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Background: Cystic echinococcosis (CE) is a parasitic and zoonotic infection, recognized globally as a neglected disease, with significant morbidity and mortality rates, especially in low-advantaged countries. We aimed to evaluate the recurrence rate after hydatid disease surgery in Fars Province, Iran. Methods: A retrospective design was used to examine the data collected from Nemazee and Shahid Faghihi Hospitals, Shiraz, southern Iran, over eight years, from 2011 to 2019. The research was conducted in 2023. The study extracted the following data from hospital records: demographic characteristics, paraclinical findings (such as sonography and CT scan), organ involvement, cyst number and size, surgical procedure, cyst complications, intraoperative or postoperative complications, and recurrence rate. Results: The study included 303 patients, of whom recurrence occurred in 36 (11.9%). Intra or postoperative complications were associated with recurrence (P=0.001). In the recurrent cases, the most common intraoperative complication was anaphylactic shock (P=0.001), and the most common postoperative complications were unresolved pneumothorax and empyema (P=0.001). There was a significant association between recurrence and complicated cysts (P=0.001). There was no significant difference between the organ involved and the complicated cyst in the recurrence (P=0.50). There was no association between increasing the cyst's size and the chance of the recurrence rate. There was a significant relationship between recurrence and the number of cysts in the affected organ (P=0.001). There was a significant association between using no scolicidal agents and recurrence (P=0.001), and no antiparasitic drugs were used in only one (2.7%) patient (P=0.3240). There was no significant association between recurrence and duration of admission (P=0.193). Conclusion: Intra or postoperative complications (anaphylactic shock, unresolved pneumothorax, and empyema), complicated cysts, the number of cysts in the affected organ, and injecting of no scolicidal agents were significantly associated with recurrence. Recurrence may have many reasons, such as insufficient drainage (incomplete peri-cystectomy and minute spillage of cyst contents), missing hidden cysts (numbered cysts), rupture or spillage of the cysts, and inadequate medical treatment. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis is of particular importance in southern Iran. This study aimed to investigate the infection of rodents with Leishmania major in an urban area of Fars Province, located in southern Iran. Rodents were trapped and samples from the liver, spleen, and skin were collected. Impression smears were prepared from these tissues and any skin lesions and were examined microscopically. In addition, a portion of the samples were preserved for subsequent DNA extraction. A total of 41 rodents belonging to three species were caught from 10 trapping stations in gardens or houses within the area. The caught rodent species were Rattus rattus (n = 25, 60.97%), Mus musculus (n = 15, 36.58%), and Meriones persicus (n = 1, 2.5%). Leishmania amastigotes were seen in the spleen tissue smear of 6 (2.43%) of the rodents, including 4 of R. rattus and 2 of M. musculus. Skin lesions were observed on the muzzles of two R. rattus and one M. musculus. Samples taken from these lesions tested positive for Leishmania infection. Leishmania DNA was detected in 18 (43.9%) rodents, including 11 R. rattus, 6 M. musculus, and one M. persicus, based on DNA sequencing of the ITS2 gene and PCR of the kDNA. Phylogenetic reconstruction revealed that the parasite infecting the rodents was L. major. The detection of Leishmania infection in these rodents in urban areas raises concerns about the urbanization of cutaneous leishmaniasis caused by L. major. This urbanization poses unique challenges for control and prevention efforts. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE) is a parasitic disease caused by the larval stages of Echinococcus and is considered a neglected disease of public health worldwide. CE primarily affects the liver and demonstrates distinctive radiological findings in computed tomography (CT) and ultrasonography (US). Surgery is considered the mainstay of CE treatment. The patient was a 17-year-old man admitted to the Emergency Department of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences with dull right upper quadrant abdominal pain, loss of appetite, abdominal distention, and fullness. An abdominal CT scan revealed a giant hepatic cyst measuring about 24x20x15 cm in the right hepatic lobe (RHL) with a pressure effect on the right kidney, pancreas, and bowel loops. Semi-chevron incision was done and the patient underwent partial precystectomy with capitonnage and omentoplasty. The surgical outcome was uneventful and the patient was discharged on the eighth day after the surgery with the oral Albendazole. Reviewing the literature, our case was the 5th rank according to the size of the recorded published cases. The most common countries where the largest liver hydatid cysts were reported were Greece and Turkey. The most common surgery was the open surgery and the most common incisions were Kocher and then Chevron incisions. When dealing with a huge liver cyst, a high index of suspicion for echinococcal etiology becomes important in endemic areas such as Iran. The choice of treatment for giant hepatic cysts substantially seems to be radical surgery by surgical ablation in general to mitigate the mortality and morbidity rate, because they are at risk of rupture, anaphylaxis, and so forth. (The abstract is too long for a case report [260 words], it should be around 100 words. The part I highlighted can be deleted.) [ABSTRACT FROM AUTHOR]

Objective: To assess knowledge, attitudes, and practices (KAP) of inhabitants of an endemic area in Fars province toward cutaneous leishmaniasis (CL). Methods: The study was carried out in Lapui district in Fars province, south of Iran, one of the most important foci of CL in this province. Sample size (237 residents) was calculated based on population. House-to-house survey was done to collect the data regarding knowledge, attitudes, and practices of the inhabitants. The head of each household was interviewed by a trained staff to assess his/her KAP related to CL. A semi-structured KAP questionnaire was used for data collection. Results: Mean age of participants was 39 and more than half of the respondents were in the age group of 31-40. Males constituted 172 (72.5%) of subjects. Most of the respondents (84.3%) were literate. The majority of the study population (83%) had heard about Salak (local name for CL) and most of these respondents (91%) were aware that CL is presented with a cutaneous lesion. Nearly two-third of the participants (63.5%) stated the bite of mosquito (not specifically sandflies) for CL transmission. The respondents’ attitude regarding the treatment of CL was not satisfactory since only 48% believed that CL can be treated by medicine. A noticeable proportion of respondents (21%) believed in indigenous medicine for the treatment of CL. A small proportion of respondents (14%) stated that traditional healers are good at treating this disease. More than two-third (69%) of respondents believed that the disease is preventable although most of interviewees did not know about preventive measures. Conclusions: In this study, insufficient knowledge of community about infection nature, vector, transmission mode and preventive measures of CL, highlights the needs for a health education initiative to enhance the awareness of people about CL. This would improve inhabitants’ contribution in control program of CL in this area.

Cutaneous leishmaniasis (CL), a neglected tropical disease, is an important health problem in Fars Province, southern Iran. Fars, the fourth most populous Province in Iran, is the center of both anthroponotic and zoonotic cutaneous leishmaniasis (ZCL). Rodents, the reservoir of Leishmania major, play an important role in transmitting ZCL. In the present study, we report Leishmania infection in calomyscid rodents for the first time in mountainous residential areas of Shiraz, the capital of Fars Province, in southern Iran. Rodents were trapped in urban mountainous areas. The skin, liver, and spleen of rodents were examined microscopically for Leishmania infection. In addition, DNA was extracted from the tissues and they were evaluated for Leishmania infection by targeting the kDNA and subsequent sequencing of the nuclear rDNA internal transcribed spacer two (ITS2) region. DNA of L. major was detected in the spleen and liver of calomyscid rodents. Molecular evolution based on DNA-sequencing of the ITS2 gene confirmed the taxonomic situation of the parasite as L. major. Our findings suggest the eco-epidemiological importance of calomyscid rodents in the foci of leishmaniasis in the mountainous residential area on the plateau of Iran. These rodents may play a role in the transmission of leishmaniasis in a residential area and could be considered a potential reservoir for CL. [ABSTRACT FROM AUTHOR]

The secondary sex ratio can be affected by various factors such as stress, immunosuppression, and age of parents in addition to mother infectious disease (Maternal infections). Toxoplasmosis is one of the critical maternal parasitic infections during pregnancy. Besides the complications of the acute form of the disease, hormonal shifts, and even alterations in the secondary sex ratio can be induced by the manipulative activity of the chronic form of the disease. Therefore, this study aimed to evaluate the correlation between Toxoplasma gondii infection in mothers and neonate's gender. In this case-control study, 137 seropositive mothers to Anti-Toxoplasma IgG(case) was compared to 137 age-matched subject Toxoplasma-seronegative mothers(control) in terms of their neonate's gender. These individuals were randomly selected based on exclusions and inclusions criteria of the study from among 2014 mothers who had been tested for Toxoplasma infection during pregnancy from 2015 to 2018 in Shiraz, Iran. From a total of 2014 studied pregnant mothers, 326 (16.2%) mothers were seropositive to anti-Toxoplasma IgG, and 1688 (83.8%) were negative for IgG. It was found that the numbers of female and male neonates were 136 (45.48%) and 163 (54.51%) in the control group whereas, they were 165 (49.84%) and 166 (50.15%) in the case group, respectively. The sex ratio was 1.006:1 in Toxoplasma-seropositive and 1.2:1 in Toxoplasma-seronegative mothers. The number of male and females offsprings indicated a significant difference in Toxoplasma-seronegative mothers (54.5%, p =.015). Moreover, comparing the number of males and females between the two randomly selected groups showed that female gender is significantly more than male gender in seropositive mothers to Toxoplasma (54.8%, p =.014), which means that of 301 females, 165 offspring were born to seropositive mothers. No significant difference was observed for the sex ratio of aborted fetuses between groups. However, in the Toxoplasma-seropositive group, the sex ratio of aborted fetuses showed that the aborted male fetuses were significantly higher in number. (31 male vs 13 female, p <.001). Comprehensively, a significant relationship was found between chronic Toxoplasma infection and secondary sex ratio. However, it is suggested that this relationship be investigated in further studies as well as an animal study. [ABSTRACT FROM AUTHOR]

Toxoplasmosis is a parasitic disease with worldwide prevalence. Despite the relatively similar effects of toxoplasmosis and smoking on alteration in neurotransmitters, especially dopamine, little is known about the relation of Toxoplasma gondii infection and addiction to cigarette smoking. Therefore, the main objective of this study was to assess the relationship between latent toxoplasmosis and smoking. Through a case-control study, 216 regular cigarette smokers and 324 nonsmoker age- and gender-matched subjects were evaluated for anti-T.gondii IgG antibodies with enzyme-linked immunosorbent assay (ELISA). During the sampling, a structured questionnaire was used to obtain the demographic information of participants and the risk factors of acquired Toxoplasma. The median ages of case and control groups were 51.04 ± 18.1 (22–97 years) and 51.03 ± 16.5 (21–89 years), respectively (p = 0.99). Anti-T.gondii IgG antibodies were detected in 44 (20.37%) cases and in 135 (41.67%) controls. There was a statistically significant difference for the positivity rate between the smokers and the control group (OR = 0.35; 95%CI: 0.19–0.65; and p = 0.001). The overall prevalence was 33.14%. This study indicated the inverse association between seropositivity to Toxoplasma infection and cigarette smoking. This relationship could be due to the changes that latent toxoplasmosis has on the neurotransmitters, especially dopamine, which needs more research. [ABSTRACT FROM AUTHOR]

Objective: To examine the fauna of rodents as zoonotic cutaneous leishmaniasis reservoir hosts in Zarqan County, Fars Province, south of Iran, during 2012. Methods: During 2012, wild rodents from different parts of this region were caught by Sherman traps and checked by the examination of liver and spleen smears, for Leishmania infection, to see which species were acting as reservoir hosts; the slides were then processed to extract DNA for molecular test using PCR assay. Results: From 108 rodent species caught, 63% were male and 37% identified as female. Meriones libycus was the most abundant species caught (80.5%) and 5.7% of them were found to be smear-positive for Leishmania amastigotes. The other species were Rattus rattus (14.8%) and Mus musculus (4.7%), but none of them were found positive. Leishmania infection was observed in male and female samples microscopically. Moreover, molecular results revealed Leishmania major in three male and two female specimens. Conclusions: Based on our knowledge, Meriones libycus is incriminated as the main reservoir hosts of Leishmania major in the rural area of Zarqan.

Background: Psychiatric patients are at increased risk of exposure to Toxoplasma gondii infection, which may be linked to their living facilities and behaviors. Limited knowledge on the prevalence of T. gondii infection and its associated risk factors in psychiatric patients are available to the international medical communities. Thus, the aim of the current study was to assess seroprevalence of T. gondii and its associated risk factors in psychiatric inpatients in Fars Province, southern Iran. Methods: This cross-sectional study was carried out on psychiatric patients hospitalized in Ibn Sina Hospital affiliated to Shiraz University of Medical Sciences, Fars Province, southern Iran, March to July 2021. Blood samples were collected from 318 psychiatric patients and assessed for the detection of IgG against T. gondii using enzyme-linked immunosorbent assay (ELISA). Moreover, structured questionnaires were completed for the participants at the time of sampling. Logistic regression analysis was used to assess possible associations between the latent toxoplasmosis and the variables. Results: The overall seroprevalence of anti-T. gondii IgG in psychiatric inpatients was 22.3% (71/318; 95% CI = 17.9-27.3). Multivariate analyses revealed that age > 30 years [adjusted odds ratio (AOR) = 2.24, 95% CI = 1.10-4.60, p = 0.03], contact with cats (AOR = 2.52, 95% CI = 1.14-5.58, p = 0.03), raw vegetable consumption (AOR = 3.65, 95% CI = 1.74-7.65, p = 0.001), raw/undercooked meat consumption (AOR = 4.30, 95% CI = 1.47-12.63, p = 0.008), suicide attempt (AOR = 3.77, 95% CI = 1.58-8.97, p = 0.003) and cigarette smoking history (AOR = 0.38, 95% CI = 0.17-0.83, p = 0.02) were independent risk factors for T. gondii infection. Conclusion: The current results demonstrated that contact with cats, raw vegetable consumption and raw/undercooked meat consumption were independent risk factors for T. gondii seropositivity. Moreover, the current study showed significant associations between seropositivity of T. gondii and suicide attempts as well as negative associations between seropositivity of T. gondii and cigarette smoking in psychiatric inpatients using multivariate logistic regression. [ABSTRACT FROM AUTHOR]

Background. Parkinson's disease (PD) has been described in dopamine brain level reductions. Conversely, several studies have shown that Toxoplasma parasite can increase the level of dopamine in an infected host. This study was conducted to assess the serum, cerebral dopamine levels, and downregulation of Parkinson's disease manifestations in mice with chronic toxoplasmosis. Methods. PD induction was done by oral inoculation of rotenone into BALB/c mice. To induce the chronic infection, cysts of T. gondii Prugniaud strain (genotype II) were injected intraperitoneally into the mice. The rotarod test was used for the evaluation of functional motor disorders in experimental mice. The serum and cerebral dopamine levels of the mice were also measured by using high-performance liquid chromatography (HPLC) on consecutive periods (10 days). Results. Findings of the rotarod test showed the highest and lowest average of running duration belonged to the uninfected mice and PD mice, respectively. Remarkably, the running duration of infected mice with PD was higher than PD mice. As well, the level of serum and cerebral dopamine increased in mice with PD and toxoplasmosis in comparison with PD mice. Conclusion. Increasing the serum and cerebral dopamine levels in mice infected with toxoplasmosis is related to the presence of the parasite. Moreover, the dopamine upregulation due to the infection is effective in the reduction of PD complications. [ABSTRACT FROM AUTHOR]

Background and purpose: Cutaneous leishmaniasis is a global health problem. The discovery of new and highly efficient anti-leishmanial treatments with lower toxicity is globally needed. The current study was carried out to evaluate the anti-leishmanial effects of artemether (ART) and ART-loaded nanostructured lipid carriers (ART-NLCs) against promastigotes and amastigotes of Leishmania major. Experimental approach: Solvent diffusion evaporation technique was applied to prepare ART-NLCs. These nanoparticles were characterized using a particle size analyzer (PSA), transmission electron microscopy (TEM), and dynamic light scattering (DLS). The antiparasitic activity on amastigote was assessed in J774 cell culture. The drug cytotoxicity on promastigote and macrophage was assessed using the MTT technique after 24 and 48 h and compared with NLCs, ART, and amphotericin B, as the control agents. The selectivity index was calculated for the agents. Findings/Results: The DLS and PSA techniques confirmed that ART-NLCs were homogenous in size with an average diameter of 101 ± 2.0 nm and span index of 0.9. The ART-NLCs significantly heighten the anti-leishmanial activity of ART (P < 0.001). The IC50 values of ART and ART-NLCs on promastigotes after 24 and 48 h were 76.08, 36.71 and 35.14, 14.81 μg/mL, respectively while they were calculated 53.97, 25.43 and 20.13, 11.92 for amastigotes. Also, ART-NLCs had the lowest cytotoxicity against macrophages. Furthermore, among the agents tested, ART-NLCs had the highest selectivity index. Conclusion and implications: ART-NLCs had lower cytotoxic effects than ART and amphotericin B, also its selectivity index was significantly higher. Based on the findings of the study, this formulation could be a promising candidate for further research into leishmaniasis treatment. [ABSTRACT FROM AUTHOR]

Background. Toxoplasma parasite alters the transduction of neurotransmitter signals and leads to changes in the level of brain neurotransmitters including tyrosine and dopamine, so behavior changes can occur in infected hosts. Based on this concept, this study was conducted for evaluation of the tyrosine and dopamine serum levels in infected mice with chronic toxoplasmosis. Materials and Methods. Toxoplasma gondii (Prugniaud strain II) was injected intraperitoneally into BALB/c mice to induce chronic toxoplasmosis. Modified agglutination test (MAT), polymerase chain reaction (PCR), and microscopic methods were conducted to confirm the induction of chronic toxoplasmosis. The infected mouse sera were separated at days 40, 50, 60, 70, and 80 for evaluation of tyrosine and dopamine serum levels using high-performance liquid chromatography (HPLC). Results. Microscopic methods confirmed the formation of the Toxoplasma cysts in mouse tissues. Inducing chronic toxoplasmosis is also confirmed by MAT, PCR, and histological methods. HPLC results indicated a decrease in serum tyrosine level at day 40 in infected mice in comparison to control, and the levels were too low to be measured at other times. However, a significantly high serum dopamine level was observed that gradually increased after parasite inoculation. Conclusions. No detection of tyrosine level in most of the sample groups is probably related to the very low concentration of tyrosine in sera. However, low concentration of tyrosine at day 40 and increase of dopamine in most of the sample groups suggest the production of dopamine from tyrosine due to the presence of Toxoplasma in infected mice. [ABSTRACT FROM AUTHOR]

Background. Toxoplasmosis is a zoonosis disease that can cause a variety range of manifestations in human specially fetus duration and immunodeficiency conditions. Due to toxicity and side effects of current treatment, we evaluated in vivo and in vitro effects of ethyl acetate extract of Acorus calamus rhizomes (rootstocks) on Toxoplasma gondii. Methods. The plant, Acorus calamus, was collected from Sari, North of Iran in spring season. Ethyl acetate extract was provided from plant rhizomes using Soxhlet apparatus. The total phenolic and flavonoid contents of the extract were measured by the Folin–Ciocalteu method. The mortality effect of different concentrations (1-256 μg/ml) of the extract on Toxoplasma tachyzoites was assessed by flowcytometry and propidium iodide staining. For the therapeutic effect assessment, the tachyzoites were inoculated intraperitoneally to mice, and then these mice were orally and intraperitoneally administered different concentrations (32, 64, 128, and 256 mg/kg) of the extract. Also, an infected group received PBS including DMSO 1% as negative control, and an infected group administered sulfadiazine as positive control. For toxicity evaluation of this extract, a group only received dose 256 mg/kg. Results. The plant extract was rich of phenolic compounds (41.27 ± 0.21 mg / g), whereas it contained fewer amounts of flavonoids (4.79 ± 0.01 mg / g). Results of in vitro experiments showed that there is an inverse relationship between the concentrations and the mortality of the parasites (I C 50 = 200.01 ± 7.74 μ g / ml). The highest percentage (62%) of dead tachyzoites was seen at maximum concentration of the extract. A significant longevity (8.9 days) was belonged to mice orally administered extract dose (256 mg/kg/day).Conclusion. The ethyl acetate extract of A. calamus rhizomes had significant anti-Toxoplasma activities either in vitro or in vivo. It may be connected to high amount of phenolic compounds. We suggest that the effects of different fractions and the admin types of the extract will be evaluated on the parasite. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]