Archives of Clinical Infectious Diseases
Volume:18 Issue: 1, Feb 2023

Infections caused by Strongyloides stercoralis are quite difficult to detect. It can remain silent long before manifesting, which used to occur when patients were under immunosuppressed conditions. This scenario makes the patient’s treatment and recovery hard to deal with.

This paper reports the case of a renal transplant patient who presented disseminated strongyloidiasis infection complicated with neurological manifestations. In order to eliminate Strongyloides stercoralis, the patient initially received oral Ivermectin treatment, and as the infection persisted, parenteral treatment was provided. The patient developed flaccid tetraparesis andincreased cerebrospinal fluid protein with albumin- cytological dissociation, initially suggesting the diagnosis of Guillain-Barré syndrome.

This clinical report highlights the need for early diagnosis and treatment in cases of immunosuppressed patients with strongyloidiasis infection, as the diagnosis might be neglected.

The COVID-19 infection may adversely affect both the mother and baby. Evaluation and identification of aggravating factors can help prevent adverse outcomes.

The present study aimed to examine pregnant women with COVID-19 infection and evaluate the disease outcomes in Sari, Iran.

The present case series study was performed on 17 pregnant women hospitalized for COVID-19 in Sari. A convenience sampling method was used. First, the researcher took the demographic information and medical history and obtained informed consent from all participants. Then, the selected subjects were examined for inclusion and exclusion criteria, and a throat swab sample was taken from eligible ones for PCR. The PCR was performed for amniotic fluid and neonatal throat samples at pregnancy termination. Six weeks after delivery, the status of rehospitalization of the baby, breastfeeding status, rehospitalization of the mother due to COVID-19, and the state of depression of the mother were evaluated by a 21-item questionnaire over the phone. The collected data were analyzed in SPSS version 23 using the Chi-square test.

Outof 19 participants, 17 (68%)hadpositive results for COVID-19 laboratory tests. The prevalence of preterm labor, admission to the neonatal intensive care unit, and vertical transmission were significantly high in pregnantwomenwith COVID-19 and positive PCR results for amniotic fluid (P < 0.050). The frequency of admission to the ICU was significantly higher in pregnant women with diabetes infected with COVID-19 (P = 0.025). There was no rehospitalization of the mother and newborn due to COVID-19, but one case of postpartum depression (9.5%) and two cases of formula feeding (11.8%) were reported.

Due to the high risk of maternal and neonatal outcomes of COVID-19 during pregnancy and the high probability of vertical transmission, it is recommended to take special precautions to prevent the disease during this period.

Community-acquired pneumonia (CAP) refers to pneumonia attained outside the hospital or less than 48 hours before admission, which is a significant cause of mortality and morbidity, especially in major comorbidities and older age. Several microorganisms contribute to developing CAP, primarily Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis, and atypical pathogens, e.g., Mycoplasma pneumonia. The incidence of these microorganisms depends on outpatient or inpatient settings. Administering appropriate treatment among available antibiotics is a critical issue affecting patient survival.

With a multidisciplinary panel expert, this document offers evidence-based recommendations for managing CAP in Iran.

The document evaluated the availability of antimicrobial agents and local antibiotic resistance patterns based on 94 relevant published studies from Google Scholar, Scopus, PubMed, Scientific Information Database (SID), Iran Medex, Iran doc, Mag Iran, PubMed, and expert opinions.

The panel addressed two main parts of rational recommendations for managing outpatients or hospitalized patients with CAP.

Adipose-derived stem cells (ADSCs) have been shown to enhance wound healing in rats with type 1 diabetes (DM1).

This experimental study aimed to explore how ADSC administration affects bacterial count, wound size, biomechanical and stereological parameters, and the expression of microRNA-21 and FGF2 in a rat model of infected, ischemic, and delayed wound healing in DM1.

Twenty-four male adult Wistar rats weighing less than 250 g were randomly assigned to four groups (n = 6 per group). Type 1 diabetes was induced in all animals, resulting in the development of a delayed, ischemic, and infected wound model. The CGday4 and CGday8 groups served as controls. In the AGday4 group, the animals received allograft h-ADSs and were euthanized on day four after surgery. Similarly, in the AGday8 group, the animals received h-ADSs and were euthanized on day eight after surgery. Microbial colony counts, wound size, stereological parameters, and the expression of microRNA-21 and FGF2 were evaluated in this study during the inflammation (day 4) and proliferation (day 8) stages of wound healing.

We demonstrated that h-ADSs significantly reducedmicrobiological counts compared to the control group on days 4 and 8. Moreover, in the AGday8 group compared to the AGday4 group, this decline in microbiological counts was even more pronounced. Moreover, we observed that the stereological characteristics in the AGday4 and AGday8 groups were significantly superior to those in the CG groups. Additionally, the AGday4 and AGday8 groups exhibited smaller ulcer area sizes compared to the CG groups. Furthermore, the AGday4 and AGday8 groups demonstrated higher expression levels of FGF2 and microRNA-21 than the CG groups on days 4 and 8. Notably, on day 8, the AGday8 group’s outcomes surpassed those of the AGday4 group (P < 0.01).

Through lowering microbial counts, modifying stereological parameters, microRNA-21, and FGF2 expression, the administration of hADS dramatically speeds up the healing of MARS-infected and ischemic ulcers in DM1 rats.

Coronavirus disease 2019 (COVID-19) is difficult to treat in pregnant women due to pregnancy itself and the lack of standard treatment for the disease. As of August 2021, the etiotropic drug remdesivir has been added to the prescription list for women during gestation. There are few publications in the global scientific community regarding the use of this antiviral drug in pregnant women. Moreover, there are only sporadic scientific studies in Kazakhstan, so the question remains open.

This study aimed to evaluate the efficacy of remdesivir in pregnant women with probable or confirmed COVID-19.

The study comprehensively examined 120 pregnant women with severe to very severe COVID-19, who were divided into two groups of patients. The study group consisted of women who received remdesivir and standard therapy. The control group included patients who received standard therapy per the protocol.

Statistically significant age differences were observed between the main and control groups (P = 0.019). The differences detected were due to a higher frequency in the age group of 33 and 42 years in patients taking remdesivir than in the control group (P = 0.036). Women in the main group (Median = 9.00; Q1 - Q3 = 8.00 - 11.0) had longer hospital stays than the control group (Me = 8.00; Q1 - Q3 = 7.00 - 10.0). This was due to the more severe condition of the patients in this group. There were statistically significant differences in amniotic fluid changes according to ultrasound between the control and main groups (P = 0.013). When comparing the groups in pairs, amniotic fluid was more common in women who received remdesivir (P = 0.316) than in the control group. Our study found that a decrease in temperature to normal levels occurred earlier in the control group (68%) than in the main group. Further SpO2 increases of more than 95% were seen on days 3 - 4 in the main group (71%) and days 1 - 2 in the control group (43%). After three days, there was an improvement in respiratory rate (41.6%) and a reduction in subjective dyspnea (66.6%) in the main group.

The study found that repeat mothers have a more severe course of COVID-19. The older age group and the third trimester of pregnancy are risk factors for progression to severe disease.

Manyaspects of the severe acute respiratorysyndrome coronavirus 2 (SARSCoV2)pandemicin 2019 have been unclear, especially in newborns, and reports of neonatal diseases are usually associated with perinatal infection.

The purpose of this study was to evaluate clinical and para-clinical manifestations in newborns that contracted the infection after birth.

This observational research was conducted from October 2020 to March 2022 to examine postnatal SARSCoV2 infection in infants admitted to the NICU or neonatal ward at the Children’s Medical Center in Tehran, Iran. Inclusion in the study was open to neonates who had positive RT-PCR results postnatally.

In total, 55 newborns were confirmed to have postnatal SARSCOV2. Fever was the most frequently observed symptom, with 35 (61%). Necrotizing enterocolitis was seen in 18% of neonates, and 30% of them were preterm. Neutropenia was seen in 34% of cases, with five cases having severe neutropenia. All neonates had a normal platelet count. Twenty percent of patients showed C - reactive protein higher than 6 mg/L. Two newborns had co-existing bacterial urinary tract infections. Our neonates didn’t require antiviral, anticoagulant, or corticosteroid medications, and they recovered while receiving only supportive care. Everyone in the group of newborns was discharged without complications, and there were no deaths.

The high rate of fever, high C- reactive protein, and neutropenia in SARSCoV2 neonates suggests that more observational research is needed to compare these symptoms to bacterial sepsis to avoid the overuse of antibiotics in these patients.

Sexually transmitted infections (STIs) are among the most common infectious diseases and a globally concerning public health issue, especially in developing countries.

This study aimed to evaluate the syndrome-based point and lifetime prevalence of sexually transmitted infections in a big Iranian city.

This cross-sectional study was conducted in 2019 on a hospital-based random sample of 2107 people (men and women aged 15 - 50) at Marvdasht Central Hospital (Iran).

The lifetime prevalence of Sexually Transmitted Diseases (STDs) was significantly higher in women than in men (81.56% vs. 33.60%, P-value < 0.0001). Also, about 20.7% of men and 48.26% of women had at least one of the STIs-associated syndromes at the time of the interview (instantaneous prevalence) (P-value = 0.001).

The estimated prevalence of syndromes associated with sexually transmitted infections is alarmingly high. The results emphasize the need for further studies on effective health care and health promotion services to reduce STIs (including early detection and treatment of infections and public education).