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Background Cerebral toxoplasmosis (CTX) occurs as a latent form of Toxoplasma gondii infection, commonly found in human immunodeficiency virus (HIV)-infected individuals. A proper and timely diagnosis of CTX enables effective treatment, reducing complications and mortality. We aimed to investigate the prevalence, clinical course, and in-hospital mortality rate of CTX in HIV-positive patients admitted to the hospitals of Shiraz University of Medical Sciences (SUMS). Methods This retrospective study included 876 HIV-positive patients admitted to Namazi and Shahid Faghihi hospitals of SUMS from 2013 to 2022. After reviewing the medical records, the clinical data of CTX patients were extracted and analyzed. Results Overall, 4.00% of HIV-positive patients were diagnosed with toxoplasmosis, with CTX occurring in 2.17%. The mean age of CTX patients was 37.95 ± 9.32 years, with 57.89% males and 42.11% females. The prevalence of CTX in HIV-positive women (4.32%) was significantly higher than in HIV-positive men (1.59%) ( p  = 0.04). In 57.89% of CTX patients, the disease was the first manifestation of HIV infection. Focal neurological deficit (52.63%), decreased level of consciousness (52.63%), headache (47.37%), and fever (42.11%) were the most common clinical manifestations of CTX. Age was inversely correlated with toxoplasmosis diagnosis in logistic regression analysis ( p  = 0.001). CTX had a 21.05% in-hospital mortality rate. Conclusion Physicians should be aware of the clinical course and high mortality rate of CTX in HIV-positive patients. Our findings also highlight the importance of implementing HIV screening programs, particularly for at-risk young adults. Future studies should address the limitations of this study by employing larger and more diverse samples.

Intestinal parasitic infections (IPIs) are still a serious public health problem worldwide, particularly in developing countries. The COVID-19 pandemic has affected people’s lifestyles and quality of life. Besides, the prevalence of IPIs is directly associated with environmental sanitation, overcrowding, and personal hygiene. Therefore, the current study aimed to determine the prevalence of IPIs among patients referred to hospitals affiliated to Shiraz University of Medical Sciences by reviewing the available data of hospital information system database in the pre- and post-COVID-19 pandemic. The total data of 13,686 patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran were collected from March 2019 to March 2021. The overall prevalence of IPIs was found to be 4.4%, and Blastocystis spp. was the most common parasite. The prevalence of protozoan parasites (4.4%) was significantly higher than helminthic parasites (0.04%, P  < 0.001). A significant association was observed between IPIs with age, gender, and year ( P  < 0.05). The prevalence of IPIs among those referred to hospitals before the COVID-19 pandemic was higher than those referred to hospitals during the COVID-19 pandemic (5.8% vs 2.8%), and the differences were statistically significant ( P  < 0.001). The odds of infection among people investigated during the COVID-19 pandemic was about 40% lower than those investigated before the COVID-19 pandemic (AOR: 0.60, 95% CI: 0.49–0.73, P  < 0.001). Our results showed that the prevalence of IPIs has decreased during the COVID-19 pandemic. Improved sanitation, personal hygiene, and health education can be effective in reducing parasitic infections in the COVID-19 pandemic.

Natural polysaccharides such as chitosan (CS) are widely used as antimicrobial agents. In recent years, and considering that CS has a strong antimicrobial potential, interest has been focused on antimicrobial activity of chitosan nanoparticles (CS NPs). The main factors affecting the antibacterial activity of chitosan include molecular weight (MW) and concentration. In this regard, the aim of this study was to produce various MWs and concentrations of CS NPs, through the ionic gelation method, and investigate their potential anti-parasitic activity against tachyzoites of RH strain. The MWs and degree of deacetylation of the CS were characterized using viscometric and acid-base titration methods, respectively. The efficacy of various MWs and concentrations of NPs was assessed by performing in vitro experiments for tachyzoites of RH strain, such as MTT assay, scanning electron microscopy, bioassay in mice and PCR. In vivo experiment was carried out in BALB/c mice which were inoculated with tachyzoites of RH strain and treated with various MWs of CS NPs. The results of in vitro and in vivo experiments revealed that anti- activity strengthened as the CS NPs concentration increased and the MW decreased. In vitro experiment showed 100% mortality of tachyzoites at 500 and 1,000 ppm concentrations of low molecular weight (LMW) CS NPs after 180 min and at 2,000 ppm after 120 min. Furthermore, a 100% mortality of tachyzoites was observed at 1,000 and 2,000 ppm concentrations of medium molecular weight (MMW) CS NPs and at 2,000 ppm concentration of high molecular weight (HMW) CS NPs after 180 min. Growth inhibition rates of tachyzoites in peritoneal exudates of mice receiving low, medium and high MWs of CS NPs were found to be 86%, 84% and 79% respectively, compared to those of mice in sulfadiazine treatment group (positive control). Various MWs of CS NPs exhibited great anti- efficiency against tachyzoites of RH strain, with the greatest efficacy shown by LMW CS NPs in both experiments. It seems that CS NPs can be used as an alternative natural medicine in the treatment of toxoplasmosis.

The aim of this study was to prepare curcumin nanoemulsion (CR-NE) to solve the problems associated with poor water solubility and low bioavailability of CR and to test its efficiency in the treatment of acute and chronic toxoplasmosis in mouse models. CR-NE 1% was prepared using spontaneous emulsification by soybean as oil phase; a mixture of Tween 80 and Tween 85 as surfactant; ethanol as cosurfactant and distilled water. Particle size and zeta potential of NE were assessed using Nano-ZS90 dynamic light scattering. Stability testing of NE was assessed after storage for 2 months at room temperature. In vivo experiments were carried out using 50 BALB/c mice inoculated with virulent RH strain (type I) and 50 BALB/c mice inoculated with avirulent Tehran strain (type II) of and treated with CR-NE (1% w/v), CR suspension (CR-S, 1% w/v), and NE without CR (NE-no CR). The mean particle size and zeta potential of CR-NE included 215.66±16.8 nm and -29.46±2.65 mV, respectively, and were stable in particle size after a three freeze-thaw cycle. In acute phase experiment, the survival time of mice infected with RH strain of and treated with CR-NE extended from 8 to 10 days postinoculation. The differences were statistically significant between the survival time of mice in CR-NE-treated group compared with negative control group ( <0.001). Furthermore, CR-NE significantly decreased the mean counts of peritoneum tachyzoites from 5,962.5±666 in negative control group to 627.5±73 in CR-NE-treated mice ( <0.001). Growth inhibition rates of tachyzoites in peritoneum of mice receiving CR-NE, CR-S, and NE-no CR included 90%, 21%, and 11%, respectively, compared with negative control group. In chronic phase experiment, the average number and size of tissue cysts significantly decreased to 17.2±15.6 and 31.5±6.26 µm, respectively, in mice inoculated with bradyzoites of Tehran strain and treated with CR-NE compared with that in negative control group ( <0.001). Decrease of cyst numbers was verified by downregulation of BAG1 in treatment groups compared with negative control group with a minimum relative expression in CR-NE (1.12±0.28), CR-S (11.76±0.87), and NE-no CR (14.67±0.77), respectively, ( <0.001). Results from the current study showed the potential of CR-S and CR-NE in treatment of acute and chronic toxoplasmosis in mouse models for the first time. However, CR-NE was more efficient than CR-S, and it seems that CR-NE has a potential formula for the treatment of acute and chronic toxoplasmosis, especially in those with latent bradyzoites in brain.

Objective Toxoplasmosis, caused by Toxoplasma gondii ( T. gondii ), is a common zoonotic disease worldwide. Novel therapeutic options are required due to the limited effectiveness and side effects of existing treatments. This study aims to evaluate the in vitro antiparasitic activity of linalool at various concentrations against tachyzoites of the T. gondii RH strain, in comparison with a positive control (saponin 0.2%) and a negative control (no treatment), using flow cytometric analysis. Results The flow cytometry results revealed a dose-dependent anti- Toxoplasma activity for linalool, with 18.37%, 36.77%, 38.75%, 47.57%, and 50.63% mortality rates at the concentrations of 37.5, 75, 150, 300, and 600 µg/mL, respectively. The mortality rate at the concentration of 1200 µg/mL (74.44%) was slightly higher than that of the positive control group (67.87%). Our findings provide primary evidence for the extracellular potential of linalool against T. gondii tachyzoites. This study provides a rationale for further research to evaluate linalool’s intracellular and in vivo efficacy and safety.

Medical and surgical treatments for cystic echinococcosis (CE) are challenged by various complications. This study evaluates in vitro protoscolicidal activity of piperine-loaded mesoporous silica nanoparticles (PIP-MSNs) against protoscoleces of Echinococcus granulosus . MSNs were prepared by adding tetraethyl orthosilicate to cetyltrimethylammonium bromide and NaOH, and then loaded with PIP. The mean particle size and hydrodynamic diameter of MSNs were determined at 68 ± 4.5 and 101.4 ± 50.4 nm using transmission electron microscopy and dynamic light scattering, respectively. X-ray diffraction, Fourier-transform infrared analysis, and UV-spectrophotometry confirmed drug loading. Drug loading efficiency and drug loading capacity were calculated at 60% and 18%, respectively. The drug release profile confirmed a 75% PIP release plateau after about 24 h. The cytotoxicity assay showed cell viability > 90% in all concentrations used (≤ 512 µg/mL). E. granulosus protoscoleces were exposed to PIP-MSNs and their viability was assessed using the eosin exclusion test. In a dose-dependent manner ( p  < 0.001), exposure to 375 and 500 µg/mL of PIP-MSNs for 180 min killed 89.67 and 94.67% of protoscoleces, respectively. This study introduces PIP-MSNs as a potential protoscolicidal agent in the treatment of CE. Further studies are necessary to uncover safety aspects, biodistribution patterns, and potential combination therapies.

Background Toxoplasma gondii is a protozoan parasite with worldwide distribution, infecting a broad-range of humans and warm-blooded animals. In the current study, role of this parasite on secondary sex ratio and risk of miscarriage was investigated. Methods In this cross-sectional study, 850 cord blood samples were collected in Tehran, Iran, 2014–2015. Enzyme-linked immunosorbent assay (ELISA) was used to assess anti- Toxoplasma IgG in samples. Information such as sex of the neonates and age, number of previous pregnancies and history of miscarriage of the mothers were recorded in questionnaires. Logistic regression analysis was used to assess the possible relationship between the latent toxoplasmosis and the highlighted parameters. Results Logistic regression analysis showed that the odds of having a male neonate in seropositive women is nearly 64% higher than that in seronegative women (OR = 1.64, CI 95  = 1.16–2.33, P  = 0.005). The odds ratio of having male neonate increased to 2.10 (CI 95  = 1.24–3.57, P  = 0.006) in high-titer seropositive women, compared to that in seronegative control group. The odds of having a miscarriage history was approximately two and a half times greater in seropositive women than in seronegative ones (OR = 2.45, CI 95  = 1.56–3.87, P  < 0.001). The odds ratio of having miscarriage increased to 2.76 (CI 95  = 1.61–4.73, P  < < .001) in low-titer seropositive women, compared to that in seronegative control group. Conclusion Results of the current study have shown that T. gondii infection affects secondary sex ratio in human offspring and can be addressed as one of the major miscarriage causes in women.

Cutaneous leishmaniasis (CL) is a tropical disease that can cause chronic lesions and leave life-long scars, leading to social stigmatization and psychological disorders. Using growth factors and immunomodulatory agents that could accelerate wound healing and reduce the scar is highly demanded. Epidermal growth factor (EGF) plays an essential role in wound healing. It stimulates the proliferation of keratocytes and fibroblasts, and promotes re-epithelialization. Here, the effect of EGF in combination with Glucantime and nano-liposomal Amphotericin B (SinaAmpholeish) on the healing process of CL in BALB/c mice was investigated. Seventy-two mice were infected with Leishmania major parasites and randomly divided into eight treatment groups after the appearance of the lesion. The treatment was continued for five weeks, and lesion sizes were measured weekly. Parasite load was determined in the skin biopsies using qPCR. We found that subcutaneous injection of EGF at 4.5 μg/kg, combined with each of the two antileishmanial drugs, significantly reduced the wound size and parasite load; however, EGF at 1.5 μg/kg failed to be effective. Besides, the wound size and parasite loads were significantly lower in the SinaAmfoleish groups compared to the Glucantime groups. Among the treatment groups, EGF 4.5 μg/kg combined with SinaAmpholeish exhibited the most significant reduction in wound size and parasitic load. Our results suggest that EGF can potentiate the wound healing effect of antileishmanial drugs. Further studies are warranted to explore the beneficial effects of combining EGF with antileishmanial drugs in patients with cutaneous leishmaniasis in order to accelerate wound healing and reduce the scar.

Pentavalent antimonials remain the treatment of choice for all the clinical forms of leishmaniasis. The increasing rates of antimony resistance are becoming a serious health problem in treatment of anthroponotic cutaneous leishmaniasis (ACL). Accordingly, unraveling molecular markers is crucial for improving medication strategies and monitoring of drug-resistant parasites. Different studies have suggested the importance of genes involved in trypanothione metabolism and drug transport. In this regard, present study was designed to investigate the RNA expression level of five genes including γ-GCS, ODC, TRYR (involved in trypanothione metabolism), AQP1 (acts in drug uptake) and MRPA (involved in sequestration of drug) in sensitive and resistant Leishmania tropica isolates. Seven antimony-resistant and seven antimony-sensitive L. tropica clinical isolates were collected from ACL patients. Drug sensitivity test was performed on the samples as well as reference strains; afterwards, gene expression analysis was performed on clinical isolates by quantitative real-time PCR. The results revealed that the average expression level of AQP1 gene was decreased (0.47-fold) in resistant isolates compared to sensitive ones whereas MRPA (2.45), γ-GCS (2.1) and TRYR (1.97) was upregulated in resistant isolates. The average expression of ODC (1.24-fold) gene was not different significantly between sensitive and resistant isolates. Our findings suggest that AQP1, MRPA, GSH1 and TRYR can be considered as potential molecular markers for screening of antimony resistance in some L. tropica clinical isolates.