shalaleh ganji

Leishmaniasis is a zoonotic disease and is known as a health problem in all of the world. The patient, a 47-year-old man car driver from the city of Bostan Abad, with a history of traveling to cutaneous leishmaniasis endemic provinces last year, was referred to the city health center with a 17 mm, no discharge and pus with a necrotic appearance skin lesion. Biochemical, hematological parameters and urine culture and analysis were normal. Three smears were prepared with sterile vaccinostyle from the margins of the wound and transferred to a specific medium in sterile conditions. After staining the prepared smears from the wound, amastigotes with a large nucleus and small kinetoplast in macrophages and active promastigotes in the liquid phase of the medium were observed. Polymerase chain reaction (PCR) was performed using ITS-1 by specific primers. In the PCR product electrophoresis was compared with the marker bands and 350 bp band weight determined. With electrophoretic patterns and comparison with positive control band, isolates parasites belonged to the Leishmania genus. In order to definitively diagnose the parasite species, a sequencing method was used. The results showed 99% homology with Leishmania major. Finally, the patient with a diagnosis of rural cutaneous leishmaniasis was induction with Glucantime drug. Diagnosis of suspected cases with cutaneous leishmaniasis is of major importance. If an infected patient is diagnosed in the early stages of the disease, the extension of the scar after recovery, as well as the possible complications of rural infection can be prevented.

Premature birth is an important issue in developed and developing countries. Surfactant replacement therapy of respiratory distress syndrome (RDS) causes a change in the normal pattern of the disease and increases the likelihood of survival of more premature newborns with chronic pulmonary damage. The purpose of this study was to investigate the effects of budesonide and surfactant on the treatment of respiratory distress syndrome and the prevention of bronchopulmonary dysplasia.

In a randomized clinical trial, 128 preterm infants less than 1250 g or gestational age of 26-30 weeks that were admitted to Al-Zahra Hospital from 2017 to 2018 with RDS and needed surfactant replacement therapy were enrolled. They were randomly allocated into two groups. In one group (group Surfactant), the surfactant was administered intratracheally 2.5 cc/kg and in the second group (group Surfactant + Budesonide), budesonide was administered 0.25 mg/kg in addition to the intratracheal surfactant. The primary outcome was bronchopulmonary dysplasia and the secondary outcome was complications of prematurity.

In this study 128 neonates including 48 (60.9%) boys and 50 (39.1%) girls were studied. The mean gestational ages of studied neonates were 28.32±1.60 weeks. The mean duration of mechanical ventilation, continuous positive airway pressure (CPAP), high flow nasal cannulae (HFNC), and need for supplemental oxygen were significantly shorter in the group that received surfactant and budesonide combination. The required FiO2 at four hours after surfactant treatment was significantly lower in group Surfactant + Budesonide than the Surfactant group (p = 0.01). In the group Surfactant, 38 neonates (59.4%) and in group S+B, 24 cases (37.5%) developed bronchopulmonary dysplasia (BPD), (p = 0.04). The mortality rate was 15 neonates that 6 cases were in group S+B (p =0.29).

In our study, using surfactant with budesonide combination in comparison with surfactant alone is associated with less respiratory support and BPD rate. Future studies with a larger number of patients before routine use of surfactant and budesonide combination is recommended.

Hydatidosis is an important zoonotic parasite disease in several herbivorous mammals. Human cystic echinococcosis (CE) caused by infection with larval stage of Echinococcus granulosus has been frequently reported from different organs. Here, we report the first case of a urinary echinococcosis in Iran with a pain in the lower left abdominal quadrant and severe frequent urination (pollakiuria). We detected a cyst 120 × 15 mm dimensions with heterogeneous mass contain fluid in the back of the urinary bladder neck between the umbilical region and external urethral sphincter. The patient was candidate for open-abdomen surgery and cysts were resected. The isolated cysts from liver and urinary bladder were referred to pathology laboratory, and the tissue sections were stained with Tri-chrome and Hematoxylin/eosin staining methods. Microscopic examination of prepared tissue sections showed protoscoleces of E. granulosus with specific and thick laminated hyaline layer (non-cellular membrane), with covers the thin activate germinal epithelium, which revealed the diagnosis of a hydatid cyst. This rare case illustrates that CE is the necessity of considering in the differential diagnosis from cysts, abscesses, malignant and benignant tumors, especially is essential in endemic areas of CE.

The procedure for weaning from mechanical ventilation in many patients is a difficult and long process and increases the time of mechanical ventilation. There are numerous ways to achieve weaning. One common method is the use of CPAP. Considering the lower price of a humidifier, blender, and T-piece compared with CPAP and in light of the limited number of studies in this field the current study purposed to compare these two procedures.Fifty-one patients with neurological disorders who were under mechanical ventilation and ready to wean were allocated randomly into two groups: the CPAP group and the humidifier, blender, and T-piece group. Duration of hospital and PICU stay, number of days under mechanical ventilation, frequency of re-intubation, and mortality rate among patients were documented.The patients were 33 males and 18 females (64.7% and 35.3%, respectively) with an average age of 22.5 ± 4.5 months.The main indication for intubation was impending respiratory failure.Hospital stay was 22±15 and 21±13 days for the humidifier and CPAP groups, respectively.PICU stay was 13±11 and 21±13 days for the humidifier and CPAP groups, respectively. Re-intubation rates were 17.2% and 45.5% for the humidifier and CPAP groups, respectively.Mortality rates were 3.4% and 22.5% for the humidifier and CPAP groups, respectively.Considering no statistically significant difference between the two groups, using the humidifier, blender, and T-piece is recommended.

Trichomonas vaginalis which is flagellated unicellular organism is the causative agent of vaginitis. Medications used to treat trichomoniasis often have unpleasant side effects or are not effective. Given the prevalence of this disease, the production of safe, effective and affordable medicines is necessary. Various species of ferula are antibacterial and anti-fungal and anti- protozoan. So far, no study has been done on the effect of Ferula szowitsiana on trophozoite of Trichomonas vaginalis. Coma (Ferula), native to Eastern Azerbaijan province, was collected and methanol extracts were prepared. Trophozoite of Trichomonas vaginalis was cultured in vitro in CPLM medium and the effect of the mentioned extracts on the growth and survival of Trichomonas vaginalis trophozoite was measured by Mack-master slide. Concentrations of 2 and 3 mg/ml in Methanol extracts of F. szowitsiana and could inhibit the growth of Trichomonas vaginalis trophozoite completely after 72- hour incubation. Trichomonas vaginalis trophozoite survived at concentrations of 0.5 and 0.375 and 0.25 mg/ml and methanol extract of F. szowitsiana were 42, 52 and 68%, respectively. The reduction of the number of parasites was visible 48 hours after incubation which was statistically significant (P<0.05). Ferula extract in different concentrations inhibited the growth of the dose-dependent trophozoite of Trichomonas vaginalis. The results of this study showed that native species of F. szowitsiana is suitable for the study of anti-trichomonas nature of it in vitro. Therefore, further study and identification of effective components in the methanol extract in the studied species are required.

The weaning procedure of mechanical ventilation in many patients is a difficult and long process and increases the time of mechanical ventilation. There are numerous ways to achieve this goal. One common way is using Continuous positive airway pressure (CPAP) ventilator. Considering the lower price of Blender-Humidifier compared to CPAP of ventilator and the limited number of studies in this field, this study was aimed to compare these two procedures. 102 patients in Pediatric intensive care unit (PICU) were allocated randomly in one group: CPAP-ventilator and Blender-Humidifier. Duration of hospital and PICU stay, the number of days of mechanichal ventilation, the frequency of re-intubation, and the mortality of the patients were recorded. The study was conducted on 66 male and 36 female patients (64.7% and 35.3% respectively). The average age was (22.5 ± 4.5) months. The most frequent complaint of the patients at the time of visit was coughing (35%), hyperventilation and respiratory distress (21.6%). Hospital stay was (23±14) and (20±12) days in humidifier and cpap groups respectively (p=0.52). PICU stay was (15± 11) and (20±11) days in humidifier and cpap groups respectively (p=0.18). Re- intubation rate was 16.2% and 33.5% in humidifier and cpap groups respectively (p=0.15). Mortality rate 8.4% and 21.5% in humidifier and cpap groups respectively (p=0.06). Although there was no statistically significant difference between two groups, considering the differences in mortality rate, the need for re-intubation, rate of hospital and PICU stay, and at the same time, with easy availability and low prices, using Blender- Humidifier is recommended.