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Considering the anti-viral effects of Spirulina platensis (Sp), this study investigated the impact of Sp on impaired blood biomarkers of patients hospitalized in the intensive care unit (ICU) with COVID-19. Therefore, 104 patients (aged 48–66; 61.5% male) were randomly assigned to the Sp (daily consumption of 5 g) or placebo group for 2 weeks. Linear regression analysis was employed to assess the differences in blood test results between the control and intervention groups among patients with COVID-19. Our results showed significant differences in certain hematological tests, including a higher level of hematocrit (HCT) and a lower platelet count (PLT) in the intervention group (p < 0.05). The percentage of lymphocytes (Lym%) in serology testing was significantly different between the control and intervention groups (p = 0.03). In terms of biochemical test analyses, Sp supplementation was associated with reduced levels of both blood urea nitrogen (BUN) and lactate dehydrogenase (LDH) (p = 0.01). Furthermore, on day 14, the intervention group displayed significantly higher medians of serum protein, albumin, and zinc compared to the control group (p < 0.05). Additionally, patients supplemented with Sp had a lower BUN–albumin ratio (BAR) (p = 0.01). No immunological and hormonal differences were observed between groups following 2 weeks. Our analysis indicates that Sp supplementation may be effective in regulating some blood test abnormalities associated with COVID-19. This study was registered at ISRCTN as IRCT20200720048139N1. [ABSTRACT FROM AUTHOR]

Background: Very few studies have investigated athletes with disabilities during a long period of competitions, such as a professional league. Also, there are limited findings related to specific mechanisms and risk factors of injury, and prevention strategies in Wheelchair Basketball. Therefore, the objective of this study was to investigate the rate and characteristics of injuries in the 2021-2022 Iran Wheelchair Basketball League and present prevention strategies. Methods: This retrospective study was conducted after the 2021-2022 (Mar 2021-Sep 2022) competition season. The sample size consists of 36 players, who were randomly selected among 129 players. All the data was processed using SPSS (version 21). Results: 111 injuries were registered, equivalent to 132 per 100 players (95% CI: 100-180) and 8.16 Injuries per 1000 hours of athlete exposure (6.2-9.8). Also, 77.8% occurred during training and 22.2% in competitions. Most injuries affected the fingers and hands (35.13%), and shoulders (22.57%). The most common types of injuries were contusions (30.63%), laceration and skin lesion (23.42%), and muscle spasms (13.51%), in which, half of the injuries were slight (0-1 days), 27.8% (mild 4-7 days), and 22.2% moderate (8-28 days). Also, 66.9% of injuries were new, and 33.1% were recurrent. Most situations and actions leading to injury include quick wheelchair pushing (29.72%), the intense ball hitting (17.14%), and sudden stops or changes of direction of the wheelchair (12.63%). A multiple linear regression analysis (Enter method) demonstrated (R2 Adjusted=0.530) Wheelchair inappropriateness (P=0.015), lack of protective equipment (P=0.028), and previous injury (P=0.003) explained close to 55% of the injury rate. Conclusion: The injury rate during the league period was higher than the amounts reported from Paralympic games. Prevention strategies should be focused on rethinking athletes' pre-season readiness evaluation, return to play assessments and protection equipment technologies. [ABSTRACT FROM AUTHOR]

Dysentery is a water- and food-borne infectious disease and its incidence is sensitive to climate change. Although the impact of climate change on dysentery is being studied in specific areas, a study in Iran is lacking. In this study, RCP 4.5 and RCP 8.5 scenarios were used to predict the prevalence of dysentery in Iran between 2050 and 2070. This study is a secondary analysis using Geographically Weighted Regression, and 273 cities of Iran were analyzed between March 2011 and March 2017. Bioclimate variables were used as independent variables. Ecological data about the prevalence and incidence of dysentery, which were collected between 2011 and 2017, were used as the dependent variables. The result shows the incidence of dysentery is significantly associated with bioclimate change exposure, in 2050 and 2070, based on RCP 4.5 and RCP 8.5. Our findings showed that in the absence of adaptation of the population, an increase in the risk of bioclimate-related diseases is expected by around 95.6% in the mid-century compared with the beginning of the century with regional variations. Based on these findings, the geographical distribution of the disease will also change. In 2050, the pattern of disease distribution would be changed, and the north of Iran will be included in the vulnerable regions. In 2070, the southeastern and northern parts of Iran will have the most vulnerability to climate change. Our study contributes important knowledge to this perspective by providing insightful findings and pieces of evidence for climate change adaptation and mitigation. [ABSTRACT FROM AUTHOR]

Background: Women are at higher risk of death during disasters due to physical, biological, psychological, and cultural differences. After a disaster, they experience more miscarriages, premature births, inadequate fetal growth, low birth weight, sexual violence, and unwanted pregnancies. This study aims to investigate the reproductive health status of women affected by the 2017 earthquake in Kermanshah, Iran. Materials and Methods: This descriptive cross-sectional study was conducted in 2018. The study population consists of women aged 15-49 years (Mean age=31.7 years) living in Sarpol-e Zahab, Javanrood, and Thalas Babajani towns in Kermanshah city affected by the earthquake in 2017. The questionnaire used for assessing the status of reproductive health in women was the Reproductive Health Assessment Questionnaire for Women of Reproductive Age, which has already been localized in Iran and its reliability and validity have been confirmed. Native Kurdish language experts completed the questionnaires on behalf of 396 participants. Descriptive statistics were used to describe the variables. Results: It was found that 42.4% of women complained of abnormal menstruation and 34.09% of limited menstrual hygiene materials. Sixty women were pregnant at the time of the earthquake, all of whom gave birth in hospital; two had miscarriages, two had premature births, and one had stillbirth. Urinary tract infection was the most common problem (21%) in pregnant women. Moreover, 48% of women used contraceptive methods after the earthquake, the most commonly used method was the use of contraceptive pills (23%). Access to contraception methods was difficult for 14.4% of them after the earthquake. Furthermore, 25% had experienced violence after the earthquake; of these, 30 reported physical violence, 86 verbal violence, and 13 sexual violence. Conclusion: The control of pregnancy and safe delivery in earthquake-affected areas of Kermanshah is relatively acceptable; however, the provision of reproductive health services seems to be challenging. It is recommended to pay attention to the menstrual hygiene of women and regular distribution of contraceptives (despite the current population growth plan), address sexual acts of violence, and develop a protocol to support the victims. [ABSTRACT FROM AUTHOR]

Objective: Progressive visual impairment is one of the problems that threatening the health of patients and has the negative effects on their abilities. This study aimed to explore the health concerns of patients with Retinitis Pigmentosa (RP). Materials & Methods: A qualitative inductive approach was used. Eleven patients with RP, participated in this study in Iran. Patients were selected through purposeful sampling. Data collection was done through two methods of in-depth semi-structured individual interviews and field notes. Data analysis was performed using approach of conventional content analysis. Results: The categories of "perceived health threat" and "perceived support needs", were extracted. The category of perceived health threat included sub-subcategories of "gradual decline in physical function", "sustained fluctuations in mental health", and "weakening of social capability". "need for socio-economic support", "need for educational support", "need for psychological support", and "need for a personal assistant" were extracted as sub-subcategories of perceived support needs. Conclusion: RP Patients faced with the problem of abilities impairment in various physical, mental, and social dimensions and need for support in society. So, to improve the health of these patients, members of the health group are suggested to develop a context-based wholistic care program through multidisciplinary cooperation. [ABSTRACT FROM AUTHOR]

Purpose: Low back pain is one of the most common musculoskeletal problems. Various complications, such as disability, depression, anxiety, sleep disorders, stress, decreased sexual function and Quality of Life (QoL) are associated with chronic low back pain. The aim of this study was to compare the relationship between demographic, physical fitness, health status, socio-economic indicators, and sexual function indicators on the QoL of women with chronic non-specific low back pain. Methods: The present cross-sectional study was performed in 2020 in the private center of Cyrus Physiotherapy in Tehran, Iran. Thirty married women with non-specific chronic low back pain who were sexually active and living in Tehran were included in the study based on inclusion and exclusion criteria. At first, the goals and process of the study were explained to them and they were given written consent to participate in the study. Then demographic information was recorded and pain, sexual function, and QoL were measured using relevant tools. SPSS software v. 22 was used for statistical tests. Pearson correlation test was used to examine the relationship between the above variables. Results: The Mean±SD age of participants was 38.6±7.48 years. Pearson correlation coefficient showed no statistically significant relationship between the QoL with age (r=-0.172, P=0.364), the number of children (r=-0.166, P=0.382), pain intensity (r=-0.181, P=0.339) and regular exercise (r=-0.159, P=0.402), but there was a statistcally significant relationship between QoL with body mass index (r=-0.406, P=0.026), sexual function score (r=0.379, P=0.039), general health status (r=0.436, P=0.026), education level (r=0.463, P=0.010), and physical fitness status (r=-0.406, P=0.026). Conclusion: In women with chronic non-specific back pain participating in the present study, the lower the body mass index, the higher the level of education and sexual function score, the better overall health and physical fitness status, the better the QoL. However, the results of this study did not confirm the relationships between QoL and age, number of children, pain intensity, and regular exercise. Improving education, health status, fitness status, body mass index, and sexual function index help improve QoL. [ABSTRACT FROM AUTHOR]

Background and Objectives: Human T-lymphotropic virus type-1 (HTLV-1) belongs to retrovirus family that causes the neurological disorder HTLV-1 adult T-cell leukemia/lymphoma (ATLL). Since 1980, seven subtypes of the virus have been recognized. HTLV-1 is prevalent and endemic in some regions, such as Africa, Japan, South America and Iran as the endemic regions of the HTLV-1 in the Middle East. To study HTLV-1 subtypes and routes of virus spread in Iran, phylogenetic and phylodynamic analyses were performed and for as much as no previous phylogenetic studies were conducted in Tehran, we do this survey. To this purpose, the Tax region of HTLV-1 was used. Materials and Methods: In this study 100 samples were collected from blood donors in Tehran. All samples were screened for anti-HTLV-I antibodies by ELISA. Then, genomic DNA was extracted from all positive samples (10 people), and for confirmation of infection, ordinary PCR was performed for both the HBZ and LTR regions. Moreover, the Tax region was amplified and purified PCR products were sequenced and analyzed, and finally, a phylogenetic tree was constructed using Mega X software. Results: Phylogenetic analysis confirmed that isolates from Iran, Japan, Brazil, and Africa are located within the extensive ‘‘transcontinental’’ subgroup A clade of HTLV-1 Cosmopolitan subtype a. The Japanese sequences are the closest to the Iranian sequences and have the most genetic similarity with them. Conclusion: Through phylogenetic and phylodynamic analyses HTLV-1 strain in Tehran were characterized in Iran. The appearance of HTLV-1 in Iran was probably happened by the ancient Silk Road which linked China to Antioch. [ABSTRACT FROM AUTHOR]

Background: Occult hepatitis B infection (OBI) has been described in various clinical settings including after hepatitis B virus (HBV) immunization. The purpose of study was to characterize the prevalence of OBI among immunized children from a subset of general population and the parents of OBI‐positive cases. Methods: Sera of 1200 children from general population who have been previously immunized by HBV vaccine were assayed for anti‐HBs. 660 were randomly selected for HBV DNA testing by different polymerase chain reaction (PCR) methods and were analysed by direct sequencing on surface genes. Results: None of participants were positive for HBsAg and anti‐HBc. 549 (45.7%) and 651 (54.3%) cases had anti‐HBs > 10 mIU/mL (responders) and < 10 mIU/mL (nonresponders) respectively. Of 660 selected specimens, 91 (16%) of children were positive for OBI. 23 (25.2%) and 68 (74.8%) of HBV DNA positive cases were belonged to responders and nonresponders, respectively, showing significant difference (P <.001). The mean levels of anti‐HBs in OBI‐positive and OBI‐negative groups, showed no considerable variations. The mean viral load for OBI‐positive cases showed substantial differences between responders and nonresponders (P =.007). Of 49 parents (98 individuals) of OBI‐positive children 11 (22%) and 18 (36%) were positive for anti‐HBc and anti‐HBs respectively. Molecular testing was positive in 32 subjects (16 couples, 32.6%). In total, 6 mothers and 11 fathers were positive for OBI. Conclusion: A proportion of OBI‐positive vaccinated children could be existed in different populations. This finding could be arisen from vertical HBV transmission or vertical OBI possibly from their parents. [ABSTRACT FROM AUTHOR]

Objectives: Health care workers, including dentists, are at the front line for acquiring blood-borne virus infections. This study aimed to investigate the prevalence of hepatitis B, hepatitis C and human immunodeficiency viruses among Iranian dentists. Material and Methods: The survey included 1628 dental health care workers who attended the 51st annual Congress of the Iranian Dental Association. Data on the risk of blood-borne virus transmission during health care and infection control practices were gathered from self-administered questionnaires. Sera were screened serologically by enzyme-linked immunosorbent assay (ELISA). The positive samples were examined by polymerase chain reaction (PRC) followed by direct sequencing. Results: Six (0.36%) and 81 (5.0%) were positive for hepatitis B surface antigen (HBsAg) and (anti-hepatitis B virus core antigen (anti-HBc), respectively. Only 1 (0.061%) was positive for anti-hepatitis C virus (anti-HCV). No case was positive for anti-human immunodeficiency virus (anti-HIV). One case was diagnosed as being occult hepatitis B virus (HBV) infection. One thousand five hundred thirty-five (94.3%) of participants had received at least 1 dose of HBV vaccine. One thousand three hundred fifty-nine (88.5%) contained hepatitis B surface antibody (anti-HBs) > 10 IU/ml, of whom 55 (4.0%) were anti-HBc positive, suggesting that they had been infected with HBV in the past. Anti-HBc positive cases had past histories of hepatitis, either their own or their spouses'. Individuals with inadequate anti-HBs levels (< 10 IU/ml) were significantly more prevalent among anti-HBc positive cases (p < 0.001). Conclusions: The prevalence of blood-borne viruses among dental HCWs found in this study was lower than past reports from Iranian dentists and general population. The implementation of HBV vaccination together with improvement in infection control procedures has reduced the potential for risk infection among Iranian dentists. [ABSTRACT FROM AUTHOR]

Mutations in the human hepatitis B virus (HBV) genome contribute to its escape from host immune surveillance and result in persistent infections. The aim of this study was to characterize the molecular variations of the surface gene and protein in chronically-infected patients from the southern part of Iran. The surface genes from 12 HBV chronic carriers were amplified, sequenced and subsequently aligned using international and national Iranian database. All strains belonged to genotype D, subgenotype D1 and subtype ayw2. Of all 30 mutations occurred at 22 nucleotide positions, 18 (60%) were missense (amino acid altering) and 12 (40%) were silent (no amino acid changing). The mean mutation frequency (missense to silent nucleotide ratio), was 1.5, indicating application of a high positive selection pressure on the surface proteins. At the amino acid level, of 17 substitutions, 15 (88%) occurred in different immune epitopes within surface protein, of which 7 (46.6%) in B cell epitopes in 5 residues; 7 (46.6%) in T helper epitopes in 6 positions; 1 (7%) in inside CTL epitopes in 1 residue. We therefore conclude that the distribution of 93.2% of amino acid mutations inside B and T helper immune epitopes as well as the ratio between silent and missense nucleotide mutations showed a positive, focused immune selection pressure on the surface protein, which led to the evolution and emergence of escape mutants in these patients. [ABSTRACT FROM AUTHOR]

Background: Immunomodulators and Nucleotide analogues have been used globally for the dealing of chronic hepatitis B virus (HBV) infection. However, the development of drug resistance is a major limitation to their long-term effectiveness. Objectives: The aim of this study was to characterize the hepatitis B virus reverse transcriptase (RT) protein variations among Iranian chronic HBV carriers who did not receive any antiviral treatments. Materials and Methods: Hepatitis B virus partial RT genes from 325 chronic in active carrier patients were amplified and directly sequenced. Nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. Results: All strains belonging to genotype D.365 amino-acid substitutions were found. Mutations related to lamivudine, adefovir, telbivudine, and entecavir occurred in (YMDD) 4% (n = 13), (SVQ) 17.23% (n = 56), (M204I/V + L180M) 2.45% (n = 8) and (M204I) 2.76% (n = 9) of patients, respectively. Conclusions: RT mutants do occur naturally and could be found in HBV carriers who have never received antiviral therapy. However, mutations related to drug resistance in Iranian treatment-naïve chronic HBV patients were found to be higher than other studies published formerly. Chronic HBV patients should be monitored closely prior the commencement of therapy to achieve the best regimen option. [ABSTRACT FROM AUTHOR]

This study was designed to determine the correlation of hepatitis B virus surface Ag (HBsAg) variations with the clinical/serological pictures among chronic HBsAg positive patients. The surface gene (Sgene) was amplified and directly sequenced in twenty-five patients. Eight samples (group I) contained at least one mutation at the amino acid level. Five showed alanine aminotransferase (ALT) levels above the normal range of which only one sample was anti-HBe positive. Group II (17 samples) did not contain any mutation, 4 were anti-HBe positive and 9 had increased ALT levels. In both groups, from a total of 18 mutations, 5 (27.5%) and 13 (72.5%) occurred in anti-HBe and HBeAg positive groups respectively. The small number of amino acid mutations might belong to either the initial phase of chronicity in our patients; or that even in anti- HBe positive phase in Iranian genotype D-infected patients, a somehow tolerant pattern due to the host genetic factors may be responsible. [ABSTRACT FROM AUTHOR]

Objective(s) The aim of this study was to characterize the hepatitis B virus surface protein genotypes and sequence variations among hepatitis B virus surface antigen (HBsAg) positive chronic patients in Hormozgan province, south of Iran. Materials and Methods A total of 8 patients enrolled in this study. The surface gene was amplified and directly sequenced. Genotypes and nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. Results All strains belonged to genotype D. Overall 77 "mutations" occurred at 45 nucleotide positions, of them, 44 (57.14%) were silent (no amino acid altering) and 33 (42.86%) were missense (amino acid changing). A number of 24 (80%) out of 30 amino acid changes occurred in different immune epitopes within surface protein, of which, 9 (30%) in B cell epitopes in 7 residues (2 occurred in "a" determinant region); 8 (42.1%) in T helper epitopes in 7 residues and 7 (10%) in 4 residues inside CTL epitopes. Conclusion Hepatitis B virus genome containing mutated immune epitopes no longer could be recognized by specific Tcells of the host immune surveillance and did not enhance anti-HBs production. This could led to the progression of chronicity of hepatitis B virus infection. [ABSTRACT FROM AUTHOR]

A Cretaceous/Paleogene (K/Pg) boundary interval in the north flank of Alborz Mountains (Aboksar section), northern Iran, has been studied to investigate the biological and geochemical variations of this event in the eastern Tethys. Abathomphalus mayaroensis at the late Maastrichtian, Pα (Parvularugoglobigerina eugubina), P1a (Parasubbotina pseudobulloides) and P1b (Subbotina triloculinoides) at the early Danian are the recognized planktic foraminiferal biozones and subzones in the studied area. The Plummerita hantkeninoides subzone at the uppermost Maastrichtian and P0 Biozone at the base of Danian were not defined in the studied section. This proposes a short-term hiatus and sedimentary discontinuity at the base of Paleocene and probably uppermost Maastrichtian, which most likely caused by winnowing of sediments after a cooling phase and development of bottom current in the Albors Basin. The K–Pg transition in the Aboksar section is characterized by a bloom in the Guembelitria cretacea , evolution of first Danian species (Pv. eugubina , Pv. longiapertura), δ13C negative shift (about 0.5‰), and a gentle Ir anomaly (0.1 ppb). Planktic foraminifera were diverse and abundant during the late Maastrichtian of studied section in a warm (relatively lower δ18O contents) and well stratified environment. Bloom of the opportunist species, G. cretacea , and decrease of planktic foraminiferal abundance and diversity at the base of Paleocene interval propose an abnormal stressful environment in this time probably after the asteroid impact and its following temperature decline. The appearance of more complete species with more specialized shells and larger sizes, such as Globoconusa daubjergensis , Parasubbotina pseudobulloides, Eoglobigerina eobulloides and Subbotina triloculinoides in the P1a and P1b subzones and return of carbon isotope diagram into the pre-boundary values testify an environmental recovery and optimization of ecosystem conditions. • The studied interval has been deposited across the K–Pg interval of the Alborz Basin. • A short-term gap across the K/Pg boundary is marked by lack of P.hant and P0 biozones. • The base of Danian is accompanied by a gentle Ir anomaly and δ13C negative shift. • The Paleocene is initiated by planktic foraminiferal extinction and G. cretacea bloom. [ABSTRACT FROM AUTHOR]

Acceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccine and identify its associated factors, and explain the most important barriers and acceptance strategies for vaccination. This research was a concurrent quantitative and qualitative mixed-method study. In the quantitative part, 1200 individuals aged more than 18 years were selected from the households in 22 districts of Tehran City, with a multistage stratified cluster sampling method. Two questionnaires were used to evaluate the acceptance of the COVID-19 vaccine and vaccine acceptance determinants. The qualitative content analysis method addressed the influencing factors, as well as challenges and strategies related to the acceptance of the COVID-19 vaccine in four groups of Tehran inhabitants: the elderly, people with underlying diseases, healthcare workers, and the general population. The related data were simultaneously collected by applying in-depth semi-structural interviews and a data analysis process. Furthermore, we used the Graneheim and Lundman method for data analysis. We analyzed the data of 1200 people with a mean (SD) age of 46.4 (11.1) years, and approximately 58% of them were men. The vaccine acceptance was 83.6% (95% CI: 81.3–85.9). Among those who welcomed vaccination, 58% preferred the imported vaccines, 25% the Iranian ones, and 17% both. There was a significant association between the variables of age (adjusted odds ratio [AOR] = 1.72, 95% CI: 1.01–2.93), being single (AOR = 0.54, 95% CI: 0.41–0.91), moderate pharmacotherapy adherence (AOR = 0.58, 95% CI: 0.4–0.85), and the willingness to receive COVID-19 vaccine. Qualitative study after interviewing 45 people from four study groups showed an insufficient social trust in healthcare system officials, pharmaceutical and vaccine production companies; distrust in the effectiveness of the vaccines, concerns about the vaccine adverse effects, being tracked by microchips after vaccination, traditional anti-vaccination movements, the feeling the inessentiality of vaccination, and uncertainty about the fair distribution of the vaccine. These concerns were the main challenges addressed by the study groups. A good proportion of Tehran residents reported their willingness to receive the COVID-19 vaccine. Additionally, they expressed their critical concerns, such as insufficient trust in the healthcare system, vaccine safeties, and adverse effects that were the significant barriers to vaccine acceptance. It seems that conflicts raised by the shortage of vaccines and their import due to the sanctions have led to intense desire and demand in the general population, and especially the elderly, for vaccination. Besides, vaccination phobia in some individuals requires further investigations. [ABSTRACT FROM AUTHOR]

Background: Behcet's disease (BD) is a chronic multisystem vasculitis with an unknown etiology. During the past years, several reports are published on the occult hepatitis B infection (OBI), the presence of hepatitis B virus (HBV) DNA in the absence of HBsAg, in rheumatic diseases. Objectives: The current study aimed to, firstly, investigate the prevalence of OBI in patients with BD, and, secondly, its potential association with the clinical and therapeutic status of BD. Methods: HBV serological markers and HBV DNA were evaluated in 220 consecutive BD patients to detect OBI. Demographic and clinical data of OBI positive and negative groups were compared. Results: The mean age of patients was 39.24 (±10.57), and 134 (62.9%) were male. The mean disease duration was 14.13 (±8.63) years. No HBsAg positive case was found, but HBV DNA was found in 19 (8.6%) patients. The median viral load value was 475.84 copy/mL. We compared clinical data of 10 OBI positive and 156 OBI negative BD patients with complete and accessible data. There was no difference between the two groups concerning demographic characteristics (age, sex, and disease duration), different clinical manifestations, or types of medications (immunomodulatory, cytotoxic, and corticosteroids). Conclusions: This is the first study showing a rather high prevalence of OBI among BD patients. We did not find any correlation between OBI positivity and different clinical manifestations, medications, or HLA-B51. Further studies are needed on a larger group of patients and by molecular HBV evaluation (as well as serologic) regarding this possible association. [ABSTRACT FROM AUTHOR]

Free-living amoebae belong to the genus Acanthamoeba; can feed on microbial population by phagocytosis, and with the capability to act as a reservoir and a vehicle of microorganisms to susceptible host. Therefore, the role of endosymbiosis in the pathogenesis of Acanthamoeba is complex and not fully understood. The aim of the present study was to identify bacterial, fungal, and human adenovirus (HADV) endosymbionts as well as evaluating the endosymbionts role of such organisms in the pathogenesis of Acanthamoeba in keratitis patients living in Iran. Fifteen Acanthamoeba (T4 genotype) isolates were recovered from corneal scrapes and contact lenses of patients with keratitis. Cloning and purification was performed for all isolate. Gram staining was performed to identify bacterial endosymbionts. DNA extraction, PCR, and nested PCR was set up to identify endosymbiont of amoeba. Evaluation of pathogenicity was conducted by osmo-tolerance and thermo-tolerance assays and cell culture, and then CPE (cytopathic effect) was survey. Statistical analysis was used between Acanthamoeba associated endosymbionts and Acanthamoeba without endosymbiont at 24, 48, 72, and 96 h. A p value < 0.05 was considered as significant, statistically. A total of 9 (60%) Acanthamoeba (T4 genotypes) isolates were successfully cloned for detecting microorganism endosymbionts. The only isolate negative for the presence of endosymbiont was ICS9. ICS7 (Pseudomonas aeruginosa , Aspergillus sp., and human adenovirus endosymbionts) and ICS2 (Escherichia coli endosymbiont) isolates were considered as Acanthamoeba associated endosymbionts. ICS7 and ICS2 isolates were highly pathogen whereas ICS9 isolate showed low pathogenicity in pathogenicity evaluated. Positive CPE for ICS7 and ICS2 isolates and negative CPE for ICS9 isolate were observed in cell culture. The average number of cells, trophozoites, and cysts among ICS7, ICS2, and ICS9 isolates at 24, 48, 72, and 96 h was significant. This is the first survey on microbial endosymbionts of Acanthamoeba in keratitis patients of Iran, and also the first report of Aspergillus sp, Achromobacter sp. , Microbacterium sp., Brevibacillus sp , Brevundimonas sp and Mastadenovirus sp in Acanthamoeba as endosymbionts. Our study demonstrated that microbial endosymbionts can affect the pathogenicity of Acanthamoeba ; however, further research is required to clarify the exact pattern of symbiosis, in order to modify treatment protocol. Image 1 • Our study demonstrated that microbial endosymbionts can affect the pathogenicity of Acanthamoeba. • This is the first report of some microbial endosymbionts in Acanthamoeba. • Further research is required to clarify the exact pattern of symbiosis, in order to modify treatment protocol. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate Rabies virus vaccine strains. The obtained results may be helpful for vaccine producers and researchers to compare the strains with wild type and other vaccine strains and select the correct strain to challenge their products. Methods: Fourteen rabies virus vaccine strains were compared with each other. The full genomes of the selected strains were taken from the GenBank and the N, P and G genes were labeled. The major and minor antigenic sites of these sequences were identified and contrasted with each other. The identity matrix was designed for rabies virus full genome, N and G genes. In addition, the phylogenetic tree was drawn based on rabies virus N gene for deep analysis. Results: Although there were no significant differences between antigenic sites in N, P, and G genes, there were noticeable differences for full genome identity matrix and this significant difference can also be observed in N and G identity matrix. In the phylogenetic tree, the Iranian sequences were distant from currently applied vaccine strains. Conclusion: It is necessary to pay attention to the results shown in phylogenetic tree because they warn us about distance between the Iranian sequences and current strains used in applied vaccines. In addition, the obtained results help vaccine producers to choose a correct strain to challenge their product and evaluate their vaccine potency. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) gene and protein variations have frequently been observed in chronic patients. The aims of this study were to determine the genotypes as well as the patterns of HBsAg variations in chronically-infected patients from the south-eastern part of Iran. Methods: Twenty-one chronic inactive HBV carriers from Sistan-Balouchestan Province (an area with a low prevalence of HBV complications such as cirrhosis and hepatocellular carcinoma [HCC]) were enrolled. The surface genes were amplified, sequenced, and subsequently aligned using international and national Iranian database. Results: All strains belonged to genotype D, subgenotype 01 , and subtype ayw2. Of all 39 mutations occurred at 31 nucleotide positions, 15 (38.5%) were missense (amino acid altering) and 24 (61.5%) were silent (no amino acid changing). A! the amino acid level, 15 substitutions occurred; 10 (66.67%) were distributed in different immune epitopes, five of which (33.33%) were in B cell epitopes; four (36.27%) were distributed in T helper epitopes, and one (6.67%) occurred inside CTL epitopes. Conclusion: A narrowly-focused immune pressure has been on the surface proteins, especially at the B cell level, led to the emergence of escape mutants in these patients that might be related to the pathogenicity of HBV chronic infection. Also, due to the negative selection imposed on HBV genome and the uniqueness of genotype Din this ethnic group, complications (cirrhosis and HCC) are lower than other published studies. [ABSTRACT FROM AUTHOR]

Human T-lymphotropic virus type-1 (HTLV-1) is a retrovirus that causes the neurological disorder HTLV-1 associated myelopathy/ tropical spastic paraparesis (HAM/TSP) and/or adult T-cell leukemia/lymphoma (ATLL). Iran is one of the endemic regions of the HTLV-1 in the Middle East. To infer the origin of the virus in Iran and to follow the movements of human population and routes of virus spread to this country, phylogenetic and phylodynamic analyses were performed. To this purpose, the long terminal repeat (LTR) region of HTLV-1 was used. New LTR sequences were obtained from 100 blood samples which infected with HTLV-1. Moreover, all Iranian LTR sequences which have been reported so far, were obtained from GenBank database. Sequences were aligned and maximum-likelihood and Bayesian tree topologies were explored. After identification of Iranian specific cluster, molecular-clock and coalescent models were used to estimate time to the most recent common ancestor (tMRCA). Bayesian Skyline Plots (BSP), representing population dynamics HTLV-1 strains back to the MRCA, were estimated using BEAST software. Phylogenetic analysis demonstrated that the Iranian, Kuwaiti, German, Israelite and southern Indian isolates are located within the widespread "transcontinental" subgroup A clade of HTLV-1 Cosmopolitan subtype a. Molecular clock analysis of the Iranian cluster dated back their respective tMRCA to be 1290 AC with a 95% HPD confidence intervals (918, 1517). BSPs indicated a rapid exponential growth rate in the effective number of infections prior the 15th century. Our results support the hypothesis of a multiple introductions of HTLV-1 into Iran with the majority of introductions occurring in prior the 15th century, at the same time the Mongol invasion of Iran. Our results further suggest that HTLV-1 introduction into Iran was facilitated by the commercial/migratory linkage as known as the ancient Silk Road which linked China to Antioch (now in Turkey). • Phylogenetic and dynamic studies demonstrated the origin, movements of human population, and spread routes of HTLV-1 in Iran. • The Iranian, Kuwaiti, German, Israelite and Indian isolates are belonging to HTLV-1 Cosmopolitan subtype, transcontinental A. • Primary spreading of HTLV-1 into Iran might be occurred prior to the 15th century, the time of Mongol invasion to Iran. • Spreading of HTLV-1 in Iran could be facilitated by the commercial/migratory linkage via the ancient Silk Road. [ABSTRACT FROM AUTHOR]

Background: The prevalence of occult hepatitis B infection (OBI) among Iranian liver transplant recipient patients has not been explored yet. The present study aimed to determine the OBI prevalence among Iranian liver transplant recipients., Methods: This study encompassed 97 patients having undergone liver transplantation due to several clinical backgrounds in the Liver Transplantation Center, Tehran, Iran. After serological evaluation, two different types of PCR methods were applied for amplification of HBV DNA, followed by the direct sequencing of whole hepatitis B virus (HBV) surface genes., Results: At the time of admission, none of the patients were positive for HBsAg. However, 24 (25%), 12 (12.3%), and 5 (5.1%) cases were positive for anti-HBc, hepatitis C virus (HCV), and hepatitis delta virus (HDV) antibodies, respectively. Moreover, two males were positive for OBI (2.1%). Both were positive for anti-HBc and negative for anti-HBs, anti-HCV, and anti-HDV. HBV-related cirrhosis was the underlying reason for their liver transplantation. HBsAg sequences revealed no amino acid substitution., Conclusions: The prevalence of OBI in the Iranian liver transplantation patients was relatively low. Future longitudinal studies with a larger sample size are suggested to explore the significance of this clinical finding, including the reactivation of cryptic HBV DNA, in liver transplant subjects., (© 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Background: The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)., Methods: One hundred and sixty-six coronavirus disease 2019 (COVID-19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files., Results: Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety-six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO 3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X-ray and in chest computed tomography scan, respectively. Sixty-one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death., Conclusions: We describe a higher than previously recognized rate of COVID-19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate., (© 2021 Wiley Periodicals LLC.)

Background: Responsiveness to hepatitis B vaccine among patients with autism spectrum disorders (ASD) has not been evaluated worldwide. We aimed to determine the anti-HBs antibody duration in autistic and healthy children few years after primary vaccination and evaluate their immunological memory against hepatitis B virus (HBV) vaccine with booster dose administration., Methods: One hundred seven and 147 HBsAg-negative children from ASD and normal population were recruited, respectively. HBV seromarkers (HBc-Ab, HBsAg, and HBs-Ab) were assessed and subsequently, molecular tests were used on all the subjects. A booster dose of vaccine was injected for those who showed low levels (<10 mIU/mL) of anti-HBs and their antibody levels was measured 4 weeks later., Results: The mean ages of ASD and control groups were 7.14 ± 2.42 and 8.68 ± 1.96, respectively. Seven (6.5%) of the ASD group were positive for anti-HBc and one child was positive for occult hepatitis B infection (HBsAg negative, HBV DNA positive). In ASD, 54 (50.4%) and 53 (49.6%) had adequate (>10 mIU/mL) and low anti-HBs levels, respectively. Among control group, 74 (50.4%) and 73 (49.6%) had sufficient and low antibody levels, respectively. After injection of a booster dose for all children with low antibody, 100% of ASD and 92% (59 of 64) of control pupils contained >10 mIU/mL of antibody, respectively. In both the groups, the HBs-Ab titer increased similarly in response to the booster injection (P < 0.05)., Conclusion: Despite previous investigations regarding immune impairment in individuals with autism, the immune system of these individuals was able to manage the hepatitis B vaccine challenge., (© 2019 Wiley Periodicals, Inc.)

Human T-cell lymphotropic virus 1 (HTLV-1) is associated with two progressive diseases: HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL). Although HTLV-1 proviral load (PVL) has been introduced as a risk factor for these diseases' progression, it is not sufficient on its own to yield an accurate estimation of the outcome of the infection. In the present study, PVL and HTLV-1 basic leucine zipper factor (HBZ) expression level as viral factors, and IFN λ3 as a host factor, were evaluated in HAM/TSP patients and HTLV-1 asymptomatic carriers (ACs). During 2014-2015, 12 HAM/TSP patients and 18 ACs who had been referred to the HTLV-1 Clinic, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran, were enrolled in this study. Peripheral blood mononuclear cells (PBMCs) were isolated and the DNA and mRNA were extracted for quantification of HBZ, IFN λ3 expression, and PVL using real-time PCR (TaqMan method). Although the PVL was higher in the HAM/TSP group, with a 94% confidence interval, there were no considerable differences in terms of HBZ mRNA and PVL between ACs and HAM patients. IFN λ3 expression in the HAM/TSP group was significantly higher than in the ACs (P = 0.02). To the best of our knowledge, no study has evaluated the expression level of IFN λ3 in HTLV-1 positive patients. The immune response against HTLV-1 viral antigens and virulent factors will therefore further refine our knowledge of interactions between the virus and host in the pathogenesis of HTLV-1-related disorders. The virus PVL and the host IFN λ3 can be used as pathogenic factors of HTLV-1 infected patients at risk of HAM/TSP manifestation. J. Med. Virol. 89:1102-1107, 2017. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Background: In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated with known host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probably leading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factors associated with HS in CHB are not clearly explored., Materials and Methods: 160 CHB patients were divided into two groups depending on the results of liver biopsy. Group I consisted of 71 patients with confirmed steatosis. Group II comprised 89 patients without steatosis. The groups were compared in terms of basal characteristics, body mass index (BMI), liver enzymes (ALT, AST, ALP), serum fasting blood sugar (FBS) and lipids, hepatitis B e antigen (HBeAg), viral load, and histological findings., Results: In terms of host factors, male gender, older age, BMI, high serum FBS and lipid levels were associated with HS. On the other hand, ALT levels, the HAI scores of necroinflammation and stage of fibrosis did not associate with HS. On multivariate analysis, parameters of sex, BMI, cholesterol and FBS levels were independently associated with HS. Regarding viral factors, HBeAg negativity was significantly associated with HS (81.7%, p value 0.006), but not HBV DNA level (p value 0.520)., Conclusions: HS in CHB appears to be unrelated to the status of HBV replication. However, fibrosis progression in CHB is related to variable host factors. HS may be enhanced through these factors in HBV chronic patients.