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Diarrhoea is an important cause of malnutrition, morbidity and mortality among children in Yemen. Coccidian parasitic infections are an important cause of diarrhea in children particularly malnutrition and immune-compromised patients, but their investigations are rarely required by the treating physicians in apparently immunocompetent children. This study was aimed to find the prevalence of intestinal coccidian parasites in country with high incidence rate of malnutrition. Between May 2016 and October 2016, 228 fecal samples from 228 selected school children in Al Turbah city, Taiz governorate, Yemen, aged between 6 and 15 years were examined using wet-mount preparations and formal concentration method then films stained by modified acid-fast staining. Also data of children were collected including demographic data, and sources of water. Findings of positive intestinal coccidian parasites were analyzed in relation with demographic data, and sources of water.  The prevalence of Cryptosporidium species, Cyclospora species and Isospora belli were 75.9%, 45.6% and 1.75% respectively. There was significant association between positive of Cryptosporidium species and females (OR= 2.1 times, P=0.01), and spring water source (OR=4 times, P=0.04), while there was no significant association between positive of Cryptosporidium species and others factors studied. Also there was no significant association between positive of Cyclospora species and Isospora belli and children sex, age groups, or different sources of water. In conclusion the study highlights the high prevalence of coccidian parasites among immunocompetent school children in Yemen. The clinicians in Yemen need to be aware that coccidian parasites are a potential cause of childhood diarrhea even in immunocompetent children.

BackgroundEchinococcus multilocularis is a causative agent of human alveolar echinococcosis (AE). AE leads to cirrhosis in several organs, such as the liver, triggering severe conditions, including hepatic failure and encephalopathy. The main purpose of this study is to explore the interaction between treated hepatic stellate cells and AE-protoscoleces (AE-PSCs). The results of this study will be provided experimental basis for revealing the mechanisms of hepatic fibrosis after AE infection.MethodsWe investigated the role of alveolar echinococcosis-protoscoleces (AE-PSCs) in liver fibrosis and structural changes and liver fibrosis-related protein expression in a coculture of PSCs and human hepatic stellate cells (HSCs). Structural changes were detected by transmission electron microscopy, whereas liver fibrosis-related proteins, collagen I, alpha-smooth muscle actin, and osteopontin levels were measured by western blotting and enzyme-linked immunosorbent assay. ResultsPSCs exhibited morphological changes, specifically changes in shape, and showed slight changes in the cytoplasmic membrane, whereas structural modifications were observed in HSCs. Additionally, western blotting and enzyme-linked immunosorbent assay revealed that PSCs treated in vitro with HSC-LX2 showed significantly increased collagen-Ⅰ, α-smooth muscle actin, and osteopontin expression levels after 3–4 days of incubation in a coculture system. AE-PSCs induced liver fibrosis by inducing extracellular matrix expression and HSC activation.ConclusionsThese results provide insight into the pathogenesis of echinococcosis- induced hepatic fibrosis and introduce therapeutic targets and diagnostic criteria for managing echinococcosis-dependent liver fibrosis.

Inflammatory bowel disease (IBD) encompasses a spectrum of diseases, with Crohn's disease (CD) and ulcerative colitis (UC) representing the two broadest subtypes of IBD. Multiple extraintestinal manifestations (EIMs) are more frequent in (IBD); 5% –50% of the patients might be affected. The most often implicated sites of manifestations are musculoskeletal and dermatological structures. However, while some symptoms like peripheral arthritis and erythema nodosum correlate with IBD progression, others have their own course of disease like axial arthropathy, gangrenosis of the pioderma and primary sclerosic cholangitis. This review would provide a summary of the most frequent EIMs and their prevalence. Peer Review History: Received 31 May 2020; Revised 7 June; Accepted 4 July, Available online 15 July 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Name: Dr. Md. Parwez Ahmad Affiliation: National Medical College, Birgunj, Nepal E-mail: parwezmedicine@gmail.com   Name: Dr. George Zhu  Affiliation: Tehran University of Medical Sciences, Tehran, Iran E-mail: sansan4240732@163.com   Comments of reviewer(s):

Background Echinococcus multilocularis is the causative agent of human hepatic alveolar echinococcosis (AE). AE can cause damage to several organs, primarily the liver, and have severe outcomes, such as hepatic failure and encephalopathy. The main purpose of this study was to explore the interactions between hepatic stellate cells (HSCs) and E. multilocularis protoscoleces (PSCs). The results of this study provide an experimental basis for further examination of the pathogenesis of hepatic fibrosis due to AE infection. Methods We investigated the role of Echinococcus multilocularis (Echinococcus genus) PSCs in hepatic fibrosis by examining structural changes and measuring hepatic fibrosis-related protein levels in cocultures of PSCs and human HSCs. Structural changes were detected by transmission electron microscopy (TEM), and levels of the hepatic fibrosis-related proteins collagen I (Col-I), alpha-smooth muscle actin (α-SMA) and osteopontin (OPN) were measured by western blotting and enzyme-linked immunosorbent assay (ELISA). Results Under coculture (1) both PSCs and HSCs exhibited morphological changes, as observed by TEM; (2) Col-I, α-SMA, and OPN expression levels, which were determined by western blotting and ELISA, significantly increased after 3 days of incubation. Conclusions The results of this study provide insights into the molecular mechanisms of AE-induced hepatic fibrosis. Graphical abstract