Global incidence of surgical site infections following caesarean section: a systematic review and meta-analysis.

BACKGROUND: Surgical site infection (SSI) is a health-threatening complication following caesarean section (CS); however, to the authors' knowledge, there is no worldwide estimate of the burden of post-CS SSIs. Therefore, this systematic review and meta-analysis aimed to estimate the global and regional incidence of post-CS SSIs and associated factors. METHODS: International scientific databases were searched systematically for observational studies published from January 2000 to March 2023, without language or geographical restrictions. The pooled global incidence rate was estimated using a random-effects meta-analysis (REM), and then stratified by World-Health-Organization-defined regions as well as by sociodemographic and study characteristics. Causative pathogens and associated risk factors of SSIs were also analysed using REM. Heterogeneity was assessed with I2. RESULTS: In total, 180 eligible studies (207 datasets) involving 2,188,242 participants from 58 countries were included in this review. The pooled global incidence of post-CS SSIs was 5.63% [95% confidence interval (CI) 5.18-6.11%]. The highest and lowest incidence rates for post-CS SSIs were estimated for the African (11.91%, 95% CI 9.67-14.34%) and North American (3.87%, 95% CI 3.02-4.83%) regions, respectively. The incidence was significantly higher in countries with lower income and human development index levels. The pooled incidence estimates have increased steadily over time, with the highest incidence rate during the coronavirus disease 2019 pandemic (2019-2023). Staphylococcus aureus and Escherichia coli were the most prevalent pathogens. Several risk factors were identified. CONCLUSION: An increasing and substantial burden from post-CS SSIs was identified, especially in low-income countries. Further research, greater awareness and the development of effective prevention and management strategies are warranted to reduce post-CS SSIs.

Susceptibility of different mouse strains to peri-implantitis.

BACKGROUND AND OBJECTIVE: Peri-implantitis (PI) is an inflammatory condition that affects the tissues surrounding dental implants. Although the pathogenesis of PI is not fully understood, evidence suggests that the etiology is multifactorial and may include a genetic component. The aim of this study was to investigate the role of genetics in the development of peri-implantitis. MATERIAL AND METHODS: Four-week-old C57BL/6J, C3H/HeJ and A/J male mice had their left maxillary molars extracted. Implants were placed in the healed extraction sockets. Upon osseointegration, ligatures were placed around the implant head for 1 or 4 weeks to induce PI. Micro-computed tomography scanning was used to measure volumetric bone loss. Histological analyses were also performed to evaluate collagen organization and the presence of neutrophils and osteoclasts. RESULTS: Radiographically, comparing the ligature-treated mice, C57BL/6J displayed the greatest amount of bone loss, followed by C3H/HeJ and A/J mice at 1 and 4 weeks. Histologically, at 1 week, C57BL/6J mice presented with the highest numbers of neutrophils and osteoclasts. At 4 weeks, C57BL/6J mice presented with the most active bone remodeling compared with the other two strains. CONCLUSION: There were significant differences in the severity of peri-implantitis among the different mouse strains, suggesting that the genetic framework can affect implant survival and success. Future work is needed to dissect the genetic contribution to the development of peri-implantitis.

A Molecular and Serological Study on Visceral Leishmaniasis in Asymptomatic Stray Dogs in Mashhad, Iran.

Zoonotic visceral leishmaniasis is caused by Leishmania infantum (L. infantum),and its major reservoir hosts are domestic dogs, most of which are asymptomatic. This study aimed to detect L. infantum spp. in asymptomatic stray dogs by molecular and serological methods in Mashhad, Iran, during 2011-12. In this study, 94 asymptomatic stray dogs were randomly selected and their blood samples were collected for indirect fluorescent antibody testing. Furthermore, tissue samples from all the L. infantum seropositive stray dogs were examined using semi-nested polymerase chain reaction (PCR). Accordding to the results, 11.7 %(11/94) of the dogs were L. infantum seropositive. The PCR positivity rate of L. infantum was 63.6% (7/11) in at least one of the collected specimens of the seropositive dogs. The L. infantum kinetoplast DNA (kDNA) was detected in the liver of 36% (4/11), the spleen of 27% (3/11), and the skin of 54.5 %(6/11) of the stray dogs. In this study, based on the molecular and serological examinations, visceral leishmaniasis infection among the stray dogs in Mashhad was confirmed.

Molecular detection of equine piroplasms in donkeys (Equus asinus) in North Khorasan province, Iran.

Equine piroplasmosis is a tickborne disease of equids with worldwide distribution, caused by Theileria equi and Babesia caballi. The aim of this study was molecular detection of T. equi and B. caballi in donkeys in northeastern Iran and investigate the association between positivity of piroplasm infection and host-related factors. In the present study, Blood samples were collected from 106 apparently healthy donkeys (Equus asinus) in North Khorasan province, Iran. Blood smears were prepared and stained by giemsa method. DNA was extracted from blood and then multiplex-PCR was done for detection of any piroplasms infection. According to the results, four donkeys showed T. equi in blood smears but B. caballi was not found. Also, fifty four donkeys (50.94%) showed T. equi infection using multiplex-PCR. No siginificant difference was observed between the frequency of T. equi infection with host-related factors in donkeys. This is the first report on the molecular detection of eqiune piroplamosis in donkeys in Iran. Also, no significant association was found between the rate of T. equi infected animals.

Molecular genotyping of Echinococcus granulosus from dromedaries (Camelus dromedarius) in eastern Iran.

With the aim of genotyping Echinococcus granulosus cysts found in Iranian dromedaries (Camelus dromedarius), 50 cysts of E. granulosus were collected from five geographical regions in Iran. Cysts were characterized using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the internal transcribed spacer 1 (ITS1) gene and sequencing fragments of the genes coding for mitochondrial cytochrome c oxidase subunit 1 (cox1). Morphological criteria using rostellar hook dimensions were also undertaken. The present results have shown that 27 out of 50 E. granulosus cysts (54%) were determined as the G1 strain, and the other (46%) were determined as the G6 strain. The molecular analysis of the ITS1 region of ribosomal DNA corresponded with the morphological findings. Because of its recognized infectivity in humans, the G1 genotype is a direct threat to human health and its presence in Iranian dromedaries is of urgent public health importance.

A serological study of Leishmania infantum in dogs of Khorasan Razavi province, Iran.

Leishmania infantum is the principal agent of visceral leishmaniosis (kala-azar) in all areas of Iran. The disease is endemic in Fars, Ardabil, East Azerbaijan and Bushehr provinces while it is sporadic in other parts of the country. Dog as a member of canidae family is the main animal reservoir host of kala-azar. The present study was carried out to determine the sero-prevalence of canine leishmaniosis in Mashhad, the capital city of Khorasan Razavi Province, in the north east of Iran. Two-hundred and nine dogs in two different classes including stray and sheepdogs were selected for this cross-sectional study. The blood samples were collected and tested by indirect immunofluorescent antibody test for detection of anti-Leishmania infantum antibodies. The results showed that 16/209 (7.6 %) of blood samples were positive. The sero-prevalence rates in stray and sheepdogs were 11/94 (11.7 %) and 5/115 (4.3 %), respectively (p < 0.05). Based on the results obtained, it is concluded that visceral leishmaniosis is distributed among dogs of this area, also sero-prevalence of canine leishmaniosis in stray dogs higher than sheepdogs.

An epidemiological study on Anaplasma infection in cattle, sheep, and goats in Mashhad Suburb, Khorasan Province, Iran.

The prevalence of Anaplasma infection was studied in cattle, sheep, and goats in the Mashhad area from 1999 to 2002. A total of 160 cattle from 32 farms and 391 sheep and 385 goats from 77 flocks were clinically examined for the presence of Anaplasma spp. in blood smears. The study revealed that 19.37% of cattle were infected with Anaplasma marginale and 80.3% of sheep and 38.92% of goats were infected with Anaplasma ovis. Prevalence of Anaplasma infection between male and female and between different age groups of cattle, sheep, and goats were statistically nonsignificant. Seasonally, the prevalence of Anaplasma infection in sheep and goats reached its highest level in summer, while a decrease was observed in autumn, and reached the lowest level in winter. The seasonal prevalence of Anaplasma infection in cattle was not significantly different. Symptomatic cases were not observed in any of the cattle, sheep, and goats. The ranges of anaplasmatemia in infected cattle, sheep, and goats were 0.005-0.5%, 0.01-3%, and 0.01-3%, respectively.

Trials to induce protective immunity in mice and sheep by application of protoscolex and hydatid fluid antigen or whole body antigen of Echinococcus granulosus.

In the current study, soluble proteins prepared from 200 mature Echinococcus granulosus and protoscolices of sheep hydatid cysts were applied to immunize sheep and mice respectively. The samples were mechanically homogenized in a blender, sonicated and the final yield was maintained at -20 degrees C until analysis. Hydatid fluid was isolated from liver or lung of sheep under sterile conditions. In the first experiment, 15 mice were randomly allocated to three groups of five mice each. Each mouse in groups 1 and 2 was immunized with 100 microg of hydatid fluid and protoscolex proteins in 100 microl of phosphate-buffered saline (PBS) and emulsified with an equal volume of Freund's complete adjuvant (FCA) respectively. The mice of group 3 were immunized with adjuvant in PBS. The mice were boosted 4 weeks after the first vaccination with the same preparation except that FCA was replaced by Freund's incomplete adjuvant (FIA). In the second experiment, eight male or female lambs 4-6 months of age, were allocated to two groups of four lambs each. Each lamb in the test group was vaccinated subcutaneously in the neck with a 2-ml dose of vaccine (1 mg of whole body protein of E. granulosus dissolved in 1 ml of PBS plus 1 ml of FCA). Control lambs were vaccinated with adjuvant in PBS. Lambs were boosted the same way as in the first experiment. Three weeks after the second vaccination, each mouse and lamb received a challenge infection with 2000 protoscolices intraperitoneally and each lamb additionally received 10 gravid E. granulosus. All mice and sheep were killed after 7 months and examined for hydatid cysts. In these studies, protective immunity was induced in mice with protoscolex protein and with hydatid fluid, and in sheep with whole-body homogenate of E. granulosus and the levels of protection afforded were found to be 72.1, 82.6 and 90.9% respectively.

An epidemiological study on ovine babesiosis in the Mashhad suburb area, province of Khorasan, Iran.

The prevalence of Babesia spp. infection was studied in sheep of the Mashhad area in Iran from 1998 to 2000. A total of 677 sheep originating from 115 flocks were clinically examined and investigated for the presence of Babesia spp. in appropriate blood smears and any tick species on the body of the animals. The study revealed that the infection rate for Babesia ovis and Babesia motasi were 167 (24.6%) and 4 (0.5%), respectively. Double (mixed) infections occurred in 21 (3%) sheep. Differences in infection rates were statistically non-significant between male and female sheep and between different age groups. Seasonally, the prevalence of Babesia spp. infection started to increase in April and reached highest values in August (56%), while a decrease was observed in September, reaching the lowest levels In February and March. The study demonstrated that 1.7% of sheep infected with B. ovis and 50% of sheep infected with B. motasi exhibited clinical signs. Sheep infected with B. motasi showed the highest levels of parasitemia. We found that 550 (73%) of the animals harbored Rhipicephalus sanguineus; 166 (21%) Hyalomma marginatum; 19 (2.5%) Dermacentor daghestanicus; 14 (1.8%) Hyalomma anatolicum; 6 (0.66%) Hyalomma asiaticum; and one (0.13%) Haemaphysalis punctata. The examination of 727 tick haemolymph samples and 52 tick egg smears showed that one sample (0.2%) of haemolymph of R. sanguineus, two (1.2%) haemolymphs of H. marginatum and two (2%) eggs of R. sanguineus harbored kinetes morphologically matching the criteria described for B. ovis.

The energy expenditure of female carpet weavers and rural women in Iran.

The energy cost of individual activities and the daily energy expenditure of female carpet weavers and villagers were measured in Iranian villages and in the town of Isfahan as part of a series of studies to assess the validity for the population of past and present FAO recommended energy allowances. The energy cost of typical activities was measured by indirect calorimetry using Max-Planck respirometers. Daily energy expenditure was assessed using these figures combined with a 24-hr activity diary. The results of standard activity values are compared with other published values for Europeans and populations of countries with hot climates. The mean daily energy expenditure for both groups was in the order of 2000 kcal/day, below but close to the FAO recommendations which appear valid for rural women in a large part of the country but are probably an underestimate for areas where the participation of women in agriculture is greater.