Pasteur Institute of Iran

---

Introduction: Vulvovaginal Candidiasis (VVC) is one of the most common genital tract infections among women, especially in diabetic patients. The increasing prevalence of recurrent infections caused by drug-resistant non-albicans species necessitates further studies on diabetic patients and the identification of causative agents by reliable molecular techniques. The obtained results can assist in adopting proper treatment procedures and prevention of recurrent vulvovaginitis (RVVC). Methods: In a cross-sectional study, 150 vaginal discharge samples were collected from diabetic women suspected of candidiasis referring to health centers in Tehran province. Following the culture of samples on SDA, CHROMagar Candida and PCR-RFLP were used for presumptive and definitive identification of Candida species, respectively. Results: Out of 115 positive patients, 105 showed infection with one species, and 10 had a mixed infection with two species. The frequency of Candida glabrata isolated from non-mixed and mixed infections in RVVC group was higher than Candida albicans (27.8% vs. 9.6%), which contradicted the results of the VVC group (6.1% vs. 24.3%). In the RVVC group, therefore, the patients were more infected with non-albicans species than C. albicans (47.8% vs. 9.6%), while in the VVC group the non-albicans were of lower frequency (18.3% vs. 24.3%). Conclusion: Our findings showed a statistically significant correlation (P<0.001) between the frequency of C. glabrata and the prevalence of RVVC. On the other hand, that blood sugar, duration of diabetes, and antibiotics usage had significant correlations (P<0.001) with the recurrence of severe symptoms. 

---

Introduction: Hepatitis C virus (HCV) infection and type 2 Diabetes Mellitus (T2DM) are among the severe threats to health care systems worldwide. Here, we investigated the association of HCV genotypes and cirrhosis with T2DM among HCV-positive patients. Methods: This descriptive-analytical study was performed from Jan 2017 to Jan 2018 at Sina Clinical-Educational infectious diseases ward, the reference center of infectious diseases in northwest Iran. All serology HCV–positive patients attending this center were included in the study. Forty-eight patients were included, 19 of which had a positive history of diabetes. Blood samples from patients were used for complete blood count, liver function tests, fasting blood sugar, HbA1C, HCV antibodies, and HCV genotype. Then the characteristics among patients with and without T2DM were compared. A P-value of less than 0.05 was considered statistically significant. Results: No significant difference in demographic variables were observed between patients with and without T2DM. Of 48 patients with HCV infection, 29 patients (39.58%) had T2DM.  The hepatitis C infection duration among diabetic and non-diabetic patients was 9.03 ± 0.76 years and 8.53 ± 1.01 years, respectively (P = 0.04). Of 8 patients with cirrhosis, six patients (75%) had diabetes. The relative risk for diabetic patients with HCV infection to develop cirrhosis was 4.57 (95% CI [1.02-20.36], P = 0.04). The most prevalent genotype was HCV type 1 among both diabetic and non-diabetic groups. No significant association was observed in logistic regression analysis between the HCV genotypes and T2DM (P = 1.000). Conclusion: In the current study, we showed that patients with HCV infection are at a higher risk of developing T2DM, and T2DM showed to be a risk factor for the developing cirrhosis among patients with HCV infection.

---

Introduction: latent tuberculosis infections (LTBI) are not detectable by a single-stage tuberculin test and maybe detected after repeating tests 7-21 days later. This phenomenon, called the boosting phenomenon, supports a two-stage test to identify false negatives in a single-stage test. The present study investigates the value of a two-stage tuberculin test in diabetic patients. Methods: We performed a tuberculin test for 195 diabetic patients. The patients with induration > 10 mm were subjected to a second tuberculin test 7-21 days later. Results: Of 195 patients, 115 came for measuring the tuberculin test induration, which was positive in 3 out of 115 patients (2.61%). Of the remaining 112 patients, 53 patients were subjected to the second test, and 38 patients came back for measuring the induration, which became positive in 4 (10.52%) patients. Conclusion: The increased LTBI rate from 2.61% to 10.52% following the second tuberculin test indicates a boosting phenomenon due to a delayed hypersensitivity reaction. Hence, patients with latent tuberculosis who had a false negative test in the first stage were identified.
 

---

Introduction: Acromegaly is often associated with alterations in carbohydrate metabolism, ranging from impaired glucose tolerance to overt diabetes mellitus (DM). This study aimed to evaluate the serum concentrations of TNF-α and IL-10, along with other biochemical parameters, in patients with acromegaly and concomitant diabetes. Furthermore, we sought to investigate the associations between these parameters. Additionally, this study investigated the prevalence of Cytomegalovirus (CMV) infection and its potential correlation with TNF-α, IL-10, and other biochemical parameters in this patient population. Methods: Serum concentrations of TNF-α and IL-10 were measured in 50 patients with acromegaly and concomitant diabetes and 50 healthy controls using commercially available ELISA kits. CMV DNA was detected in serum samples using a qualitative PCR assay targeting the CMV late antigen gp64 gene. Results: Patients with acromegaly and concomitant diabetes exhibited significantly higher levels of IGF-1, insulin, HOMA-IR, cholesterol, triglycerides, LDL, VLDL, ALT, AST, bone-specific alkaline phosphatase (BALP), TNF-α, and IL-10 compared to the control group (all P<0.05). CMV infection was detected in 1.9% (1/50) of the healthy control group and 23.5% (12/50) of the acromegaly and diabetes group. Within the acromegaly and diabetes group, CMV-positive patients had significantly higher levels of TNF-α and IL-10 compared to CMV-negative patients (both P<0.05). Conclusion: This study demonstrated a significant association between elevated levels of TNF-α and IL-10 and acromegaly with concomitant diabetes. Further research is needed to determine if these cytokines play a causal role in the pathogenesis of these comorbidities. The observed increase in ALT, AST, and BALP levels in patients suggests potential liver and bone involvement in acromegaly with concomitant diabetes. Moreover, a higher prevalence of CMV infection was observed in patients with acromegaly and concomitant diabetes compared to healthy controls, suggesting a potential link between CMV infection and this patient population. Further research is warranted to elucidate the nature of this association and its potential clinical implications.