In the years since the start of the COVID‐19 pandemic, numerous neurological manifestations have been reported following this novel virus. Myasthenia gravis is one of them. Here, we present the patient that was referred to us with myasthenia gravis symptoms after a COVID‐19 infection.

Background: Acne vulgaris is a common skin disease that is more common in young population and it can be associated with some sequels after resolving the lesions. Post‐inflammatory erythema is one of these complications that can be disturbing for patients and does not have any definite treatment. This study was aimed to evaluate the efficacy and safety of tranexamic acid (TA) as mesotherapy in treatment of post‐acne erythema (PAE) treatment.Method: This clinical trial study was performed in the dermatology clinic on 17 patients with persistent PAE (3 months after acne recovery). Two sessions of treatment were performed by a physician with 2‐week intervals; TA was injected as mesotherapy into the right side of each patient's face as the case group, while the opposite side was used as the control group. A Visioface device was used to compare before and after treatment photographs of each side of the face in color mode with quantitative measures such as lesions count, area, and area percent.Results: Finally, 15 patients completed treatment sessions. There were statistically significant differences in right side lesions before and after treatment withp‐values of 0.047, 0.002, and 0.035 for count, area, and area percent, respectively. There was no significant difference before and after treatment in terms of count, area. and area‐percent on the left side.Conclusion: According to the results of this study, TA injection as mesotherapy for resolving PAE can be effective. However, due to small sample size, further studies are needed.

Objectives. Lophomonas protozoan is an emerging pathogen transmitted through arthropods such as cockroaches. Lophomoniasis is still a mysterious disease with many unknown epidemiological aspects. The current study aimed to determine the prevalence of lophomoniasis among patients who were hospitalized in Hajar Hospital, Shahrekord, southwestern Iran, using a conventional PCR technique. Methods. In this retrospective study, 132 frozen bronchoalveolar lavage fluid (BALF) specimens from patients with respiratory disorders hospitalized in Hajar Hospital, Shahrekord district, southwestern Iran, were analyzed during 2020-2021. Samples are referred to the Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran Province, Northern Iran, for detecting Lophomonas spp. infection by a conventionally small subunit ribosomal RNA (SSU rRNA) PCR test. Results. A total of 132 frozen BALF specimens were examined, 36 (27.3%) tested Lophomonas spp. positive using the conventional PCR technique. Also, based on sequencing data and blast analysis, the presence of L. blattarum species was confirmed. The average age of Lophomonas spp.‐ positive patients was 67.02 ± 15.14 years. Out of the 36 positive subjects, 63.9% were male and 36.1% female. Male and Lophomonas infection had a significant correlation ( ). Our findings revealed that L. blattarum infected nonsmokers more than smokers ( ). The most common underlying disease was also bronchitis Conclusion. Our results showed, for the first time, that pulmonary lophomoniasis caused by L. blattarum is a common and emerging disease in the study area, southwestern Iran. Furthermore, our findings support the use of the PCR test to detect Lophomonas infection in archived frozen clinical samples.

Background: Tranexamic acid is used to treat pigmented disorder in dermatology for a long time however there are limited data for effectiveness of tranexamic acid for rejuvenation and improvement of wrinkle. Here we want to find the effectiveness of tranexamic acid as mesotherapy in improvement of periorbital wrinkle in a clinical trial study.Methods: Patients with melasma who were treated with 4 session of tranexamic acid mesotherapy at intervals on 1 week were evaluated with Visioface device before starting and 1 month after last course of treatment. The outcomes including volume, area, area percent, and depth were measured by Visioface device.Results: Mean of periorbital wrinkles volume before and after procedure were 89 271 and 74 639 pixel³ (px³), respectively. Very significant difference with p‐value of <0.001 was detected at volume of patient wrinkles before and after treatment. Moreover, the mean of area (and area percent) of their periorbital wrinkles before and after therapeutic method were 8481 Px³ (1.131%) and 7184 Px³ (0.646%), respectively, with significant differences (both have p‐value of <0.001).Mean of periorbital wrinkles depth at before and after treatment were 9.8 and 9.6, respectively, without remarkable difference (p‐value was 0.257).Conclusion: Tranexamic acid mesotherapy significantly leads to reduced volume and area of wrinkles. Injection of tranexamic acid as mesotherapy seems to be effective in improvement of periorbital wrinkling.

Lophomoniasis is an emerging protozoan disease that mostly involves the lungs. Because the disease has similar symptoms to other pulmonary infections such as tuberculosis, most cases are underdiagnosed. Here, we present a patient with co-infection of Lophomonas/Mycobacterium.

In this case report, we address the diagnostic challenges and clinical implications of severe infection with Lophomonas blattarum in a patient initially suspected of experiencing long COVID symptoms. We describe the patient's medical history, initial symptoms, diagnostic tests, and treatment. A female patient with diabetes in her early 60s presented with severe shortness of breath and was initially diagnosed with diabetic ketoacidosis (DKA). After resolution of her DKA symptoms, persistent respiratory issues led to a COVID-19 test, which was negative. A chest computed tomography scan revealed abnormalities, prompting bronchoscopy and bronchoalveolar lavage fluid analysis, which confirmed the presence of L. blattarum. Notably, the protozoan remained mobile and viable even after a 4-day transport at ambient temperature. This case emphasizes the importance of considering alternative diagnoses and improving awareness about L. blattarum infection in patients with respiratory symptoms, for timely and accurate management.