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Echinococcus granulosus is a helminth from the family Taeniidae, which causes cystic echinococcosis (CE) in humans and diverse livestock around the world. The identification of existing genotypes in different regions is a major step towards the prevention and establishment of control programmes for the disease. This study aimed to detect CE genotypes using polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) of the internal transcribed spacer-1 (ITS1) gene and sequencing of the cytochrome c oxidase subunit 1 (Cox1) gene in isolates from the central part of Mazandaran province, northern Iran. Forty isolates were collected from sheep, 17 from cattle and 6 from human formalin-fixed paraffin-embedded tissues (FFPE). The ITS1 and Cox1 genes were successfully amplified by PCR in 41 and 42 samples, respectively. PCR-RFLP and sequencing showed that all isolates had the G1–G3 genotypes in this study. Out of 31 isolates subjected to sequencing for the Cox1 gene, 80.7% had the G1 genotype. G2 (16.1%) and G3 (3.2%) genotypes were observed in five sheep and one cattle samples, respectively. Five human isolates were also sequenced for the ITS1 gene, which showed that all samples belonged to the G1 genotype. Ten haplotypes were determined among the isolates by alignment analysis of the Cox1 gene. In summary, this study demonstrated that G1 was the dominant genotype circulating between humans and livestock in the studied region. Furthermore, high genotypic diversity among the CE isolates was observed. [ABSTRACT FROM AUTHOR]

The objective of the present study was to evaluate the probiotic effects of different concentrations of four selected native Lactobacillus strains on laying performance and egg quality parameters of quails. To do this, a six-week farm trial was performed in completely randomized design with seven different probiotic treatments of four replicates each consisting of eight quails, resulting in a total of 224 quails. Four native Lactobacillus strains whose probiotic potentials had previously been confirmed at in vitro levels were cultured in a 10 liter batch fermentor and lyophilized (1010 CFU/g). Treatments were as follows: T1: control (basal diet without probiotics); T2: basal diet + Primalac® (454 g/ton); T3: basal diet + Protexin® (50 g/ton); and T4, T5, T6, and T7: four native strains in levels of 50, 100, 150, and 200 g/ton diets, respectively. The native strains and Protexin® could significantly improve egg production, feed conversion ratio (FCR), and egg mass during the laying period (P<0.05), whereas no significant effect was observed on feed intake and egg weight. The probiotic treatments had significant positive effects on the albumen height, Haugh unit, and internal quality unit (IQU) (P<0.05), whereas there was no difference between the treatments in terms of egg shell weight, egg yolk weight, and egg albumen weight of the quails (P>0.05). It can be concluded that the use of native strains (a 50 g/ton diet) improved the performance (egg production, egg mass, and FCR) and egg quality parameters (Haugh unit and IQU) of quails. [ABSTRACT FROM AUTHOR]

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Fibrous dysplasia is a benign bone lesion of unknown etiology. Bone involvement usually is solitary (monostotic). Multiple forms (polyostotic) associated with extra skeletal symptoms, particularly cutaneous pigmentation, endocrine dysfunction and precocious puberty is called McCune-Albright syndrome (MAS). We report the case of a 40-year-old man who presented with left mandibular body expansion and intermittent suppuration from the skin sinus tract formation since he was 18 years old. He had skeletal deformities, limping, and multiple skin pigmentation. X-ray revealed multiple fractures and radiolucent lesions in numerous bones. Laboratory analysis showed an increased serum alkaline phosphatase. Precocious puberty was determined upon taking the patient's history. The patient's height was 148 cm. Microscopic findings of the mandibular lesion, clinical presentation and X-ray findings were strongly diagnostic for MAS. [ABSTRACT FROM AUTHOR]

Background: Gastric and colorectal cancers are the second and the fourth most common cancers in Iran, respectively. The presence of Murine Double Minute 2 (MDM2) has been identified in many cancers and its relationship with prognosis is under investigation. This study aimed to assess the status of MDM2 and its relationship with prognostic factors in gastric and colorectal carcinoma. Materials and Methods: This study was performed on 99 paraffin blocks of gastric and colorectal cancers, during the years 2001 to 2007 from Mostafa Khomeini Hospital, Tehran, Iran. Tissue sections were prepared, stained with Hematoxylin and Eosin and immunohistochemistry to evaluate for MDM2 expression. The type of tumor, lymph node involvement and tumor grade was determined. Results: Of the 99 cases, 34.3% and 65.7% cases were diagnosed with gastric and colorectal adenocarcinoma, respectively. The average tumor size was 5.5 cm. MDM2 expression level was 82.4% and 90.8% in gastric and colorectal adenocarcinoma, respectively. No statistical difference was found between MDM2 expression and various prognostic factors; however, significant correlation was observed between gastric (P = 0.03) and colorectal (P = 0.03) tumor size and the percentage of MDM2 immunoreactivity. Conclusion: Considering the role of MDM2 in cell growth and its positive correlation with tumor size (an established prognostic factor), it can be indirectly concluded that MDM2 is also important in prognosis. However, additional investigation is needed.

Background: Acute respiratory tract infections, both bacterial and viral, cause 4.5 million childhood deaths worldwide, most of which occur in developing countries. Parainfluenza viruses, of the paramyxoviridae family, are among the common causes of acute respiratory infections, giving rise to 30% of respiratory infections in children before school age. The four parainfluenza viruses that cause a spectrum of respiratory illness in humans are designated as human para influenza virus-1 through 4. Spreading from the respiratory tract by aerosolized secretions or direct hand contact with secretions, parainfluenza viruses replicate in the respiratory epithelium without evidence of systemic spread. The destruction of cells in the upper airways can lead to secondary bacterial invasion and resultant bacterial tracheitis. Eustachian tube obstruction can lead to secondary bacterial invasion of the middle ear space and acute otitis media. In otherwise healthy children, the majority of illnesses remain in the upper respiratory tract. As with many viruses, three approaches to the diagnosis of parainfluenza virus are currently used: viral culture, detection of viral antigen or nucleic acid, and serologic analysis. The gold standard remains the isolation of virus in tissue culture.Methods: This descriptive case-series study was conducted from January 2003 to January 2004, and included 96 children five years of age and younger. To determine the relative frequency of parainfluenza respiratory tract infection, the nasopharyngeal secretions were studied by immunofluorescent antibody (IFA) assay. Seasonal incidence, age distribution and clinical signs and symptoms of this infection were also recorded.Results: Among our study group, the relative frequency of parainfluenza respiratory infection was 26%, most commonly in children aged 25-36 months and in autumn. Cough (84%) and rhinorrhea (96%) were the most common symptoms, with fever (68%) as the most common sign in our patients. Pharyngotonsilitis was the most common (40%) clinical manifestation in our patients. Conclusions: According to above data, patient age and the frequency of parainfluenza infection were similar to other studies.

Background: Bacterial meningitis is one of the most serious infections in infants and children. Three organisms include S.Pneumo;N.mening;H.Influ are the most common cause of meningitis in children between 2M-14y age.Etest is a new method for determination the MIC of some antimicrobial drugs in agarose .This method is useful for some organisms like as S .Pneumo; N.mening; H.Influ;sensitive Streptococcus and anaerobic ;aerobic gram negative. Materials and Methods: In this descriptive cross sectional study; In 57 suspected meningitis children ; organisms isolated from blood; CSF or other sterile boy fluid after culturing and antibiogram;. .MIC of someorganisms detected by Etest method. Results: Streptococcuswas the most prevalent ( 70%) and S.pneumon( 90% of all Streptococcus); H.infl 2%;N.mening 4%and L.monocyt 6%(more than expected);Gram negative (Ecoli; Klebsiella; entrobacter and psudomona) 18%. There was significant difference (P =0.01)in type of organisms between age groups. S.pneumonia was more frequent in children > 2 year ;N.meningitis in>4yr old .Site of isolation :blood; CSF (35.8*;28.3%)other sterile site 18.4%;concomitant positive culture in two site:17%.Mean age in Streptococcus was significantly different with Listeria (p=0.05); N.meningitis (p=0.04);H.influ (p=0.04);.but no difference with Staphylococcus;Klebsiella and E.coli Two type of H.inf were sensitive to Ampici or chloram ;both of them were sensitive to ceftiaxon. GBS were sensitive to PNC or Ampici Strep.nonAnonBnon- Cotrimoxazol>32mic/ml /PNC >256mic/ml/ Vanco>256mic/ml Strep.D: Cotrimoxazol>0.062mg/ml/ /PNC >0.016mic/ml/Imipenem>0.032mic/ml. Strep Pneumonia: All fo them were sensitive except 3 cases /Cotrimoxazol>2ic/ml /PNC =0.01mic/ml/Vanco>0.125mic/ m Vanco>0. 25mic/ ml/.Cotrimoxazol>2ic/ml / PNC =0.01mg/ml Vanco>0.125mic/ ml / Cotrimoxazol>2mic/ml /MIC-PNC >0.016mic/ml Therefore high dose of PNC is adequate for S.pneu ;because of Interm resistance to PNC All 3 N.menin were sensitive to PNC;Chlora;Ceftria and vanco Resistant to all drugs and high MIC for cefotaxime;CIPRO>32mic/ml. E coli: Pseudomona Aerogenosa:: Ceftriaxon>256mic/ml/ /Genta>0.038mg/ml Imipenem>32mic/ml. Klebsiella; only Sensitive to Cipro Staph .Aureous:Sensitive to Clinda;Cipro;Chlora;Resistant toCeft;PNCand Cotri Conclusion: Most type of N.meningitidis;H.inf and S.pneumonia were sensitive to many drugs. Only minority of them were resistant to Ampicillin but sensitive to chloramphenicol and vice versa. limited number of pneumococcal resistance to penicillin is medium resistance( MIC:0.1-1) .we can treat this resistant type by increasing of penicillin dosage .The others were sensitive to all drugs. Therefore ampicillin and chloramphenicol are the drug of choice in empiric treatment of bacterial meningitis after neonatal period.

Abstract Background Chronic granulomatous disease (CGD) is a rare disorder of phagocytes in which absence of superoxide and hydrogen peroxide production in phagocytes predisposes patients to bacterial and fungal infections. The most common fungal infections in these patients are caused by Aspergillus species. Case presentation Here, we describe Aspergillus osteomyelitis of the ribs and hepatic abscess in a 5-year-old boy. The patient was successfully treated with Amphotericin B and INF-γ. Conclusion With respect to the high frequency of aspergillosis in the CGD patient, immune deficiency should be investigated in patients with invasive aspergillosis. Moreover, using antifungal drugs as prophylaxis can improve the quality of life in these patients.

Background and Purpose: The clinical and epidemiologic features of Kawasaki disease (KD) suggest an infectious etiology; however, the agent(s) remain unknown. Our purpose was to isolate the causative bacterial gene from peripheral blood leukocytes of patients with acute KD, by Universal polymerase chain reaction (UPCR), in Tehran Children's Medical Center. Materials and Methods: Universal polymerase chain reaction (UPCR) assay was used to amplify the bacterial l6S ribosomal RNA gene (rDNA). Results: Forty three (28 boys and 15 girls) were diagnosed with acute Kawasaki disease included in this study. The median age at diagnosis was 3.5 years (range: 0.5 -9 years). Twenty Nine (29) cases had typical KD criteria and 14 patients had atypical KD at diagnosis. Two of the 43 KD patients were positive for the Universal PCR assay for 16S rRNA, prior to intravenous γ-globulin therapy (IVGT), while all specimens were negative by conventional blood culture. In our study, there was fever in 100%, conjunctivitis in 62.7%, rash in 83 .72%, oral mucosal changes in 76.74%, peripheral changes in 37.20%, and cervical lymphadenopathy in 39.53% cases. Conclusion: The 16S rDNA sequence was positive in 4.65% of acute KID patients; this data shows that an infectious KD agent is traced in peripheral leukocytes. The question remains as to what true frequency of the 16S rDNA sequence in KD is. [ABSTRACT FROM AUTHOR]

Objective: To correlate the histopathologic results of conjunctival specimens with clinical findings in patients with conjunctivochalasis and report the results of the paste-pinch-cut technique for management., Design: Retrospective chart review., Setting: Single tertiary ophthalmological centre (Ocular Surface Diseases and Dry Eye Clinic, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Md.)., Methods: Twenty-five patients (32 eyes) with clinically significant conjunctivochalasis. All patients were referred for clinically significant dry eye without previous diagnosis of chalasis. Sixteen patients had an underlying inflammatory systemic condition. Intervention or Observation Procedure(s): Patients underwent surgery with paste-pinch-cut technique. Subjective dry eye symptoms and ocular surface staining scores (corneal and conjunctival staining using fluorescein and lissamine green respectively) were assessed at every visit., Main Outcome Measures: Change in patient symptoms and ocular surface staining scores and histopathologic findings in conjunctival specimens., Results: After surgery, significant improvement was achieved in dry-eye symptoms as well as both corneal and conjunctival staining scores in 29 eyes on reduced topical therapy. Only 3 eyes had persisting conjunctival lissamine staining. Light microscopic examination disclosed mild to moderate lymphoplasmocytic inflammation of the conjunctivae with areas of epithelial goblet cell loss, squamous metaplasia, stromal edema, and fibrosis., Conclusion: Conjunctivochalasis appears to be associated with significant inflammation in the setting of dry eye and underlying inflammatory systemic conditions. Although topical anti-inflammatory treatment could be attempted in the initial management, surgical excision should be considered in the absence of clinical response., (Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

In-situ hybridization provides a convenient and reliable method to detect human papillomavirus (HPV) infection in formalin-fixed paraffin-embedded tissue. Cases of conjunctival papillomas, conjunctival intraepithelial neoplasia (CIN), conjunctival carcinoma in situ (cCIS), and invasive squamous cell carcinoma (SCC), in which low-risk (LR) and/or high-risk (HR) HPV types were evaluated by RNA or DNA in-situ hybridization, were retrospectively identified. LR HPV types were frequently detected in conjunctival papillomas (25/30, 83%), including 17/18 (94%) with RNA probes, compared to 8/12 (75%) with DNA probes. None of the CIN/cCIS or SCC cases were positive for LR HPV by either method. HR HPV was detected by RNA in-situ hybridization in 1/16 (6%) of CIN/cCIS cases and 2/4 (50%) of SCC cases, while DNA in-situ hybridization failed to detect HPV infection in any of the CIN/cCIS lesions. Reactive atypia and dysplasia observed in papillomas was generally associated with the detection of LR HPV types. Collectively, our findings indicate RNA in-situ hybridization may provide a high-sensitivity approach for identifying HPV infection in squamous lesions of the conjunctiva and facilitate the distinction between reactive atypia and true dysplasia. There was no clear association between HPV infection and atopy in papillomas or dysplastic lesions.

Introduction: Pilomatrixoma is a relatively rare, benign tumor arising from the hair root matrix. It is found frequently on the head and neck, with most involving the eyebrow in the periocular region. In contrast, eyelid pilomatrixoma is less common, and often clinically misdiagnosed. Here, we present clinical and histological data from 19 pilomatrixomas arising in the eyelid., Methods: The study represents a retrospective study of eyelid pilomatrixoma diagnosed at our institution since 1981. All slides were reviewed, and demographic as well as clinical data were obtained., Results: Patient ages ranged from 2 to 63 years (mean 24 years), including 12 (63%) females and 7 (37%) males. Eight (42%) and 4 (21%) cases arose in the first and second decades of life, respectively. Upper eyelid involvement was found in 14 (74%) of cases. Microscopically, the tumors were characterized by basaloid and shadow cells accompanied by calcification and foreign body giant cells., Conclusions: Eyelid pilomatrixoma is rarely suspected clinically, and can be mistaken for cyst, chalazion, sebaceous carcinoma, and other tumors. Physicians should consider the possibility of pilomatrixoma in the eyelid area, especially in children or young female patients. Complete excision is curative, and diagnosis can generally be established by histopathological examination., Competing Interests: The authors have no conflicts of interests to declare., (Copyright © 2021 by S. Karger AG, Basel.)

Purpose: Tarsal epithelial cysts (TECs) are squamous epithelial-lined lesions of the eyelid that are often mistaken for chalazia or epidermal inclusion cysts. They remain poorly described in the literature. This study is designed to characterize the prevalence and clinical features of TEC., Methods: We conducted a single-center retrospective review of adult patients with a diagnosis of eyelid neoplasm, eyelid cyst, hordeolum, stye, or chalazion between January 1, 2011 and July 1, 2017. Among this cohort, we identified patients with a histopathologic diagnosis of TEC. We also conducted a PubMed literature review and synthesis of existing clinical data of patients reported to have TEC, noting common clinical and histopathological features., Results: Of 7,516 patients, we identified 6 patients with a histopathological diagnosis of TEC, amounting to a prevalence of 0.08% amongst patients with eyelid lesions. Average age was 49.7 years (range 18-76 years), with a 1:1 male to female ratio. The most common presenting symptom was a painless eyelid mass, and the majority (66.6%) had a preoperative diagnosis of chalazion. All but 1 patient had surgical excision from the posterior approach and there was 1 recurrence in the follow-up period. On review of the literature, we identified 68 prior cases of TEC from 18 clinical studies, with clinical features mirroring our case series., Conclusions: TEC has stereotypical clinical and histologic features that distinguish it from other tarsal lesions. Our review identified TEC as a relatively rare cause of eyelid lesions., Competing Interests: The authors have no financial or conflicts of interest to disclose., (Copyright © 2021 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)

Late-onset orbital hemorrhage is a rare complication of alloplastic implant use in orbital wall reconstruction following trauma. The authors report 3 patients with chocolate cysts presenting 3 to 9 years after orbital fracture repair with porous polyethylene implants. All patients were managed by implant removal and evacuation of cyst contents. Complete excision of the cyst was performed in 1 patient, while partial excision of the capsule was performed in 2 patients. Improvement of symptoms associated with the mass effects of the cyst was noted after surgical intervention. The authors also report the first case of orbital volume expansion from a chocolate cyst associated with a nonbarriered porous polyethylene implant. Delayed hemorrhage with capsule formation, although extremely rare, is a possible complication following orbital fracture repair with porous polyethylene implants., Competing Interests: The authors have no financial or conflicts of interest to disclose., (Copyright © 2020 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)

A 76-year old African American female with a history of arteritic ischemic optic neuropathy (AION) secondary to biopsy-proven giant cell arteritis (GCA) presented with unilateral vision loss in her contralateral eye despite high-dose oral steroid treatment. Dilated fundus examination revealed three cotton wool spots. Fluorescein angiography showed slowed arteriolar filling with late staining of small peripheral arteries, consistent with small vessel arteritis. Laboratory tests for alternative vasculitides were negative. Review of her temporal artery biopsy specimen confirmed lymphoplasmacytic inflammation around small adventitial vessels with no destructive granulomatous or leukocytoclastic small vessel vasculitis, consistent with GCA. Our unique case demonstrates peripheral small vessel retinal arteriolar leakage in GCA, which is a rare finding. This association is of interest because GCA is commonly associated with medium to large vessel pathology without small vessel involvement.

Background: Inflammatory bowel disease (IBD) is a chronic disease with a relapsing course of inflammation in the digestive system. Endoscopy and histopathology are the golden standard methods for detection and assessment of IBD. A distinct increase of fecal calprotectin level can be a useful marker for the diagnosis of IBD. The aim of this study was to evaluate the fecal calprotectin level in patients with IBD and without inflammatory diseases of the colon., Methods: Calprotectin levels of patients referred to the Ayatollah Rouhani Hospital of Babol, northern Iran with clinical symptoms of colon disease were evaluated. After a week, colonoscopy and biopsy were performed on all patients and they were divided into two groups. The first group included patients with confirmed IBD and the second group included patients with diseases other than IBD, patients with IBS and healthy persons. Then the measured fecal calprotectin level was compared between the two groups before colonoscopy., Results: We observed correlation between calprotection in these two groups (p<0.0001). 38 (86.8%) patients in the case group and 5 (13.2%) patients in the control group had positive fecal calprotectin test and 12 (23.1%) patients in the case group and 40 (76.9%) patients in the control group had negative results. Basad on ROC curve, the cutoff point of calprotectin was 127.65 with 73% sensitivity and 89% specificity. The area under the curve was 0.83 with 95% confidence interval, 0.74-0.91 (p<0.0001)., Conclusions: The results pointed to this fact that fecal calprotectin can be a noninvasive marker in differentiating IBD from IBS., Competing Interests: There was no conflict of interest.