A large-scale study on the seroprevalence of Toxoplasma gondii infection in humans in Iran.

It is estimated that nearly one-third of the world's human population is infected with Toxoplasma gondii (Nicolle et Manceaux, 1908). Human infection is commonly asymptomatic, multifaceted, and can manifest in severe pathological forms in congenital toxoplasmosis and immunocompromised individuals. This study attempted to recognise the seroprevalence of T. gondii infection in Iranian residents referred to medical laboratories for toxoplasmosis tests throughout the country. This retrospective cross-sectional study was conducted from 2015 to 2019 on individuals referred to diagnostic laboratories in 26 provinces, and these laboratories sent their samples to the referral centres. Accordingly, data associated with serodiagnosis of toxoplasmosis, age, sex, anti-T. gondii IgG, and IgM status in Iranian residents were collected from two referral diagnostic laboratories. All individuals were evaluated using the antibody immunocapture-chemiluminescence assay (CLIA) method with the Immulite®2000s XPi system. In this study, the first large-scale assay of T. gondii infection in Iran, an overall seroprevalence of 30.4% was among 35,047 patients examined. The highest IgM seropositivity rate was in the 10-20 years old patients. In addition, this study showed a very different prevalence of T. gondii across the country, highest in the humid areas, such as the Caspian Sea basin in the North, and the North West with seroprevalence of 48.6%.

Comparison of Chloral Hydrate Solution, Hydroxyzine Syrup, and Lidocaine/Prilocaine Cream as Premedication for Lumbar Puncture in Children: A Double-Blind Study.

Objectives: This study aimed to compare the clinical effectiveness of oral hydroxyzine and chloral hydrate to topical lidocaine/prilocaine 2.5% cream as premedication in pediatric leukemia patients. Materials & Methods: This double-blind clinical trial study was conducted on 70 leukemic and nonleukemic patients aged 3-11 years. The patients were divided into four groups. In group A, chloral hydrate solution was given to 18 patients. In group B, hydroxyzine syrup was used for 18 patients. In group C, chloral hydrate solution and lidocaine/prilocaine cream were used for 17 patients. In group D, hydroxyzine syrup and lidocaine/prilocaine cream were used for 17 patients. These groups were assessed and judged based on the visual analog scale (VAS). The side effects of the drugs were also recorded. Results: In this study, 54.3% (n=38) and 45.7% (n=32) of the cases were female and male, respectively. Furthermore, 77%, 7.2%, and 15.8% of the cases were reported with acute lymphocytic leukemia, acute myeloid leukemia, and infectious disease, respectively. The VAS results showed no difference in these four groups. Nontraumatic lumbar puncture (LP) (red blood cell<50) was observed in 97.1% of the cases. Conclusion: Although premedications for LP with hydroxyzine syrup and chloral hydrate solution were not statistically effective in pain relief, they increased patient and parent satisfaction. Moreover, adding lidocaine/prilocaine cream does not improve the effectiveness of the drugs.

Evaluation of the Relationship Between Serum and Urine Ferritin Level of Low Birth Weight Infants.

Background & Objective: Iron deficiency before birth or in infancy can cause long-term behavioral and neurological disorders. Measuring serum ferritin is an effective way to diagnose iron deficiency but requires significant blood volume from a low birth weight infant. Therefore, the present study was performed to investigate the relationship between serum and urinary ferritin levels in low birth weight infants. Methods: In this cross-sectional study, 76 infants weighing less than 2500 g were studied. To measure serum ferritin level, 1.5 mL of blood and to measure urinary ferritin level, at least 1 mL of urine was collected from each infant. Then the results were compared. Data analysis was performed using SPSS software version 16, and the significance level was considered less than 0.05. Results: Out of 76 neonates studied, 51.3% were boys, and 80.3% were premature infants. The mean birth weight of infants was 2056.31±318.74 g, and the mean serum and urinary ferritin levels were 134.77±72.35 and 85.55±70.97 ng, respectively. There was a statistically significant relationship between serum and urinary ferritin levels. Also, serum ferritin and urinary ferritin levels had a statistically significant relationship with birth weight and gestational age. The higher the birth weight as well as the age at birth, the higher the serum ferritin and urinary ferritin. Conclusion: According to the findings of this study, measurement of urinary ferritin level can be used as a noninvasive tool for iron deficiency screening in low birth weight infants instead of serum ferritin level.

A double jeopardy: COVID-19 impacts on the travel behavior and community living of people with disabilities.

The COVID-19 pandemic response has had a significant impact on the general population's ability to participate in their communities. Individuals with disabilities, an already socially disadvantaged population, are more vulnerable to and have likely been disproportionately impacted by COVID-19 response conditions. Yet, the extent to which the daily community living activities of people with disabilities have been impacted is unknown. Thus, this study assesses their travel behavior and community living during the COVID-19 pandemic conditions compared with those of the general population. A web survey was conducted using Qualtrics's online panel data (respondents included 161 people with any type of disability and 232 people without a disability). Regression models found that people with disabilities reduced their daily travel to a greater extent but at varying degrees, depending on the destination types and travel modes. Reductions in taxi rides (including ride-hailing services) were most significant among people with cognitive and sensory (e.g., vision and hearing) disabilities. By place type, cognitive disability was associated with a trip reduction for multiple destination types-grocery, restaurants, outdoor recreation, indoor recreation, and healthcare providers. Findings from this study could contribute to decision- and policy-making in planning, transportation, and community services during the remainder of the COVID-19 pandemic, in future major public health crises, and post-COVID, because the adjustments in travel behavior and community living might be longer-term.

Heart involvement in transfusion-dependent beta-thalassemia with conventional echocardiography.

BACKGROUND: The most important prognostic factor in transfusion-dependent beta-thalassemia is cardiac involvement which is usually evaluated with echocardiography. METHODS: In this cross-sectional study (April 2011 to April 2012), conventional echocardiography was used to assess myocardial performance and valvular involvement (through transvalvular Doppler study) for right and left heart abnormalities in transfusion-dependent beta-thalassemia. RESULTS: Among the 60 patients, 43 cases had heart problems, 26 (43.3%) of them had left myocardial dysfunction and 11 (18.3%) of them had right myocardial dysfunction, 3 cases had both RV and LV myocardial dysfunction, (based on LVMPI & RVMPI, respectively). In patients with right myocardial dysfunction, 4 cases had pulmonary hypertension (PH) and 3 had both sided myocardial dysfunction. LVMPI and RVMPI significantly increased in patients with cardiac involvement (p<0.001). Serum ferritin levels in patients with and without cardiac involvement were 2427±1788 ng/ml and 1573±592 ng/ml, respectively (P=0.008). All 4 patients who had PH, had been splenectomized. In splenectomized and non-splenectomized patients, LVMPI was 0.37±0.11 and 0.38±0.1 (P=0.589), RVMPI was 0.3±0.07 and 0.25±0.39 (P=0.004), and TR gradient (TRG) was 28±11.8 mmHg and 19.7±5.2 mmHg (P=0.033), respectively. Mean ferritin level in patients with a history of splenectomy (n=31), was 2525±1968 ng/ml and in patients without the history of splenectomy (n=29) was 1821±947 ng/ml (P=0.082). CONCLUSION: In addition to left-sided heart involvement, conventional echocardiography revealed right-sided heart involvement in transfusion-dependent thalassemia patients which did not correlate with serum ferritin level in splenectomized patients.

Premature pubarche as a first presentation of pituitary macroprolactinoma.

Prolactinoma is a rare tumor of childhood. Clinical presentations of prolactinoma include amenorrhea, delayed puberty, and galactorrhea. For the first time, in this case, elevated prolactin levels were associated with unexpected premature pubarche. We describe an 8-year, 7-month-old boy with acne and gradual appearance of pubic hair, corresponding to tanner stage 2. Hormonal tests showed severe hyperprolactinemia (prolactin = 246.8 µg/L and pooled prolactin = 175 µg/L and macroprolactin = 5 µg/L) and mildly elevated level of dehdroepiandrostenedion sulfate (DHEAS) and testosterone. Magnetic resonance imaging (MRI) findings confirmed the presence of a pituitary macroprolactinoma, measuring 14 mm × 12 mm × 8 mm on the right side of the pituitary gland. Cabergoline therapy was commenced (0.5 mg/week) and after 3 months, no evidence of pubarche progression was observed. Prolactin level and tumor size markedly reduced. At the 9-month follow-up visit, a normal MRI was reported. This case highlights that even when facing premature pubarche, careful examination is mandatory, and if no obvious etiology is found for premature pubarche, clinicians should consider prolactinoma.

Risk of Acute Lymphoblastic Leukemia: Results of a Case-Control Study.

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Different environmental factors might be effective in the occurrence of this malignancy during childhood. The aim of this study was to find environmental risk factors in childhood ALL in Hamadan, Iran. Methods: This case-control study was done in 2015-2018 on 125 children younger than 15 years of age suffering from ALL. Patients were matched with 130 controls with respect to age, gender, and residence location. The identification of risk factors for ALL was sought based on the comparison of studied variables between case and control individuals. Results: A statistically significant increased risk for ALL was found with regard to type of delivery (OR: 0.43, 95% CI: 0.20 - 0.92, p˂0.02), childcare (OR: 4.58, 95% CI: 0.95 - 22.20, p˂0.04), birth weight (OR: 1.44, 95% CI: 1.53 - 2.21, p˂0.006), father's education level (OR: 2.67, 95% CI: 1.10 - 6.45, p˂0.02), and father's job (OR: 0.2 95% CI: 0.08 - 0.51, p˂0.001). Also observed were increased odds for ALL regarding male gender, mother's high education level, mother's freelance job, and medium or high family income. No association with ALL incidence was observed for age, gender, breastfeeding, mother's age at pregnancy, malignancy in first- or second-degree relatives, or mother's use of hair dye during pregnancy (p> 0.05). Conclusion: This study showed that father's education level, father's job, delivery type, birth weight, and childcare can play a role in the incidence of childhood ALL.

Qualitative improvement of low meat beef burger using Aloe vera.

Low meat beef burgers have found their niche in the food markets in developing countries because of their lower price. However, these burgers still lack an acceptable quality. This study investigates the effects of different concentrations of Aloe vera on the quality of this food product. For this purpose, beef burgers were produced with 0%, 1%, 3%, and 5% Aloe vera and the changes in their cooking parameters, lipid oxidation, texture, and appeal to consumers over 7days of refrigerated storage were evaluated. Results indicate that Aloe vera contributed to some extent to decreased cooking loss and diameter reduction in the burgers. Increased concentrations of Aloe vera led to improvements in the water absorption and texture of the burgers as well as their lipid stability. However, a concentration level of 3% led to the most acceptability of the product to the panelists. Finally, it was found that Aloe vera acts as a hydrocolloid and improves the quality of burgers.

Infantile extrapancreatic pancreatoblastoma: a report on a rare infantile abdominal mass.

Pancreatoblastoma is an extremely rare tumor in children, especially under 3 months of age. This tumor may arise from any portion of the pancreas, but in more rare cases the ectopic pancreas is the origin. We are reporting a 3-month-old boy who was presented with an abdominal mass. Computed tomography images revealed a huge lobulated mass anterior to the kidneys, with internal calcification and enhancement after intravenous contrast media injection. He underwent a complete surgical resection of the mass that was located in the transverse mesocolon without any connection with the pancreas. Pathologic studies specified that the disease was pancreatoblastoma. His parents refused any chemotherapeutic regimen but continued postsurgical follow-ups.

Presepsin (scd14) as a marker of serious bacterial infections in chemotherapy induced severe neutropenia.

OBJECTIVE: Timely detection of serious bacterial infections or prediction of sepsis and death is of paramount importance in neutropenic patients especially in oncology settings. The aim of this study was to determine a rapid and secure predictor of sepsis in severe neutropenic cancer children. METHODS: In addition to blood culture, we have evaluated serum soluble CD14 on this role and measured it in 39 neutropenic episodes in Mahak pediatric oncology center from September 2012 to January 2013. Fifteen episodes had positive bacterial cultures and 18 had fever. The mean sCD14 values were compared in the presence or absence of fever, positive blood culture and other clinical conditions. Also, mean levels compared in different white cell counts and different four combination settings of fever and blood culture. FINDINGS: It was statistically higher in febrile episodes, in the presence of oral mucositis, indwelling catheter infection, otitis media, and post toxic epidermal necrolysis sepsis and in instances of death within 15 days. Leukocyte count did not affect sCD14 level and in combinations of fever and blood culture, mean sCD14 values were ranked as follow: febrile culture negatives, febrile culture positives, afebrile culture positives and afebrile culture negatives. CONCLUSION: Although sCD14 was not sensitive in detection of bacteremia, in the absence of clinically detectable source of infection, it was significantly higher in culture positives.

A case report of simultaneous occurrence of Wilms tumor and acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) is the most and Wilms tumor is the sixth most common malignancy in childhood. Genetic changes in WT1 or WT2 in Wilms tumor and a wide range of chromosomal mutations are reported in ALL that may predispose them to other congenital anomalies especially in Wilms tumor patients. Hospitalized patient was a 3-year-old girl with high-grade fever, petechia, and solid abdominal mass. The patient had anemia, thrombocytopenia, and leukocytosis in her initial homogram, and a large renal mass originated from left kidney in abdominal imagings. Bone marrow aspiration revealed ALL, and simultaneous kidney biopsy uncovered her Wilms tumor. Leukemia and Wilms tumor are 2 independent malignancies but occurred together in this patient. It is reasonable to investigate cellular and genetic relation of these 2 independent malignancies.

Generalized myelolipoma.

Myelolipoma is a benign tumor originating from hematopoietic and adipose tissue. This tumor usually develops in the adrenal gland, but rare presentations of extraadrenal myelolipoma are also reported, which usually arise from the presacral region. Herein, we present a 6-year-old girl with myelolipoma with generalized involvement of her abdomen, pelvis, chest, and retroorbital region.