Background: Both primary and secondary tumors can develop in distal phalanx of the hand presenting as Lytic lesions. The presence of a Lytic lesion in the distal phalanx has been a dilemma making the differential diagnoses, prognosis, and treatment of these lesions challenging. Objectives: This study was designed to evaluate the patients who were presented with a Lytic lesion in their distal phalangeal bone of the hand. Patients and Methods: In this retrospective study, we reviewed the final diagnosis, clinical presentation, treatment, and outcomes of the Lytic lesions in distal phalangeal bones of the hand in 14 patients who were referred to our hospital from 2008 to 2013. Results: The mean age of our patients was 36. 14 ± 15. 8 years. Thumb and middle finger were the most common involved digits (four cases of each) followed by the index finger (three patients). Enchondroma was the most common final diagnosis (five patients) followed by giant cell tumor and glomus tumor (two cases of each). Painless mass was the chief complaint of most patients with enchondroma, whereas pain and swelling were the chief compliant of others. Enchonromas were located in the proximal part of the distal phalanx and other Lytic lesions were seen in the distal part. Conclusions: Because of the diverse diagnosis for the Lytic lesions in the distal phalanx of the hand, a complete tumor work-up should be performed to evaluate the condition properly, especially in distally located lesions.

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Background and Objectives: Multi-drug-resistant Enterobacter aerogenes is associated with various infectious diseases that cannot be easily treated by antibiotics. However, bacteriophages have potential therapeutic applications in the control of multi-drug-resistant bacteria. In this study, we aimed to isolate and characterize of a Lytic bacteriophage that can lyse specif-ically the multi-drug-resistant (MDR) E. aerogenes. Materials and Methods: Lytic bacteriophage was isolated from Qaem hospital wastewater and characterized morpholog-ically and genetically. Next-generation sequencing was used to complete genome analysis of the isolated bacteriophage. Results: Based on the transmission electron microscopy feature, the isolated bacteriophage (vB-Ea-5) belongs to the family Myoviridae. vB-Ea-5 had a latent period of 25 minutes, a burst size of 13 PFU/ml, and a burst time of 40 min. Genome se-quencing revealed that vB-Ea-5 has a 135324 bp genome with 41. 41% GC content. The vB-Ea-5 genome codes 212 ORFs 90 of which were categorized into several functional classes such as DNA replication and modification, transcriptional regu-lation, packaging, structural proteins, and a host lysis protein (Holin). No antibiotic resistance and toxin genes were detected in the genome. SDS-PAGE of vB-Ea-5 proteins exhibited three major and four minor bands with a molecular weight ranging from 18 to 50 kD. Conclusion: Our study suggests vB-Ea-5 as a potential candidate for phage therapy against MDR E. aerogenes infections.

Background & Objective: This study aims to isolate a Lytic bacteriophage against planktonic Enterococcus faecalis V583 culture and evaluate its ability to disrupt and inhibit biofilm. Methods: An anti-E. faecalis phage was isolated from sewage and visualized by electron microscopy, the vB_EfsS_V583 (V583) host range was determined by spot test on 13 E. faecalis clinical strains. Inhibition and degradation experiments were designed to investigate the effect of phage on biofilm. In the inhibition and degradation assay, biofilms were formed in the presence and absence of phage, respectively. Finally, crystal violet method tested the effect of phage on biofilm. Results: Phage V583 belongs to the Siphoviridae family and can infect all E. faecalis strains. Antibacterial activity has been shown to degrade and inhibit biofilm produced by V583. The study results showed that phage v583 is more efficient in biofilm inhibition than biofilm degradation. In both assays, phage-treated wells' absorption is less than untreated wells. These results were confirmed by Colony-forming unit reduction in the treated biofilm. Conclusion: The anti-biofilm activity showed that phage therapy using phage V583 might be an alternative tool to remove E. faecalis biofilms.

Introduction: Skeletal involvements are less reported in tuberculosis and even less likely observed in fingers. Fingers are rarelyinvolved in adults and it often has been reported in children under 5 years old. Most likely, a recent condition in adult patients isrequired to provoke reactivation of bacilli lodged in the bone during the original mycobacteremia of primary infection. Case Presentation: In this report, a 31-year-old female patient, suffered from detached extensor tendon due to the fourth fingertrauma, was diagnosed as a Mallet finger and treated by closed percutaneous pining is introduced. The patient had chronic swellingand progressive pain in the same finger for six months after treatment. Thecommonanti-inflammatory and antibiotic therapy wasnot successful. Radiographic images of the ring finger demonstrated erosion and irregularity of the articular surfaces around thedistal interphalangeal join (DIP). She expressed a history of untreated cough and exposure to people with tuberculosis. A positivetuberculosis (TB) skin testwasdetermined withmorethan10mminduration. Treatment with anti-tuberculosis medication regimenwas successful and continued for 12 months. Conclusions: Skeletal tuberculosis should always be considered by physicians in endemic areas. Aslow progression of the disease inskeletal involvement and lack of clinical suspicion can lead to misdiagnosis. Using anti-tuberclusis medications for an appropriateperiod is effective in the disease control and treatment of patients.