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Onychomycosis is a fungal disease that caused by different types of fungi. Non-dermatophyte molds are a large saprophytic fungi group that live in nature and could affect traumatic nails. The aim of this study was to identify non-dermatophyte molds causing onychomycosis and evaluation of several antifungal activities against the isolates. The samples consisted of 50 non-dermatophyte molds isolated from patients with onychomycosis confirmed by direct and culture examination fungal. DNA was extracted, amplified, and sequenced. Disk diffusion method was used to evaluate itraconazole, fluconazole, ketoconazole, terbinafine, posaconazole, and econazole activity against the isolates. The species identified as: Aspergillus flavus 22 (44%), A. niger 12 (24%), A. fumigates, 3 (6%), A. sydowii 3 (6%), A. terreus 1 (2%), Penicillium commune 2 (4%), P. glabrum 2 (4%), P. chrysogenum, 1 (2%), Fusarium solani 3 (6%) and F. thapsinum 1 (2%). Most of the samples were sensitive to terbinafine, itraconazole, and econazole and 94% of the isolates were resistant to fluconazole. This study showed that Aspergillus species were the most common cause of non-dermatophyte mold onychomycosis and fluconazole was the most resistant antifungals. Care must be taken to choose the appropriate antifungal drug for a better cure.

Background Considering increased trends toward molecular methods for detection/identification of fungi causing onychomycosis, the aim of this study is comparison three DNA extraction methods based on steel‐bullet beating to extract DNA from nail. Methods Ex ‐vivo onychomycosis model was developed using bovine hoof with Candida albicans and Aspergillus flavus. For two models, total DNA was extracted using the three different methods. In method 1, the extraction and purification were performed by steel‐bullet beating and phenol chloroform protocol, respectively. In method 2, a freezing step were applied before beating. The purification step in method 3 was carried out using a commercial kit, although DNA extraction was done similarly to method 1 in that approach. To evaluate the efficacy of each method, the extracted genomic DNA was amplified with Polymerase Chain Reaction (PCR) using Internal Transcribed Spacer (ITS) regions. Moreover, 50 nail samples were evaluated for onychomycosis using direct microscopy examination as well as PCR in order to evaluate the diagnostic efficiency of the optimal DNA extraction method. Results Regarding the desirable quality of the extracted DNA, cost effectiveness, and simplicity, method 1 could be used to extract DNA effectively. Additionally, the obtained data showed that PCR had a higher detection rate of fungal agents in the nail samples than direct microscopic examination. Conclusions This study demonstrated that the mechanical disruption of the cell wall by steel‐bullet beating is a useful and practical method to improve the quantity and quality of fungal DNA thorough the extraction process.

Introduction: Viral hepatitis has been declared as one of the major health problems by World Health Organization. Hepatitis B surveillance system is one of the most important tools for managing the disease and achieving the targets of disease elimination. Despite its high efficiency, hepatitis B surveillance system has always been faced with many challenges. Therefore, the present study aimed to investigate the core functions of the hepatitis B surveillance system in southeastern region of Iran. Method: Semi-structured in-depth interviews were conducted with 14 hepatitis B surveillance experts in five counties of Sistan and Baluchestan Province, southeast Iran. The data were analyzed using content analysis method, based on the structure of the disease surveillance system. Purposeful sampling method was carried out and continued until saturation of the themes was achieved. Results: The main studied themes were case finding, case reporting, case registration, case confirmation, data analysis, sending feedback, and implementing interventions. The results of this study showed that all of the core functions of the hepatitis B surveillance system were running in the studied counties, although they did not meet the relevant standards in some cases. Conclusion: It seemed that, despite the numerous efforts and activities, it was still far from reaching the targets of the program. Considering the goal of World Health Organization to eliminate hepatitis B by 2030, it is essential to address these challenges and make attempt to overcome them.

Candidiasis is an opportunistic fungal infection caused by Candida species that can affect different parts of the body such as skin involvement, onychomycosis, mucosa involvement (mouth, throat, vagina, and esophagus), and systemic infections. 1 Candida species have the highest frequency of invasive fungal infections in hospitalized patients. 2 Invasive candidiasis includes several types, the most common being candidemia, the fourth and seventh cause of bloodstream infections in the USA and Europe. [3][4][5] Another common infection is vaginal candidiasis, which at least 75% of women of reproductive age will get infected once in their lifetime. 6,7 The