Land filling is the most common disposal method in most parts of the world and landfill site has always been the final destination in solid waste management hierarchy. Thus, the selection of landfill site is always an essential part in the management of solid waste. Selecting an appropriate site for landfill minimizes any unwarranted ecological and socio-economic effects. Hence, landfill site selection requires a detailed analysis of the area that must be able to meet the local authority requirement and criteria. The present study presents a feasibility assessment of landfill establishment for Khomeynishahr city in Isfahan, applying a multi criteria evaluation (MCE) method using GIS technique. Information layers related to topography, soil, water table, sensitive habitats, land use and geology maps were prepared and superposed using Boolean logic in GIS environment. Essential analysis and regulation, criteria and site selection assessment showed that because of many limitations khomeynishahr city doesn’t have adequate conditions for landfill site establishment. Khomeynishahr city has a dense population and limited area and is not suitable for landfill establishment. In this case consideration of adjacent cities and finding a common landfill site between two or more cities could be a viable solution of solving this problem.
Landfill ; solid waste ; GIS ; MCE ; Boolean Logic

Post-vaccination side effects of AstraZeneca (AZ) coronavirus disease 2019 (COVID-19) vaccine are common. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection immediately after the first dose of AZ COVID-19 vaccine has not been reported. In this case, a 30-year-old female without a past medical history of SARS-CoV2 infection presented to an outpatient clinic with lightheadedness and weakness 2 hours after getting the first dose of the AZ COVID-19 vaccine. Blood pressure (BP) was 80/60 mm Hg, and oxygen saturation (SpO2) was 98%. After administering normal saline intravenous fluid, the BP was 110/80 mm Hg. On the first day, fever (oral temperature of 39℃), sweating, dry cough, sore throat, and injection-site pain were presented. On the second day, diarrhea, productive cough, and hypotension occurred in addition to fever (oral temperature of 39.9℃). The fever did not stop and productive cough, change in smell, and fatigue were reported. SpO2 was 96%. On the third day, no abnormality of the spiral lung computed tomography and the positive reverse transcriptase-polymerase chain reaction (RT-PCR) test were reported. Simultaneously, two out of three members of the family became symptomatic on the second day and their RT-PCR tests were positive. Dexamethasone ampule, Cefixime tablet, Acetaminophen tablet, and Diphenhydramine syrup were prescribed. After a week, fever subsided and SpO2 was 98%. After 3 weeks of self-quarantine at home, her general condition improved. Despite the similarity between SARS-CoV2 infection signs and symptoms and AZ COVID-19 vaccine side effects, none of the approved vaccines contain the live virus that causes disease. Therefore, any unusual post-vaccination signs and symptoms should not be attributed to the vaccine itself and need to be considered for further evaluations and early actions in order to prevent the spread of the disease in society.

OBJECTIVES: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. METHODS: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. RESULTS: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. CONCLUSIONS: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.
Child* ; Growth Disorders ; Health Surveys* ; Humans ; Iran* ; Malnutrition* ; Proxy ; Social Class ; Socioeconomic Factors* ; Thinness

Background: Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory. Methods: In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015–2016. Two questionnaires were used to collect the family caregivers’ characteristics, care burden, and self-efficacy, and patients’ negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention. Results: There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05). Conclusion Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced.

Objective: To determine the prevalence and antimicrobial resistance of Clostridium difficile (C. difficile) isolated from ready-to-eat foods of Iran. Methods: From January to August 2013, a total of 368 unpacked ready-to-eat food samples were purchased from randomly selected supermarkets, retail stores and restaurants located in Isfahan and Shahrekord, Iran and were evaluated for the presence of C. difficile. Results: C. difficile spores were detected in 5 (1.36%) of the 368 samples. The highest prevalence of C. difficile was found in fasl salad (4.29%), followed by yogurt stew (2%), and olovyeh salad (0.93%). All 140 maccaroni salad and falafel sandwich samples were negative for C. difficile. One of the five C. difficile isolates (20%) contained tcdA, tcdB and cdtB toxin genes and four strains (80%) contained tcdA, and tcdB toxin genes. Also, among the five C. difficile isolates, only three strains were found to be toxigenic for toxin A and/or B by ELISA. Isolates were susceptible to vancomycin and metronidazole, but variably resistant to other antimicrobial drugs. Conclusions: This study, combined with studies on other food sources, suggests that widespread contamination of food is common.

A 30-day study was conducted on the effects of diets supplementation with 0, 1.0%, 3.0%, and 5.0% Sonneratia alba leaf extracts on healthy goldfish, Carassius auratus against Aphanomyces invadans. Results showed that the numbers of white blood cell significantly increased in the infected fish fed with 3.0% and 5.0% supplementation diets after the second week of experiments. Whilst the numbers of red blood cell significantly decreased in the infected fish fed with 0 and 1.0% supplementation diets. After the third week of feeding trials, the total protein, albumin level and lysozyme activity were significantly increased in the infected fish fed with 3.0% and 5.0% supplementation diets. However, the myeloperoxidase activity significantly increased after two weeks in the infected fish were fed with 3.0% and 5.0% supplementation diets. The cumulative mortality rate of goldfish decreased up to 17% when the infected fish were fed with 3.0% supplementation diets. This study indicates that enriched fish feed with 3.0% and 5.0% S. alba leaf extracts enhanced the non-specific immunity and survival rate of the goldfish, suggesting that the extract may serve as a potential prophylactic treatment against A. invadans.

Objective: To investigate the antimicrobial resistance patterns and prevalence of integrons in Shigella species isolated from children with diarrhea in southwest Iran. Methods: In this study, 1 530 stool samples were collected from children under 15 years with diarrhea referred to teaching hospitals in Ahvaz and Abadan, southwest Iran. Shigella spp. were identified by standard biochemical tests and PCR. The antibiotic resistance pattern of all Shigella isolates was determined by the disk diffusion method and minimum inhibitory concentration (MIC) by E-test. Results: Of 1 530 stool samples, 91 (5.9%, 91/1 530) were positive for Shigella spp. the most common Shigella isolates were Shigella flexneri 47 (51.6%, 47/1 530). Antibiotic susceptibility tests showed that the highest antibiotic resistance was related to trimethoprim-sulfamethoxazole (87.9%, 80/91) and ampicillin (86.8%, 79/91). Multiplex PCR results revealed that 56% and 86.9% of Shigella isolates carried integron class I and integron class II genes, respectively. None of the isolates included the integron class III gene. Conclusions: The high prevalence of multi-drug resistance in Shigella isolates in our area increases the concerns about dissemination of the antibiotic-resistant isolates in this bacterium.