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Background: Antibiotics are among the most commonly prescribed drugs in pediatrics. Due to lack of uniformity in pediatric antimicrobial prescribing and the emergence of antibiotic resistance, appropriate drug utilization studies have been found to be crucial to evaluate whether these drugs are properly used. Methods: Data were collected between January 2014 and February 2014 in 16 Iranian pediatric hospitals using a standardized method. The point prevalence survey included all inpatient beds. Results: Of 858 children, 571 (66.6%) received one or more antimicrobials. The indications were therapeutic in 60.6%. The parenteral route was used in 92.5% of therapeutic indications. Ceftriaxone was the most prescribed antimicrobials for therapeutic indications (32.4%) and combination-therapy was the most type of therapy in pediatric intelligent care unit (PICU). Conclusion: According to results of this study, antibiotics' prescribing in pediatrics wards of Iranian hospitals is empirical. Therefore, for quality improvement of antimicrobial use in children continuous audit process and antibiotic prescriptions require further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is considered the most frequent type of cancer in women with high mortality worldwide, and most importantly, it is the second most common cancer. However, some breast cancer-related risk factors remain unknown. So, the current study was designed to evaluate the effect of Toxocara canis on the biomarkers correlated with proliferation, apoptosis, inflammation, and angiogenesis in 4T1 tumor-bearing mice infected with Toxocara canis for the first time., Methods: Mice were categorized into four groups: A) control, B) treated with 4T1+ Toxocara canis , C) treated with Toxocara canis , and D) treated with 4T1. The expression of Ki-67 and P53 was then evaluated by using the immunohistochemical technique. In addition, the levels of transforming growth factor-β, Interferon gamma-γ, Interleukin 10, tumor necrosis factor-α and vascular endothelial growth factor as well as anti- Toxocara canis IgG were determined using the enzyme-linked immunosorbent assay method., Results: The expression of Ki-67 was significantly increased in the 4T1+ Toxocara canis group than control and Toxocara canis groups ( P < 0.001 and P < 0.001, respectively). Moreover, a significant decrease in P53 was found in the 4T1+ Toxocara canis group than in the control and Toxocara canis groups ( P < 0.001 and P < 0.001, respectively). Also, the 4T1+ Toxocara canis group significantly reduced the expression of P53 more than 4T1 tumor-bearing mice ( P = 0.005). In addition, the 4T1+ Toxocara canis group had an increasing tumor necrosis factor-α and vascular endothelial growth factor than controls ( P = 0.004 and P = 0.002, respectively). Furthermore, a significant reduction in Interleukin 10 was found in the 4T1+ Toxocara canis group than in the control group ( P = 0.004)., Conclusion: Our findings showed that Toxocara canis could probably increase the potential of breast cancer by reducing P53 in 4T1 tumor-bearing mice infected with Toxocara canis more than other groups., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: Toxoplasmosis and narcotic drug addiction are endemic in various regions of Iran. These drugs can provide situations for infections by disrupting the immune system. The current case-control study was designed to determine the prevalence of toxoplasmosis in narcotic drugaddicted persons in comparison with healthy subjects using serology and molecular techniques in the southwest of Iran., Methods: A total of 201 subjects (including 101 individuals with drug addiction and 100 control participants) were randomly selected. Chronic and acute toxoplasmosis was detected using the enzymelinked immunosorbent assay (ELISA) IgG avidity. T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) were also determined by the ELISA. Moreover, the presence of T. gondii in blood samples was diagnosed using the nested-polymerase chain reaction (Nested-PCR)., Results: For T. gondii IgG, 17 (17.0%) of 100 and 39 (38.6%) of 101 cases were diagnosed in the control participants and drug-addicted people, respectively [P=0.001, OR=3.071, CI= (1.591-5.929)]. Moreover, 16 (15.8) and 5 (5.0%) cases were positive for the B1 gene in the drug-addicted patients and controls by the nested-PCR technique, respectively [P=0.019, OR=3.576, CI= (1.257-10.179)]. However, no significant differences were found between the opium (n=64) and crystal methamphetamine (n=37) groups in terms of T. gondii IgG and IgM antibodies and the presence of the parasite in the blood ( P >0.05)., Conclusion: The present results demonstrated that the outbreak of the infection was more frequent in narcotic drug-addicted persons than the controls using serology and molecular techniques., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: Recently, the use of pentavalent antimony compounds for Leishmaniasis treatment has been associated with disease recurrence, drug resistance, and severe side effects. Therefore, there is a need to develop alternative treatment strategies. This study investigates the in vitro effects of Zingiber officinale on promastigotes and amastigotes of Leishmania major and Leishmania tropica ., Methods: Promastigotes and amastigotes of Leishmania major and Leishmania tropica were cultured and mass-produced in an RPMI1640 medium enriched with other necessary compounds. The MTT colorimetric method and calculating the IC50 value were used to evaluate the anti-leishmania activity of hydroalcoholic extract of Zingiber officinale ., Results: The hydroalcoholic extract of Zingiber officinale inhibited the growth of Leishmania major and Leishmania tropica promastigotes in 24, 48, and 72 hours after in vitro incubation. The IC50 of hydroalcoholic extract of Zingiber officinale was 56 μg/mL for Leishmania major and 275 μg/mL for Leishmania tropica promastigotes after 72 hours. The IC50 of hydroalcoholic extract of Zingiber officinale was 75 μg/mL for Leishmania major and 325 μg/mL for Leishmania tropica amastigotes after 72 hours., Conclusion: The results showed that hydroalcoholic extract of Zingiber officinale has cytotoxicity properties, and Leishmania tropica has a higher resistance to hydroalcoholic extract of Zingiber officinale than Leishmania major . Further research is recommended., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 Turkish Society for Parasitology)

Introduction: Free-living amoebae are opportunistic amoebae that usually live freely in various environmental conditions, including warm water and even in water supply network pipes and reservoirs connected to water. In addition to living freely, these protozoa are able to attack the host's body when they enter a human or animal body. Therefore, it is necessary to identify their presence in water resources. So, this study aimed to identify free-living amoebae isolated from water reservoirs of hospitals in southwest Iran., Methods: A total of 80 water samples were isolated from the hospitals of Ahvaz city, southwest Iran, and their physical and chemical parameters were measured. The samples were then put into non-food agar culture medium and stained using the Wright-Giemsa staining. Finally, the samples were identified by the PCR molecular method., Results: The mean pH and turbidity values were 7.57 ± 0.03 and 3.31 ± 0.26 nephelometric turbidity unit (NTU), respectively. The mean residual chlorine and electrical conductivity were 0.91 ± 0.02 and 1122.39 ± 24.31, respectively. In addition, 9 (11.25%) and 3 (3.75%) samples were contaminated with Acanthamoeba spp. and Naegleria spp., respectively. However, no positive cases of Balamuthia spp. infection were observed. Moreover, two samples were co-infected with Acanthamoeba spp. and Naegleria spp., Conclusion: Due to the existence of free-living amoebae in water storage tanks at hospitals, it is necessary to prevent possible contamination with these amoebae and infectious agents by using new methods of disinfection and purification of water resources., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: The infections caused by Toxocara spp. are considered as one of the most important zoonotic diseases in the world, especially in developing countries. Human toxocariasis, particularly in children, is acquired by playing in public parks. Hence, the aim of the current study was to detect Toxocara spp. in the soils of public parks of the city of Ahvaz, southwest of Iran, using the PCR and loop-mediated isothermal amplification (LAMP) methods., Methods: In this descriptive cross-sectional study, 260 soil samples were randomly collected from the different public parks of the city of Ahvaz. After performing zinc sulfate (ZnSO 4 ) flotation technique, the DNA samples were extracted from the isolated Toxocara spp. eggs. Lastly, the extracted DNA was used for PCR and LAMP-based molecular detection., Results: Out of 260 specimens, 57 (21.9%) samples were found positive for Toxocara spp., using the PCR method, out of that 38 (14.6%) samples were positive for T. canis and 19 (7.3%) samples were positive for T. cati. Also, out of 260 specimens, 81 (31.1%) cases were positive for Toxocara species, using the LAMP method, among them 51 (19.6%) samples were found positive for T. canis and 30 (11.5%) samples were positive for T. cati. Kappa (κ) coefficient between PCR and LAMP showed a strong agreement (0.766, P-value=0.002)., Conclusion: The obtained data showed a relatively high outbreak of Toxocara spp. in the public parks' soils of the city, using the PCR and LAMP methods. Since the parasite can cause human toxocariasis, particularly in children; thus, the health authorities of the city of Ahvaz and other similar cities, especially in developing countries, must pay more attention to the hygiene of the public parks' soils., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: Parasitic myositis is caused by some parasites, such as Toxoplasma gondii) T. gondii (and Toxocara canis (T. canis). So, the aim of the study was to evaluate the prevalence T. gondii and T. canis in patients with myositis and healthy individuals., Methods: A total of 108 samples were randomly selected as the control (54 healthy individuals) and test (54 myositis patients) groups. IgG and IgM antibodies (Ab) against T. gondii and IgG Ab against T. canis were measured by the enzyme-linked immunosorbent assay (ELISA). The detection of chronic and acute toxoplasmosis was performed by the ELISA IgG avidity. The presence of T. gondii in the blood was evaluated using the nested polymerase chain reaction (nested-PCR)., Results: Of 108, 33 (30.6%) cases were positive for IgG against T. gondii that 19 (35.2%) and 14 (25.9%) were observed in myositis patients and healthy individuals, respectively (P=0.296). Of 19 positive cases, 12 (63.2%) and 7 (36.8%) cases were detected as chronic and acute toxoplasmosis, respectively, while, all positive cases in the control group had chronic toxoplasmosis (P=0.013). One (1.9%) sample was positive for anti- T. gondii IgM and two (3.7%) samples were positive for IgG against T. canis by the ELISA that these positive cases were observed only in myositis patients (P=1.000 P=0.495, respectively). B1 T. gondii gene was amplified in 12 (63.2%) and 1 (7.1%) in myositis patients and healthy subjects (P=0.001)., Conclusion: Our findings showed that there was a relatively high prevalence of acute toxoplasmosis in myositis patients in comparison with the control subjects in the Southwest of Iran., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: Current in-silico research was designed and administered for the screening of 20000 Food and Drug Administration-approved drug compounds with the goal of finding promising drugs against lipophosphoglycan (LPG) and γ-glutamylcysteine synthetase (γ-GCS) of Leishmania infantum ., Methods: After the protein sequence of both targets was taken, the 3D structures of protein of interest were predicted and validated. Molecular docking was done among the two putative targets (LPG and γ-GCS) and approved compounds were selected using AutoDock 4.2 program to predict ligand-receptor interactions., Results: After docking experiment was done on 20000 drug compounds, a total number of seven ligands, two for γ-GCS receptor and five for LPG receptor, were assigned as novel, potent anti-leishmanial drugs based on their binding affinity and energy. Of those, five ligands possessed cytotoxic and anti-cancer characteristics and showed good binding capacity to LPG receptor with Δ Gbinding up to 8.5 kcal/mol more negative; while two compounds showed good binding capacity to glutamyl receptor with Δ Gbinding up to 7.8 kcal/mol more negative., Conclusion: The latest software-based methods are powerful tools for scanning and predicting new peptide templates specific to biological targets in organisms for new drug discovery. However, the use of in vitro and in vivo techniques is a requirement for better evaluation of the potential of projected ligands with the help of in-silico approaches, identifying molecular mechanism of action of the more active compounds is possible. This can help in defining the most likely molecular target, so that the subsequent optimization using in vitro and in vivo techniques can be undertaken.

Background: Intestinal parasitic infections (IPIs) are frequently considered one of the public health problems worldwide. Therefore, we aimed to evaluate the prevalence of IPIs among patients., Methods: In this Retrospective cross-sectional study, 50000 stool samples (24551 males) were collected among males and females referred to Naft Hospital of Ahvaz, southern Iran during 2007-2017. At first, the collected specimens were macroscopically observed for the presence of trophozoites, eggs, cysts using the procedure of direct as well as the method of formalin-ether concentration., Results: Of 50000 samples, 2878 (5.75%) cases were positive for IPIs that 1426 and 1452 cases were observed in the males and females, respectively. Giardia lamblia with 887 (1.774%) cases, Blastocystis hominis with 784 (1.568%) cases, Entamoeba histolytica/dispar with 685 (1.37%) cases, E. coli with 357 (0.714%) cases, Trichomonas hominis with 43 (0.086%) cases, Chilomastix mesnili with 40 (0.08%) cases, Hymenolepis nana with 38 (0.076%) cases, Lodamoeba butschlii with 25 (0.05%) cases, Endolimax nana with 18 (0.036%) cases, Taenia saginata proglottid with one (0.002%) case were found., Conclusion: Our finding showed a relatively high prevalence of IPIs among people referred to Naft Hospital of Ahvaz, southern Iran during 2007-2017., Competing Interests: Conflict of interest The authors declare no conflict of interests., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Context: Cutaneous Leishmaniasis (CL) is a self-healing lesion but prevention of complications and involvement of vital organs such as palpebra requires proper treatment., Aims: The main objectives were to detect agents of CL in palpebral region and estimate the proportion of palpebral lesion also possible complications among CL patients in a zoonotic CL endemic area., Settings and Design: The study was performed from April 2012 to March 2013 in a total of 1613 CL suspected patients by interview and physically exam., Subjects and Methods: The samples were used for direct smear using Giemsa stain method, or cultured in Novy-McNeal-Nicol medium. For further checked, nested polymerase chain reaction (PCR) was used for negative palpebral samples. Of the 1613 examined samples, 848 (81.4%) by direct smear, 188 (18%) by culture and 6 (0.6%) by nested PCR were positive, respectively. A total of 233 of the patients showed lesions on the face of whom 15 (male = 5, female = 10, 1.43% of all and 6.43% of facial lesions) presented with palpebral CL. The results of nested PCR indicated that all the palpebral cases were due to Leishmania major ., Conclusions: About 93% of the patients with palpebral lesion were under 5 years old and were infected in the hyper endemic regions, but no ocular complication was seen in any of them. Based on the results, it seems that early referring to the medical center for proper diagnosis and treatment is the main reason for prevention of further complications., Competing Interests: There are no conflicts of interest.

Background: Resistance of Leishmania species to antimonial drugs has increased. Hence, in the present study Leishmania major isolates were collected from patients with resistance phenotype and the presence/absence of resistance to Glucantime was investigated., Materials and Methods: Samples were taken from 10 cutaneous leishmaniasis (CL) patients who had not responded to chemotherapy with Glucantime. Nested polymerase chain reaction (PCR) was performed to identify the isolated species. Stationary phase promastigotes were added to the grown, adhesive J774 macrophages. Values obtained from standard strain were compared with the test cultures after exposure to the medicine. In vivo , the effects of Glucantime were assessed by comparing the sizes and the parasite burden of the lesions on mouse model., Results: The results of amplified band on agarose gel demonstrated all samples were L. major . After exposure to medicine, a reduction of intracellular amastigotes to half was detected. In vivo , the parasite was eliminated in 90% of mice with lesions caused by both isolates of patients and standard L. major , and their lesions became smaller significantly., Conclusion: Pentavalent antimonial (SbV) salts are the main component of chemotherapy against leishmaniasis. However, the medicine has been found ineffective. In the present study, isolates from patients with no response to treatment had no significant difference from the standard L. major strain (as the sensitive strain). Therefore, in patients with resistance phenotype to Glucantime, the parasites did not actually have intrinsic resistance, i.e., environmental and host factors prevented the successful treatment of the disease., Competing Interests: There are no conflicts of interest.

Background: Leishmaniasis is a major health problem in some endemic areas of tropical and subtropical areas of the world. Interleukin-12 (IL-12) and interferon gamma (IFN-γ) are essential cytokines associated with initiation of Th1 response. The main objective of this study was to evaluate of the type of immune response to L. major isolates from patients with no clinical response to antimonite (Glucantime)., Materials and Methods: This experimental study was carried out during 2013-2014. In the current study Leishmania major were isolated from 10 CL patients with a history of at least one course of treatment with Meglumine antimonate (Sb5). The isolates were used to evaluate in vitro and in vivo response to Sb5. J774 murine macrophage cell line was used for in vitro tests and Balb/c mice was used for in vivo studies. IL-12 gene expression was evaluated using Real-time PCR and IFN-γ serum level was quantified using ELISA technique. SPSS (version: 20), analysis of Covariance (ANCOVA) was used for statistical analysis., Results: PCR results confirmed that all 10 isolates were L. major. The mean of IL-12 gene expression in vitro, in vivo and IFN-γ serum levels (pg/ml) after 2 and 3 weeks treatment in vivo, increased significantly following the treatment with Glucantime in the two groups of Balb/c mice infected either with patients' isolates or standard L. major. No significant difference was seen between the patients' isolates and standard species., Conclusions: Although the L. major were isolated from patients with active lesion and no clinical response to Glucantime after at least one courses of Glucantime treatment but in vivo and in vitro immune response of L. major isolates showed no difference between the patients' isolates and standard L. major.

Background: Leishmania is a parasitic protozoan of trypanosomatidae family which causes a wide spectrum of diseases ranging from self-healing cutaneous lesions to deadly visceral forms. In endemic areas, field trials of different preparations of Leishmania total antigen were tested as leishmaniasis vaccine. Two preparations of killed Leishmania major were produced In Iran, which were heat-killed vaccine called autoclaved L. major (ALM) and thimerosal-treated freeze-thawed vaccine called killed L. major (KLM). In this study, the protein content of both ALM and KLM were compared with that of freshly harvested intact L. major promastigotes using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)., Materials and Methods: L. major (MRHO/IR/75/ER) from pre-infected Balb/c mice was isolated with modified Novy-MacNeal-Nicolle (NNN) medium and then subcultured in liquid RPMI 1640 medium supplemented with fetal calf serum (FCS) 20% for mass production. Two preparations of KLM and ALM were produced by Razi Vaccine and Serum Research Institute, Iran, under WHO/TDR supervision. Electrophoresis was performed by SDS-PAGE method and the gel was stained by Coomassie brilliant blue dye. The resultant unit bands were compared using standard molecular proteins., Results: Electrophoresis of the two preparations produced many bands from 10 kDa to 100 kDa. KLM bands were much like those of freshly harvested intact L. major., Conclusion: It is concluded that although there are similar bands in the three forms of Leishmania antigens, there are some variations which might be considered for identification and purification of protective immunogens in a total crude antigen, and detection of their stability is essential for the production and marketing of a putative vaccine.

Background: Leishmaniasis, a parasitic disease, is caused by the Leishmania genus, a protozoan parasite transmitted by sand fly arthropods. Cutaneous leishmaniasis (CL) in old world is usually caused by L. major, L. tropica, and L. aethiopica complexes. One of the most important hyper endemic areas of CL in Iran is Isfahan province. Varzaneh is a city in the eastern part of Isfahan province. Due to different biological patterns of parasite strains which are distributed in the region, this study was design to identify Leishmania species from human victims using Kinetoplastid DNA as templates in a molecular PCR method., Materials and Methods: Among 186 suspected cases, 50 cases were confirmed positive by direct microscopy after Giemsa staining. Species characterization of the isolates was done using Nested- PCR as a very effective and sensitive tool to reproduce mini circle strands., Results: After Nested-PCR from all 50 cases, 560 bp bands were produced which according to products of reference strains indicate that the infection etiologic agent has been L. major. 22 (44%) of patients were females and 28 (56%) of them were males. Their age ranges were between 7 months and 60 years., Conclusion: According to the results of the study and the particular pattern of infection prevalent in the region, genetic studies and identification of Leishmania parasites are very important in the disease control and improvement of regional strategy of therapy protocols.

Background: It seems that the incidence of pertussis-like illnesses is considerably increasing despite the wide coverage of immunization with the whole cell pertussis vaccine. We aimed to investigate the occurrence of pertussis in vaccinated children by measuring anti-pertussis antibodies., Methods: In this cross-sectional study, blood samples were taken from vaccinated children aged 2, 4, 6, 12, 18, and 72 months. Anti-pertussis IgG and IgA were measured by ELISA. P<0.05 was considered significant., Results: 725 children were enrolled in the study. Geometric mean titers for IgG that showed a slight decease after 2 months of age and increased distinctly in children aged 72 months. The frequency of the individuals whose IgG was above the determined cut-off (derived from mean+2SD) was observed in 1% of the 2, 4, and 6-month-old infants, 6% of the 12 and 18-month-olds and 12% of the 6-year -old children. Positive IgA titers were detected in 5, 9, 6, 23, 11, and 8% of children aged 2, 4, 6, 12, 18, and 72 months, respectively., Conclusion: Since a considerable percentage of children had high levels of anti-pertussis IgG antibodies (≥2 SD), positive anti-pertussis IgA, and most importantly an increased level of anti-pertussis IgG geometric mean titer at 6 years of age, further investigations regarding the protection provided by the presently used pertussis vaccine seems necessary.