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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]

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.

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]