The Association between Diet and Multiple Sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune disease of the Central Nervous System (CNS) that affects individuals between the ages of 20 and 40 years, with a higher prevalence among women. Prevalence of this disease has increased significantly in recent decades in different geographical areas. There is evidence to suggest that both genetic and environmental factors play a role in the development of MS. OBJECTIVE: This study aims to investigate the potential relationship between diet and MS in the Azeri population of the East Azerbaijan province of Iran. METHODS: 467 MS patients and 260 non-related healthy individuals under the age of 15 completed a dietary demographic questionnaire. The relationship between food consumption and MS was evaluated using the obtained data. RESULTS: MS patients had a significantly higher consumption of fat, high-fat dairy, fast food, soybean, sausages and kielbasa, pickles, and leftover food (p-value=0.0001), while healthy individuals had a higher consumption of fruit (p-value=0.0001). Consumption of Meat, sweets, and fizzy drinks was also found to be higher in MS patients (p-value<0.05). There was no significant difference in the consumption of vegetables, cakes biscuits, and spices between the two groups (p-value>0.05). CONCLUSION: The results suggest that fruit consumption under the age of 15 may be a protective factoragainst MS, while the consumption of fat, high-fat dairy, fast food, soybean, sausages and kielbasa, pickles, leftover food, meat, sweets, sauce, and fizzy drinks under the age of 15, maybe risk factors for MS.

COVID-19, HIV, and Cryptococcal Meningitis Coinfections with Abnormal Laboratory Findings.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first introduced in China in 2019, and it has rapidly spread all around the world. Cryptococcus neoformans is the leading cause of fungal meningitis in human immunodeficiency virus- (HIV-) infected patients. A variety of laboratory tests have been introduced for rapid diagnosis of meningitis. Methods: Here, we report a case of coinfection with COVID-19 and cryptococcal meningitis in a HIV-positive patient with abnormal laboratory findings. In this case, COVID-19 was positive by polymerase chain reaction (PCR) and computerized tomography (CT) scan diagnosis. Cryptococcal antigen testing of CSF was negative, whereas India ink staining and cerebrospinal fluid (CSF) culture confirmed the presence of C. neoformans. Results: Although the patient was in a critical stage of illness, serum and CSF levels of procalcitonin were abnormally low, within normal limits. On the other hand, although initial lumbar puncture had showed elevated protein level, the repeat CSFs presented remarkably reduced protein levels. Our findings indicate that despite COVID-19 infection, procalcitonin level may remain normal in HIV-associated cryptococcal meningitis, and findings of an apparently normal procalcitonin level should not exclude the possibility of infection. Also, antigen testing may present false-negative result, and it should not be the sole laboratory method for diagnosis of infectious meningitis. Consequently, CSF culture and staining is recommended, even when antigen testing of organism is negative and CSF profile is unremarkable. Conclusion: Laboratory information should be combined with a good understanding of clinical manifestations of patient to determine if meningitis is present and confirmed COVID-19 should not ignore possibility of other infections for consideration.

A Thematic Analysis of Dimensions of Spiritual Care.

Background: An overview of spiritual care studies can help reveal the dimensions of spiritual care and summarize the findings of available studies. Thus, we designed the present study based on existing studies to explain the dimensions of spiritual care. Materials and Methods: In this thematic analysis, we gathered the related articles published in Persian and English in the last 8 years (2013-2021) with the help of the keywords of Care, Support, Spirituality, Religion, Treatment, Hospice, and Palliative, and searching in electronic databases, including PubMed, Scopus, Web Of Sciences, Magiran, Islamic Science Citation (ISC), and Scientific Information Database (SID). We accurately studied 79 articles that met the inclusion criteria, and then the spiritual care components were extracted and coded, and finally, the codes were categorized as themes and sub-theme. Results: Thematic analysis of available studies revealed that the dimensions (theme) of spiritual care include: spiritual and religious assessment, developing a structure for providing spiritual care, establishing effective and supportive communication with the patient, training the patient, answering his questions, encouraging, maintaining, and improving social communications, encouraging the patient to live happily, helping the patient to achieve peace and calmness, supporting for spiritual rituals and activities, supporting and training the patient's family, and supporting the dying patient. Conclusions: Spiritual care includes various and numerous dimensions. Considering the widespread dimensions of spiritual care, it seems necessary to design and plan appropriate studies to reveal other spiritual care dimensions from the perspective of patients and care providers in different cultures.

Paediatric pre-B acute lymphoblastic leukaemia-derived exosomes regulate immune function in human T cells.

Exosomes derived from solid tumour cells are involved in immune suppression, angiogenesis and metastasis; however, the role of leukaemia-derived exosomes has less been investigated. Hence, changes in immune response-related genes and human T cells apoptosis co-incubated with exosomes isolated from patients' pre-B cell acute lymphoblastic leukaemia were evaluated in this in vitro study. Vein blood sample was obtained from each newly diagnosed acute lymphoblastic leukaemia (ALL) patient prior any therapy. ALL serum exosomes were isolated by ultrafiltration and characterized using Western blotting and transmission electron microscopy. Exosomes were then co-incubated with T lymphocytes and the gene expressions, as well as functions of human T cells were quantified by qRT-PCR. Apoptosis and caspase-3 and caspase-9 protein expression were also evaluated by flowcytometry and Western blotting analysis, respectively. Exosomes isolated from ALL patients affected T lymphocytes and elevated the apoptosis. Moreover, these exosomes altered the T cells profile into regulatory type by increasing the expression of FOXP3 and Tregs-related cytokines, including TGF-B and IL-10. The expression level of Th17-related transcription factors (RoRγt) and interleukins (IL-17 and IL-23) decreased after this treatment. According to our findings, exosomes derived from ALL patients' sera carry immunosuppressive molecules, indicating the possible effect of exosomes as liquid biomarkers for cancer staging.

Susceptibility Pattern of Caspofungin-Coated Gold Nanoparticles Against Clinically Important Candida Species.

Purpose: The present study was performed to examine whether caspofungin-coated gold nanoparticles (CAS-AuNPs) may offer the right platform for sensitivity induction in resistant isolates. Methods: A total of 58 archived Candida species were enrolled in the research. The identification of Candida spp. was performed using polymerase chain reaction-restriction fragment length polymorphism and HWP1 gene amplification approaches. The conjugated CAS-AuNPs were synthesized and then characterized using transmission electron microscopy (TEM) and Zetasizer system to determine their morphology, size, and charge. Furthermore, the efficacy was assessed based on the Clinical and Laboratory Standards Institute M60. Finally, the interaction of CAS-AuNPs with Candida element was evaluated via scanning electron microscopy (SEM). Results: According to the TEM results, the synthesized CAS-AuNPs had a spherical shape with an average size of 20 nm. The Zeta potential of CAS-AuNPs was -38.2 mV. Statistical analyses showed that CAS-AuNPs could significantly reduce the minimum inhibitory concentration against C. albicans (P =0.0005) and non-albicans Candida (NAC) species (P < 0.0001). All isolates had a MIC value of ≥ 4 µg/ml for CAS, except for C. glabrata. The results of SEM analysis confirmed the effects of AuNPs on the cell wall structure of C. globrata with the formation of pores. Conclusion: According to findings, CAS-AuNPs conjugates had significant antifungal effects against Candida spp. Therefore, it can be concluded that the encapsulation of antifungal drugs in combination with NPs not only diminishes side effects but also enhances the effectiveness of the medications.

Development and Psychometric Analysis of the Measure of Perceived Adherence to the Principles of Medical Ethics in Clinical Educational Settings: Trainee Version (PAMETHIC-CLIN-T).

OBJECTIVE: This study was conducted to develop and assess psychometric properties of the "Measure of Perceived Adherence to the Principles of Medical Ethics in Clinical Educational Settings: trainee version (PAMETHIC-CLIN-T)" as a data collection tool to enhance research performance rigor in future medical ethics studies. PATIENTS AND METHODS: A multi-tiered six stage procedure was applied to develop the PAMETHIC-CLIN-T and assess its psychometric properties in a sample of Iranian medical science undergraduate students (n=263). The final constructed item pool contained 16 questions with the response options in five Likert-type categories. The higher total score indicated better compliance with the ethics and professional conduct regulations. Internal consistency reliability was examined and exploratory factor analysis (EFA) with direct oblimin rotation and principal components analysis (PCA) were carried out to reduce the overall constructed items into latent factors based on commonalities within the data set. FINDINGS: Factor analysis results revealed a 4-factor solution. All 16 items had factor loading greater than absolute value of 0.3 that accounted for 60.57% of the variance. The value of Kaiser Meyer Olkin (KMO) measure of sampling adequacy for factor analysis (0.909) and also Bartlett's test of sphericity (X2=1630.63, df=120, P-value<0.001) approved interpretability of the EFA output. CONCLUSION: Feasibility testing and psychometric analysis of the constructed scale yielded research evidence to support a four-factor model to be applied in future studies about the extent of perceived adherence to the principles of medical ethics in clinical educational settings.

Role of Immigration in Tuberculosis Transmission to Iran: A Systematic Review.

BACKGROUND: Today, because of increasing immigration and the prevalence of drug-resistant tuberculosis in Iran, identifying intra-community cases is necessary in the country. It will be possible through the use of molecular epidemiologic methods. In this inquiry, in order to determine the role of immigrants in the transmission of specific strains to Iran, the studies have been examined which had been conducted based on molecular epidemiologic methods among Iranians and non-Iranians people. METHODS: All studies from 1997 to the end of March 2017 were examined in three databases of PubMed, Scopus, and Google Scholar and finally, 16 studies were selected. RESULTS: The common clustering rate between Iranians and non-Iranians was determined to be 19.8, and the intra-community recent transmission rate was from 0% to 49% with average of 18.1%. The rate of multidrug-resistant tuberculosis (MDR-TB) was 12.5%, which was higher among immigrants, especially Afghans, and a significant number of the strains were Beijing. CONCLUSIONS: The studies have shown that migrants, especially Afghans, are more effective in transmitting specific strains of tuberculosis to migratory areas. To control tuberculosis, it is necessary to register of immigrant's health information, while enter to the country, so that, by doing appropriate diagnostic tests, the curing the patients, the transmission of tuberculosis to the country would be prevented.

Tuberculosis and Diabetes Mellitus in Northwest of Iran.

BACKGROUND: Planning for control of tuberculosis would need to screen and identify individuals susceptible to TB. Due to the weakness of immune system in diabetic patients, it is more likely for them to reactivate latent TB infection. Regarding the increasing number of diabetics in the community, in this study efforts have been made to estimate the frequency of individuals who have tuberculosis and diabetes mellitus (TB-DM) simultaneously, as it could help making preventive decisions to reduce TB in this part of Iran. MATERIALS AND METHODS: In this study, 329 cases of confirmed TB patients were divided into two groups of diabetic and non-diabetic, then demographic information and clinical variables have been compared between the two groups. RESULTS: Among the examined subjects, 47 patients (14.29 %) had suffered from diabetes mellitus and tuberculosis. All of the DM patients had pulmonary tuberculosis and 87.23% of them were over the age of 50. CONCLUSION: Majority of DM-TB patients were over 50 years of age and also more than half of them were women. So it seems that for DM women over the age of 50, to detect tuberculosis, screening tests such as PPD may be necessary.

Stopping of the Downtrend of Tuberculosis in Iran, a Systematic Review of Associated Risk Factors.

Tuberculosis (TB) is a public health problem in developing countries. In recent decades, the incidence of the disease has been gradually reducing in Iran. However, the reducing incidence of the disease has stopped in the country during recent years. It could be due to an increase in immigration, diabetes, HIV/AIDS, and the prevalence of drug-resistant strains. In order to prevent the spread of TB cases and control this disease, it is essential to identify the predisposing factors, which may be related to bacteria, host and environment. The objective of the present systematic review was to investigate the role of potentially effective factors in the increase in TB cases in the country. The epidemiological studies that had considered the risk factors for the development of TB in populations from different regions of Iran were reviewed systematically from the beginning of 2007 to the end of June 2017 in electronic databases. Upon evaluation of the literature, these 7 major risk factors were identified in twenty-five eligible studies, including poor living conditions, drug abuse, HIV/AIDS, multidrug-resistant tuberculosis (MDR-TB), diabetes, migration, and smoking. In conclusion, the increase in predisposing risk factors for catching TB, especially the migration and Beijing strain, shows that in the absence of accurate monitoring, TB cases will increase in the near future in Iran.

Rhinocerebral mucormycosis, risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz, Iran 2007-2017.

Inadequate data are available on the global epidemiology of mucormycosis, mainly derived from the evaluation of specific population groups. Rhinocerebral mucormycosis is an invading and fatal mycosis, particularly among diabetic patients. In the present study, patients hospitalised in Imam Reza Hospital in Tabriz, from 2007 to 2017, were evaluated. The hospital information system (HIS) was used to collect the records of the patients. A total of 42 patients with a diagnosis of mucormycosis were included in the study, 40 cases (95%) of which had a diagnosis of the rhinocerebral form. Of these 40 patients, 21 (52.5%) and 19 (47.5%) were male and female, respectively. Seven cases (17.5%) of rhinocerebral mucormycosis were due to dental procedures. The most predisposing factor in the patients was diabetes with 36 (90%) cases. In our study, the role of tooth extraction in patients with uncontrolled diabetes was identified as an important factor. It may show the important role of dentists in preventing of the disease in diabetic patients.

Role of Molecular Epidemiology on Tuberculosis Control in the Middle East Countries: a Systematic Review and Meta-Analysis.

BACKGROUND: Tuberculosis (TB) is a public health problem in developing countries and yet the numbers of people with the disease are abundant. Early detection of transmission sources and effective treatment of the cases is essential to control the disease which will be possible by application of molecular epidemiology approaches. Studies conducted based on Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) method in Muslim Middle East countries were evaluated to determine their role in TB control. MATERIALS AND METHODS: All studies from January 2005 to April 2016 were systematically reviewed in four electronic databases and finally 16 articles were found eligible to be included in this study. The mean clustering rate was determined as 44% and the recent transmission rate was 12.3 to 78.8% with average of 33%. RESULTS: The results showed that both reactivation and recent transmission were important in developing new cases of TB in Middle East countries; but, reactivation plays a more critical role. CONCLUSION: Regarding to ongoing war and immigration in the region along with the increasing of drug-resistant TB, in the case of improper supervision in the future, the disease, especially drug- resistant TB, will be problematic.

Tuberculosis Control and Role of Molecular Epidemiology Studies in Iran: A Systematic Review.

BACKGROUND: Today because of immigration, HIV pandemic and spread of drug resistant tuberculosis, mortality caused by tuberculosis (TB) has increased. To control the disease it is essential to identify the sources of the infection and patterns of transmission. This becomes possible through using molecular epidemiology methods. MATERIALS AND METHODS: This research reviewed studies based on IS6110-restriction fragment length polymorphism (IS6110-RFLP) as a primary method to recognize the role of molecular epidemiology researches in managing TB in Iran. Within 1995-2015 all human population based studies which had use IS6110-RFLP as the primary method systematically reviewed. RESULTS: At the end, 11 articles were selected. The mean clustering rate obtained was 28.1%. The rate of recent transmission was variable from 2% to 49% and the mean value was determined 17%. CONCLUSION: The studies revealed that in Iran both reactivation and recent transmission were significant in developing new cases of TB. Yet, reactivation plays greater role. If the matter is supervised insufficiently and carelessly, because of increasing rate of drug resistant TB, immigration of HIV infected individuals, TB especially drug resistant TB will be problematic in the near future.

Introducing nitazoxanide as a promising alternative treatment for symptomatic to metronidazole-resistant giardiasis in clinical isolates.

OBJECTIVE: To identify the frequencies (F) of ferredoxin and nitroreductase mutations on Iranian clinical isolates of Giardia lamblia in order to predict whether the nitazoxanide can be prescribed as suitable drug for symptomatic to metronidazole-resistant giardiasis. METHODS: Forty Giardia lamblia isolates as of 38 symptomatic and two metronidazole-resistant patients were collected from Iran. DNAs were extracted and amplified by targeting ferredoxin and GlNR genes. The amplicons were directly sequenced to determine gene mutations. RESULTS: The various amino acid substitutions (F: 20%, Haplotype diversity: 0.891, Tajima's D: -0.44013) were identified by analyzing ferredoxin gene in four symptomatic and two resistant isolates. Only two haplotypes (F: 5%, HD: 0.345; Tajima's D: 0.77815) characterized in metronidazole-resistant isolates of GlNR, however, no point mutations was found in symptomatic isolates. CONCLUSIONS: Non-synonymous mutations of ferredoxin oxidoreductase gene reduce translational regulatory protein's binding affinity which concludes reduction of ferredoxin expression and its activity. This leads to decrease in metronidazole drug delivery into the cells. Mutations in these isolates may lead to their resistance to metronidazole. No to low synonymous mutations of GlNR demonstrates that nitazoxanide can be prescribed as promising alternative treatment for symptomatic to metronidazole-resistant giardiasis in Iranian clinical isolates.

Etiologic Agents of Otomycosis in the North-Western Area of Iran.

BACKGROUND: Otomycosis is a superficial fungal infection often involves the pinna and external auditory canal. It is a pathologic condition, with Candida and Aspergillus, the most common fungal species. It is common worldwide but more prevalent in tropical and subtropical countries. OBJECTIVES: The aim of this study was to determine the etiologic agents and local epidemiologic pattern of otomycosis in northwest Iran. PATIENTS AND METHODS: A series of 140 patients with clinically symptomatic otomycosis were studied in 21 cities, towns, and villages throughout northwest Iran between 2009 and 2011. Clinical samples were collected by swabs and then assessed by mycological investigation. RESULTS: Otomycosis was diagnosed in 129 cases (92%, 76 male, 53 female) with the highest prevalence of cases occurring in males between 21 - 40 years of age. From an etiological point of view, 116 patients (90%, 21 - 40 years old) were infected by saprophytic mold and 9 patients (7%) were infected by yeast. Three cases (2%) involved dermatophytes, and in one case (1%) the subject was infected with Eurotium (the perfect stage of Aspergillus fumigatus). Aspergillus niger was the most common mold that was isolated, followed by A. flavus, A. fumigatus, Penicillium spp., Fusarium spp., and Rhizopus spp. A total of 2 yeasts belonging to genus Candida, C. albicans and C. tropicalis, were isolated. CONCLUSIONS: Our study showed a high prevalence of otomycosis in the northwestern area of Iran. As such, proper diagnosis and treatment by aseptic techniques for this disease is urgently needed.

Crisis management aspects of bam catastrophic earthquake: review article.

BACKGROUND: Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis management during and after the catastrophic earthquake in Bam City, Iran. METHODS: Data needed for this systematic review were collected through searching PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis. RESULTS: Out of 422 articles, 25 articles were included in the study. Crisis Management aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information management. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. CONCLUSION: The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.

Aflatoxin in raw and salt-roasted nuts (pistachios, peanuts and walnuts) sold in markets of tabriz, iran.

BACKGROUND: Nuts are one of the main consumed snacks worldwide and also have an important role among Iranian's food habits. Natural contamination of nuts with aflatoxin is unavoidable and causes a special challenge for nuts safety and quality. OBJECTIVES: The purpose of this research was to study the aflatoxin contamination in commercially-available nuts (pistachio, walnut and peanut) in the markets of Tabriz, Iran. MATERIALS AND METHODS: Sixty two samples of 50 g salt-roasted peanuts and pistachios and 109 samples of 50 g pure pistachios, walnuts and peanuts were collected from different areas of local markets. After the initial preparations, ELISA test was performed for Aflatoxin measurement. RESULTS: Result showed that walnut (90%) and pure pistachio (2.3%) were the most and least contaminated samples, respectively. Mean aflatoxin contamination in the salt-roasted samples (19.88 ± 19.41 µg/kg) was significantly higher than the pure ones (6.51 ± 9.4 µg/kg) (P < 0.001). Respectively, 58.6%, 48.4% and 47.6% of salt-roasted pistachios, salt-roasted peanuts and walnut samples had aflatoxin contamination, which were more than the maximum tolerated level of Iran (MTL, 15 ppb). CONCLUSIONS: It was concluded that aflatoxin content of nuts should be monitored regularly to minimize the risk of aflatoxin hazard and ensure the food safety and quality.

Mold contamination of untreated and roasted with salt nuts (walnuts, peanuts and pistachios) sold at markets of tabriz, iran.

BACKGROUND: Nuts are one of the main consumed snacks worldwide and a significant component of Iranian's diet. Natural contamination of nuts with fungus is unavoidable and is a major challenge to nuts safety and quality. OBJECTIVES: The purpose of this research was to study fungal contamination in commercially available nuts (pistachios, walnuts and peanuts) in the markets of Tabriz, Iran. MATERIALS AND METHODS: 100 samples of 50 gr roasted with salt peanuts and pistachios and 300 samples of 50 gr pure pistachios, walnuts and peanuts were collected from different areas of the local markets. After initial preparation, the samples were cultured on Sabouraud's dextrose agar (SDA). 19 fungal isolates were identified. RESULTS: The results show that Aspergillus niger was the predominant mold among pure (44%) and roasted with salt (14%) nuts (P < 0/001). In addition, percentage of mycotoxigenic fungal contamination was 18% for roasted with salt nuts and 11% for pure samples. CONCLUSIONS: The overall results of the analysed samples showed that the rate of fungal contamination in pure samples was higher than roasted with salt ones (P < 0.005). Results of the current survey could be useful for minimizing fungal contamination and can educate people about the dangers of mold in nuts.

Surgery for Gynecomastia in the Islamic Golden Age: Al-Tasrif of Al-Zahrawi (936-1013 AD).

The rise of European science during the Renaissance is greatly indebted to the flourishing of the sciences during the Islamic Golden Age. However, some believe that medieval Islamic physicians and in particular surgeons had been merely a medium for Greco-Roman ideas. Contrarily, in some medieval Islamic medical books, such as Al-Tasrif of Al-Zahrawi (936-1013), the surgical instructions represent a change in the usual techniques or are accompanied by a case history, implying that the procedure was actually undertaken. Along with the hundreds of chapters on different diseases and related medical and surgical treatments, Al-Tasrif includes a chapter on surgical techniques for gynecomastia. The present paper is a review of the description of the surgical management of gynecomastia by Al-Zahrawi as well as that of the ancient Greek, medieval, and modern medicine. Although Al-Zahrawi seemed to base his descriptions of surgery for gynecomastia upon those of Paulus of Aegina, his modification of the procedure and application of the medicinal substances might be indicative of Al-Zahrawi's own practice of the procedure. Al-Zahrawi's surgical procedures remained unchanged for many centuries thenceforward until the technological evolution in the recent centuries.

Tinea unguium in the north-west of Iran (1996-2004).

Tinea unguium is a common mycosis in many part of the world including Iran. The prevalence of this mycosis varied depending on time, health level and geographical location. To stabilise the etiological, epidemiological and risk factors of tinea unguium in North-west Iran, a study of patients with suspected dermatophyte infections of their nails was carried out between 1996 and 2004. During this study 590 (354 females and 236 males) patients with clinical presentation of fungal infection in fingernails, toenails or in the both sites, were investigated using direct microscopy and culture of clinical samples. Tinea unguium was documented in 41 cases (7%) and among positive cases, 16 cases (39% total positive cases) were female and 25 cases (61% total positive cases) were male. Seventeen patients (41% total positive cases) had tinea unguium in their finger nails and 24 patients (59% total positive cases) had infection in their toe nails. According to the isolated etiologic agent, 66% (19 cases) of tinea unguium infections were caused by zoophilic drematophytes, 31% (9 cases) were caused by anthropophilic drematophytes and 3% (1 case) were caused by geophilic dermatophytes. With regard of sex, tinea unguium did not show a significant difference. The highest prevalence of tinea unguium was found in patients between 11 and 40 years of age. In conclusion the current results identified the etiological agents and epidemiological aspects of tinea unguium in North-west Iran. Tinea unguium in this region is associated with animal husbandry and direct or indirect contact with their products (wool, leather).

Sporotrichosis in Iran.

This report describes a 23 year-old male florist gardener diagnosed with subcutaneous sporotrichosis caused by the dimorphic pathogenic soil fungus Sporothrix schenckii. The patient had several small skin lesions over the left upper arm with ascendant chains of enlarged lymph nodes.Sporothrix schenckii was detected from clinical samples by direct microscopy and culture and its ability to switch from mould to yeast form at 37 degrees C. The patient was successfully treated with long-term potassium iodide and advised to wear gloves and long sleeves when handling any kind of plant material.