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Background: Toxoplasma gondii (T. gondii) is the most successful obligate protozoan that can infect warm-blooded vertebrate hosts. Some researchers suggest that the presence of Toxoplasma cysts in the brain can lead to mental disorders. Bipolar disorder (BD) is one of the serious neuropsychiatric disorders. Several studies have shown a high seroprevalence of T. gondii in bipolar patients. Therefore, this study aims to determine the prevalence of this infection in patients with BD. Methods: In this case-control study, anti-Toxoplasma immunoglobulin (Ig) G and IgM antibodies were measured in serum samples from 115 patients with BD and 115 subjects without this disorder from the general population using commercially available enzyme-linked immunosorbent assay. Demographic characteristics of the patient and control groups, information about T. gondii infection and BD, and their potential risk factors were analyzed. We utilized the Mann-Whitney U test for continuous variables, the chi-square test for categorical data, and multivariate logistic regression to assess T. gondii infection and BD, with significance set at P < 0.05. Results: Twenty-eight (24.34%) of 115 patients with BD and 10 (8.7%) of 115 controls had anti-T. gondii IgG antibodies. IgM antibodies against T. gondii were not reported to be positive in any participants. Furthermore, there was a statistically significant difference in the results [odds ratio (OR) = 2.89: 95% confidence interval (CI) = 1.08–7.73. P = 0.03]. Within the study population, various factors were identified as significant risk factors for BD: sex (OR 8.10, 95% CI 3.16–20.75), age 20–50 (OR 5.11, 95% CI 1.81–14.45), age over 50 (OR 19.54, 95% CI 4.02–94.89), education level (OR 0.24, 95% CI 0.09–0.60), working status (non-employment, OR 4.12, 95% CI 1.65–10.30), and income (middle, OR 0.29, 95% CI 0.10–0.89; high, OR 0.12, 95% CI 0.01–0.77), all with P-values less than 0.05. In addition, in the group of patients, there was no statistically significant relationship between T. gondii infection with the type of bipolar disease (P = 0.93), the severity of the disease (P = 0.61), and the history of suicide attempts (P = 0.63). Conclusion: This study showed that toxoplasmosis is a risk factor for BD and increases the chance of developing BD. However, more studies with a larger sample size are recommended to clarify the development pathways of this disorder and provide new strategies for the prevention and treatment of this disease. Clinical trial: Not applicable. [ABSTRACT FROM AUTHOR]

Background and Objectives: Understanding the epidemiology of Candida species among cancer patients is crucial for preventing invasive infections. This study aimed to identify Candida species and assess risk factors among cancer patients receiving chemotherapy in Birjand, eastern Iran. Materials and Methods: The samples were obtained from the oral cavity of 140 patients and the initial identification of Candida species was carried out through fungal cultures. Subsequently, Candida isolates were molecularly identified using the PCR-RFLP method with the restriction enzyme Msp1. Furthermore, the demographic characteristics, risk factors, and clinical history of the patients were extracted and scrutinized using a multiple logistic regression model. Results: Among the 140 patients examined, 55 individuals (39.3%) tested positive for oral candidiasis (OC). Notably, Hemorrhagic cancer emerged as the most common type of cancer associated with OC (46.7%). The predominant species isolated was the Candida albicans complex (64.8%), followed by the Candida glabrata complex (26.8%). A noteworthy finding was the significant association between the occurrence of OC and the number of chemotherapy sessions (P<0.05). Conversely, no significant correlations were detected between OC and variables such as sex, age, type of cancer, occupation, residence, underlying disease, and drug use (P>0.05). Conclusion: The prevalence of Candida spp. and its correlation with the number of chemotherapy sessions underscored the importance of preventive measures. These findings provided valuable insights for designing targeted interventions to mitigate the burden of oral candidiasis in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) remains a major public health issue in Iran, especially smear-positive pulmonary tuberculosis (SPPTB), due to its high transmission rate. Examining the effective reproduction number(Rt) of SPPTB and patient characteristics is crucial for crafting targeted TB control measures. This study aimed to assess the Rt of SPPTB in Iran from 2011 to 2021 and profile SPPTB patient demographics, initial smear bacilli density, diagnosis delays, and spatial distribution. Study Design: This is a historical cohort study. Methods: A time-dependent method was used to estimate Rt, and monthly data from the national TB registry were scrutinized from 2011 to 2021. Results: A decline was observed in SPPTB incidence rates of 50 909 SPPTB cases in Iran from 2011 to 2021. Approximately 29.1% of the cases were diagnosed within a month, while 44.5% experienced a one to three-month delay in diagnosis. The analysis revealed substantial heterogeneity in TB transmission dynamics across various provinces of Iran. Provinces such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi exhibited the highest effective reproduction numbers. Additionally, there was a decreasing trend in the effective reproduction numbers across all provinces from 2011 to 2020. Conclusion: Effective reproduction numbers declined in most provinces from 2011 to 2020 but increased moderately after the COVID-19 pandemic, highlighting the need for targeted public health interventions. Although SPPTB incidence rates are declining nationally, elevated incidence rates and effective reproduction numbers in regions such as Sistan and Baluchestan, Golestan, Guilan, Khuzestan, Tehran, and Khorasan Razavi signify the need for persistent TB management efforts in Iran. [ABSTRACT FROM AUTHOR]

Background: Smear‑positive pulmonary tuberculosis (SPPTB) is a significant public health concern in Iran. This registry‑based study aimed to investigate the incidence rates of SPPTB in Iran from 2018 to 2022. Methods: The study analyzed SPPTB cases using the Spatial Lag Model to investigate the spatial distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces of Iran and mapped the results using GIS maps. Results: The study found that SPPTB is prevalent among older individuals and males. The analysis identified significant spatial variation in the distribution of SPPTB incidence rates, income inequality, and delayed diagnosis across the provinces. The highest incidence rate of SPPTB was found in Sistan and Baluchestan Province and Golestan provinces. The study found a positive association between income inequalities, measured by the Gini index, and SPPTB incidence rates, indicating that provinces with higher income inequality may have higher incidence rates of SPPTB. The negative correlation with delayed diagnosis implies that predominantly, SPPTB cases are identified in the early months. Conclusions: The study highlights the need to address socioeconomic disparities in health outcomes and implement targeted interventions in areas with higher income inequality to reduce the burden of SPPTB in Iran. Despite decreased SPPTB incidence rates in Iran over the past decade, some regions, such as Sistan and Baluchestan, still have high incidence rates. The Iranian government has implemented policies and programs to reduce income inequality and delayed diagnosis within the country, which can contribute to reducing the burden of SPPTB. [ABSTRACT FROM AUTHOR]

Cutaneous Leishmaniasis (CL) is one of the world's neglected diseases which is caused by Leishmania spp. The aim of this study was to assess molecular profile and antimony resistance of Leishmania isolated from human and rodent hosts. Samples were collected from suspected CL patients referred to health centres and wild rodent's traps in Gonbad-e-Qabus region, north-eastern Iran. Smears were subjected to PCR-RFLP to identify Leishmania species. In addition, ITS1-PCR products were sequenced for phylogenetic analysis. Clinical isolates and rodent samples were subjected to MTT assay to determine IC50 values and in vitro susceptibilities. Expression levels of antimony resistance-related genes were determined in CL isolates. Out of 1,949 suspected patients with CL and 148 rodents, 1,704 (87.4%) and 6 (4.05%) were positive with direct smear, respectively. Digestion patterns of BusRI (HaeIII) endonuclease enzyme were similar to what expected for Leishmania major. Phylogenetic analysis revealed that the highest interspecies similarity was found between current L. major sequences with L. major obtained from Russia and Uzbekistan. Out of 20 L. major samples tested, 13 (65%) were resistant to meglumine antimoniate (MA) treatment, with an activity index (AI) exceeding 4. The remaining 7 samples (35%) responded to MA treatment and were classified as sensitive isolates, with a confirmed sensitive phenotype based on their AI values. The comparison expression analysis of three major antimony resistance-associated genes in unresponsive clinical isolates demonstrated significant fold changes for TDR1 (4.78-fold), AQP1 (1.3-fold), and γ-GCS (1.17-fold) genes (P < 0.05). Herein, we demonstrate genetic diversity and antimony resistance of L. major isolated from human and reservoir hosts in north-eastern Iran, which could be the basis for planning future control strategies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of Candida species in cancer patients with candidemia around the world, and to identify related risk factors and their antifungal resistance, with an emphasis on non-albicans Candida species (NACs). Methods: The published papers related to the subject were systematically searched in databases of MEDLINE (including PubMed), Web of Science, Scopus, Science Direct, and Google Scholar between the 1st January 2000 and 21st April 2021. Candida (C.) parapsilosis was the most frequently isolated organism followed by C. tropicalis and C. glabrata. In addition, the therapeutic usage of antibiotics was found as the most common risk factor, accounting for 85% (95% CI 81%-89%) and central venous catheter accounting for 69% (95% CI 62%-77%). Conclusions: The incidence of Candida bloodstream infections among cancer patients is a growing concern, especially when the etiologic agents of candidemia tend to shift towards NACs. [ABSTRACT FROM AUTHOR]

Background: The similarity in the mechanism of action between paracetamol and ibuprofen can cause similar side effects. However, in preterm neonates with feeding intolerance, intravenous (IV) paracetamol has replaced oral ibuprofen. Therefore, a comparison of the effectiveness and side effects is essential. Methods: In this retrospective cohort study, the data of 118 preterm infants with a definite diagnosis of patent ductus arteriosus (PDA), including 59 patients who received oral ibuprofen and 59 patients who received IV paracetamol were analyzed. Laboratory evaluations of serum total and direct bilirubin, hemoglobin, and creatinine levels before and seven days after treatment were made. Using analysis of covariance (ANCOVA) and multiple multinomial logistic regression models, the effect of two treatment groups on the post-treatment variables as well as their efficacy comparison were evaluated. Results: In both pre- and post-treatment periods, there was no significant association between echocardiography variables with treatment groups. The results from the ANCOVA model showed that the paracetamol and ibuprofen were followed by a significant decrease in the mean total bilirubin and Hct variables after treatment by 1.38 and 1.65 units, respectively. In addition, results from the Mann-Whitney U test revealed that the median Hb and K differences after and before treatment had a significant difference between the two treatment groups. Furthermore, based on the multiple multinomial logistic model results, the odds of complete arterial duct closure with IV paracetamol was 1.27 times higher than with oral ibuprofen, while in the oral ibuprofen group, the odds of closing was 1.44 times higher than the IV paracetamol group, but there was no statistically significant difference between the two groups. Conclusion: Intravenous paracetamol has equal efficacy compared to oral ibuprofen in the treatment of PDA. Also, it seems to be associated with a lower risk of hyperbilirubinemia following the treatment. [ABSTRACT FROM AUTHOR]

Background: Arterial stiffness is a crucial factor in determining an increase in systolic blood pressure and pulse pressure and can also predict the development of cardiovascular disease (CVD). The purpose of this study was to examine the relationship between arterial stiffness and future CVD., Methods: Out of the original 9704 participants in the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, we randomly selected 363 healthy participants, 226 normal subjects (who reported symptoms of CVD but were not confirmed) and 292 individuals who had experienced a major cardiovascular event. The SphygmoCor XCEL System (AtCor Medical Incorporation) was utilized to measure pulse wave velocity (PWV), central augmentation index (CAI), cardio-ankle vascular index (CAVI) and central aortic pressure (CAP). A multivariate multiple regression model was used to analyse the factors associated with non-invasive arterial stiffness parameters (PWV, CAVI, CAP and CAI) after adjusting for potential confounders. All statistical analyses were conducted using SPSS 21 with a significance level of 0.05., Results: The mean PWV was significantly higher in patients who had experienced a confirmed CVD event (P < 0.001). The multivariate multiple regression model results, after adjusting for potential confounders, showed a significant association between PWV and the CVD group (normal vs. healthy and event vs. healthy), as well as between hypertension and obesity with PWV and diabetes with CAI (P < 0.05)., Conclusions: PWV was found to be associated with CVD and its related risk factors such as diabetes, obesity and hypertension. It may be more effective than other arterial stiffness parameters in predicting CVD in clinical settings., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)