Psychological and psychiatric disorders have a high frequency in multiple sclerosis (MS). However, their relationship with MS is complex and the extent to which they might be reactive to countless psychosocial factors, or symptoms resultant of the pathological process itself remains unclear. The aim of this study was to compare psychological symptoms in a group of MS patients and compared to healthy controls. The study subjects were MS patients admitted to the Farshchian hospital in Hamadan, Iran. The diagnosis was based on McDonald (2011) criteria. There were 120 patient), aged 34.5 ± 10.8 (mean ± SD) years. It was a cross sectional study. The psychological symptoms were assessed using Symptom Checklist-90 (SCL-90). It was found that the MS patients exhibited significantly more psychological symptoms than the healthy controls. The SCL-90 scores of MS patients were significantly higher for somatization, obsession-compulsion, interpersonal sensitivity, hostility, depression and anxiety. The high rate of psychological symptoms in adult MS supports the need for routine psychological screening.

No abstract available.
Esophageal Achalasia* ; Esophagus*

Background/Aims: We performed a systematic review and meta-analysis evaluating the symptomatic response rate to antibiotics in patients with small intestinal bacterial overgrowth (SIBO). Similarly, we performed a meta-analysis on the symptomatic response to antibiotics in irritable bowel syndrome (IBS) patients with and without SIBO. Methods: MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched from inception to March 2021. Randomized controlled trials and prospective studies reporting dichotomous outcomes were included. Results: There were 6 studies included in the first meta-analysis comparing the efficacy of antibiotics to placebo or no antibiotic. This included 196 patients, of whom 101 received antibiotics and 95 received placebo or no antibiotics. Significantly more patients improved with antibiotics (relative risk [95% CI] = 2.46 [1.33-4.55], P = 0.004). There were 4 studies included in the analysis comparing symptomatic response rates in IBS patients with or without SIBO with 266 IBS patients, of whom 172 had SIBO and 94 did not. The pooled response rate for symptomatic response was 51.2% in the SIBO group vs 23.4% in the no SIBO group, respectively. Significantly more IBS patients with SIBO responded to antibiotics compared to those without SIBO (relative risk [95% CI] = 2.07 [1.40-3.08], P = 0.0003). Conclusions Antibiotics appear to be efficacious in treating SIBO, although small sample sizes and poor data quality limit this interpretation. Symptomatic response rates also appear to be higher in IBS patients with SIBO. This may be the first example of precision medicine in IBS as opposed to our current empiric treatment approach. Large-multicenter studies are needed to verify the results.

Gut microbiota and their metabolites like bile acid (BA) have been investigated as causes of irritable bowel syndrome (IBS) symptoms.Primary BAs are synthesized and conjugated in the liver and released into the duodenum. BA biotransformation by gut microbiota begins in the intestine and results in production of a broad range of secondary BAs. Deconjugation is considered the gateway reaction for further modification and is mediated by bile salt hydrolase, which is widely expressed by the gut microbiota. However, gut bacteria that convert primary BAs to secondary BAs belong to a limited number of species, mainly Clostridiales. Like gut microbiota modify BA profile, BAs can shape gut microbiota via direct and indirect actions. BAs have prosecretory effects and regulates gut motility. BAs can also affect gut sensitivity. Because of the vital role of the gut microbiota and BAs in gut function, their bidirectional relationship may contribute to the pathophysiology of IBS. Individuals with IBS have been reported to have altered microbial profiles and modified BA profiles. A significant increase in fecal primary BA and a corresponding decrease in secondary BA have been observed in IBS with predominant diarrhea. In addition, primary BA was positively correlated with IBS symptoms. In IBS with predominant diarrhea, bacteria with reduced abundance mainly belonged to the genera in Ruminococcaceae and exhibited a negative correlation with primary BAs. Integrating the analysis of the gut microbiota and BAs could better understanding of IBS pathophysiology. The gap in this field needs to be further filled in the future.

The mainstay therapy against leishmaniasis is still pentavalent antimonial drugs; however, the rate of antimony resistance is increasing in endemic regions such as Iran. Understanding the molecular basis of resistance to antimonials could be helpful to improve treatment strategies. This study aimed to recognize genes involved in antimony resistance of Leishmania tropica field isolates. Sensitive and resistant L. tropica parasites were isolated from anthroponotic cutaneous leishmaniasis patients and drug susceptibility of parasites to meglumine antimoniate (Glucantime(R)) was confirmed using in vitro assay. Then, complementary DNA-amplified fragment length polymorphism (cDNA-AFLP) and real-time reverse transcriptase-PCR (RT-PCR) approaches were utilized on mRNAs from resistant and sensitive L. tropica isolates. We identified 2 known genes, ubiquitin implicated in protein degradation and amino acid permease (AAP3) involved in arginine uptake. Also, we identified 1 gene encoding hypothetical protein. Real-time RT-PCR revealed a significant upregulation of ubiquitin (2.54-fold), and AAP3 (2.86-fold) (P<0.05) in a resistant isolate compared to a sensitive one. Our results suggest that overexpression of ubiquitin and AAP3 could potentially implicated in natural antimony resistance.
Amino Acid Transport Systems/*genetics/metabolism ; Antimony/*pharmacology ; Antipruritics/*pharmacology ; *Drug Resistance ; Humans ; Leishmania tropica/drug effects/enzymology/*genetics/isolation & purification ; Leishmaniasis, Cutaneous/*parasitology ; Protozoan Proteins/*genetics/metabolism ; Ubiquitin/*genetics/metabolism

Objective To investigate the fauna of a highly venomous marine species group, the cone snails (Family Conidae), in the shores of Qeshm Island, of evaluating the possibility of envenomation in the area and summarize recommendations for emergency first aid. Methods Shores surrounding Qeshm Island were surveyed to collect cone snails during cold (February and March) and warm (May and June) seasons of 2017. Collected snails were identified to the species level. Abundance and species richness were estimated in shores of different structures, including muddy and sandy-rocky shores. Also, the most updated medical literature was reviewed to summarize related emergency first aid. Results Three cone snail species were recorded from southern sandy-rocky shores of the Island, in decreasing order of abundance, included crowned cone (Conus coronatus) (65%), feathered cone (Conus pennaceus) (28%), and frigid cone (Conus frigidus) (7%). Abundance of these species were significantly higher in cold season compared to the warm season (P < 0.05). No cone snails were recorded along the northern muddy shores of the Island. Conclusions Envenomation can cause various symptoms ranging from minor local pain to systemic paralysis and death due to respiratory failure. We recommend an awareness programme for the seashore visiting public.