Pasteur Institute of Iran

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Distinction between brucellar epididymo-orchitis (BEO) and nonspecific epididymo-orchitis (EO) is an important medical issue. This study was conducted to compare demographic, clinical and laboratory features, treatment and outcome of patients with BEO and nonspecific EO in Arak city, Markazi Province, Iran. We compared the clinical and laboratory characteristics of 40 BEO and 40 non-specific EO patients. The diagnosis of brucellosis was based on the symptoms, compatible clinical findings and standard tube agglutination test. Epididymo-orchitis was diagnosed by swelling and tenderness of scrotal skin, testis and epididymis, which was confirmed by sonography. BEO can be distinguished from nonspecific EO based on having a history of living in rural areas, contact with domestic animals, and consumption of unpasteurized dairy products. Other criteria include seasonal pattern, gradual onset (P<0.05), sweating (P<0.001), arthralgia (P=0.02), associated lower urinary tract symptoms (P=0.004) and lower rate of leukocytosis and abnormal urine analysis (P=0.002). Our results showed that brucellosis should be considered as a cause of EO in endemic areas like Iran. Combination antibiotic therapy to manage BEO is usually effective and all patients in this study responded quite satisfactory to the treatment.

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Introduction: Spondylitis is a serious disease caused by a variety of pathogens. The identification of spondylitis etiologies is a very important medical issue. This study was conducted to compare clinical, laboratory and radiological features of the patients with tuberculous (TS), brucellar (BS) and pyogenic spondylitis (PS) in a central city of Iran. Methods: In this retrospective study, we obtained the data of 100 patients with spondylitis from a hospital in Arak city. The patients were divided into three groups including TS (8 cases), BS (71 cases) and PS (21 cases), based on the spondylitis etiology. Results: The mean age of cases with TS, BS, and PS was 67.25±20.26, 55.39±15.60 and 52.19±12.74 years, respectively. The most common clinical feature was back pain followed by fever. Twenty-one cases had psoas abscess which was more common in PS group. No significant difference regarding the involved vertebral regions was observed between the groups. Intravenous drug use, history of vertebral surgery and chronic renal failure were frequent in patients with PS, and all TS cases had pulmonary involvement. Conclusion: Our data showed that presence of concomitant pulmonary involvement and a confirmed history of tuberculosis are suggestive of tuberculous spondylitis. However, the distinction between TS and BS is still problematic and only a combination of clinical data, laboratory findings, radiological features and history of TB can be helpful in differentiation of TS and BS.

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Introduction: Despite considerable efforts to control AIDS pandemic, it is still one of the significant infectious concerns worldwide. The advance in medical research has led to the development of highly active antiretroviral therapy with a considerable effect to suppress the disease. However, an effective vaccine capable of eradication the HIV pandemic is not available yet. Failure to develop a prophylactic vaccine diverted the efforts to clinical trials of therapeutic vaccines. Methods: Here, we review different approaches to dendritic cell-based HIV therapeutic vaccines. We have summarized the dendritic cell-based trials as HIV therapeutic vaccination, registered in the United States clinical trial database. Results and Conclusion: The strategies applied in the clinical trials were mostly of low success rates; however, by using dendritic cell therapy, they could trigger the host immune response against HIV-1 infections.

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Precision tracking and monitoring viral genome mutations are critical during a viral pandemic such as COVID-19. As molecular assays for diagnosing numerous infectious agents are being developed, RT-PCR is still deployed as the gold standard for detecting SARS-CoV-2. Despite its proofreading capability, SARS-CoV-2, like other RNA viruses, adopts several changes in its genome. If these mutations, especially deletions, occur in the target areas of primers and probes, they will hinder molecular detection methods from identifying the given gene. The authors describe the cases in which, despite the lack of the N gene detection, the ORF1ab gene was discovered with a relatively low cycle of threshold (Ct). Following sequencing, changes were discovered in the annealing region of the forward and reverse primers and probes used in the SARS-CoV-2 detection kit. Among the most significant mutations is a large deletion of 15 nucleotides in the N gene, which has never been seen in prior variants. This highlights the importance of persistent monitoring of hypervariable regions in the SARS-CoV-2 genome through sequencing and updating the molecular detection kits during the COVID-19 pandemic.