فهرست مطالب محمدرضا افلاطونیان

The dogs' relationship with their owners has made them one of the most popular pets. They can be a reservoir of many microbial pathogens, so they are important for public health. This study was performed to determine the phylogenetic backgrounds and antimicrobial resistance of E. coli isolates from healthy household dogs and their owners in Kerman province, Iran. Samples were taken regardless of antibiotic usage in the dogs. Based on the history of the animals, 90% of them had not used antibiotics during the few months before the study. 168 E. coli strains belonging to feces of healthy household dogs (n=49), their owners (n=49) and the people without a pet (n=70) were studied; phylogenetic sequences including chuA, yjaA and TspE4.C2 were screened by conventional polymerase chain reaction (PCR). The isolates were investigated phenotypically for antimicrobial resistance against 11 commonly used antibiotics in dogs which were erythromycin, streptomycin, enrofloxacin, oxytetracycline, cefotaxime, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin-clavulanic acid, ceftazidime, ceftriaxone and kanamycin. E. coli isolates were classified into A, D, B1 and B2 phylogroups with the prevalence of 55.9%, 30.3%, 7.1% and 5.3%, respectively. Considerably, antimicrobial resistance to erythromycin and oxytetracycline were predominant while the lowest frequency of antibiotic resistance was detected against ceftriaxone, ceftazidime, amoxicillin-clavulanic acid and kanamycin. This study was performed on apparently healthy dogs so it could determine their carrier role for antibiotic-resistant E. coli strains. This research revealed that healthy household dogs should be considered as the significant reservoir of resistant E. coli isolates especially to erythromycin, oxytetracycline, streptomycin, enrofloxacin, cefotaxime and ampicillin which these resistant strains were mostly belonging to A and D phylogenetic groups.

Cutaneous leishmaniasis (CL) is one of the health problems in Iran, especially in Kerman Province. The aim of this study was to determine the morbidity rate of CL in two new foci in the east and southeast of Kerman. 

At the end of 2017, demographic data were obtained from the health centers of Kerman. Using cluster sampling, 800 households (40 clusters of 20 households) were studied in Allahabad (southeast) and Sarasiab (east), Keramn. From each subject, data were collected regarding age, sex, number and location of the ulcer(s), scarring, and time and place of infection. The collected data were analyzed using SPSS software. 

The prevalence of CL was 9.6 in Allahabad and 42.8 in Sarasiab and the incidence (new cases) was 3.2 and 3.8, respectively. The highest rate of infection was found in Allahabad in the age group under 6 years old and in the Sarasiab was over 40 years old. There was a significant difference in nationality and local transmission between the rwo regions (P <0.001). 

The ratio of the prevalence to incidence in two regions showed that the focus in the east of Kerman was almost 12 years old, whilst a new focus is developing in the southeast. It is suggested that the health centers in the city of Kerman provide a regular program including active case- detection and free-of-charge treatment of patients in the aforementioned areas until complete recovery to achieve disease control.

Aim. The aim of this study was to examine the relationship of quality of life with general self-efficacy and perceived social support among people with Acute Coronary Syndrome (ACS) hospitalized in cardiac care unit of teaching hospitals in Kerman, Iran.
Background. Quality of life is considered as one of the important health indicators and components that is influenced by several variables.
Method. The present study is a descriptive correlational research in which 150 people with ACS who admitted to cardiac care unit of teaching hospitals in Kerman, Iran, were recruited by convenience sampling method. The instruments for data collection included Perceived Social Support questionnaire, Quality of Life questionnaire and General Self-efficacy questionnaire. Data were analyzed using SPSS version 18.
Findings. The mean age of the participants was 56.74±11.63. The mean score of quality of life, self-efficacy and perceived social support were 84.82±12.32, 27.19±6.89, and 63.58±13.1, respectively. There was a statistically significant direct association of general self-efficacy and perceived social support with dimensions of quality of life.
Conclusion. General self-efficacy and perceived social support have great impact on quality of life in people with ACS. It is recommended to consider these concepts in taking care of these people.

Nanoparticles are particles that have at least one dimension between 1 and 100 nanometers. Nanoparticles are a new generation of antimicrobial agents. Nanoparticles with antimicrobial activity, especially as a new class of biomedical materials for use in increasing the level of public health in daily life have emerged. Zinc oxide nanoparticles have attracted a great attention due to the variety of their applications in medical science. The aim of this study was to evaluate and compare the antimicrobial activity of zinc oxide nanoparticles synthesized by green method.
This experimental study was done in 2017, from March to September in the Bam Research Center of University of Medical Sciences Kerman, Iran. Green synthesis of zinc oxide nanoparticles was investigated using cumin seeds. The physicochemical characteristics of synthesized nanoparticles were studied by UV-visible ultraviolet spectrometer (Analytik Jena AG, Germany), X-ray diffraction and transmission electron microscope (TEM) (Carl Zeiss, Germany). Broth microdilution method was used to investigate the antimicrobial activity of zinc oxide nanoparticles. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these nanoparticles were determined for Pseudomonas aerogenes and Enterococcus faecalis strains.
The UV-visible ultraviolet spectroscopy showed an absorption peak in the range of 370 nm. Transmission electron microscopy shows the synthesis of zinc oxide nanoparticles, mostly spherical, with a size less than 50 nm. Minimum inhibitory concentration of zinc oxide nanoparticles against P. aerogenes and E. faecalis strains was determined at 6.25 and 12.5 μg/ml, respectively. Both bacteria were sensitive to zinc oxide nanoparticles. This sensitivity was higher for gram-negative bacteria.
Zinc oxide nanoparticles were produced using Iranian natural resources and our results showed significant antibacterial activity. Nanotechnology creates materials with novel properties every day, and creates new hope for improving environmental pollution. These nanoparticles can be used as a new generation of antimicrobial agents in various medical disciplines. For example, toothpaste containing zinc nanoparticles can be produced and prescribed for patients with immune deficiency to prevent the growth of microbial pathogens in the mouth and its transmission to the patient's body.

Aim and Pain management is an important component of patient care; in which nurses play a key role. In this regard, Knowledge of health care providers about pain management is very important and it is a part of patient’s right.
This is a descriptive study which assesses the knowledge and attitude of practitioner nurses in Jiroft University of Medical Sciences about pain management.
Findings: The results showed that more than 70% of nurses had negative to moderate attitude and 71.6% of them had a low level of knowledge about pain management.
According to the results and the problem that most nurses did not have enough knowledge about pain and as they showed negative attitude towards pain management, it is essential to provide continuous education for the nurses in pain management.

Human brucellosis is a significant public health problem in many middle east countries including Iran. Brucella organisms, which are small aerobic, facultative intracellular coccobacilli, localize in the reproductive organs of host animals, causing abortions and sterility. They are shed in large numbers in the animal’s urine, milk, placental fluid, and other fluids. Dairy product from raw milk are a potential threat to public health in endemic developing countries. The gold standard for the diagnosis of brucellosis is isolation of Brucella species. However, isolation Brucella species is time consuming and needed to level 3 biocontainment facilities and highly skilled technical personnel to handle samples and live bacteria for eventual identification. Handling Brucella species increase risk of laboratory infection. Polymerase chain reaction (PCR) with high sensitivity and specifity overcomed to these disadvantages. The aim of this study was to detect Brucella species in milk from dairy cattle farms in Kerman province, Iran by PCR technique.
Forty and eight bulk tank milk (BTM) were collected from October 2015 to March 2016 from 48 dairy cattle farm including 4200 cows. DNA of milk samples extracted by lysis buffer and proteinase K method. All milk samples were examined by PCR to detect Brucella-specific DNA targeting IS 711. Positive samples must be showed 317 bp amplified, corresponding to the expected size of the IS 711 genome region in all Brucella species.
Using IS711 primer were detected in 4 samples (8.3%) Brucella spp. from 48 BTM samples in this area.
The results indicate that brucellosis by Brucella species is endemic in the Kerman province dairy farms. Consumption of raw milk dairy products by individual farmers operating under poor hygienic conditions represents an high risk to public health. The need for implementing control measures and raising public awareness on zoonotic transmission of brucellosis are recommended. Vaccination of cattle is recommended for control of bovine brucellosis in enzootic areas with high prevalence rates.

Cutaneous leishmaniasis (CL) is a public health problem in Iran and Kerman Province which is expanding to new foci. This study was conducted to estimate the incidence of CL by a simple and cost – effective method in a major focus of CL in the city of Kerman, southeastern Iran.
A combination of two longitudinal and cross – sectional studies was performed. First, the frequency of referred patients to the CL treatment clinic in 2009-2014 was assessed. Then, four highly infected zones consisting of 800 households in the city were selected. In addition, the relative proportions of referred and non – referred subjects were assessed. Eventually, the incidence of CL was calculated by dividing the number of CL cases over the total at risk population for the corresponding period (2009-2014).
The mean annual incidence was 175 per 100000 (943 patients) in the city of Kerman, while it was 500 per 100000 people (0.5%) in the new foci. The highest CL infection was observed among the The incidence rate probably increased significantly following the 2003 Bam earthquake because of the migration of CL patients to southern, eastern, and northeastern areas of the city of Kerman. Since only 50% of the cases were passively referred to the CL treatment clinic, health authorities should actively detect CL cases by house – to – house visit for effective treatment strategies.

Anthroponotic cutaneous leishmaniasis (ACL) is restricted to humans; thus, prompt diagnosis and early treatment are significant measures to control the disease. This study was conducted to determine the effect of direct active case- detection and early treatment on the control of ACL in Bam District.
This retrospective cohort study was performed based on intervention and nonintervention. After the 2003 earthquake, an equipped treatment center was established to actively detect CL cases following the CL epidemic. This intervention was carried out in 2007 and the suspected cases were referred to the center for diagnosis and treatment Another comparable CL treatment center was selected as the control in Kerman. The recorded data of the patients were analyzed with statistical tests at p The incidence rate steadily increased to 30% from 2003 to 2007 whereas the incidence gradually decreased to 1% after the intervention. However, by contrast, the incidence rate increased significantly in the control area. The treatment failure and relapse rate of ACL showed no significant difference with the control group before and after the intervention. The effectiveness of the intervention was calculated to be 85%.
Active case-detection and early treatment of ACL could be an effective measure in controlling ACL, particularly during epidemics. Lessons learned from the 2003 Bam earthquake could be used as a suitable model for ACL endemic areas, nationally and globally.

Brain death is one of the greatest crises experienced by families who are faced with the decision of organ donation. Families of brain dead patients are faced with many psychological problems. Thus, the experiences of intensive care unit (ICU) nurses regarding the psychosocial status of family members of organ donating patients were studied in the present study.
This qualitative study was conducted through phenomenological approach. The study participants consisted of 8 nurses of ICUs in Kerman, Iran, who were selected through purposive sampling. Subjects were assured of confidentiality of data and were able to leave the study any time they wished. Data were collected through open and semi-structured in-depth interviews until data saturation was achieved. All interviews were recorded, transcribed verbatim, and analyzed using Colaizzi's method.
Through analysis and integration of codes, 3 main codes and 13 secondary codes were extracted. The main code of unknowns consisted of the secondary codes of ambiguity, anxiety, unknowns, and the reaction of family members. The main code of understanding the family’s critical situation contained the secondary codes of fear of remorse, the chances of recovery, others’ lack of approval, and obsessive thoughts. Moreover, the main code of understanding the cultural, social, and religious aspects consisted of the secondary codes of altruism, religious beliefs, growing up in difficult circumstances, interests and expectations, and emotional relationships.
The psychological problems of families of brain dead patients can be managed through the elimination of the unknown, understanding the critical situation of the family, and understanding their cultural, social, and religious status. In this way, these difficult stages can be passed in greater psychological tranquility.

Q fever is a public health concern in many countries especially in recent years. There are a few studies in Iran. This study aimed to determine the seropositivity for Q fever among veterinary staff in southern Khorasan, Iran.
92 serum samples were obtained from all veterinary employees and tested using an indirect enzyme-linked immunosorbent assay (ELISA). The data including age, sex, education, having contact with the secretion of cattle abortion, and keeping animal in house were analyzed using descriptive statistics and confidence interval of 95%, and chi-square and logistic regression tests.
Totally, 54.3% of serum samples were positive (57.1% in men and 40.0% in women). The results of logistic regression showed that in people who had contact with the secretions of cattle abortion the odds ratio was 2.3 times more than those who had not contact with livestock abortion. Other factors did not show any significant relationship.
These data indicate high seropositivity in veterinary staff of southern Khorasan. Thus, training this high-risk group of people looks to be necessary to prevent the disease. In addition, complementary studies in other parts of Iran are suggested to clarify the epidemiological aspects of Q fever in this group.

Q fever is a zoonosis with a worldwide distribution; this disease is a public health concern in many countries. The aim of this study was to determine the association between risk factors with Q fever seropositivity among veterinarians and vet staff in Southern Khorasan.
Questionnaires were prepared and 92 blood samples were obtained from all veterinary staff in the South Khorasan (East of Iran). The serum samples were tested with an indirect ELISA kit (anti body phase II); then, SPSS version 19.0 was employed to analyze the data using descriptive statistics and a confidence interval of 95%, chi-square test, and logistic regression.
The results showed that 50 serum samples (54.35%) were positive and the results of data analysis with logistic regression indicated an association between seropositivity and contact with animal secretions and abortive materials. There was no correlation between seroprevalence and age, gender, work experience, education, use of unpasteurized dairy products, knowledge of disease, and clinical findings.
In conclusion, the present study showed a high seropositivity rate among vet staff which indicates that further attention should be paid to this disease in these groups.

Organ donation is a very difficult decision for families. Families of brain death patients are facing difficult and damaging stages of experiencing and understanding the brain death, and at the same time they also encounter the crisis of decision about organ donation. Quantitative methods and questionnaires have been used for identification of psychological problems in most studies, but perception of people’s mentality and experiences with common quantitative approach is not possible. Thus we decided to combine both quantitative and qualitative methods for deeper understanding of the psychological problems of donor’s family, to help them in making this difficult decision.
This study was performed by combining investigations. Quantitative data and donor’s family view were evaluated through questionnaire and interviews, respectively.
Qualitative results were classified in three general concepts: unknowns-fear, doubt-dependency, and excellence. Each of these concepts was divided into smaller profile. Knowledge, concerns, unknowns, dealing with family and the therapist relationship were in the subgroup of unknowns; fear of regret, the chances of recovery, rejection of others', beliefs, and obsessive thoughts were in the subgroup of doubt and fear; and acceptance of reality, altruism, religious beliefs, growing up in difficult circumstances, interests and expectations, and emotional relationships were in the subgroup of development and dependence. In the quantitative results members of the families of 224 brain death patients were evaluated. The mean age of the participants in this study was 37/13 ± 60/35 years. The mean age of patients was 51/21 ± 82/44 years. Among all the demographic characteristics of individuals only the level of education was associated with psychological disorders (P> 0.05). Children’s anxiety was also significantly higher than the other family members’ (P Quantitative and qualitative results of the psychological problems of families of brain-dead organ donors showed that because of different experiences of families, lack of awareness, harmful levels of anxiety and depression, it is necessary to appropriately support families in this crisis situations. All of them are in need of medical team sympathy and in this way we must help them to find an awareness of their unknowns, thus better understanding of these conditions is provided. By strengthening the humanitarian morale of the people, the incidence of inappropriate thoughts and confounding factors in the adoption of this crisis would reduce.

Purposes of this study were to determine the phylogenetic groups، prevalence of enterotoxigenic pathotype and antibiotic resistance of Escherichia coli (E. coli) isolates from diarrheic cases in Bam city. In this study 155 E. coli were isolated from diarrheic samples in Bam city. Phylogenetic groups of isolates and enterotoxigenic pathotype were determined by detection of chuA، yjaA، TspE4C2 and ST، LT genes respectively. One hundred fifty five examined isolates were distributed in phylogenetic groups: A (71. 60%)، B1 (3. 22%)، B2 (9. 67%) and D (15. 48%). The genes for enterotoxigenic pathotype were detected in 52 isolates (33. 54%)، which ST gene were found in 29 isolates، LT in 16 isolates and LT، ST genes in 7 isolates. Twenty nine ST gene positive isolates were distributed in three phylogenetic groups A (48. 28%)، D (41. 38%) and B2 (10. 34%). According to the antibiotic susceptibility tests maximum and minimum antibiotic resistance rate was against to trimethoprim/sulfamethoxazole (74. 19%) and ciprofloxacin and gentamycin (9. 67%). Fifteen multiple antibiotic resistance patterns were detected in four phylogenetic groups. Escherichia coli isolates from enterotoxigenic pathotype have a considerable antibiotic resistance rate in Bam city and were distributed in different phylogenetic groups. Since a considerable number of isolates were negative for LT and ST genes، it is necessary to study the other virulence genes and their phylogenetic background in E. coli isolates from diarrheic cases in Bam city.

Assessment of physical growth is one of the most important methods of determining nutrition and health status. Body mass index (BMI) is a suitable index for growth monitoring and helps in the identification of growth disorders and malnutrition in teenagers. The aim of this study was to determine BMI status in secondary school students in Kerman, Iran, in 2012. This was a descriptive-analytic study in which data were collected cross-sectionally and compared with the results of the study in 1997. After gaining permission from the Department of Education of Kerman, the samples were selected randomly from the secondary schools in Kerman. Height and weight were measured by standard tools. Data were analyzed through SPSS software and using Studentsindependent t-test. Mean BMI of the students (n = 424) was 19 ± 4.2 and 44.8% of students had normal BMI. Mean BMI of boys was significantly lower than girls. In total, 6% of the students were excessively thin and they were mainly from public schools in the suburb of the city. Over 50% of students had weight problems; underweight was the main problem in the studied population and only 9.2% of our subjects were overweight. Since the pubertal height and weight growth spurt occurs earlier in girls (10-13 years) than boys, the absolute comparison of BMI based on sex is not wise; if necessary it should to be performed after this period. Malnutrition or lack of access to food, or cultural factors and body shape care could explain our findings in regard to the distribution of BMI in the student population of Kerman.

Q fever is an important zoonotic disease caused by infection with Coxiella burnetii, a Gram negative, obligate intracellular bacterium classified within the order Legionellales. Farmers, veterinarians, abattoir workers and laboratory personnel are among persons at risk of Q fever. The aim of this study was to determine frequency of IgM anti-Coxiella burnetii antibodies in slaughterhouse workers in Kerman city/ Iran. In this survey, 64 sera samples were gathered during May - June 2011 from slaughterhouse workers to evaluate the presence of phase II IgM antibodies against Q fever, using a commercial indirect ELISA test (Virion/Sermon, Germany). Among all sera samples tested, only 5 samples (7.8%) were positive for the presence of IgM antibodies. Since chronic Q fever leads to more complex conditions like endocarditics, chronic fatigue syndrome and recurrent abortion, preventive measures like using mask or available vaccines are recommended. Moreover, early diagnosis of Q fever followed by appropriate treatment is necessary.

Breast cancer is the most common cancer among women. Numerous factors are effective in the improvement of patients undergoing surgery in terms of preventing relapse or need for repeated treatment during 6 months after the surgery. This study aimed to determine the factors affecting improvement of patients undergoing surgery for breast cancer using a logistic regression model. In this study information of 150 patients were extracted from the surgical records of patients underwent surgery at the Cancer Institute of Tehran Imam Khomeini Hospital. Data were analyzed through SPSS software and using logistic regression models. Of 150 studied patients, 18 patients (12%) were not fully recovered while 132 (88%) had complete remission. The mean age of the patients was 43 ± 7.5 years, 92.8% were married, and 87.3% had children. According to the results, the odds of non recovery increased by 1.26 times with each one-year increase in age, 5.3 times with each one lymph node involvement, and 8.67 times in the case of metastasis. Other variables, such as marital status, number of children, tumor size, and location of the metastasis showed no significant relationship. The Results showed that age at diagnosis, due to its relationship with metastases and number of involved lymph nodes can be directly or indirectly affect the outcome. Therefore, increasing the women's awareness about breast cancer seems to be necessary for early diagnosis which requires planning a sufficient screening program by health policy makers of the country.

There are still many unknowns about prevention and control of Anthroponotic cutaneous leishmaniasis (ACL). Bam district is one of the old foci of CL. The aim of this study was to compare the effect of knowledge of prevention and improving housing, conditions in control of ACL based on a natural experience of earthquack, in Bam city. This comparative – analytical study was carried out in two time periods of before and after the 2003 bam Earthquake. Sampling was performed through random cluster method from the CL high risk areas within the city of Bam. The selected houses were actively visited in a similar manner and data about houses, hygienic conditions and the history of CL infection in the last three years were recorded. Data were analyzed through SPSS software and using t, Chi-Square and regression tests. Both knowledge of CL prevention and housing, conditions were significantly better (p<0.0001) after the 2003 earthquake than before the earthquake. While the knowledge of CL prevention alone had no direct effect on the incidence rate of disease during both two time periods, improvement of housing, conditions was effective in decreasing the incidence rate significantly (p<0.0001). The household heads of houses with better living conditions indicated a high knowledge of prevention (r= 0.7, p<0.001). As it was seen, the earthquake has caused basic changes in hygienic conditions of houses and promotion of knowledge of CL prevention. Therefore, consequenthy improvement of housing, conditions directly and improvement of prevention knowledge indirectly decreased the incidence rate of CL. Therefore, for control and elimination of ACL, in addition to the early treatment, improvement of housing conditions is highly important.

Visceral leishmaniosis (VL) is a sporadic disease in many provinces of Iran, while it is considered endemic in other parts. This study was designed to assess the seroprevalence of canine VL in the Kerman city. Samples were randomly selected from the referred household dogs to the veterinary hospital of Shahid Bahonar university, Kerman, Iran and stray dogs, euthanized by Kerman municipality. Blood samples were taken after complete clinical examination. All collected sera were tested by a commercial indirect ELISA kit for the presence of anti Leishmania infantum antibodies. In addition, complete blood count tests were performed in all dogs to detect hematological alterations. Collected data were analyzed through SPSS software and using 2 and fishers’ exact tests. The overall seroprevalence was 7.03%, which was calculated 11.1% in stray dogs. Seroprevalence of disease was significantly higher in dogs over 5 years old in comparison to younger dogs (P<0.01). Seroprevalence had no significant relationship with sex and hematological alterations. Although the seroprevalence of canine VL in Kerman city was less than that in endemic parts, stray dogs could be a potential risk factor for public health in this area. Further complementary ecological studies on vectors and reservoirs in different areas of Kerman province seem to be necessary.

Ehrlichiosis is an emerging tick-borne zoonotic disease caused by the gram-negative coccid obligate intracellular bacteria of the family Anaplasmataceae. Since the only available evidence in regard to monocytic Ehrlichiosis in Iran is related to dogs, the present study was designed to use the polymerase chain reaction assay for confirming the presence of Ehrlichia spp. in tick infested client-owned dogs in Kerman. Blood samples were prepared randomly from 100 owned tick infested dogs regardless of clinical status. Complete blood count was done for each sample and in the next step, DNA extraction was done and PCR was carried out by a commercial kit. Six of 100 (6%) examined dogs were positive for Ehrlichia spp. based on PCR. Results of the present study confirmed the presence of Ehrlichiosis as an emerging zoonotic disease in Iran and dogs could be considered as a main reservoir for the disease. It is recommended to determine the prevalence of Ehrlichiosis and the most prevalent Ehrlichia species in animal reservoirs, vectors, and human population in different geographical regions of Iran in further epidemiological studies.

Health system services are an important program and successful from it’s in our country. Those principles are based on sameness. Social justice and community participation Fruition and satisfaction of population are an important aspect PHC (Primary health care). This study was done to evaluate fruition rat and satisfaction of population in the community research center of Kerman. This study is cross sectional and from kind of community Based participatory research. Views 328 person’s with method of cluster was c collected and data analysis was done. 32.9 Percent had no file. Average 69.9 percent used not from services and only 17.7 percent used regularly and 13.8 percent irregularly. 23.8 percent were unsatisfactory. Among of 7 services had best of situation vaccination that 47% percent of population used regularly and 94.5 were unsatisfactory opposite 17% percent used from dentist services and 34.5 percent were un satisfaction. Census of region and to inform of population and supervise by responsible from this center is necessary that use from potentiality better

With regard to the perceptible population, cultural, social and environmental changes in the aftermath of the earthquake in Bam City, this study was conducted to pinpoint substance misuse patterns and to figure out the probable relationship between substance misuse and blood types of the addicts referred to Substance rehabilitation Clinics from 2006 to 2007 in Bam City.In this case-control study, the sample size includes volunteering and self-introduced addicts and also a random selection of 360 healthy clients referred to the Blood Transfusion Organization as the control group. Both group's data were analyzed using descriptive statistics and Chi square and the odds ratio was estimated too.Three-hundred ninety nine individuals from nearly 3000 clients referred to the rehabilitation clinic from 2005 to 2008 participated with complete consent in the study. The highest frequency belonged to opium addicts (85.6%) and the most prevalent addiction type pertains to opium consumption via smoke inhalation (58.2%). The probability rate of AB negative blood type compared to other blood types among the addicts was 6.07 fold the control group.There has been an increasing rate of addiction in bam after earthquake and The substance consumption pattern has moved towards more dangerous methods. The high prevalence of AB blood type brings about a lot of presuppositions for geneticists, epidemiologists, hematologists and all majors in basic sciences.

Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime®) is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL). This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime® and the other group treated with intralesional Glucantime® twice a week. Type and size of each lesion (induration, ulcer and scar) were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure. A total of 48 patients completed the study; complete cure was seen in 24 of 27 (89%) patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77%) patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23). It seems that the efficacy of intralesional injections of Glucantime® once a week is similar to efficacy of twice a week Glucantime® injections.

There have already been a few studies on Q fever in Iran and most of them go back to more than 50 years ago. Preliminary serologic studies on ruminants and febrile patients in Southeast Iran show a high seropositivity in this region. Misdiagnosis as well as poor attention of public health authorities to this infection can facilitate the epidemic spread of Q fever. Further studies on the diagnosis of acute and chronic types of Q fever and detection of Coxiella burnetii are in progress by the authors.

Cutaneous leishmaniasis (CL) has been endemic in Bam district for many years and several epidemics have already occurred. Following a silent period, another outbreak of CL occurred after the earthquake in 2003. This study was performed to find the trend of CL during 20 years (1988-2007) in Bam district. In a retrospective study, data of 29395 CL patients were collected from medical records of Center for CL Control and Treatment and also from previous published studies and analyzed. Before the earthquake there were three periods of outbreak, control and silent. The highest prevalence (8.3%, 6734 cases) was in 2000, whereas the lowest (0.2%, 215 cases) was in 2003 just prior to the earthquake. Again, in 2006 CL prevalence increased to an epidemic level (2.6%, 2880 cases). During these 20 years, age of patients has increased and after the earthquake males infected more than females. Lesion sites has changed from face to hands and legs. The causative agent and the vector have been Leishmania tropica and phlebotomus sergenti, respectively. Epidemiology of CL varies with environmental changes and due to the immunity after infection, the incidence rate becomes equivalent to the birth rate. Increase in the prevalence of CL after the earthquake is mainly due to the immigration of non–immune individuals to this area. In endemic areas with frequent natural disasters such as earthquake, it is very essential to consider preventive programs in advance.