[Investigation of prevalence of onychomycosis due to yeast fungi in dystrophic nails of patients who referred to Razi hospital [2010 - 2011]]

Yeasts are one of the most common causes of onychomycosis. In countries like Iran, Saudi Arabia, Italia and Spain, yeasts are reported as the most frequent causes of onychomycosis. Inhibition of the immune system such as chemotherapy, radiation therapy, the use of broad spectrum antibodies, aggressive treatment with corticosteroids, HIV and diabetes melitus predispose the body with these fungal infections. Onychomycosis due to yeast has a higher prevalence in finger nails and its incidence in women is two or three times more than men. In some occupations such as nurses, dish washers, confectionery and housewives it can be more observed. Among the yeasts, Candida albicans is the most common agent onychomycosis. This study has been designed for investigation of prevalence of onychomycosis due to yeast in patients who referred to Razi hospital. This was a cross sectional study and 700 dystrophic nail samples were examined by both direct examination and culturing. In direct examination KOH [hydroxide potassium] 20% and for culturing saboroud dexterose agar [S] media were used. For identification yeasts complementary examination were done such as: Reynold braude test, API test and culturing on candida chrom agar media and corn meal agar media were used. For investigation of relevance between variables, Chisquare test and Fisher exact test were used. Of 700 dystrophic nail samples [15.71%], 110 samples were yeast positive by both direct examination and culturing. Thirty one patients were males and 79 patients were females and in both sexes those most infected were between 50-59 years of age [27.3%]. Eighty patients had fungal infection of finger nails and 16 patients had fungal infection on toe nails; 14 patients had both infections on finger and toe nails. The most frequent detected yeast species was Candida albicans [42.7%] which was followed by Candida parapsilosis [20.9%], Candida tropicalis [14.5%], Candida krusei [12.7%], Candida glabrata [3.6]%, Candida gillermondi [2.7%], and Candida lousitani, famatata, rodotroula [each 0.9%] .The most common clinical type noted was distal subungual onychomycosis in 50% of cases. In this study 52 patients [48.1%] had diabetes which was the most common disease between patients with onychomycosis due to yeasts. Diagnosis of onychomycosis due to yeast is very important because it shows the person's immune response. Identification of pathogenic yeast species in terms of epidemiology and selecting appropriate and effective treatment is important

[Report of 34 cases of saprophytic fungi isolated from dystrophic nails of patients referred to Razi Hospital [2010 - 2011]]

Saprophytes are one of the agents causing nail dystrophy. Saprophytes can invade healthy nail or may invade nails previously damaged in the course of other diseases and grow with suitable conditions. The reported incidence of saprophytic nails is between 1.43-17.6%. Saprophytes preferably invade the nails on the big toes, especially in individuals above 60 years. The most etiologic agents of saprophyte nail are Aspergillus spp, Acremonium spp, Scopulariopsis spp, Penicillium spp, and fusarium. The purpose of this study was to determine the prevalence agents of saprophytic nails in patient that had referred to Razi hospital. This was a cross sectional study and nail samples were analyzed by direct microscopy and culture. Microscopic examination of these specimens was carried out in potassium hydroxide solution [20%]. These specimens were cultured on two media of sabourad dextrose Agar [S]. Czapek-Dox Agar [CZA] medium was used for identification of Aspergillus species. For investigation of relevance between the variables, Chi-square test and Fisher exact tests were used. In this study, 34 cases were positive by both direct microscopy and culture. Of those, 17 patients were females and 17 patients were males. The most frequently isolated saprophytes from nails was Aspergilus flavous [35.3%]. Meanwhile 58.8% of saprophytes were isolated from toe nails. In this study the distal subungual onychomycosis was the most frequent [% 64.7%]. The age group 50-59 years [29.4%] had the highest prevalence of saprophytic nail infections.In this study the prevalence of saprophytic nails infections was 17.2%. A proper diagnosis, consisting of both clinical and mycological examinations, may aid the clinician in selecting the most appropriate therapy. Knowledge of epidemiology and mycology characteristics of nail infections has been noted by many authors as being an important tool for control of these fungal infections

[Comparision of antifungal effect of fluconazole alone and in combination with nanosilver particles against candida species isolated from chronic candidal vulvovaginitis]

Candidal vulvovaginitis is a female genital infection that is occured by the over growth of candida species and specially Candida - albicans and occasionally it appears as recurrent and chronic and resist to therapy. Fluconazole is one of the current drugs that is used in treatment of this disease and sometimes resistance is observed to this. Therefore indirection of making the therapy better we decided to investigate the activitiy of fluconazole in combination with silver nanoparticles against candida species isolated from chronic and recurrent candidal vaginitis. This was an experimental study with convenient sampling that was performed on 30 patients. All specimens were examined in direct microscopy, culturingand differential tests to identify different candida species from each other such as culture on candida chrom agar, germ tube, temperature test and sugar assimilation with API. Then the antifungal effects of fluconazole and silver nanoparticles, each of them alone and in combination with each other, were examined .Findings were described on the base of logestic regression and man-vitni exam. In our study 30 specimens of chronic genital candidiasis were diagnosed with isolated agents Candida albicans, glabrata, krusei, tropicalis, parapsilosis and Candida famata respectively. Also findings suggested that fluconazole was able to inhibit the growth of candida species at an expanded range of concentration between 4-128 microgeram per milliliter.As well antifungal activity of Fluconazole with silver nanoparticles was increased in comparision with using Fluconazole alone. For the prevention of recurrent cases and to stabilish correct diagnosis it is essential to carry out sensitivity and diagnostic tests in laboratory and also administration of silver nanoparticle in combination with fluconazole in drug formulation for topical uses in treatment of chronic vaginal candidiasis and inhibition of recurrent cases, can useful

[Investigation of serum C-reactive protein and mannose binding lectin levels in patients with dermatophytosis]

Dermatophytosis is common cutaneous fungal disease with worldwide distribution. Interleukin8 [IL-8] realized from keratinocytes in the presence of dermatophytic antigens causes induction of acute responses in dermatophyte infection and subsequently production of acute phase proteins occurs in hepatocytes. C-reactive protein [CRP] and Mannose binding lectin [MBL] are acute phase proteins. Since few researches in the case of acute phase proteins in dermatophytic infections has been accomplished, this study has been designed for determining serum CRP and MBL levels in patients affected to dermatophytosis. This was a cross sectional study and samples were carried out on 96 healthy individuals and 105 patients affected to dermatophytosis with non probable and in access procedure. For isolation and identification of dermatophyte direct microscopic examination, culturing and complementary examinations were done and for determination of serum CRP and MBL levels in healthy individuals and in patients ELISA test were used. For investigation of relevance between variables, Chi-square, Fisher exact, Mann-Whitney and Roc curve analysis were used and p<0.05 was considered as meaningful level. The median serum CRP level in healthy individuals and in patients group was 3.31 +/- 3.32 micro g/ml and 16.60 +/- 35.96 micro g/ml [p<0.001] respectively and the median serum MBL level was 1.53 +/- 1.87 micro g/ml and 1.97 +/- 2.03 micro g/ml [p=0.039] respectively. CRP [p<0.001] and MBL [p=0.042] were determined meaningful parameters for dermatophytosis. MBL deficiency [MBL concentrations<1 micro g/ml] was higher in control subjects [56.2%] than in patients [41.0%]. Findings of this study indicate increased concentrations of CRP and MBL in patients affected to dermatophytosis and their role in this infection. Probably observation of high frequency of MBL deficiency in healthy individuals in compare with patients group indicates that it is not predisposing factor in affecting to dermatophytosis