A case of malaria infection in a 42-year-old woman in rural area of Mahmodabad, Mazandaran Province, North Iran was reported and discussed elaborately. She was complaining about recurrent fevers, sweating, headache and myalgia in back. After her first admission to hospital due to misdiagnose she did not receive proper treatment and the patient suffered from clinical manifestations again. Eventually in the second admission to another hospital, after a precise examination on her thick and thin blood smear the agent of disease was recognized appropriately as Plasmodium vivax and treated accordingly.

We present and discuss elaborately a case of malaria misdiagnosis in a 27-year-old woman in Chalus, Mazandaran Province, North Iran in 2013. The patient has been complaining of fever, shivering and myalgia for three months. Although she visited two physicians during this time, the problem still remained owing to misdiagnose. Eventually in hospital after a precise examination on her thick and thin blood film, the causative agent of disease was diagnosed as plasmodiumvivax. The patient received treatment accordingly and all clinical manifestations were vanished.

STUDY DESIGN: A cross-sectional case-control study was designed to compare the sagittal alignment of lumbosacral regions in two groups of patients suffering from low back pain, one with intervertebral disc pathologies and one without. PURPOSE: To evaluate the correlation between lumbosacral sagittal alignment and disc degeneration. OVERVIEW OF LITERATURE: Changes in lumbar lordosis and pelvic parameters in degenerative disc lesions have been assessed in few studies. Overall, patients with discopathy were shown to have lower lumbar lordosis and more vertical sacral profiles. METHODS: From patients with intractable low back pain undergoing lumbosacral magnetic resonance imaging, 50 subjects with disc degeneration and 50 controls with normal scans were consecutively enrolled. A method was defined with anterior tangent-lines going through anterior bodies of L1 and S1 to measure global lumbosacral angle, incorporating both lumbar lordosis and sacral slope. Global lumbosacral angle using the proposed method and lumbar lordosis using Cobb's method were measured in both groups. RESULTS: Lumbar lordosis based on Cobb's method was lower in group with discopathy (20degrees-67degrees; mean, 40.48degrees+/-9.89degrees) than control group (30degrees-62degrees; mean, 44.96degrees+/-7.68degrees), although it was not statistically significant. The proposed global lumbosacral angle in subject group (53degrees-103degrees; mean, 76.5degrees+/-11.018degrees) was less than control group (52degrees-101degrees; mean, 80.18degrees+/-9.95degrees), with the difference being statistically significant (p=0.002). CONCLUSIONS: Patients with intervertebral disc lesions seem to have more straightened lumbosacral profiles, but it has not been proven which comes first: disc degeneration or changes in sagittal alignment. Finding an answer to this dilemma demands more comprehensive long-term prospective studies.
Animals ; Case-Control Studies ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Lordosis ; Low Back Pain ; Lumbosacral Region ; Magnetic Resonance Imaging ; Pathology

BACKGROUND: Since the cornea is responsible for transmitting and focusing light into the eye, injury or pathology affecting any layer of the cornea can cause a detrimental effect on visual acuity. Aging is also a reason for corneal degeneration. Depending on the level of the injury, conservative therapies and donor tissue transplantation are the most common treatments for corneal diseases. Not only is there a lack of donor tissue and risk of infection/rejection, but the inherent ability of corneal cells and layers to regenerate has led to research in regenerative approaches and treatments. METHODS: In this review, we first discussed the anatomy of the cornea and the required properties for reconstructing layers of the cornea. Regenerative approaches are divided into two main categories; using direct cell/growth factor delivery or using scaffold-based cell delivery. It is expected delivered cells migrate and integrate into the host tissue and restore its structure and function to restore vision. Growth factor delivery also has shown promising results for corneal surface regeneration. Scaffold-based approaches are categorized based on the type of scaffold, since it has a significant impact on the efficiency of regeneration, into the hydrogel and non-hydrogel based scaffolds. Various types of cells, biomaterials, and techniques are well covered. RESULTS: The most important characteristics to be considered for biomaterials in corneal regeneration are suitable mechanical properties, biocompatibility, biodegradability, and transparency. Moreover, a curved shape structure and spatial arrangement of the fibrils have been shown to mimic the corneal extracellular matrix for cells and enhance cell differentiation. CONCLUSION Tissue engineering and regenerative medicine approaches showed to have promising outcomes for corneal regeneration. However, besides proper mechanical and optical properties, other factors such as appropriate sterilization method, storage, shelf life and etc. should be taken into account in order to develop an engineered cornea for clinical trials.

OBJECTIVES: Enterobius vermicularis is a parasitic disease that is common in crowded areas such as schools and kindergartens. Primary investigations of electronic evidence have reported different prevalences of E. vermicularis in Iran. Therefore, we aimed to estimate the total prevalence of this infection among Iranian children using a meta-analysis. METHODS: Relevant studies were identified in national and international databases. We selected eligible papers for meta-analysis after investigating titles, abstracts, and full texts; assessing study quality; and applying inclusion/exclusion criteria. Data were extracted by two independent researchers. The results were combined using a random effects model in Stata v. 11 software. RESULTS: Among 19 eligible articles including 11,676 participants, the prevalences of E. vermicularis among all children, boys, and girls were 1.2%–66.1%, 2.3%–65.5%, and 1.7%–65.5%, respectively. Pooled prevalences (95% confidence interval) of E. vermicularis among all children, boys, and girls were 17.2% (12.6%–21.8%), 17.2% (12.6%–21.8%), and 16.9% (9.03%–24.8%), respectively. CONCLUSION: This meta-analysis showed that a great majority of Iranian children are infected with E. vermicularis, possibly due to poor public health.
Child* ; Enterobius* ; Female ; Humans ; Iran* ; Parasitic Diseases ; Prevalence* ; Public Health

OBJECTIVES: Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users. METHODS: In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR. RESULTS: The ANL results ranged from −3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR. CONCLUSION: The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.
Hearing Aids* ; Hearing Loss ; Hearing* ; Humans ; Noise* ; Rehabilitation ; Signal Processing, Computer-Assisted

BACKGROUND: Since the cornea is responsible for transmitting and focusing light into the eye, injury or pathology affecting any layer of the cornea can cause a detrimental effect on visual acuity. Aging is also a reason for corneal degeneration. Depending on the level of the injury, conservative therapies and donor tissue transplantation are the most common treatments for corneal diseases. Not only is there a lack of donor tissue and risk of infection/rejection, but the inherent ability of corneal cells and layers to regenerate has led to research in regenerative approaches and treatments. METHODS: In this review, we first discussed the anatomy of the cornea and the required properties for reconstructing layers of the cornea. Regenerative approaches are divided into two main categories; using direct cell/growth factor delivery or using scaffold-based cell delivery. It is expected delivered cells migrate and integrate into the host tissue and restore its structure and function to restore vision. Growth factor delivery also has shown promising results for corneal surface regeneration. Scaffold-based approaches are categorized based on the type of scaffold, since it has a significant impact on the efficiency of regeneration, into the hydrogel and non-hydrogel based scaffolds. Various types of cells, biomaterials, and techniques are well covered. RESULTS: The most important characteristics to be considered for biomaterials in corneal regeneration are suitable mechanical properties, biocompatibility, biodegradability, and transparency. Moreover, a curved shape structure and spatial arrangement of the fibrils have been shown to mimic the corneal extracellular matrix for cells and enhance cell differentiation. CONCLUSION Tissue engineering and regenerative medicine approaches showed to have promising outcomes for corneal regeneration. However, besides proper mechanical and optical properties, other factors such as appropriate sterilization method, storage, shelf life and etc. should be taken into account in order to develop an engineered cornea for clinical trials.

PURPOSE: FimH (the adhesion fragment of type 1 fimbriae) is implicated in uropathogenic Escherichia coli (UPEC) attachment to epithelial cells through interaction with mannose. Recently, some studies have found that UPEC can thrive intracellularly causing recurrent urinary tract infection (UTI). Almost all vaccines have been designed to induce antibodies against UPEC. Yet, the humoral immune response is not potent enough to overcome neither the primary UTI nor recurrent infections. However, DNA vaccines offer the possibility of inducing cell mediated immune responses and may be a promising preventive tool. MATERIALS AND METHODS: In this study, we employed two different open reading frames within mammalian (mam) and wild type (wt) codons of fimH gene. Optimized fragments were cloned in pVAX-1. Expression of the protein in COS-7 was confirmed by western blot analysis after assessing pVAX/fimH(mam) and pVAX/fimH(wt). The constructs were injected to BALB/c mice at plantar surface of feet followed by electroporation. RESULTS: The mice immunized with both constructs following booster injection with recombinant FimH showed increased interferon-gamma and interleukin-12 responses significantly higher than non-immunized ones (p<0.05). The immunized mice were challenged with UPEC and then the number of bacteria recovered from the immunized mice was compared with the non-immunized ones. Decreased colony count in immunized mice along with cytokine responses confirmed the promising immune response by the DNA vaccines developed in this study. CONCLUSION: In conclusion, DNA vaccines of UPEC proteins may confer some levels of protection which can be improved by multiple constructs or boosters.
Animals ; Antibodies ; Bacteria ; Blotting, Western ; Clone Cells ; Codon* ; DNA* ; Electroporation ; Epithelial Cells ; Foot ; Immunity, Cellular* ; Immunity, Humoral ; Interferon-gamma ; Interleukin-12 ; Mannose ; Mice ; Open Reading Frames ; Urinary Tract Infections* ; Uropathogenic Escherichia coli ; Vaccines ; Vaccines, DNA

PURPOSE: This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. RESULTS: The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. CONCLUSION: The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.
Cone-Beam Computed Tomography ; Diagnostic Imaging ; Humans ; Joints ; Male ; Mandibular Condyle ; Maxilla ; Temporomandibular Joint ; Temporomandibular Joint Disorders*

The gold standard method for diagnosis of tuberculosis is the isolation of Mycobacterium tuberculosis through culture, but there is a probability of cross-contamination in simultaneous cultures of samples causing false-positives. This can result in delayed treatment of the underlying disease and drug side effects. In this paper, we reviewed studies on falsepositive cultures of M. tuberculosis . Rate of occurrence, effective factors, and extent of false-positives were analyzed. Ways to identify and reduce the false-positives and management of them are critical for all laboratories. In most cases, falsepositive is occurring in cases with only one positive culture but negative direct smear. The three most crucial factors in this regard are inappropriate technician function, contamination of reagents, and aerosol production. Thus, to reduce false-positives, good laboratory practice, as well as use of whole-genome sequencing or genotyping of all positive culture samples with a robust, extra pure method and rapid response, are essential for minimizing the rate of false-positives. Indeed, molecular approaches and epidemiological surveillance can provide a valuable tool besides culture to identify possible false positives.