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Objective HIV-infected patients have immunological and clinical features that might affect the pathogenesis, as well as the outcome of the HIV/HEV co-infection. The current study aimed to determine the seroprevalence of anti-HEV antibodies and HEV antigens among HIV-infected patients in Fars Province, Southwest Iran. Methods Blood samples (5 mL) were collected from 251 HIV-confirmed patients. Respective data, including patients’ demographic information, were obtained for each patient. The presence of HEV antigens and anti-HEV antibodies (IgG) were assessed by commercial ELISA kits, based on the manufacturers’ instructions. Results Out of 251 cases, 158 (62.9%) were male and 91 (36.3%) were female. Patients’ age varied from 14 to 83 (mean: 40 ± 9.7) years. Out of 251 HIV positive cases, 26 (10.4%) were positive for anti-HEV IgG antibodies and 6 (2.4%) were positive for HEV-antigens. Also, 2 (0.8%) of the patients were positive for both anti-HEV IgG antibodies and antigens. Statistical analysis revealed no significant association between sex and seropositivity to either HEV antigen or antibodies. Moreover, no significant association was seen between age and seropositivity to HEV antigen or antibody (P = 0.622 and 0.945, respectively). Conclusion Our results showed a relatively low prevalence of HEV-antibodies in HIV-infected patients, indicating that HIV positive patients may not be at greater risk of HEV infection than the general population. Moreover, HEV-antigen was detected in a few cases of HIV-infected individuals which indicate an acute or chronic HEV infection in these patients.

Background Sweeping the street is a hazardous job that exposes the workers to soil-transmitted diseases, in particular, toxocariasis. In this cross-sectional study, the seroprevalence of Toxocara infection among street sweepers in Shiraz, southern Iran was assessed. Methods: Overall, 384 subjects, aged 24–64 years (all men), were randomly selected for the detection of antibodies to Toxocara by an enzyme-linked immunosorbent assay (ELISA). Results: Anti-Toxocara antibodies were detected in sera of 101(26.3%) out of 384 subjects. Most of the seropositive cases were in the age group of 31–50 years, yet no significant difference was found between age and Toxocara seropositivity (P > 0.05). Out of 101 seropositive cases, 21(20.8%) had a work experience of fewer than 5 years and 80 cases (79.2%) had a work experience greater than or equal to 5 years. However, no significant association was observed between work experience and Toxocara seropositivity. Conclusion: The findings of the study indicate that street sweepers are at high risk of infection with Toxocara infection. Therefore, appropriate preventive measures should be taken to reduce the risk of infection in this vulnerable group.

BackgroundCystic echinococcosis (CE) is considered as a neglected disease with significant mortality and morbidity in most of the developing countries. The current study aimed to retrospectively assess the demographic and epidemiologic features of human CE surgical cases in a 15-year period in Fars province, southwestern Iran.MethodsA 15-year (2004–2018) retrospective study was conducted to find out the epidemiological and clinical picture of CE in patients who undergone surgeries for CE in two main hospitals in Fars Province, southwestern Iran. Hospital records were reviewed, and data were retrieved from each CE patient’s record.ResultsA total of 501 CE surgical cases were recorded during a 15-year period, corresponding to an average annual incidence of 33.4 and a surgical incidence rate of 0.74/100,000 population. Of these, 242 (48.6%) were male, and 256 (52.4%) were female. Patients’ age ranged from 2 to 96 years, with a mean age of 34.92 (± 19.87) years. A significantly higher rate of CE cases was noted in subject’s ≥ 50 years of age. The highest frequency of cases (62:12.5%) was recorded in the year 2017. The most commonly involved organs were liver (339 cases; 57.8%) and lung (279 cases; 47.6%). Concurrent involvement of two organs was seen in 58 (9.9%) cases of both lung and liver, 10 (1.6%) cases of lung and other locations (but not liver), and 23 (3.9%) cases of liver and other locations (but not lung). Reoperation was noted in 67 (13.4%) of the cases. The size of the lung hydatid cyst varied, ranging between 2 and 24 cm (mean = 7.33, SD = 3.737). The size of liver hydatid cysts ranged from 1 to 26 cm (mean 9.04, SD = 4.275).ConclusionThe findings of the current study demonstrated a nearly constant prevalence of CE during the last 15 years in southern Iran. Further studies are needed to find out the reasons behind the recurrence of the disease, which is substantial, in surgically-treated patients.

Background: The current study aimed to evaluate the therapeutic features and complications of liver hydatid cyst in patients who underwent surgery for CE in Fars province, southern Iran.Methods: A total of 293 patients who underwent surgery for liver hydatid cyst from 2004 to 2018 in Fars Province, southern Iran, were retrospectively evaluated. The clinical records of patients were reviewed and the demographic and clinical characteristics of each patient were assessed.Results: Of the total of 293 cases, 178 (60.9%) were females and 115 (39.1%) were males. The mean age of the subjects was 37.22 (±20.55) years. The mean size of the liver hydatid cyst was 9.18 (± 4.365). Of the 293 patients studied, 227 (77.4%) had hydatid cysts only in the liver, while 55 (9.4%) had both liver and lung cysts. More than half of the liver cysts (65.9%) were located in the right portion of the liver (segment 5 to 8). Of the 293 cases, 52 (17.7%) underwent radical surgery while 241 (82.3%) underwent conservative surgery. Recurrence of hydatid cyst was recorded in 46 (15%) of cases. Patients who were treated with radical surgery in comparison with those who had conservative surgery had a lower recurrence rate but a longer duration of hospital stay (pConclusion: Recurrence remains as one of the major challenges in the management of hydatid cyst. Radical surgery reduces the chance of recurrence, although this procedure increases the length of hospital stay.This study was registered at Clinicaltrials.gov with registration ID of NCT04363151. https://clinicaltrials.gov/ct2/show/NCT04363151?cntry=IR&city=Shiraz&draw=2&rank=1

Background. Bambusa vulgaris (Tabashir) has been shown to have antimicrobial, antioxidant, and anti-inflammatory effects due to the presence of ascorbic acid, vitamin B2, flavonoid, and phenolic compounds which can be beneficial in the process of wound healing. The current study aimed to evaluate the effects of topical Tabashir extract on cutaneous leishmaniasis (CL) caused by Leishmania major in BALB/c mice. Methods. Twenty-eight female BALB/c mice (4 weeks old, 18 ± 4 grams) were injected subcutaneously in tail-base with L. major amastigotes. Treatment started when the CL lesions were appeared and continued for 21 days. Mice were then divided into four groups: E1, treated daily with 5% of Tabashir extract gel; E2, treated daily with 10% Tabashir gel; C1, irrigated daily only with normal saline; and C2, received vehicle gel daily. The wounds’ sizes were measured every 3 days, using vernier caliper. The volume densities of vessels, collagens, and hair follicles, vessels’ length density, and mean diameter were soteriologically determined. Results. Tabashir enhanced wound closure rate through increasing the number of fibroblasts, collagen bundles, and vessels, according to histomorphometric evaluation while it did not affect the parasitic load. Findings of the in vitro study revealed that the extract has substantial mortality for the Leishmania promastigotes. Conclusion. Topical Tabashir showed promising effects on the healing process of skin wounds caused by CL in this experimental study. Further studies are suggested to find out the molecules which are involved in the healing process.

HBV infection is a major public health issue that can lead to liver cirrhosis and hepatocellular carcinoma. The current study evaluated the prevalence of HBsAg and anti-HBsAb among HIV/AIDS patients in Shiraz, southern Iran. The subjects in this study comprised 251 participants previously confirmed for HIV infection registered at the Shiraz HIV/AIDS center in southern Iran. Peripheral whole blood (5 ml) was obtained from each participant and evaluated for HBsAg and anti-HBs antibodies, utilizing commercial ELISA kits. The 251 participants consisted of 158 (63.5%) males and 91 (36.5%) females. HBsAg and anti-HBsAb were detected in 16 (6.4%) and 117 (46.6%) cases, respectively, while five cases (2%) were positive for both viral markers. No statistically significant association was observed between patients' age, sex, or CD4+ cell count and seropositivity to HBsAg or anti-HBsAb. The findings of the study revealed a relatively high seroprevalence of HBsAg and anti-HBsAb among HIV patients, highlighting the importance of preventive and therapeutic programs in such patients.

Background Bambusa vulgaris (Tabashir) has been shown to have antimicrobial, antioxidant, and anti-inflammatory effects due to the presence of ascorbic acid, vitamin B2, flavonoid, and phenolic compounds which can be beneficial in the process of wound healing. The current study aimed to evaluate the effects of topical Tabashir extract on cutaneous leishmaniasis (CL) caused by Leishmania major in BALB/c mice. Methods Twenty-eight female BALB/c mice (4 weeks old, 18 ± 4 grams) were injected subcutaneously in tail-base with L. major amastigotes. Treatment started when the CL lesions were appeared and continued for 21 days. Mice were then divided into four groups: E1, treated daily with 5% of Tabashir extract gel; E2, treated daily with 10% Tabashir gel; C1, irrigated daily only with normal saline; and C2, received vehicle gel daily. The wounds' sizes were measured every 3 days, using vernier caliper. The volume densities of vessels, collagens, and hair follicles, vessels' length density, and mean diameter were soteriologically determined. Results Tabashir enhanced wound closure rate through increasing the number of fibroblasts, collagen bundles, and vessels, according to histomorphometric evaluation while it did not affect the parasitic load. Findings of the in vitro study revealed that the extract has substantial mortality for the Leishmania promastigotes. Conclusion Topical Tabashir showed promising effects on the healing process of skin wounds caused by CL in this experimental study. Further studies are suggested to find out the molecules which are involved in the healing process.

Background. Most cases of hydatid cysts form in the liver and lung and other tissues are considered as unusual locations in hydatid cysts. The current study aimed to find out the rate and features of hydatid cysts in uncommon locations in Fars Province, Southern Iran, over a 15-year period. Methods. The hospital records of patients who underwent surgery for hydatid cysts in university-affiliated hospitals in Fars Province, Southern Iran, from 2004 to 2018, were retrospectively reviewed. For each patient, clinical and demographical data were recorded. Results. During a 15-year period, a total of 501 patients were surgically treated for hydatid cysts, and out of these, 46 (9.2%) were presented with the unusual locations of hydatid disease. Males constituted 28 (60.9%) of these patients while 18 (39.1%) of the patients were females. The patients’ age ranged from 5 to 80 years (mean = 40.49; SD = 20.37). The size of the cysts ranged from 2 to 20 cm (mean = 8.69, SD = 4.59). The most common unusual location for the hydatid cyst was the spleen with 30.4% of cases, followed by the pelvic cavity (15.2%). Out of 46 cases with unusual location of the hydatid cyst, 10 (21.7%) cases had lung, 22 (47.8%) cases had liver, and 5 (10.9%) cases had both liver and lung hydatid cysts, simultaneously with cysts in unusual locations. Conclusion. In cystic echinococcosis- (CE) endemic areas, hydatid disease can affect any organ, from head to toe, in humans. The disease should be considered in the differential diagnosis of any cystic entities anywhere in the body.

Background: Cystic echinococcosis (CE) is considered a neglected disease with significant mortality and morbidity in most of the developing countries. The current study aimed to retrospectively assess the epidemiologic and clinical features of human CE in a 15-year period in Fars province, southwestern Iran. Methods: Hospital records of patients undergone surgeries for CE in two main hospitals in Fars Province, southwestern Iran in a 15-year period (2004-2018) were reviewed and data concerning the patients' demographical and clinical features were retrieved from each record. Results: A total of 501 CE surgical cases were recorded during a 15-year period, giving an average annual incidence of 33.4 cases in which 242 (48.6%) were male and 256 (52.4%) were female. Patients' age ranged from 2 to 96 years, with a mean age of 34.92 (±19.87) years. A significantly higher rate of CE cases was noted in subjects ≥ 50 years of age. The highest frequency of cases (62: 12.5%) was recorded in the year 2017. The most commonly involved organs were liver (339 cases; 57.8%), and lung (279 cases; 47.6%). Concurrent involvement of two organs was seen in 58 (9.9%) cases of both lung and liver, 10 (1.6%) cases of lung and other locations (but not liver) and 23 (3.9%) cases of liver and other locations (but not lung). Recurrence was noted in 67 (13.37%) of the cases. The size of the lung hydatid cyst varied, ranging between 2 to 24 cm (mean = 7.33, SD= 3.737). The size of liver hydatid cysts ranged from 1 to 26 cm (mean: 9.04, SD= 4.275). Conclusion: The findings of the current study demonstrated a nearly constant prevalence of CE during the last 15 years in southern Iran. Further studies are needed to find out the reasons behind the recurrence of the disease, which is substantial, in surgically-treated patients.

Background: The current study aimed to investigate the possible cross-protective effects of attenuated L. major against L. infantum in BALB/c mice. Methods: This experimental study was performed in 2017 in Shiraz University of Medical Sciences, Shiraz, Iran. The attenuated strain of L. major was prepared by continuous weekly subculturing of the parasite. Forty-eight female BALB/c mice were divided into eight groups. Group 1 injected (ID) with wild type of L. major; group 2 injected (IV) with L. infantum; group 3 injected (ID) with attenuated L. major; group 4 injected (ID) with attenuated L. major, and after three weeks challenged (IV) with L. infantum; group 5 injected (IP) with attenuated L. major; group 6 injected (IP) with attenuated L. major, and challenged (IV) with L. infantum (IV); group 7 injected (IV) with attenuated L. major; and finally group 8 injected (IV) with attenuated L. major and after three weeks challenged (IV) with L. infantum. Forty-five days post-infection, the parasite load in the spleen and liver of the mice was determined as Leishman-Donovan units (LDU). Results: The differences in mean of LDU of spleen between different groups were statistically significant (P

Background: Cutaneous leishmaniasis (CL), caused by the intracellular protozoa Leishmania, causes full-thickness skin wounds and scar formation afterwards, which may bring about some complications such as scar formation, secondary infection, and wound expansion. Objectives: This investigation was conducted to determine the effect of hydroalcoholic extract of silymarin, as an anti-oxidant, anti-inflammatory, and anti-scar, for treatment of CL caused by Leishmania major. Methods: A total of 28 female BALB/C mice were injected with amastigotes of Leishmania major and after the wounds came up on their tail-base they were randomly divided into four groups (n = 7): E1 and E2, which received silymarin 5% and 10% gel, respectively, and C1 and C2 were treated with normal saline and vehicle gel, respectively, every 24 hours for 20 days. Wound size was measured every three days. Finally, the mice were sacrificed with high dose of ether, and full-thickness skin samples from the wound site was obtained for stereological estimation of collagen and vessel volume densities, fibroblasts population, vascular length density, and mean diameter of the vessels. Results: Silymarin gel in either concentration of 5% and 10% accelerates wound closure (P < 0.05) and also improves collagen synthesis and revascularization by means of increasing length density, volume density, and mean diameter of blood vessels (P < 0.05). Conclusions: Topical administration of silymarin extract in both doses of 5% and 10% showed promising effects on the healing process of CL-induced wounds.

Background: The current study aimed to investigate the possible cross-protective effects of attenuated L. major against L. infantum in BALB/c mice. Methods: This experimental study was performed in 2017 in Shiraz University of Medical Sciences, Shiraz, Iran. The attenuated strain of L. major was prepared by continuous weekly subculturing of the parasite. Forty-eight female BALB/c mice were divided into eight groups. Group 1 injected (ID) with wild type of L. major; group 2 injected (IV) with L. infantum; group 3 injected (ID) with attenuated L. major; group 4 injected (ID) with attenuated L. major, and after three weeks challenged (IV) with L. infantum; group 5 injected (IP) with attenuated L. major; group 6 injected (IP) with attenuated L. major, and challenged (IV) with L. infantum (IV); group 7 injected (IV) with attenuated L. major; and finally group 8 injected (IV) with attenuated L. major and after three weeks challenged (IV) with L. infantum. Forty-five days post-infection, the parasite load in the spleen and liver of the mice was determined as Leishman-Donovan units (LDU). Results: The differences in mean of LDU of spleen between different groups were statistically significant (P