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Background: There are ten genotypes of Echinococcus granulosus with different intermediate and final hosts affecting the parasite's life cycle and its transmission to humans. Therefore, this study was conducted to determine the genotype of isolated hydatid cysts using the simple and fast high-resolution melting point analysis (HRM) method. Methods: The paraffin tissue samples of patients who underwent surgery were obtained from the pathology sample bank of Vasei and Emdad Hospitals in Sabzevar, Iran during 2010-2020. The DNA content of the samples was extracted after collecting and determining the characteristics using the DNA extraction kit. PCR was performed on the samples and the presence of the hydatid cyst genome was confirmed using the special Master Kit. Mix PCR of Solis Biodyne Company and Real-Time device (Bio-Rad) were used, and the genetic identity of hydatid cysts were determined. Results: Out of 33 paraffin samples, 21 samples contained hydatid cyst DNA, two of which were from the brain and 19 from the liver tissues; 12 samples did not contain hydatid cyst DNAs. All liver samples were from sheep species (G1), and the brain samples were from buffalo species (G3). Therefore, 9.53% of the Echinococcus species collected were buffalo (G3), and 90.47% were sheep (G1) strain. Conclusion: Based on previous patterns, HRM methods can be used for easy and quick identification of Echinococcus strains. The G1 strain was the dominant strain causing hydatid cyst in different human organs, including the liver and brain. [ABSTRACT FROM AUTHOR]

Hydatid disease is endemic in some regions of the world. Even in endemic regions, splenic hydatid cysts are rare, especially in pregnancy. The most serious presentation is intra peritoneal rupture, which is a surgical emergency. Exploration with splenectomy is the favoured management. We present a case of splenic hydatid cyst, detected late in pregnancy, with intraperitoneal rupture in the postpartum period. Cystic lesions located anywhere in the body in endemic regions could be hydatid cysts. Prompt treatment should be planned immediately on detection in order to prevent potentially serious complications like rupture. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the common Echinococcus granulosus genotypes in Ağrı, Türkiye and to obtain information on the transmission of this parasite. Methods: Cystic echinococcosis samples from 100 slaughtered cattle and 100 slaughtered sheep and faecal samples from 200 stray dogs were included in 2021. Collected cyst fluid samples and faces were examined microscopically. DNA was isolated from the germinal membrane of the cysts and from the parasite eggs in the stool samples. The mitochondrial cytb gene region of the parasite was amplified by PCR. Genotypes were determined using the Basic Local Alignment Search Tool (BLAST) after sequence analysis of PCR amplicons. Results: The highest percentage of cysts was found in the lungs of sheep and the liver of cattle. In addition, 75% of sheep cysts and 25.6% of cattle cysts were fertile. Taenia spp./Echinococcus spp. eggs were found in 6% of the faeces of 200 dogs examined microscopically. E. granulosus eggs were detected in 4 out of 50 stool samples analysed by PCR. All samples analysed by sequence analysis were identified as E. granulosus s.s. G1 genotype. Sequence comparison revealed revealed one or more-point mutations in different regions of the five samples. Conclusion: E. granulosus s.s. G1 genotype, known as sheep strain, is common in the Ağrı, Türkiye. The controlled slaughter of livestock, especially sheep, and the avoidance of feeding hydatid cyst organs to dogs, together with public education, were necessary to prevent the spread of the disease. [ABSTRACT FROM AUTHOR]

Hydatid disease can virtually involve any organs, liver being the most common followed by lungs. Pleural effusion as a complication of pulmonary hydatid cyst is exceptionally rare and its diagnosis and treatment pose significant challenges. We present an intriguing case managed in Dr D Y Patil medical college and Hospital in west India in June 2023 involving a 70-year-old female who presented with symptoms of right-sided chest pain and acute-onset dyspnoea. Referred from a local hospital, a chest radiograph revealed the presence of right pleural effusion. Subsequent radiological investigations including a contrast enhanced CT at our centre exposed two large, well-defined hypodense lesions with fluid density, encased by thick enhancing walls, along with right-sided pleural effusion and hence a diagnosis of lung abscess with right pleural effusion (right parapneumonic effusion) was established. Despite ongoing care, clinical improvement eluded us. Thoracocentesis yielded a surprising revelation - the pleural fluid was transudative with visible hooklets and protoscolices, indicating a ruptured pulmonary hydatid cyst. The patient began albendazole treatment and received a CVTS consultation. They recommended a right lower lobe lobectomy, now scheduled for the near future. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the differential expression of nanos and ago genes in the protoscoleces, germinal layer, the neck, and the sucker regions of adult Echinococcus granulosus. Methods: The study was conducted in 2018 at the Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran. In the present study E. granulosus protoscoleces were cultured in a di-phasic medium to obtain strobilated worms. The strobilated worms were harvested and using a sterile razor blade, the neck region was separated. In the molecular study the neck sections were compared with the tissues derived from the suckers from the same worm. The primers were specifically designed for RT-qPCR on nanos and ago. The germinative cells were isolated from the cyst germinal layer and cultured in DMEM for further molecular studies. The Immunohistochemical profile was designed to explore the nature of nanos protein in the strobilated worms. Differences between and within groups were statistically assessed relative to the protoscoleces. Results: An increasing nanos gene expressions were found in sucker, neck, cells and germinal layer in comparison to the protoscoleces. The expression of ago gene was decreased in sucker, cell and germinal layer, and increased in the neck region in comparison to the protoscoleces. The results showed that both genes were expressed in all developmental stages of E. granulosus. Conclusion: nanos and ago genes were differentially expressed at different developmental stages of E. granulosus and may contribute to differentiation of the parasite. [ABSTRACT FROM AUTHOR]

Hydatid cyst is an infestation caused by Echinococcus granulosus, which is endemic in most countries and most commonly affects the liver and lungs. Isolated muscle involvement is very rare and accounts for 3-5% of all cases. In April 2022, Health Sciences University Elaziğ Fethi Sekin City and Research Hospital in Turkey received a referral for a 37-year-old male patient from the physical therapy and rehabilitation outpatient clinic. The patient presented with complaints of chronic pain in his left shoulder and back, which worsened with movement. After the radiological and serological confirmation of diagnosis, the patient underwent wide surgical resection, adjuvant and neoadjuvant anthelmintic chemotherapy. Precise and complete removal of the cyst without infecting the surrounding tissues combined with anthelmintic chemotherapy will not only increase the success of the surgery but will also minimize the possibility of recurrence and distant organ spread. In this study, we aimed to raise awareness by presenting the first reported isolated hydatid cyst in the infraspinatus muscle case from our country, which is extremely rare. [ABSTRACT FROM AUTHOR]

Echinococcosis is the most common cestode infection globally caused by the Echinococcus species. The most common organ involvement is the lungs and liver, but other organs can be rarely involved. Here, we present a case with a giant cerebral hydatid cyst. A 4-year-old boy presented with abnormal gait and walking at Marmara University School of Medicine Pendik Training and Research Hospital, Istanbul, Türkiye in September 2022. Cranial magnetic resonance imaging showed a cyst of 13 cm in diameter. The cyst was enucleated successfully with no rupture. Oral albendazole therapy was started. There was no eosinophilia, and the echinococcal indirect hemagglutination test was negative. Ultrasonography detected an anechoic cystic lesion in the liver. He was evaluated for deeporgan involvement; however, no cysts were detected in other organs. The histopathological examination was compatible with a hydatid cyst. Although intracranial hydatid disease in children is rare, it should be considered among the differential diagnoses in patients with neurological symptoms, especially in endemic regions. [ABSTRACT FROM AUTHOR]

Background: Hydatid cyst is a parasitic infection, often caused by Echinococcus granulosus. Although it is classified as a benign disease, cyst ruptures in the abdomen can be fatal. Ruptures occur spontaneously or after trauma. We aimed to report data from patients who underwent emergency surgery due to spontaneous intra-abdominal hydatid cyst rupture. Methods: Upon a retrospective review of the records at Department of General Surgery, Faculty of Medicine, Harran University, Şanlıurfa, Turkey, we found that 34 cases were operated on due to hydatid cyst rupture between January 2012 and October 2022. All patients were operated on in an emergency, and partial cystectomy, intra-abdominal irrigation, and drainage were performed using laparotomy. The patients were evaluated in terms of age, sex, symptoms, radiological findings, laboratory results, intraoperative findings, and postoperative follow-ups. Results: Twenty-two (64.7%) female and 12 (35.3%) male patients were enrolled. The mean age was 39.1 (±17.58) years. All patients experienced spontaneous rupture. The ruptured cyst was found in the liver in 32 patients (94%), the spleen in 1 patient (3%), and the pelvis in 1 patient (3%). The diagnosis was determined using ultrasonography in 12 (35.3%) patients, computed tomography in 21 (61.8%) patients, and magnetic resonance imaging in 1 (2.9%) patient. All patients exhibited acute abdomen and leukocytosis. The average length of hospital stay was 5.14 (±1.37) days. Conclusion: Hydatid cyst rupture should be considered in cases of acute abdomen, particularly in regions where the disease is endemic, as in our region. The ruptured hydatid cyst was primarily observed in the liver (94.11% of cases). [ABSTRACT FROM AUTHOR]

Introduction: Echinococcosis is the most common cestode infection globally caused by the Echinococcus species. The most common organ involvement is the lungs and liver, but other organs can also be rarely involved. Here, we present a case with a giant cerebral hydatid cyst. Case report: A 4-year-old boy presented with abnormal gait and walking. Cranial magnetic resonance imaging showed a cyst of 13 cm in diameter. The cyst was enucleated successfully with no rupture. Oral albendazole therapy was started. There was no eosinophilia, and the echinococcal indirect hemagglutination test was negative. Ultrasonography detected an anechoic cystic lesion in the liver. He was evaluated for deep-organ involvement, however, no cysts were detected in other organs. The histopathological examination was compatible with a hydatid cyst. Discussion: Although intracranial hydatid disease in children is rare, it should be considered among the differential diagnoses in patients with neurological symptoms, especially in highly endemic regions.

Human alveolar echinococcosis (AE) remains a serious public health concern in endemic areas and a challenge for clinicians. Here a confirmed case of human AE in a patient from Armenia who had not visited a known Echinococcus multilocularis endemic area is reported. In October 2012, a 12- year-old girl from a little Armenian village, presented with paroxysmal pain in the right lumbar area to the children's medical center (MC). The girl mentioned having close contact with an animal, like a cat. She was admitted to the surgical department with a diagnosis of a malignant liver tumor in the right lobe. In November 2012, the patient underwent laparotomy, removal of the hepatic lesion and abdominal cavity drainage. The histopathological examination of the biopsy material confirmed the main diagnosis of liver AE with suppurative lesions. The patient was given albendazole (ABZ) following 20 days in the hospital, but she stopped receiving the preventive chemotherapy at home and even missed the dispensary visits. It later caused complications, and in July 2016, the child had once again surgery. In January 2017, the child was readmitted to the MC with no content from the external biliary drainage tube in the previous 6 hours. Bile flow improved after flushing the drainage with saline solution and suturing the enterostomy tube. In February 2017, the child visited MC for examination, and the drainage of the bile ducts was blocked, although she had neither discomfort nor jaundice. It was recommended to continue the patient's follow-up, to receive ABZ and to undergo a liver transplant surgery. [ABSTRACT FROM AUTHOR]

Background: Echinococcus granulosus is spread by the excretion of cystic organs into the environment. The dog is infected via eating the cystic organ. It then contaminates the environment with eggs of E. granulosus, which are infective to humans and animals. We aimed to determine the E. granulosus genotypes that cause infection in humans in the Van region, Türkiye. Methods: Sixty patients between 18 and 100 years of age, who underwent the puncture, aspiration, injection, re-aspiration (PAIR) procedure in the Department of Radiodiognastics of Van Yüzüncü Yıl University, Van, Türkiye were included in the study. PAIR fluids were examined microscopically and DNA was isolated from the fluids. After DNA isolation, polymerase chain reaction (PCR) was performed using primers that amplify the E. granulosus NADH dehydrogenase subunit 1 (NAD1) gene region. After sequence analysis of the PCR amplicons, Basic Local Alignment Search Tool (BLAST) was performed. Results: In the microscopic examination, protoscolex or hook was detected in 42 (70%) of the samples. DNA was successfully extracted from all of the cyst fluids containing protoscolex and hook, and the NAD1 gene region was PCR-amplified. After using BLAST, all of the samples were determined to be an E. granulosus sensu stricto G1 genotype. Sequence comparison revealed that four (9.5%) isolate sequences showed single nucleotide polymorphism (SNP). Sequences of isolates with SNP submitted to the GenBank with accession numbers OR565864 to OR565867. Conclusion: E. granulosus s.s. G1 genotype, known as sheep strain, is common in human hydatid disease in the Van region of Türkiye. [ABSTRACT FROM AUTHOR]

Gallbladder is a rare localization for hydatid disease. Complications are even rarer and precise diagnosis is quite difficult even with radiological assistance. We report a rare case of 41-yr-old male patient presenting with the rupture of a gallbladder hydatid cyst with multiple fistulae to intra and extrahepatic bile ducts and pancreas, at Kocaeli State Hospital, Turkey in 2021. The patient had abdominal pain and abdominal CT scan reported a bizarre "contrast enhanced cholangiography" sign - radiopaque contrast substance in gallbladder, intra and extrahepatic bile ducts and pancreatic ducts, with concomitant acute cholecystitis. Surgery was performed and intraoperatively gallbladder hydatid cyst with multiple fistulae was noted. Cholecystectomy with total cyst excision was performed. Endoscopic retrograde cholangio pancreatography (ERCP) was utilized to irrigate and eradicate the parasite in the fistulae tracts localized near pancreas and intra/ extrahepatic ducts. Postoperative period was uneventful, antiparasitic treatment was started, and in the yearly follow-up patient had no recurrence. Multidisciplinary and minimal invasive management is crucial in such bizarre, complicated cases. [ABSTRACT FROM AUTHOR]

Echinococcosis is a parasitic disease characterized by cysts in especially liver and lung. We report a long-term survival of a 44-year-old female patient with disseminated echinococcal disease involving the brain, lung, liver, spleen, kidney, mediastinum, thyroid gland, parotid gland, pancreas, peritoneum, rectus muscle, pararenal area, left thigh, skin and breast tissue from Turkey in 2016. [ABSTRACT FROM AUTHOR]

Hydatid cyst mainly involves the liver and lung; however, it can rarely involve cardiac tissue. This study describes the presence of hydatid cysts in the heart with considerable disease points in Tehran, Iran. Two cases aged between 25 to 50 years with cardiac hydatid cyst involvement were identified in 2021 in Tehran, Iran. Epicardial hydatid cyst between a left anterior descending coronary artery (LAD) and left obtuse marginal artery (OM) on the left ventricle, and in the second case, intrapericardial cyst attached to the pulmonary trunk with a thin base were identified. The cardial cysts were resected, and the patients recovered without any complications. Cardiac hydatid cyst is a very rare disease. Rapid diagnosis and surgical and medical care are necessary for treatment. [ABSTRACT FROM AUTHOR]

Background: Hydatid cyst, caused by the larvae of Echinococcus granulosus, is one of the most severe cestode infections occurring in Iran. The liver is the most commonly involved organ. The present study was carried out to review the demographic of 20 years surgically treated hydatic cysts. Methods: Ninety-eight patients were enrolled in the study. Demographic features, time of surgery, cyst size, and albendazole usage have been reviewed from the medical records of patients in Loghman Hakim Hospital, Tehran, Iran, from 2001 to 2021. Statistical analysis was performed to find any correlation between the uses of concurrent albendazole with surgical procedure. Results: Of 98 patients with hydatid cyst, 57 (58.2%) were female. The mean age of patients was 39.4 ± 18.7 yrs, and the mean surgery time was 217.5 ± 81.4 minutes. Regarding the infection site, the liver (60.2%) and lungs (22.4%) were the most affected organs, respectively. 56.1% of patients had one cyst, and 42.9 % had two or more cysts. 20.4% of them had taken albendazole before surgery, but 86.7 % took it after the operation. No recurrent cysts were seen among 91.8% of them, but 8.2% mentioned suffering from a recurrent cyst. 85.7% of those recurrent cases did not receive albendazole before surgery, and 75% of recurrent cases after surgery did not take albendazole (P

Background: Hydatid cyst, caused by the larvae of Echinococcus granulosus, is one of the most severe cestode infections occurring in Iran. The liver is the most commonly involved organ. The present study was carried out to review the demographic of 20 years surgically treated hydatic cysts. Methods: Ninety-eight patients were enrolled in the study. Demographic features, time of surgery, cyst size, and albendazole usage have been reviewed from the medical records of patients in Loghman Hakim Hospital, Tehran, Iran, from 2001 to 2021. Statistical analysis was performed to find any correlation between the uses of concurrent albendazole with surgical procedure. Results: Of 98 patients with hydatid cyst, 57 (58.2%) were female. The mean age of patients was 39.4 ±18.7 yrs, and the mean surgery time was 217.5 ± 81.4 minutes. Regarding the infection site, the liver (60.2%) and lungs (22.4%) were the most affected organs, respectively. 56.1% of patients had one cyst, and 42.9 % had two or more cysts. 20.4% of them had taken albendazole before surgery, but 86.7 % took it after the operation. No recurrent cysts were seen among 91.8% of them, but 8.2% mentioned suffering from a recurrent cyst. 85.7% of those recurrent cases did not receive albendazole before surgery, and 75% of recurrent cases after surgery did not take albendazole (P<0.05). Conclusion: Administration of albendazole before and after the operation was significantly related to reduced recurrence, bleeding, morbidity, and even the time of surgery. [ABSTRACT FROM AUTHOR]

Hydatid cyst is an anthropozoonotic disease caused by Echinococcus for which man is an accidental intermediate host. The hydatid disease commonly involves the liver and lungs. Involvement of extrahepaticopulmonary sites is extremely rare and only a few isolated cases have been reported. In 2022, a 49 year old female from the southern part of Indian subcontinent presented to us with recurrent hydatid cyst of liver co-existing with hydatid cyst of the left broad ligament, twenty years following the initial procedure. She underwent exploratorylaparotomy and cystectomy and was then managed by ERCP and stenting following which she is asymptomatic till date. Though there are no hard and fast rules, the management of such cases mandate proper exploration to avoid any recurrence. Tailored surgical approaches maybe required according to the patient condition for effective, safe and recurrence free treatment of hepatic hydatidosis. [ABSTRACT FROM AUTHOR]

Background: The current study considers a new direction of surgical treatment of liver echinococcosis - the use of minimally invasive treatment methods of parasitic cysts. Methods: After clinical and morphological substantiation of the very possibility of carrying out such procedures, 9 microwave ablations (MWA) and 3 radiofrequency ablations (RFA) of cysts were performed in patients with liver echinococcosis from 2017 to 2021 in the surgical clinic of Botkin Hospital, Moscow, Russia. A comparative analysis of treatment results of patients with echinococcal liver cysts (12 patients who underwent "percutaneous puncture, aspiration, injection and reaspiration" (PAIR) procedure and 12 patients - MWA and RFA) was carried out. Results: The number of complications according to Clavien-Dindo classification was as follows: 8 after PAIR procedure, 3 after RFA and 3 after MWA. The median hospital length of stay (LOS) after PAIR procedure was 6.46 days versus 4.7 and 4 in the groups of patients who underwent RF and MW ablation, respectively. The frequency of relapses within the first year after PAIR procedure was 25%. The patients who underwent ablation procedures had no relapses of liver echinococcosis during observation. Conclusion: The presented clinical and morphological substantiation and the experience of using various types of ablation techniques on echinococcal cysts, as well as a comparative analysis with a commonly used PAIR treatment method, demonstrated the safety of RFA and MWA for the patient and efficacy in relation to the hydatid process. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the prevalence of Alveolar echinococcusis using ELISA in our region, to perform the specific differentiation of species by using the Western Blott method, to diagnose and treat this disease effectively in early periods, and to inform the patients about the results quickly. Methods: From the provinces of Erzurum, Kars, Ardahan, Iğdır, Ağrı and Erzincan in the Eastern Anatolia Region, Turkey in August-September 2017, blood samples were provided from 305 participants (volunteer patients and their relatives), including 151 females (49.50%), whose ages ranged between 6-85 yr and were diagnosed as Alveolar echinococcosis (AE) and operated in concerned clinics. Results: EIgG ELISA was determined as positive in 29 (9.5%) participants, including 17 (11.3%) females and 12 (7.8%) males. In addition, Em2-Em18 ELISA was also determined as positive in 15 (4.9%) participants, including 9 (6%) females and 6 (3.9%) males. Tweleve (3.94 %) of these findings were observed as positive in terms of both tests. Through the verification done by Anti-EWB IgG, Echinococcus multilocularis (EM) was identified in 7 (21.9%) of the female participants, E. granulosus (EG) in 1 (3.1%), and both parasites in 2 (6.2%). For male participants, EM was determined in 3 (9.3%) of them, EG in 1 (3.1%), and both parasites in 1 (3.1%). Conclusion: AE continues to threaten public health in the region. In families where AE is detected positive, the reason for disease is based on nutrition; thus, it will be proper to check up all family members in the terms of infection.

Background: Parasites of the genus Echinococcus are common worldwide and are important cestodes that cause serious infections in humans and animals. This retrospective study evaluated the indirect hemagglutination (IHA) test results of serum samples obtained from patients with a pre-diagnosis of cystic echinococcosis (CE) within ten years. In addition, the role of the IHA test results of the patients in the follow-up of the treatment and determining possible recurrences was investigated. Methods: The IHA test results of 2426 serum samples of patients with a prediagnosed CE admitted to Trakya University Health Center for Medical Research and Practice in Edirne, Turkey, between January 2011 and December 2020 were evaluated retrospectively. The data of 53 patients with CE who had medical treatment and/or postoperative follow-up serological records were evaluated. Results: Of 2426 IHA tests, 376 (15.5%) were seropositive, and 2050 (84.5%) were seronegative. It was determined that 376 serum samples detected as positive belonged to 207 patients with CE. Of 207 CE patients, 109 (52.7%) were female and 98 (47.3%) were male. The most common organ involvement was the liver in 186 (89.9%) cases. Of 53 patients, 16 were considered relapse cases. The median follow-up period for 16 recurrent cases was 31.8 (1-77) months. Our results showed a statistically significant correlation between long-term serological follow-up and recurrence detection (P=0.034). Conclusion: Long-term serological follow-up after treatment is considered useful in determining possible recurrent cases. CE is an important public health problem for endemic regions, including our country, and we think our study results will contribute to the status and follow-up of the disease. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the prevalence of Alveolar echinococcusis using ELISA in our region, to perform the specific differentiation of species by using the Western Blott method, to diagnose and treat this disease effectively in early periods, and to inform the patients about the results quickly. Methods: From the provinces of Erzurum, Kars, Ardahan, Iğdır, Ağrı and Erzincan in the Eastern Anatolia Region, Turkey in August-September 2017, blood samples were provided from 305 participants (volunteer patients and their relatives), including 151 females (49.50%), whose ages ranged between 6-85 yr and were diagnosed as Alveolar echinococcosis (AE) and operated in concerned clinics. Results: EIgG ELISA was determined as positive in 29 (9.5%) participants, including 17 (11.3%) females and 12 (7.8%) males. In addition, Em2-Em18 ELISA was also determined as positive in 15 (4.9%) participants, including 9 (6%) females and 6 (3.9%) males. Tweleve (3.94 %) of these findings were observed as positive in terms of both tests. Through the verification done by Anti-EWB IgG, Echinococcus multilocularis (EM) was identified in 7 (21.9%) of the female participants, E. granulosus (EG) in 1 (3.1%), and both parasites in 2 (6.2%). For male participants, EM was determined in 3 (9.3%) of them, EG in 1 (3.1%), and both parasites in 1 (3.1%). Conclusion: AE continues to threaten public health in the region. In families where AE is detected positive, the reason for disease is based on nutrition; thus, it will be proper to check up all family members in the terms of infection. [ABSTRACT FROM AUTHOR]

Background: Optimal duration for medical therapy of liver hydatid cysts before surgery in not certainly defined yet. In this study, we aimed to evaluate the effectiveness of 2 weeks preoperative albendazole in decreasing viable cysts. Methods: Patients referring to Imam Reza Hospital, Mashhad, Iran with a diagnosis of hepatic hydatid cyst were randomly divided into intervention (44 patients) and control (46 patients) groups. The case group were treated with oral albendazole before surgery and the control group underwent surgery without albendazole therapy. Efficacy of albendazole on the reduction of prevalence and viability of the protoscoleces was finally evaluated. Results: A number of 90 patients were included in the final analysis. Protoscoleces were reported alive in 10 (22.7%) and 17 (36.9%) of patients in the case and control group, respectively. The decrease of live protoscoleces in case group was not statistically significant (P=0.14). Conclusion: Decrease in the viability of protoscoleces in hepatic hydatid cysts after 2 weeks administration of oral albendazole at a dose of 10 mg/kg/day preoperatively, is not significant. Optimal duration of medical treatment before surgery seems to be 4 weeks or more. [ABSTRACT FROM AUTHOR]

Hydatid cyst is a parasitic infection transmitted by oral ingestion of Echinococcus granulosus eggs. Hydatid cyst of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We present an 8-yr-old girl with complaints of swelling of lower abdomen, pollakiuria and bilateral flank pain was brought to Emergency Department of Harran University, Turkey, in Jun 2019. The patient had simultaneous hydatid cysts of the liver, mesentery and uterus. We performed abdominal exploration and completely removed the inner germinal layer of cyst through an incision made in the anterior of the uterine fundus. Then, we applied total excision to the two cysts in the right and left colon mesentery. Finally, we performed partial cystectomy to the cyst in the liver, and we removed the cyst membrane totally. In endemic regions, hydatid cysts should be considered for the diagnosis of children with cystic mass lesions. Uterine-sparing approach should be kept in mind as an option, especially in young women. Early surgical treatment of large pelvic cysts that cause obstructive uropathy may prevent the progression of renal damage. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is an important zoonotic parasitic disease worldwide. Application of species-specific antigen for serodiagnosis of human CE has not been utilized, so far. In this regard, AgB originated from Echinococcus granulosus sensu stricto (G1-G3) and E. canadensis (G6/G7) CE cysts, confirmed by molecular biology and sequencing was used for evaluation of their ability in the diagnosis of confirmed human CE. Methods: The hydatid cyst fluid (HCF) of E. granulosus sensu stricto and E. canadensis species were separately, used for preparation of AgB during 2017-2018 in Shiraz and Tehran, Iran. A total of 45 sera samples from confirmed CE patients, 102 sera from healthy people as negative control and 44 sera from other parasitic diseases, were used for measurement of the diagnostic ability of antigen B originated from E. granulosus sensu stricto and E. canadensis species of CE, alone or in 50%:50% mixture using ELISA method. Results: Overall, 38 (84.4%) out of 45 confirmed human CE were positive by ELISA using AgB originated from E. granulosus sensu stricto. This items for AgB originated from E. canadensis was 39 (86.6) out of 45 serum samples. A total of 39 out of 45 samples (86.6%) showed positivity by a mixture of antigen B originating from both species. The specificity of the above tests was calculated as 93.15%, 96.58%, and 93.84%, respectively. Conclusion: Due to the diversity of the cyst species in human population, application of AgB from prevalent species alone or in combination with other species is suggested. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis. Methods: The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test. Results: Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001). Conclusion: The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis. [ABSTRACT FROM AUTHOR]

Hydatid disease (HD) is a zoonotic disease, which typically affects the liver and the lungs. Primary retroperitoneal localization of the disease is infrequent. The most common symptom is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. A 53-year-old female patient presented to Kocaeli University General Surgery Clinic, Turkey in September 2019 with complaints of flank pain, constipation and vomiting. The MRI revealed cystic lesions in the pancreas and psoas muscle. Both cysts were excised totally during laparotomy. Histopathology reports showed that the lesion in psoas muscle was hydatid cyst whereas the lesion in pancreas was pancreatic pseudocyst. Postoperative period was uneventful and the patient was discharged with albendazole treatment. No recurrence occurred during follow-up period. Atypical localization for hydatid disease is a diagnostic dilemma for surgeons, especially in endemic countries. Hydatid disease should always be considered in the differential diagnosis of retroperitoneal lesions, inadequate management can lead to complications and fatalities. Surgery combined with antiparasitic therapy, may be an option in the presence of obstruction of gastrointestinal and/or urinary tract. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is a common parasite with zoonotic character created by a small cestode, Echinococcus spp., and is an important public health problem in Turkey as well as all over the world. We aimed to investigate antibodies in serum samples of suspected Echinococcosis patients sent to the National Parasitology Reference Laboratories of the General Directorate of Public Health. Methods: Serum samples of 2390 patients sent to our laboratory between January 1, 2014 and May 01, 2019, evaluated by ELISA, Indirect Hemagglutination Test (IHA) and Western Blot (WB) methods are presented. Our laboratory is the national reference laboratory. All kinds of tests requested from suspected patients can be performed Results: Overall, 1199 (50.2%) of 2390 serum samples were female and 1191 (49.8%) were male. It was observed that 178 (14.9%) of men and 210 (17.5%) of women were seropositive. There was no statistical difference between the sexes in terms of seropositivity. Of all samples, 1941 (81.2%) were negative, 388 (16.2%) were positive, and 61 (2.6%) were borderline. Results determined as borderline are considered suspicious and a recommendation is made to repeat the test after 15 days. A statistical difference was found in the distribution of seropositivity by years. While seropositivity was lowest in 2014, it was found to be highest in 2018 and 2019. Conclusion: Despite all the precautions taken, it is seen that echinococcosis still continues to exist in Turkey as a zoonotic disease. Hence, CE has been involved in Turkey Zoonotic Diseases Action Plan (2019-2023) and decided to carry out studies for the protection and prevention of the disease. [ABSTRACT FROM AUTHOR]

Ba ckground: Studies on experimental model of cancer showed that hydatid cyst fluid (HCF) has antitumor activity. We aimed to investigate the effect of HCF and Antigen B (AgB) on 4T1 breast tumor cells in BALB/c mice. Methods: This study was carried out in the Department of Parasitology, Tarbiat Modares University, Tehran, Iran from 2019 to 2020. There were two control groups of BALB/c mice (one group were injected with aluminum sulfate and another group with PBS), and six groups, injected via the intraperitoneal route with 100, 300 and 500 μg/ml concentrations of HCF, AgB diluted in 100 μl PBS, and alum. Seven days after the last treatment, 7×105 4T1 cells were subcutaneously injected into the right flank of BALB/c mice. Results: The difference between the mean size of the tumor in the case and control groups was statistically significant (P<0.05). The mean level of cytokines between the case and control groups was statistically significant (P<0.05). Our histopathological studies showed a reduction in both tumor volume and carcinogenesis in groups injected with 300 μg/ml HCF and 500 μg/ml AgB. The antitumor activity of HCF and AgB may be related to the immune responses against these antigens. Conclusion: We suggest that polarization of the Th1/Th2 ratio toward the Th1 pathway occurred in groups injected with HCF and AgB. More comprehensive and precise experiments using different hydatid cyst components are required to investigate their prophylactic effects on breast cancer. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate currently protoscolices agents by using two methods including injection and impregnated sponges with protoscolices agents. Methods: Hypertonic saline 20%, silver nitrate 0.5% and Ethanol 96% were injected into sheep hydatid cysts. Then, after different exposure times (5, 10, and 15 min), the protoscolices were aspirated from the cyst and viability of the protoscolices were evaluated microscopically using vital staining. In the second part, the live protoscolices were sprayed on the soaked sponge with the mentioned protoscolicidal agents. After different exposure times live protoscolices were counted microscopically. One-way ANOVA and Tukey tests were used for showing difference significant between studied groups. Results: Cyst injection method showed that ethanol, Nacl and AgNo3 have 80%, 60% and 6% protoscolocidal efficacy, respectively (P<0.05). In sponge method the most and fastest protoscolocidal efficacy were observed in all used protoscolicidal agents. Conclusion: Ethanol and NaCl and AgNo3 with sponge method is more effective than the injection of protoscolices agents in the cyst. [ABSTRACT FROM AUTHOR]

Background: Two calcified objects recovered from an adolescent in a burial site in Amiens, France, have been previously identified as hydatid cysts using thin-section petrography. The importance of ancient hydatidosis besides the value of these unique archeological excavated materials encouraged the authors to look at this attractive subject more interdisciplinary by implementing medical radiology. Methods: In the current experiment, which has been carried out in the Radiology Department, Tehran Heart Center (THC), Tehran, Iran, the conventional and dual-energy dual-source Tomography, X-Ray Computed-scan was used in studying the remaining structures of the two calcified masses. The imaging procedure was carried out based on X-Ray attenuation by two different tube voltages. Results: A high concentration of calcium sediment in the cyst walls was revealed in Hounsfield units, the measuring of the elements in CT. Taking advantage of implementing this imaging technique the oxalate calcium was also shown as the dominant component of the samples. The results were all in favor of diagnosing hydatid cysts. Conc lusion: The achieved pictorial results in the present paper have highlighted the important role of CT scan as a noninvasive confirming technique in paleopathological investigations. Using Dual-source dual-energy CT-scan in reconfirming these previously identified hydatid cysts, is an encouraging message towards the necessity of sequential studies on invaluable biological excavated pieces. [ABSTRACT FROM AUTHOR]

Morbidity of mixed cystic and alveolar echinococcosis (CE and AE) is exceptionally rare. Less literature retrieved from a database on the internet detailed the content, including radiography, pathology, and therapeutics data. Such a case of co-occurrence of the different Echinococcus species was diagnosed and treated at our hospital center from Nov 2019 to Feb 2020. A 30 yr old female from the pastoral area in Qinghai Province, China, was diagnosed with a case of echinococcosis and diagnosis was confirmed after image studies, immunoassaying of hydatid enzymes, life history and pathology result. The patient underwent hepatectomy along with excision of the internal capsule. Post-operative pathology was done, and it confirmed a mixed infection of both CE and AE. The patient recovered well without complications after liver-protecting and tissue repair treatment for 15 days. Knowing about infective mode and immune method of the case might be vital for research on variation for Echinococcus infection.

Background: Echinococcosis is a common parasite with zoonotic character created by a small cestode, Echinococcus spp., and is an important public health problem in Turkey as well as all over the world. We aimed to investigate antibodies in serum samples of suspected Echinococcosis patients sent to the National Parasitology Reference Laboratories of the General Directorate of Public Health. Methods: Serum samples of 2390 patients sent to our laboratory between January 1, 2014 and May 01, 2019, evaluated by ELISA, Indirect Hemagglutination Test (IHA) and Western Blot (WB) methods are presented. Our laboratory is the national reference laboratory. All kinds of tests requested from suspected patients can be performed Results: Overall, 1199 (50.2%) of 2390 serum samples were female and 1191 (49.8%) were male. It was observed that 178 (14.9%) of men and 210 (17.5%) of women were seropositive. There was no statistical difference between the sexes in terms of seropositivity. Of all samples, 1941 (81.2%) were negative, 388 (16.2%) were positive, and 61 (2.6%) were borderline. Results determined as borderline are considered suspicious and a recommendation is made to repeat the test after 15 days. A statistical difference was found in the distribution of seropositivity by years. While seropositivity was lowest in 2014, it was found to be highest in 2018 and 2019. Conclusion: Despite all the precautions taken, it is seen that echinococcosis still continues to exist in Turkey as a zoonotic disease. Hence, CE has been involved in Turkey Zoonotic Diseases Action Plan (2019-2023) and decided to carry out studies for the protection and prevention of the disease.

Background: Wild foxes play an important role in echinococcosis epidemics. There have been a few studies investigating Echinococcus spp. in the Qinghai- Tibet Plateau area, China, but none on the prevention and control of Echinococcus spp. in wild foxes. Methods: From 2016 March through December 2019, two wild fox dens were selected as two test sites based on prior long-term camera screening and observation. Anthelmintic praziquantel tablets were placed near the two dens of wild foxes, and the wild foxes freely consumed the anthelmintic drugs. Morphological methods were used to detect initially the parasite species, and PCR molecular methods were used to identify accurately parasite and host species. Results: Parasite eggs of E. multilocularis (2/11, 18.2%) were found in 11 fecal samples. Importantly, the eggs of E. multilocularis (1/21, 4.8%) were found again in the feces of the foxes one year later; moreover, the eggs of E. multilocularis (2/19, 10.5%) still existed in the feces of the foxes two years later. Conclusion: Wild foxes were repeatedly infected with E. multilocularis and that deworming for prevention and control is required at least twice per year. Prevention and control methods for echinococcosis in wild foxes were explored, providing a scientific basis for the prevention and control of echinococcosis in wild animals. [ABSTRACT FROM AUTHOR]

Background: Cystic Echinococcosis is considered a cosmopolitan cyclozoonotic parasitic infection. This study aimed at evaluating the seroprevalence of human hydatidosis using ELISA test and find the role of mutable factors such as age, sex, occupation, residency in the broadcast of the parasites in rural Ardabil Province, North-West of Iran. Methods: The study population was 950 asymptomatic individuals selected randomly from urban and rural populations of Ardabil province, North-West of Iran by randomized cluster sampling in 2019-2020. Immunoglobulin G antibodies against Echinococcus granulosus spp. were analyzed by ELISA test. Data were analyzed using SPSS software and Multivariable logistic regression model. Results: Overall, 42 (4.4%) of the participants had anti E. granulosus antibodies in this region. High titer antibodies were most prevalent in people age group of >70 yr old, rural areas, females and people having history of contact with dog that showed significant difference. There was no significant association between the presence of Echinococcus antibodies and sex, occupation, having history of eating unwashed vegetable. Conclusion: This is the first description of the seroprevalence of E. granulosus infection in the population in Ardabil Province, North-West of Iran. Obtained rate of hydatidosis approves the importance of diagnosing human cystic echinococcosis in these regions and it is expected that the authorities be careful to screen the disease. [ABSTRACT FROM AUTHOR]

Hydatid cyst (HC) is a parasitic infection transmitted by oral ingestion of Echinococcus granulosus eggs. Isolated kidney involvement is extremely rare. It is even less common in children. We present a case of isolated renal HC in a 6-year-old boy from Şanlıurfa, southeast Turkey who complained of abdominal pain and distension. Cystectomy was performed with a flank incision using the extraperitoneal approach. No recurrence was detected in the postoperative 6-month follow-up. There are not enough data about the efficacy of medical treatment in renal HC. Therefore, medical treatment should be considered pre- and post-operatively to prevent dissemination, rather than being used as a primary treatment. Kidney-sparing surgery should be the first choice in patients with isolated renal HC. However, nephrectomy is recommended for nonfunctioning kidneys, large cysts thought to be connected with the collecting system, and cysts with suspicious tumor. In societies where HC disease is endemic, renal HC should be considered in children with cysts located in kidney, even if the indirect hemagglutination test is negative. [ABSTRACT FROM AUTHOR]

Background: We aimed to report the demographic characteristics with diagnosis and treatment methods in patients with concomitant hepatopulmonary hydatid cysts. Methods: Over a ten-year period (from 2002-2020) in Konya, Turkey, surgery was performed on 52 patients with hepatopulmonary hydatid cyst. Main outcome measure(s) were 52 hydatid cysts patients, which had cysts both in the liver and lungs, were investigated regarding their age, gender, cyst localization, suppuration, symptoms, and treatment methods. Results: Seventeen of the patients were males. Their mean age was 39.7±18.8 years. The most common occupation was housewifery. The most common symptom was coughing and none of the patients with concomitant hepatopulmonary hydatid cysts was asymptomatic. The pulmonary hydatid cysts were mostly encountered in the right lung and the majority of the hepatic hydatid cysts were observed in the right lobe. The mean hospitalization time of the operated patients was 17.12±6.7 days. Conclusion: In patients with hydatid cysts localized concomitantly in the right lung and subdiaphragmatic area, right thoracotomy for the pulmonary cyst and a transdiaphragmatic approach for the hepatic cyst is a safe, effective, and comfortable method. [ABSTRACT FROM AUTHOR]

Background: The migration of humans and climatic and environmental changes cause the emergence of infectious diseases. This study aimed to investigate the changes in the molecular epidemiology of the echinococcosis in the southeast region of Turkey after migrations. Methods: Overall, 159 tissues samples were taken from suspected cases of echinococcosis at the Kilis State Hospital in the southeast region of Turkey. All of the tissues samples were analyzed using histopathology methods, PCR, Real-time PCR methods, DNA sequencing, and phylogenetic analyses in laboratories. Results: The positivity values of the histopathology, the polymerase chain reaction, and the Real-time PCR methods were found to be 14.5% (23/159), 15.7% (25/159), and 16.9% (27/159), respectively. 32.0 % (8/25) E. multilocularis of Echinococcus isolates and 68% (17/25) E. granulosus of Echinococcus isolates were identified using PCR methods. 58.8% (10/17) of the E. granulosus isolates were found to be Genotype 1% and 41.2% (7/17) E. granulosus isolates were found to be Genotype 3. Conclusion: Molecular methods play an important role in the epidemiology, treatment, and diagnosis of diseases. Increasing immigration in a geographical area may create social, economic, and health problems in that area. For this reason, epidemiological studies of infectious diseases should be updated in areas with immigration. [ABSTRACT FROM AUTHOR]

Background: This study was designed to determine the frequency of hydatidosis in Khuzestan Province, Iran and to evaluate the antibody changes in infected individuals after treatment. Methods: Overall, 454 sera were collected from health centers of Khuzestan Province, southern Iran (from 2013 to 2018). Demographic data such as age, gender and history of disease were recorded. Serum samples were investigated for antibody against CE by ELISA using antigen B. Thirty six of cases were followed up after treatment. Results: Among the 454 evaluated cases, antibody against CE was detected in 184 (40.52%) including 115 (62.5%) females and 69 (37.5%) males. Age distribution was from 8-97 yr, the highest prevalence of hydatid cyst was observed in age group 40-49 years. Liver was the most infected organ (76.63%). Relapse of CE occurred in 23 of patients. In the majority of patients the antibody decreased, whereas in some cases increased CE antibody observed during post-treatment follow up. Conclusion: Current study indicated the high prevalence of hydatidosis and rate of relapse after treatment among suspected patients. Therefore, long periods and regular follow-up of patients after treatment is necessary and for these monitoring, antibody assay can be an appropriate method. [ABSTRACT FROM AUTHOR]

Morbidity of mixed cystic and alveolar echinococcosis (CE and AE) is exceptionally rare. Less literature retrieved from a database on the internet detailed the content, including radiography, pathology, and therapeutics data. Such a case of cooccurrence of the different Echinococcus species was diagnosed and treated at our hospital center from Nov 2019 to Feb 2020. A 30 yr old female from the pastoral area in Qinghai Province, China, was diagnosed with a case of echinococcosis and diagnosis was confirmed after image studies, immunoassaying of hydatid enzymes, life history and pathology result. The patient underwent hepatectomy along with excision of the internal capsule. Post-operative pathology was done, and it confirmed a mixed infection of both CE and AE. The patient recovered well without complications after liver-protecting and tissue repair treatment for 15 days. Knowing about infective mode and immune method of the case might be vital for research on variation for Echinococcus infection. [ABSTRACT FROM AUTHOR]

Hydatid disease is a parasitic infection caused by Echinococcus granulosus with worldwide distribution. The most affected organs are liver and lungs, but it can be detected in any other organs as well. We reported a 5-yr-old boy from Shiraz, southern Iran in 2017 who presented with abdominal discomfort. Imaging revealed multiple liver hydatid cyst and a huge kidney hydatid cyst. This case showed the possible implication of rapid growth of multiple hydatid cyst as well as unusual organ presentation in the pediatric population. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The present study was conducted in Jul 2019 and Jan 2020 in two wildlife parks of the Nowshera district, Khyber Pakhtunkhwa, Pakistan, where the endangered Punjab urial (Ovis vignei punjabiensis) is successfully bred in captivity. We determined diversity of internal and external parasites that take advantage of the situation of congestion, resulting in massive mortalities of wild animals in captivity. Methods: Internal parasites of living urial were determined by direct wet smear and flotation methods, while dead urial was necropsied for any pertaining observation. Results: All examined fecal samples were found infected with gastrointestinal parasites, which had significant difference in the total abundance in winter and summer. S. papillosus and H.contortus, and a single protozoan, Eimeria spp. were the dominant parasites in fecal samples. Ticks collected from urial enclosures and dead animals were of single species H. anatolicum. Theileria spp. was observed in blood, while hydatid cysts were found in lungs and liver of necropsied urial. Conclusion: The study indicates that internal parasites such as Haemonchus contortus and Strongyloides papillosus, while external parasites as Hyalomma anatolicum ticks played major role in the population decline. Strict veterinary control of infectious diseases, provision of hygienic and supplementary diet, and proper maintenance of urial population are necessary measures for the control of mortalities. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is one of the most important parasitic zoonosis in the world. Post-surgery follow up in CE patients is an important non-solved problem up to now. Therefore, the investigations on this problematic issue would be very applicable in the view of CE clinical treatment. Methods: A total of 24 confirmed liver CE patients sera including eight sera before surgery (BS), eight sera three months post-surgery (3MPS), and eight sera six months postsurgery (6MPS) were used in the present study. Proteomics methods including 2DE and LC-MS/MS were performed on the specimens followed by bioinformatics analysis such as Gene Ontology (GO) and Protein-Protein Interaction (PPI) network analysis. Results: A total of 235 proteins were detected of which 12 differentially expressed proteins (DEP) were identified by LC-MS/MS in all sera. The proteins were presented in BS and suppressed after surgery as follows: HPX, SERPINA1, SERPINC1, CP, HBD, and HBA2. Comparisons of the protein expression in sera of patients BS, 3MPS, and 6MPS revealed that GC, IGJ, AHSG, CD5L, FGG, and APOC3 have been overexpressed in 3MPS and 6MPS. PPI network analysis demonstrated that SERPINC1 and AHSG with more connection in the network could be considered as hub proteins and potential prognostic biomarkers in response to surgical treatment of liver CE. Conclusion: Application of proteomics methods on patient's sera could be used as a novel biomarker tool for following-up liver CE patients. In this regards, proteomics and, application of bioinformatics analysis including GO and PPI showed that SERPINC1, AHSG and HPX are of more value as a potential follow up biomarkers in response to surgical treatment. [ABSTRACT FROM AUTHOR]

Hydatidosis is a zoonotic disease caused by Echinococcus parasite that frequently involves liver and lungs. Primary intracranial hydatidosis is a rare condition which can be life threatening if ruptured. Here we report an unusual case of primary intracranial hydatid cyst without any other organ involvement, diagnosed in a 12-year-old boy in Emam Reza hospital, Birjand, Iran in November 2016, in order to focus on the importance of proper diagnosis and management, especially in endemic areas.

Background: The outcome and complications of liver hydatid cyst surgeries with new and old techniques are not well determined. We intended to present the results of operations done for patients with hepatic hydatid cyst in an endemic area. Methods: Data of 112 patients referred and operated for liver hydatid cyst, in Imam Khomeini Hospital complex, Tehran, Iran, from 2015 to 2018, were collected including demographic characteristics, operation parameters and complication related statistics. The variables were presented for different surgical methods including operations with and without omentoplasty. Results: Patients aged 39. 3 ± 13. 9 yr (70 females; 63. 5%). Most frequent clinical complaint was vague abdominal pain (n=45; 40. 2%). The most prevalent comorbidity was hypertension (18; 16.0%). Conservative methods were chosen more frequently including omentoplasty (44; 39. 3%), cyst drainage (27; 24. 1%), cyst resection (19; 17%) and marsupialization (3; 2. 7%). Overall, 56 patients (50%) were operated with omentoplasty as the single method or in combination with segmentectomy. Complications occurred less in patients operated with omentoplasty (41. 1 vs. 23. 2%; P=0. 043); particularly, biloma was more frequent in surgeries without omentoplasty (7. 1 vs 0. 0%; P=0. 042). Persistence and recurrence rates were 12. 5% and 3. 6% with relative predilection in, respectively, segmentectomy and lobectomy surgical methods compared to Omentoplasty. No mortality was recorded. Conclusion: In our case series of hepatic hydatid cyst patients, omentoplasty was safe with less complication and similar long-term recurrence rate. [ABSTRACT FROM AUTHOR]

Background: Human echinococcosis is a neglected zoonotic disease distributed worldwide. It comprises cystic and alveolar forms, the former being the more prevalent disease. Imaging techniques are the first choice for diagnosis of cystic echinococcosis and serology is used as an additional diagnostic technique in doubtful cases or as the sole test in low-resource settings. Rapid diagnostic tests are useful and convenient for immunodiagnosis of cystic echinococcosisin endemic areas, where medical facilities often struggle with limited resources. Methods: Recently, we have developed Hyd Rapid™, an IgG4 lateral flow dipstick test using recombinant antigen B1 for detection of cystic echinococcosis. This study was performed between 2016 until 2018 at the Institute for Research in Molecular Medicine, Universiti Sains Malaysia. The diagnostic performance of Hyd Rapid™ was tested in-house and at two international laboratories in Switzerland and Iran. Results: The overall diagnostic sensitivity for detection of cystic and alveolar echinococcosis was 95% (56/59). Meanwhile, the diagnostic specificity, with and without exclusion of cysticercosis and fascioliasis, was 100% (n=48) and 88% (63/72), respectively. Conclusion: Hyd Rapid™ detected cystic echinococcosis as well as probable cases of alveolar echinococcosis. Therefore, Hyd Rapid™ showed good potential as a serological tool for echinococcosis, and merits further evaluation. [ABSTRACT FROM AUTHOR]

Background: Hydatidosis is a cosmopolitan zoonotic infection and Hamadan Province in the west of Iran is one of the most important foci of human hydatidosis in Iran. The aim of the current study was the genetic characterization of hydatid cysts operated from humans in Hamadan Province. Methods: Seventy-two hydatid cysts samples including 50 paraffinized and 22 fresh human hydatid cysts collected from different hospitals in Hamadan Province, western Iran. The cysts' DNA genome was extracted by kit and PCR was performed for amplifying the fragments of 400 and 450bp for nad1 and cox1 mitochondrial genes, respectively. Genotype diversity and sequence variations of the cysts' isolates were studied by related software. Results: DNA from all (100%) paraffinized and fresh hydatid cysts samples extracted successfully. All paraffinized and fresh hydatid cysts samples were amplified by PCR assay using nad1gene, however, only 18 and 8 samples from paraffinized and fresh hydatid cyst samples was amplified using cox1 gene, respectively. The sequences analysis indicated that, 98.61% the Echinococcus granulosus samples were belong to the genotype G1 and 1.39% were G3 genotype. Conclusion: Genotypes of E. granulosus in human samples in Hamadan Province are G1 and G3 and these findings are proved by phylogenic analysis. [ABSTRACT FROM AUTHOR]

There is no direct evidence to support the existence of regional lymph node metastatic routes in hepatic alveolar echinococcosis, and only a few literature have been reported. There was a case of hepatic alveolar echinococcosis suspected of metastasis of regional lymph node in Clinical Center for Hydatidosis, Qinghai Province, China. The patient was a 24-yr-old male from pastoral area of Seda County, Sichuan Province, China in 2018. He was admitted to the hospital for physical examination and had no special discomfort. Preoperative examination showed liver occupancy and regional lymph node enlargement in the space between liver and stomach. Hepatectomy and lymph node resections were performed. Postoperative pathological results showed that both primary and metastatic lesion were of alveolar echinococcosis. Recovery of patient was good without complications and recurrence. In this case, metastasis was considered because the liver lesion was not directly connected to the lymph node. However, the case was still suspected due to the lack of pathological examination of other lymph nodes in the lymphatic return pathway. Regional lymph node metastasis may be one of the metastatic ways of alveolar echinococcosis. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is a worldwide zoonotic helminthic disease caused by the larval stage of Echinococcus granulosus. The infection is particularly important in terms of economic and medico-veterinary aspects in endemic areas including Iran. Considering the possibility of organ-tropism in E. granulosus strains, the present study was aimed to identify the genotypes of E. granulosus in different organs involved in patients, undergone surgery in Baqiyatallah Hospital, Tehran, Iran from 2005-2015. Methods: Overall, 29 formalin-fixed paraffin-embedded tissues (FFPT) from patients with histologically confirmed CE including liver (N: 14) lungs (N: 6) abdomen (N: 2), pancreas (N: 2) and each of spleen, gallbladder and, muscles (N: 1) plus unknown organs (N: 2) were used and genetically characterized using polymerase chain reaction, followed by partial sequencing of mitochondrial cytochrome c oxidase gene subunit 1(cox1) and analyzed. Results: Nineteen out of 29 isolates including liver (N: 6) lungs (N: 4) abdomen (N: 2), pancreas (N: 2) and each of spleen, gallbladder, and muscle (N: 1), unknown organs (N: 2) obtained from paraffin-embedded blocks of human CE created an acceptable sequence in two directions. All 19 isolates regardless of the organ involved were recognized as E. granulosus sensu stricto (G1). Conclusion: The sequence alignments of the isolates displayed two profiles. All sequenced samples showed E. granulosus sensu stricto (G1) with no organ-related genotype. [ABSTRACT FROM AUTHOR]