Nanoemulsions as emerging antifungal carriers: Potential beyond conventional boundaries

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A Review of Epidemiology and Antifungal Susceptibility of non-Candida albicans species in Iran

Background: Candidiasis is among the most widespread infections caused by fungi species. Although C. albicans still serves as the primary source of this infection, the occurrence and antifungal resistance of non-Candida albicans species seem to be increasing. Materials and Methods: The data was gathered from multiple sources across Pubmed and Google Scholar using candidiasis, anti-fungal resistance, epidemiology, non-Candida albicans species, and Iran. Different types of articles from 2016 to 2024 regarding candidiasis in various regions of Iran and cases of resistant non-Candida albicans species were included. Results: In this review article, we analyzed the susceptibility of non-Candida albicans species to multiple anti-fungal agents and observed variable resistance patterns to commonly used agents. However, fluconazole showed resistance more often than other agents, and amphotericin B showed the least amount of resistance overall. Conclusion: This study aimed to demonstrate the importance of geographical factors and causative species in Iran's resistance pattern and treatment of candidiasis. This can help medical practitioners prescribe the optimum therapeutic agent for candidiasis patients

Evaluation of the Effectiveness of Academic Writing Workshop in Medical Students Using the Kirkpatrick Model

Background: Research is an important part of the clinical practice. In recent years, several workshops are held to teach research skills to medical students. Evaluating workshops determine that workshop content can lead to higher performance in individuals. The present study aimed to evaluate effectiveness of writing scientific papers workshop for medical students using Kirkpatrick’s model. Materials and Methods: This was a quasi-experimental study using pretest-posttest design and face to face communication to assess the learning effect of the training intervention. Immediately after workshop, the partici­pants filled out a satisfaction ques­tionnaire for evaluation of level one. To assess level two, pretest and posttest questionnaire was used. To assess level three and four, number of students who started their first research project and who published their first research articles were considered for a 6 months’ period after workshop. Results: Based on our results, contributors’ gender and semester had no efficacy on knowledge improvement of the participants. Results of four levels of Kirkpatrick’s model showed all participants were satisfied from workshop and participation in this workshop has had a positive effect on participants’ knowledge about writing articles. Obviously, the workshop affect on transfer of knowledge to contributors and it leads to maintenance of change over time. Conclusion: Impressively the authors found strong evidence to validate that the training effect on students’ understanding of the research process, positively. Such courses enable medical students to investigate properly and improve their knowledge in their field. Therefore, universities must encourage medical students to participate in these workshops

A Review on Fungal Myocarditis: The Agents, Predisposing Factors and Treatments

Background and Aim: Myocarditis is an inflammatory disease of the heart muscle. It has many symptoms, from mild chest tenderness to cardiogenic alarm. Fungal myocarditis is a disseminated infection that mostly occurs in immunocompromised patients, especially in the intensive care unit (ICU). It has similar symptoms to coronary disease. The exact diagnosis of fungal myocarditis is complex and may be caused by different fungal agents. Materials and Methods: A review of the literature on fungal myocarditis using PubMed and Google Scholar was conducted. This review collected case reports of fungal myocarditis from 2010 to 2023 worldwide to provide current prevalence in different sex categories and ages. Case reports were reported from North America, Asia, and Europe. Results: According to results, Aspergillus myocarditis was more commonly reported in men (71.4 %) and had the highest mortality rate among the other fungi (close to 57%). Generally, there are no case reports from South America, Africa, and Australia. Amphotericin B is the first drug choice for Aspergillus myocarditis. Despite qualifying voriconazole treatment, voriconazole use is still under research and has not been confirmed for childcare. Fungal myocarditis mainly occurs in immunocompromised patients who have been hospitalized in ICU. Conclusion: Regarding morbidity and mortality rate, myocarditis is an alarming disease. Misinterpreting signs and symptoms with other diseases often make diagnosing this disease complex. Delayed diagnosis often leads to failure of the multiple organs and can directly affect the treatment protocol

Design and Evaluation of the Effectiveness of the Writing Workshop on Promoting the Research Skills of Basic and Clinical Students based on Kirkpatrick's Model

Background: An increasing number of workshops are held yearly to educate medical students on academic writing and research methodology. However, the actual impact of such training programs on students’ proficiency in academic research cannot be assessed without thorough evaluation.Objectives: Herein, Kirkpatrick’s model was adopted to evaluate the efficiency of a workshop held for medical students on research methodology.Methods: This cross-sectional study collected data from 280 medical students participating in seven workshops. Herein, two levels from Kirkpatrick’s model were evaluated (reaction and learning). A 12-item questionnaire was filled out by participants immediately after the workshop to assess their reactions. Two questionnaires were used before and after the workshop to evaluate learning, each consisting of 25 items.Results: Concerning the first level of Kirkpatrick’s model, all students showed a generally high level of satisfaction in terms of the content, the lecturer, and the organization of the workshop. As for the learning scores, both basic and clinical students demonstrated significant (P<0.001) improvement within groups. However, there was no significant difference between the two groups (basic and clinical).Conclusion: The high level of satisfaction experienced by the participants and their significantly improved knowledge of research methodology, suggest that such workshops can indeed put medical students on the right track toward a productive academic and clinical career. So, the workshops should be considered a necessary component of education in medical sciences

Candiduria: Prevalence, Identification of Isolated Candida Species and Trends in Antifungal Susceptibility in Hospitalized Patients

Background: Urinary tract candidiasis is known as the most frequent nosocomial fungal infection worldwide. Some of the predisposing factors of candiduria are extensive use of broad-spectrum anti-fungal agents, diabetes mellitus, indwelling urinary catheter, corticosteroids and, immunosuppressive drugs. There are some antifungal agents available for the treatment of candiduria. In recent years, resistance to antifungal agents has been increased. The aim of this study was to evaluate different Candida species (sp.) that cause candiduria and their susceptibility pattern to antifungal agents in patients admitted to educational hospitals.Materials and Methods: Urine samples (n=200) were obtained; they were spread onto Sabouraud Dextrose Agar plates. Plates were incubated at 37°C. Only specimens were considered as candiduria, which have a colony count of ≥104 CFU/mL colonies. Urine sediment was cultured in the CHROM agar Candida medium and incubated at 35°C for 48h. The cultures were evaluated based on color. PCR-RFLP was performed for a definite identification of Candida sp. In vitro antifungal susceptibility test of the Candida isolates against amphotericin B, fluconazole and itraconazole was performed using the microdilution method, according to the standard CLSI guidelines, document M27-S3.Results: Molecular findings confirmed the result of the morphological method. Candiduria rate was 11.5% among our patients. According to CHROM agar Candida and PCR-RFLP, the most common species isolated was C. albicans (74%), followed by C. glabrata (26%). In vitro susceptibility tests of urinary Candida isolates to antifungals have been evaluated. All species were sensitive to amphotericin B. None of C. glabrata isolates were sensitive to fluconazole and itraconazole.Conclusion: This study demonstrates the importance of Candida sp. in urine samples from hospitalized patients. It was concluded that Candida sp. obtained from candiduria in patients had excellent activity against Amphotericin B. Whereas, resistance against Itraconazole (21.7%) and especially Fluconazole (26%) was significant

Antifungal Effect of Probiotic Lactobacillus casei on Drug-Resistant Oral Candida albicans Isolated from Patients with Hematological Malignancy: An In vitro Study

Statement of the Problem: Candida albicans (C. albicans) is recognized as the most common opportunistic pathogen in patients with an impaired immune system, and due to the frequent use of antifungal medicine, a variety of drug-resistant species are developing. Probiotics are a part of the human microbiome and natural competitors of Candida by producing lactic acid, low pH, and other secreted metabolites. The role of probiotics in preventing fungal infections has always been discussed.Purpose: This study aimed to investigate the antifungal effect of Lactobacillus casei (L. casei) on fluconazole- and amphotericin B-resistant C. albicans species isolated from the oral cavity of acute myeloid leukemia patients.Materials and Method: In this experimental study, eight strains of fluconazole- and amphotericin B-resistant C. albicans were used. The antifungal effects of probiotic L. casei and nystatin were measured by the co-aggregation method 1, 2, and 4 h after beginning the study. After each hour of exposure, C. albicans and L. casei colonies were counted.Results: L. casei had a significant ability to aggregate with both fluconazole- and amphotericin B-resistant C. albicans in all designated intervals, which increased with time. In the first hour of the study, no significant difference was observed between the effects of L. casei on the two drug-resistant strains. However, as time passed, it had a more significant antifungal effect on fluconazole, compared to amphotericin B resistant species (p Value<0.001). Cell counts showed that the number of fungal cells decreased significantly as time passed (p< 0.001).Conclusion: L. casei had a significant ability to aggregate with both drug-resistant C. albicans species and showed higher antifungal activity on fluconazole-resistant than amphotericin B-resistant species

Fungal Central Nervous System Infections in Patients With COVID-19

Recent studies have indicated that fungal co-infections have a major impact on the morbidity and mortality of patients with COVID-19. In these patients, the excessive production of inflammatory cytokines and the reduction in CD4 + T and CD8 + T cell count entails susceptibility to fungal infections.1 In addition to impaired cell-mediated immunity, comorbidities and immunosuppressive medications have a significant role in the development of fungal infections and have serious impacts on clinical outcomes.1-

A Review on Anti Dermatophytosis Potential of Medicinal Plants: In-Vitro, In-Vivo and Important Components

Background and Aim: Dermatophytosis refers to superficial fungal infection of keratinised tissues that increase remarkable costs several plants were used as traditional medicine to treat fungal diseases. The current review aimed to provide an update on several plants used as antidermatophytosis agents and investigate the action mechanism of each plant. Materials and Methods: This systematic review was conducted on the literatures available in databases PubMed, Scopus, Web of Science and Science Direct using the search engine Google Scholar, and the following search terms: Dermatophytosis and Herbal/Herbal Medicine and Dermatophytosis treatment. Results: Forty plants were identified and information on their scientific and common name, family, parts, preparation, extraction method, fractions, solvents, phytochemical categories, compounds, dermatophyte species and inhibitory concentrations was provided from multiple in vitro, in vivo and clinical studies Conclusion: Herbals are the most effective agents on dermatophytosis which have antidermatophytosis effects due to their essential compounds

Candidemia in Febrile Neutropenic Patients; a Brief Report

Introduction: Febrile neutropenic patients are at risk of serious infections. The aim of the present study is to identify the frequency, species, and susceptibility patterns of candidemia in febrile neutropenic patients. Methods: This cross-sectional study was conducted on febrile neutropenic patients suspected with candidemia who had been referred to 3 educational hospitals during 9 months. Results: The blood samples of 80 febrile neutropenic patients with the mean age of 48§16.6 years were studied (60% female). Five (6.25%) episodes of candidemia were identified. The underlying disease was acute myeloid leukemia in 4 (80%) cases and all 5(100%) cases had central venous catheter and were receiving prophylactic ciprofloxacin and acyclovir. 100% of isolates were found to be susceptible to Voriconazole, 80% to Caspofungin, 60% to Amphotericin B, and 40% to Fluconazole. Conclusion: The frequency of candidemia among the studied febrile neutropenia patients was 6.25%, with 80% mortality rate, and themost frequently identified yeastwas Candida albicans (100% susceptible to Voriconazole)