Farshid Abedi

Cutaneous leishmaniasis is a major health problem in several parts of the world. However, existing drugs have various therapeutic effects on different Leishmania species and also cause many side effects. This study focuses on the use of the aqueous extract of quercetin in producing silver nanoparticles for the experimental treatment of cutaneous leishmaniasis in laboratory mice. Silver nanoparticles (AgNPs) were synthesized using quercetin and characterized by UV-Vis spectroscopy, DLS, FTIR, and FESEM. We investigated the antileishmanial activity of green synthesized AgNPs in vitro and in vivo. Synthesized AgNPs from quercetin macromolecules showed promising antileishmanial activity at an IC50 of 125 μg/ml against promastigotes in vitro. In the in vivo study, L. major-infected BALB/c mice were treated topically with luteolin/quercetin-capped silver nanoparticle (AgNPQct) ointment for 21 consecutive days. As a result, this ointment reduced the inflammatory response compared to the untreated group ( < 0.05). The size of lesions in the luteolin/AgNPQct group showed a slight increase compared to other groups ( < 0.01). Biogenic silver nanoparticles along with the luteolin macromolecule can be an effective and reliable candidate for the design of antileishmanial drugs in the future.

Background: The accurate diagnosis of malaria cases, especially asymptotic and low-parasitemia patients, using robust molecular methods (nested-PCR) have been emphasized. The goal of this study was to detect active cases of malaria in areas with a history of local malaria transmission focusing on the use of molecular tools to ensure that the malaria elimination program has been implemented successfully. Methods: In this cross-sectional study, 816 blood samples were taken from immigrants and local residents of malaria-endemic areas in Hormozgan province, Iran. In order to identify asymptomatic malaria parasite reservoirs, the samples were examined using microscopic, RDT, and nested-PCR techniques. Results: About twelve positive asymptomatic malaria cases were identified when the molecular method (nested-PCR) was used. The positivity rates among immigrants and local residents were 2.07% and 0.93%, respectively. No positive cases were detected using microscopic and RDT methods. Conclusions: The finding of the research emphasize that in addition to microscopy and RDTs methods, sensitive molecular tools as a standard and essential strategy are needed in the diagnosis and detection of asymptomatic parasite reservoir.

Background: Human brucellosis, also known as Malta fever, is an acute systemic zoonotic disease in several parts of the world. The most pathogenic Brucella specie is Brucella melitensis that occurs in the human population of all age groups and of both sexes. Objectives: The present study aimed to investigate human Brucella infection in Afghanistan. Methods: The participants in this cross-sectional study were 44 patients diagnosed with Brucella infection during eight months and confirmed using Wright test by physicians of Iran Clinic Hospital. For data analysis, a statistical model was used through SPSS. Results: The most affected patients were female housewives (40.9%) and students (18.18%). The most frequent clinical manifestations were recurrent attacks of fever (95.34%), weight loss (81.39%), loss of appetite (79.06%), musculoskeletal pain (69.76%), boredom (67.44%), and lethargy (60.46%). A total of 41 (93.18%) patients mentioned the consumption of unpasteurized milk as the source of infection. Conclusions: The study results revealed that the main route of Brucella transmission in Afghanistan is the consumption of contaminated dairy products. The highest prevalence of brucellosis was observed among the young and middle-aged populations and housewives.

Background: The combination of sofosbuvir and daclatasvir has shown preliminary efficacy for hospitalized patients with COVID-19 in four open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir/daclatasvir to standard care improved clinical outcomes in hospitalized patients with COVID-19. Methods: This was a placebo-controlled, double-blind, randomized clinical trial in adults hospitalized with COVID-19 at 19 hospitals in Iran. Patients were randomized to oral sofosbuvir/daclatasvir 400/60 mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O2 saturation <95% and compatible symptoms. The primary outcome was hospital discharge within 10 days of randomization. Secondary outcomes included mortality and time to clinical events. The trial is registered on the Iran Registry of Clinical Trials under IRCT20200624047908N1. Results: Between July and October 2020, 1083 patients were randomized to either the sofosbuvir/daclatasvir arm (n = 541) or the placebo arm (n = 542). No significant difference was observed in the primary outcome of hospital discharge within 10 days, which was achieved by 415/541 (77%) in the sofosbuvir/daclatasvir arm and 411/542 (76%) in the placebo arm [risk ratio (RR) 1.01, 95% CI 0.95–1.08, P = 0.734]. In-hospital mortality was 60/541 (11%) in the sofosbuvir/daclatasvir arm versus 55/542 (10%) in the placebo arm (RR 1.09, 95% CI 0.77–1.54, P = 0.615). No differences were observed in time to hospital discharge or time to in-hospital mortality. Conclusions: We observed no significant effect of sofosbuvir/daclatasvir versus placebo on hospital discharge or survival in hospitalized COVID-19 patients.

Mycobacterium tuberculosis can spread through the entire body but rarely involves the eye. We report a patient with endophthalmitis in one eye and simultaneous retinal vasculitis in the fellow eye. Systemic work-up suggested infective endopericarditis. Polymerase chain reaction analyses of the vitreous and pericardial fluid were positive for M. tuberculosis. We initiated a four-drug antituberculous treatment regimen (isoniazid, ethambutol, pyrazinamide, and rifampin). After two weeks, we discontinued all the medications due to drug-induced hepatitis. We restarted isoniazid and rifampin, but hepatitis recurred. Finally, we chose isoniazid/ethambutol combination for 18 months, and also administered short-term systemic corticosteroid. His vision improved considerably with no recurrence of hepatitis or tuberculosis for 3 years after completion of treatment. Ocular tuberculosis can masquerade as other causes of intraocular inflammation, and a medical team consisting of an ophthalmologist and an infectious disease specialist might be needed for the diagnosis and management.