signs of acute glomerulonephritis (AGN) one week after symptoms of an upper respiratory tract infection. On examination, he had fever, dysphagia, cervical lymphadenopathy, and imaging confirmed a retropharyngeal abscess. Laboratory findings revealed microscopic hematuria, proteinuria, elevated antistreptolysin O (ASO) titers, low complement (C3) levels, and elevated inflammatory markers, supporting the diagnosis of PSGN. The patient was treated with broad-spectrum intravenous antibiotics and supportive therapy, resulting in complete resolution of the infection and normalization of renal findings within four weeks. Conclusions: This case highlights an unusual presentation of PSGN in association with a retropharyngeal abscess in an older child. Clinicians should maintain a high index of suspicion for post-infectious glomerulonephritis in children presenting with acute kidney injury and deep neck infections, even beyond the typical age range for retropharyngeal abscesses.
