abedin saghafipour

Dear Editor, Dengue fever with four related dengue viruses (DEN-1, DEN-2, DEN-3, DEN-4) is transmitted to humans by some species of invasive female Aedes mosquitoes, such as Aedes aegypti and Aedes albopictus, and it is rapidly spreading in the world. It seems that the causes of increasing cases and explosive spread of dengue fever are somehow related to the vectors of this disease. These factors include: 1-Global warming due to human activities and creating favorable living conditions and reproduction of Aedes mosquitoes. 2- Numerous seasonal rains that create temporary and suitable larval habitats and breeding places for Aedes mosquitoes. 3- The presence of numerous larval habitats for Aedes mosquitoes; They lay eggs anywhere there is stagnant water: in discarded used tires, in broken containers that hold water and septic tank valve pipes, and even in abandoned cans. 4-Unlike other mosquitoes that only bite once and feed once before laying eggs; Invasive Aedes mosquitoes, especially Ae. aegypti, have repeated bites daily, and multiple and repeated bites cause more transmission of dengue fever virus and its explosive spread. 5- Aedes mosquitoes infected with one of the dengue fever virus serotypes vertically transmit the virus to their next generation; That is, Aedes infected with the virus also lay infected eggs, and from the infected eggs, the infected adult mosquitoes eventually come out, which are infected with the virus from the beginning without having a blood meal from the infected human reservoir, and with their first blood meal, they get fever. They transmit dengue to a susceptible host (human).

Cockroaches play a role in the mechanical transmission of microbial pathogens. This study was designed to determine the isolated bacteria and their susceptibility to conventional antibiotics from brown-banded cockroach, Supella longipalpa, in Qom province, central Iran.

In this cross-sectional study, brown-banded cockroaches were bred in an insectary and caught from hospitals of Qom. The samples were taken from the surface and alimentary canal and then cultured on microbial culture media; next, grown specimens were identified using differential culture media. Finally, after performing diagnostic tests and identifying the bacteria species, their susceptibility to various antibiotics was evaluated.

A total of 120 adult cockroaches from the insectary and hospitals were included in the study. Ten bacterial genera were found; nine were Gram-negative and one was Gram-positive. The genus Klebsiella, Enterobacter, Staphy lococcus, Citrobacter and Hafnia were isolated only from the hospital strain. On the other hand, Pseudomonas and Escherichia from both groups and other species such as Salmonella, Proteus and Shigella were isolated only from la boratory strains. The highest antibiotic resistance among Gram-positive cocci and Gram-negative bacilli were 100.0% and 98.1% for ampicillin and Ceftazidime, respectively.

The results of this study showed that various pathogenic bacteria harbored by brown-banded cockroaches. Moreover, it was found that most of these bacteria belong to the Enterobacteriaceae family, which can be pathogenic and thus threaten human health.

Owing to chitosan properties such as biocompatibility and antimicrobial activities, and several applications in biomedical field, some physicochemical and anti-bacterial properties, and the level of chitosan from three species of American cockroach, Periplaneta americana (Dictyoptera: Blattidae), the German cockroach, Blattella germanica (Dictyoptera: Ectobiidae) and the Mealworm beetle, Tenebrio molitor (Coleoptera: Tenebrionidae) were investigated.

The cuticle of adults derived from specimens was dried and grounded. The powders were demineralized as well as deproteinized after deacetylation via NaOH. At last, the chitosan yields from insects were studied for anti-bacterial activity on Gram-positive bacteria (Proteus mirabilis, Klebsiella pneumoniae), and Gram-negative bacteria (Enterococcus faecalis and Staphylococcus epidermidis). The Fourier transform infrared spectroscopy (FTIR) was used to analyze the chitosan composition.

The chitosan ratios of the American and German cockroaches and the mealworm beetle were 5.80, 2.95, and 1.70% per 3 g of the dried bodies respectively. The chitin DD’s for the American cockroach, the German cockroach and the mealworm beetle were 36.8%, 31.5% and 27.3%, respectively. The bactericidal activity of chitosan obtained from the American cockroach at a concentration of 1% had the greatest effect on P. mirabilis compared to other concentrations, while chitosan obtained from the German cockroach at a concentration of 0.01% had the greatest effect on K. pneumoniae compared to other concentrations.

According to the results, the anti-bacterial influence of the chitosan is based upon the insect species and chitosan concentration. Probably, the variation relates to the changes in the chitin structure among the three insect species.

Cutaneous leishmaniasis is a widespread parasitic infectious disease in the tropics and subtropics. This disease is endemic in parts of Qom province in central Iran. The aim of this study was to determine the epidemiological characteristics and endemicity of cutaneous leishmaniasis in Qom province.

In a cross-sectional study, out of 45 villages located in endemic areas of cutaneous leishmaniasis in central and Kahak districts of Qom province, 8 villages were randomly selected. At the end of each seasons, each household was visited and demographic information, infection or history of getting leishmaniasis among people living in these households were recorded in the standard forms.

Out of 4228 people living in 8 endemic leishmaniasis villages in Qom province, 1920 (45.41%) had scars and a history of getting disease. 165 new cases with active lesions were reported. The incidence of the disease in the studied population was 71.49 per 1000 persons. In the present study, 13.33% of patients were under 7 years old and 67.87% were patients over 15 years old. With this description, the study areas were generally classified as hypoendemic areas.

Due to the fact that the condition of the disease in the study areas is hypoendemic. Therefore, personal protection methods against sandfly bites such as the use of mosquito nets, especially mosquito nets impregnated with insecticides, using the nets for doors and windows in residential areas and the use of insect repellent compounds to control the disease in these areas are recommended.

Nowadays, there are many challenges in the treatment of head lice infestation and the efficacy of anti-lice products is a very important factor. The aim of this study was to determine the effectiveness of using vinegar before and after application of permethrin shampoo for the treatment of head lice infestation in the elementary school students in Qom Province.

Our study inclueded 200 female students infested with head lice referring to two comprehensive urban health centers of Qom University of Medical Sciences from September to February 2020. The patients were between 13 and 17 years of age. Using blocked randomization with randomly selected block sizes, the patients were treated with either application of vinegar before or after using 1% permethrin shampoo. Removal of adult human head lice, nymphs, and nits were considered as the outcome of the treatment methods.

The current standard treatment method proposed by the Ministry of Health (use of vinegar after applying permethrin shampoo 1%) resulted in the treatment of the infestation in 45% of cases. But the experimental treatment method (using vinegar before applying permethrin shampoo 1%) led to successful treatment of 79% of the participants and showed a high Odds Ratio (OR = 4.6 CI = 2.5-8.5 p = .000).

This study did not approve the current standard treatment method of the Ministry of Health (use of vinegar after consuming permethrin shampoo 1% for removal of head lice infestation). Therefore, we recommend application of vinegar before using permethrin shampoo 1%.

Due to the confirmation of the presence of the novel coronavirus in the feces and municipal sewerage system, and the feeding of domestic insects from fecal matter, as well as the ability of these insects to mechanically transmit microbes from the sewerage system. This study was aimed at molecular evaluation of the novel coronavirus infection isolated on cockroaches and flies collected from Kamkar-Arabnia Hospital in Qom City, Iran.

Totally, 18 samples; (12 samples cockroaches and 6 flies) from the external surface of cockroaches and houseflies as well as their digestive system were prepared. After designed and synthetized exogenous heterologous internal control, the RNA was extracted to investigate the contamination of these samples with the novel coronavirus. To detect the virus, the E and RdRp genes were identified.

Investigation of coronavirus E gene using the multiplex one-step qPCR technique on the collected samples showed an amplification plot in CT= 35.70 related to the internal surfaces of cockroaches collected from the treatment and sick room of the hospital. Also, the design of internal control to ensure the accuracy of the extraction process was successful.

According to the findings of the present study regarding detecting the presence of the coronavirus infection in the digestive system of domestic insects such as American cockroaches and considering their ability to mechanically transmit viruses, it is recommended to control the domestic insects that are in close contact with humans in crowded places such as hospitals and health centers during the Covid-19 pandemic.

With the spread of the COVID-19 and the endangerment of the health of various groups, the health of women of reproductive age is becoming more and more important. The aim of this study was to determine COVID-19 pandemic prevention needs assessment of women of reproductive age in city of Qom, Iran.

This cross-sectional study was performed on 264 women of reproductive age in Qom in 2021. Data collection was done by electronic questionnaire and its publication in domestic virtual media in a multi-step method. The questionnaire was researcher-made and included demographic, knowledge, attitude and practice questions. Data were analyzed using descriptive statistics (mean, frequency and percentage) and analytical statistics (independent t-test, ANOVA). A significance level of 0.05 was considered.

The mean age of the subjects was 28.28 + 7.2. 218 people had university education (82.6%), 175 people were married (66.3%), 87 people were housewives (33%), 123 people (46.6%) had a history of relatives and family members. There was a direct and significant relationship between knowledge and attitude, knowledge and preventive practice, attitude and preventive practice (P <0.05). Scores of knowledge, attitude and practice had a desirable level. Knowledge with age, attitude with education and performance showed a significant relationship (p <0.05)

Knowledge, attitude and practice of women of reproductive age in Qom are appropriate and acceptable. According to the prevalence of covid-19 disease and the importance of health of women of reproductive age, the results can be used in designing health interventions.

Measles is an infectious childhood disease with some death annually. The expansion of the coverage of vaccination plan has significantly reduced the mortality rate of this disease. Given that the endemic measles virus is not transmitted in the country and based on Regional Verification Commission (RVC) for Measles and Rubella Elimination has declared that measles and rubella have been eliminated in three countries of Eastern Mediterranean Region including Islamic Republic of Iran, Bahrain, and Oman. Therefore, to continue and preventing from reemerging of measles in Iran, it is essential to maintaining the immunization programs, diagnose, and investigate all suspicious cases and outbreaks. This article investigates the challenges facing to measles after elimination declaration in Iran. However, the elimination of these diseases to be sustainable needs a vigorous case identification protocol and contact follow up.

Cockroaches are one of the most common pests in many residential areas. In this study, the simultaneous effects of fungi, Metarhizium anisopliae and fenitrothion-coated baits on the mortality rate of the German cockroach nymphs were investigated.

To determine the lethal level of fenitrothion insecticide, a bioassay test was performed on the last instar nymphs of the German cockroach reared at insectarium conditions. Various toxic concentrations of fenitrothion (0.1%, 0.3%, 0.5%, 0.7%, 0.9%, 1.5%, and 2%) were used. Different concentrations of M. anisopliae (1×104 , 1×105 , 1×106 , 1×107 , 1×108 Conidia/ ml) were also applied to nymphs. Eventually, we combined the effective dose of fenitrothion (0.93%) with the effective concentration of M. anisopliae (6.6 ×106 Conidia/ml) to provide the fungus-coated bait to attract insects. Mortality was recorded 24–96 hours after exposure to the toxic bait. The resulting data were subjected to Probit analysis.

The results of applying M. anisopliae spores with fenitrothion composition showed that the mortality rate of German cockroach nymphs was significant. Therefore, the optimal dose of fenitrothion used in combination with M. anisopliae seems essential to reduce the German cockroach nymphs.

The results of this study can be considered a suitable method as a mixture with low cost and minimal damage to the environment and other organisms.

Plant extracts or compounds derived from plants are a valuable source for finding new anti-leishmaniasis drugs.

In this study, Capparis spinosa L., Ricinus communis, and Solanum luteum were used as lethal agents for the promastigotes of Leishmania major parasites in the culture medium.

Diluted extracts of 12.5, 100, and 500 mg/mL were prepared from medicinal plant dried extracts. Glucantime at a concentration of 500 mg/mL was used as a positive control.

For all three extracts, concentrations of 100 and 500 mg/mL could kill promastigotes at higher rates and speeds compared to other concentrations. The high concentrations of extracts (500 mg/mL) presented similar effects. According to the findings, hydroalcoholic extract of C. spinosa L. presented considerably lower antiparasitic effects, and S. luteum and R. communis extracts were could kill most of the parasitic promastigotes at higher doses. The ANOVA test did not show any significant viability percentage difference of Leishmania extracts between different extract types.

In this study, the lethal effects of R. communis and S. luteum hydroalcoholic extracts on L. major promastigotes were found to be stronger than the C. spinosa L. extract.

The novel coronavirus disease 2019 (COVID-19) has placed heavy direct and indirect economic burden on the people and the health system.

The present study aimed to estimate the economic burden of COVID-19 in Qom Province, using the step-down cost accounting (SDCA) method.

This descriptive, cross-sectional study included all COVID-19 patients in Qom Province from February 19, 2020, to June 19, 2020. The patients’ data were collected in the form of major cost groups with integrated health system (IHS), health information system (HIS), and a financial software called Roozamad. The governmental, out-of-pocket, and opportunity costs paid by patients and hospitals were calculated and evaluated using SDCA in Microsoft Excel software.

The incidence of COVID-19 infection was 518 per 100,000 populations in Qom Province in the aforementioned period. The total government costs for the treatment of the patients were calculated to be 2,229,216,930,370 Rials (8,916,867 $). Among the major governmental cost groups, personnel costs accounted for the highest total expenditures. In addition, out-of-pocket costs of patients and their families equaled 30,038,013,060 Rials (120,152 $). The costs of final service departments accounted for more than half of the total costs. The opportunity costs were calculated as 420 billion Rials (15.68% of total costs).

According to the findings, the direct and indirect costs associated with the treatment of COVID-19 patients can impose a heavy economic burden on the households and health care system. Therefore, disease prevention strategies such as observing health protocols are recommended to reduce the burden of the disease.

Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis. Ranchers, butchers, and slaughterhouse workers run the risk of contracting the disease more than others.

This study was aimed at the evaluation of occupational behaviors and practices of butchers and meat industry workers regarding CCHF based on the health belief model (HBM).

The present descriptive-analytical study was carried out among 207 local butchers working in slaughterhouses who were selected by cluster sampling in Qom City in the first six months of 2019. To collect data, a researcher-made questionnaire based on the HBM constructs was used. The validity and reliability of the questionnaire have been verified. The data were analyzed by SPSS version 21 using regression analysis and Pearson correlation coefficient.

A total of 141 (68.12%) of the participants used personal protective equipment, including appropriate workwear, gloves, mask, goggles, and boots when they had direct contact with raw meat products. There were significant positive relationships between CCHF preventive behaviors and perceived barrier structures (P = 0.003), perceived benefits (P = 0.004), perceived severity (P = 0.002), perceived susceptibility (P = 0.001), and cues to action (P = 0.001). Based on linear regression analysis, perceived susceptibility was able to predict 96% of the variance of CCHF preventive behaviors in Qom’s butchers.

Perceived susceptibility is a predictor of CCHF preventive behaviors; thus, future plans and programs are suggested to be based on the HBM and emphasize increasing perceived susceptibility and other constructs of this model to improve the diseasepreventing behaviors of butchers.

Cutaneous leishmaniasis is a worldwide health problem due to the complications in the transmission cycle, treatment failure, and post-healing problems.

Infected humans are the parasite reservoirs in the transmission cycle of anthroponotic cutaneous leishmaniasis (ACL); thus, the lack of efficient treatment increases the risk of the disease outbreak. The gold standard treatment for CL is mainly the topical or systematic use of antimonial compounds. Much research has been done on the development of topical therapy alone or in combination with cryotherapy. Therefore, this study was conducted to comparatively evaluate the current treatment protocol, cryotherapy, versus combined cryotherapy (Cryo) and intralesional Glucantime® (IG).

This quasi-experimental study was performed on 476 patients with cutaneous leishmaniasis lesions referred to the health centers of a CL endemic area in southern Iran (Bam County, Kerman Province) during 2013 - 2019. A total of 200 cases with 301 lesions received Cryo using liquid nitrogen once every two weeks, and 276 cases with 406 lesions received weekly IG combined with Cryo, once every two weeks. The lesion size was recorded before and after the treatment. At seven and 12 weeks after the treatment, the lesion healing rate was monitored. Healing was defined as complete re-epithelialization. The obtained data were assessed using logistic regression to calculate the relative risk and therapeutic effects.

Out of 476 CL patients with 709 lesions, 200 cases with 221 lesions received Cryo, and 276 patients with 292 lesions received Cryo plus IG. At the seventh week after the treatment, complete healing was observed in 100 out of 221 cases (50%) in the group that received biweekly Cryo only and 225 out of 276 cases (81.5%) in the group that received biweekly Cryo plus weekly IG (P = 0.001).

This study found that the use of cryotherapy plus intralesional Glucantime® increases the chance of healing for patients by 4.4 times compared to the use of cryotherapy alone.

Ticks are considered as the main vectors for the transmission of various pathogens such as relapsing fever and CCHF to humans. This study was investigated the biodiversity indices and medically importance of ticks in North Khorasan Province, Northeast of Iran during 2015–2019.

Specimens were captured from infested ruminants including cows, sheep, and goats. Additionally, tick col lections also were performed on non-domesticated creatures such as turtles, rodents, and hedgehogs. Specimens were identified using valid identification keys. Species diversity, species richness and evenness indices have been calculated to estimate species biodiversity of ticks.

A total of 1478 adult ticks were collected. The specimens were from two families: Ixodidae (90.05%) and Ar gasidae (9.95%), 6 genera and 17 species including: Rhipicephalus sanguineus (55.9%), Rhipicephalus bursa (13.4%), Hyalomma marginatum (9.5%), Hyalomma anatolicum (9.5%), Hyalomma asiaticum (0.2%), Hyalomma aegyptium (0.5%), Hyalomma scupense (1.3%), Hyalomma sp (1.2%), Haemaphysalis sulcata (0.7%), Haemaphysalis erinacea  (0.1%), Haemaphysalis inermis (0.1%), Haemaphysalis punctata  (0.2%), Haemaphysalis concinna (0.1% Boophilus annulatus (1.2), and Dermacentor marginatus (6.1%) among hard ticks as well as  Argas persicus (91.8%) and Argas reflexus (8.2%) amongst soft ticks. Rhipicephalus sanguineus, Rh. Bursa, Hy. marginatum and Hy. anatolicum were known as the most frequent species of hard ticks. Tick’s species richness, Shannon diversity index and Simpson index in this area were S= 17, H’= 1.69, D= 0.294 respectively.

Based on tick distribution veterinary authority, public health organizations and other officials should act for implementation of disease prevention.

Bedsores are caused by decreased tissue perfusion due to prolonged pressure on the skin and represent one of the problems of immobilized patients, including hospitalized ones. This study reports the successful treatment of a patient with bedsore wounds using the larvae of the fly Lucilia sericata. The study focused on a 64-year-old man residing in Qom (a city in central Iran), who was hospitalized for 45 days at Qom Shahid Beheshti Hospital in November 2019 because of cardiovascular disease and chronic obstructive pulmonary disease (COPD). He had a pressure ulcer of about 9.5 cm in diameter on the skin overlying the sacrum. After showing resistance to honey dressing and conventionalantibiotic treatments, maggot therapy was recommended. This procedure was done by releasing the larvae of L. sericata 12 times every three days. The removal of necrotic tissues and the appearance of the granulated tissues were recorded using a ruler as an indicator of healing. After 12 sessions of larval treatment, the wound surface considerably reduced and was finally healed. Thus, it can be argued that maggot debridement therapy (MDT) is an effective treatment for bedsores and can be recommended to physicians as an adjuvant treatment for complex and resistant ulcers.

Context: 

There are three families and 66 species of scorpions in Iran, some of these species are medically relevant, and their sting cause public health problems. Thus, producing of the new geographical distribution of scorpions and the new species is very important. The goal of this study was to produce the distribution maps of Iranian scorpions that are medically important according to the latest information.

Evidence Acquisition: 

This present study included a review of all the articles related to Iranian scorpions published in ISI, PubMed, Scopus, ScienceDirect, and Google Scholar databases during 2008 - 2019, using the relevant MeSH keywords. The data were entered in an Excel file, and spatial distribution maps were prepared.

 From the review of the related published documents, we found that there are 66 scorpion species in Iran, some scorpion names have been changed and new scorpion species have been added to Iranian scorpion fauna and the spatial distribution of some species has become wider.

 Considering the new distribution maps and data on Iranian scorpions, for scorpion envenomation treatment and control programs, these variations should be regarded.

There is an increase in the prevalence of head lice among urban communities with high density in recent years. This study was aimed to determine the efficacy of 1% permethrin shampoo and some traditional physical treatment for head lice infestation in Qom Province, central Iran.

This analytical cross‑sectional study was carried out on all 11,223 cases in six categories that were referred to Qom health care system from 2016 to March of 2017. The infested people were treated with 1% permethrin shampoo, twice at a 1‑week interval and other recommended therapeutic categories, such as the use of physical treatments such as wooden fine‑toothed combs impregnated with a mixture of water and white vinegar on infested hair for 30 min and secondly, carrier oils such as olive oil, bitter almond on infested hair over a therapeutic period. After completing the course of treatment, treatment success was checked by questionnaires.

A total of 11,223 cases with head lice infestation were confirmed and were enrolled for study. Out of six categories, three therapeutic categories were utilized as follows: (a) 1% permethrin shampoo and the use of physical treatments; (b) 1% permethrin shampoo and the use of carrier oils; (c) the above‑mentioned therapeutic categories combined had high treatment success. It was estimated to be 82.00%, 87.31%, and 94.33%, respectively.

According to the findings, in addition to the application of 1% permethrin shampoo, the use of physical treatments and carrier oils such as olive oil, bitter almond can increase the treatment success of head lice infestation.

Hypertension is among the most well-recognized controllable risk factors for cardiovascular diseases. Thus, the current study aimed to determine the prevalence of hypertension and its associated cardiovascular disease-induced mortality in the middle-aged and elderly populations.

This cross-sectional study examined 722836 middle-aged and elderly subjects of Qom Province, Iran (approximately 15% of the total population, aged >30 years) referring to comprehensive healthcare service centers from 2017 to 2019. In this study, due to the adjusted risk ratio, the share of mortality due to cardiovascular diseases attributed to hypertension was estimated indirectly.

The prevalence of hypertension in the study population was reported to be 16.2%, i.e., estimated as 10% among the middle-aged and 42% among the elderly. The obtained data suggested that in patients with hypertension, the process of controlling and monitoring blood pressure in women, compared to men; the elderly, compared to middle-aged; and villagers, compared to urbanites, had a more favorable trend based on relevant protocols (P<0.001). Additionally, 4.9% and 29% of deaths due to cardiovascular diseases in individuals aged >30 and >60 years were attributed to hypertension, respectively.

The present research findings supported the considerable contribution of hypertension to hypertension-related mortality in cardiovascular diseases cases in Qom Province. Hypertension is a controllable risk factor; considering limited health resources, it is recommended that educational interventions be planned by health policymakers in the target populations to reduce mortality due to this disease