Cutaneous leishmaniasis in Iran: A review of epidemiological aspects, with emphasis on molecular findings

Leishmania parasites can cause zoonotic cutaneous leishmaniasis (CL) by circulating between humans, rodents, and sandflies in Iran. In this study, published data were collected from scientific sources such as Web of Science, Scopus, PubMed, Springer, ResearchGate, Wiley Online, Ovid, Ebsco, Cochrane Library, Google scholar, and SID. Keywords searched in the articles, theses, and abstracts from 1983 to 2021 were cutaneous leishmaniasis, epidemiology, reservoir, vector, climatic factors, identification, and Iran. This review revealed that CL was prevalent in the west of Iran, while the center and south of Iran were also involved in recent years. The lack of facilities in suburban regions was an aggravating factor in the human community. Some parts of southern Iran were prominent foci of CL due the presence of potential rodent hosts in these regions. Rhombomys opimus, Meriones lybicus, and Tatera indica were well-documented species for hosting the Leishmania species in Iran. Moreover, R. opimus has been found with a coinfection of Leishmania major and L. turanica from the northeast and center of Iran. Mashhad, Kerman, Yazd, and sometimes Shiraz and Tehran foci were distinct areas for L. tropica. Molecular identifications using genomic diagnosis of kDNA and ITS1 fragments of the parasite indicated that there is heterogeneity in leishmaniasis in different parts of the country. Although cutaneous leishmaniasis has been a predicament for the health system, it is relatively under control in Iran

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic:Challenges and lessons learned

Purpose: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients. Methods: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into 3 groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage. Results: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% – 100%, 22% – 100% and 29% – 100% for groups 1 – 3. Conclusions: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.</p

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic:Challenges and lessons learned

PURPOSE: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.METHODS: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into three groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage.RESULTS: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% to 100%, 22%-100% and 29%-100% for groups 1 - 3.CONCLUSIONS: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.</p

The association between the outcomes of trauma, education and some socio-economic indicators

Background: There are many debates on socioeconomic indicators influencing trauma outcomes.Objectives: This study aimed to determine the association between education as a socioeconomic indicator and trauma outcomes.Methods: This descriptive-analytical study was conducted on 30,448 trauma patients during 2016-2021. The data were based on the minimum dataset of the National Trauma Registry of Iran (NTRI) from six different trauma centers in various cities of the country. The variables used in this study included age, education level, marital status, cause of injury, Glasgow Coma Scale (GCS), intensive care unit (ICU) admission, Injury Severity Score (ISS), and in-hospital mortality. Logistic regression was used to investigate the association between independent variables and trauma outcomes.Results: The study included 30,448 trauma patients with male predominance (75.8%). The mean age was 36.9 years. The most frequent education level was secondary education, with 14,228 (46.6%). Education levels had significant relationships with ISS, death, and ICU admission (P<0.001). Moreover, after applying the multiple logistic regression, the odds of deaths for trauma patients with no formal, primary, and secondary education levels were 3.36, 5.03, and 3.65 times, respectively, more than the odds of deaths at the higher education level after controlling for other factors (all Ps<0.05). However, there were no such relationships between education levels and the odds of ICU admission.Conclusion: Findings of the present study showed a significant association between the education levels and trauma outcomes. Adjusted for other covariates, the chance of death for trauma patients with no formal, primary, or secondary education levels was higher than that at the higher education level

Epidemiologic study on accidents among children under five years old during 2006 to 2016-Qazvin

Background: Children, due to their insufficient risk detection, are more vulnerable to accidents than adults. Objective: The present study has been done to explore the prevalence of accidents and related factors among children under five years old from 2006 to 2016 in Qazvin. Methods: This descriptive-analytic study concluded all 18184 children who had exposure to accidents during study time section from 2006 to 2016. All recorded data in Health Information System (HIS) of Qazvin Health Management Office were probed to explore the target figures, and then were entered in a qualified checklist. All data were analyzed by descriptive statistical methods and Multinomial Logistic Regression. Findings: The prevalence rate of accidents in the target children was eight percent, which more than half (62.9 %) were taken place in boys. Accidents in children before one year old (31.4 %), and home accidents (46.5%) were the most prevalent one. In addition to these, the rates of Trauma, Fallings, and Traffic accidents were 31.8%, 15.6%, 14.9%, respectively. The most prevalent time of accident was summer (29.7%), especially in July (12.1%). Conclusion: The risk of accidents in the young children, and boys are more than others. Unsafe home environment, motor vehicles accidents, and doing unsafe behaviors are the main causes for increasing the risk. Yet, application of some programs such as; mothers’ education, administration of traffic rules may decrease the risk of accidents in the children

Complications in pregnant women and newborns before and during the COVID-19 pandemic

Background: One of the high-risk groups exposed to the coronavirus disease 2019 (COVID-19) pandemic was pregnant women at risk of pregnancy complications due to a weakened immune system and inability to use various drugs to treat COVID-19. Accordingly, this study was conducted to investigate the complications in pregnancy before and during the COVID-19 pandemic. Material and Methods: This cross-sectional study was performed on all pregnant women in Shahroud, Iran. The time interval from February 18, 2019, to February 17, 2020, was considered before the COVID-19 pandemic and from February 18, 2020, to February 17, 2021, was considered the COVID-19 pandemic. Sampling was conducted by census and included 6851 pregnant women. The required information was extracted from hospitals' health deputy registration system and high-risk pregnancy registration program. Result: Based on the findings, hypertension disorder, gestational diabetes, placental abruption, pre-eclampsia, cesarean section, hospitalization in neonatal intensive care unit (NICU), preterm birth, and hospitalization in other hospital wards increased by 1.88%, 1.93%, 0.12%, 0.45%, 5.45%, 1.00%, 1.20%, and 1.40%, respectively, in 2020 compared to 2019. A statistically significant difference was also observed between them (p < 0.05). Also, the regression results showed that the chances of high blood pressure, Gestational Diabetes Mellitus (GDM), placental abruption, and cesarean section were increased by 10.91, 1.53, 5.51, and 2.83 times, respectively. Conclusions: Pregnancy complications have increased during the COVID-19 pandemic. As a result, there is a need to take appropriate health and medical measures to reduce the risks associated with the COVID-19 epidemic for pregnant women and neonates

The Incidence and Related Risk Factors for Accidents Among Women Living in Qazvin City, Iran From 2006 to 2015

Background Accident-induced disability and death in women causes undesirable effects and imposes significant costs on individuals, families, and society; this is because of the critical role of women in family and community. Objective This study aimed to investigate the accidents in women living in Qazvin Province, Iran, and its related risk factors from 2006 to 2015. Methods This descriptive study was conducted on 61954 women referring to hospitals due to accidents in Qazvin Province. The obtained data were analyzed using frequency distribution, Chi-squared test, logistic regression, and multivariate analysis. Findings The prevalence rate of accidents among women was 14.1%. Most of the accidents occurred in the age of 19-28 years, in the spring, and in the neighborhoods of the injured women. Trauma (25.3%), and traffic accidents (20.1%) were the leading causes of accidents in the studied women. Conclusion Injuries, and accidents among women living in Qazvin Province had a high incidence; mostly women in the younger age groups were affected. Therefore, considering the importance of protecting the health of female population in promoting health and maintaining public safety, planning for the prevention of accidents and incidents in this population is crucial

A case of Co-infection COVID-19 and influenza with psychotic symptoms

Coronavirus disease 2019 (COVID-19), is a pandemic disease that has appeared in recent years with different symptoms and manifestations. This disease has Co-infection with other infections and has aggravated the symptoms in patients. This study was conducted with the aim of reporting a case of Co-infection COVID-19 and influenza with psychotic symptoms. In this study, the manifestations of a case of co-infection with COVID-19 and influenza with psychotic symptoms were discussed in Shahroud city in Iran in 2022. Based on this, the patient's laboratory, pathological and therapeutic findings were investigated. The patient, a 16-year-old boy, had symptoms of fever, chills, cough, body pain, and headache with seizures and delirium. Reverse transcription–polymerase chain reaction tests for covid-19 and influenza were positive, but no abnormalities were observed in laboratory variables and graphs. The patient was treated for psychotic disorders for 40 days and then recovered

Incidence of glucose-6-phosphate dehydrogenase deficiency in malaria-prone regions of Fars province

Background: The deficiency of enzyme glucose-6-phosphate dehydrogenase (G6PD) is among the most common genetic diseases in human. The deficiency of G6PD enzyme is one of the most common encountered enzymes, affecting about 400 million people and causing a wide range of undesirable clinical complications worldwide. The performed studies have reported a variety of statements about the relationship between malaria and survival of people with defect, but these kinds of studies are limited in Iran. This study aimed to estimate the incidence of G6PD deficiency among newborns in malarious areas of Fars province. Methods: The present study was conducted ecologically and descriptively-analytically on 59745 neonates with G6PD deficiency in Fars province, Iran from April 2011 to March 2015. To determine the defect, a point fluorescence test and Kimia commercial kit (KimiaPajoohan Co., Tehran, Iran) were used. To determine the areas with malaria, factors associated with malaria-causing cells in Fars province, including the presence of carriers, the presence of malaria, the incidence of new malaria and the presence of malaria activated sites were studied. The incidence of defect was calculated using the statistical method of estimating the annual incidence rate. ArcGIS software, version 10.3 (ESRI, Redlands, CA, USA) was used to provide geographic mappings and distribution patterns in malarious areas. Results: The total incidence of G6PD deficiency in newborns was estimated as 15.58 per 100 live births, including 16.25 for boys and 14.85 for girls. The incidence of this defect in malaria-prone areas was higher than other areas. As a region was more malaria-prone, the incidence of G6PD deficiency increased too, which was statistically significant (P= 0.039). Conclusion: Based on the findings of this study, Fars province is among areas with high incidence of G6PD deficiency. The incidence of G6PD deficiency in malaria-prone areas of Fars province, Iran, is higher than other regions, which indicates better survival of patients against malaria in the past. &nbsp