Objective:To determine the bionomics and susceptibility status of the malarial vector Anopheles superpictus (An. superpictus) to different insecticides in the Sistan-Baluchestan province which has the highest malarial prevalence in Iran.
Methods:Different sampling methods, in addition to scoring abdominal conditions, were used to define the seasonal activity and endo/exophilic behavior of this species. In addition, the standard WHO susceptibility tests were applied on adult field strains.
Results: Most adult mosquitoes were collected from outdoor shelters. The peak of seasonal activity of An. superpictus occurred at the end of autumn. Most larvae were collected from natural and permanent breeding places with full sunlight and no vegetation. Blood feeding activities occurred around midnight. Compared with the abdominal conditions of adult mosquitoes collected indoors, the abdominal conditions of adult mosquitoes collected outdoors were gravid and semigravid. This species was suspected to be resistant to DDT, but was susceptible to other insecticides.
Conclusions:An. superpictus was present in almost all outdoor shelters, and the ratios of gravid, semigravid/unfed, and freshly fed confirmed that this species had a higher tendency to rest outdoors than indoors. This behavior can protect An. superpictus from indoor residual spraying in this malarious area. To the best of our knowledge, this is the first report on the susceptibility status of An. superpictus in Southeastern Iran. We do not suggest the use of DDT for indoor residual spraying in southeast Iran.

OBJECTIVES: The aim of this study was to measure the health-related quality of life (HRQoL) and to evaluate the factors affecting HRQoL in individuals with health insurance in Tehran, Iran. METHODS: A cross-sectional analytical study was conducted using the 3-level EuroQol 5-dimensions (EQ-5D) questionnaire. In order to estimate the determinants of HRQoL, information about participants’ demographic, socioeconomic, and health status was gathered. The cluster sampling technique was used to collect data from May to June, 2016. The chi-square test and weighted least squares method were employed for data analysis. Data were analyzed using Stata version 11.0. RESULTS: A total of 600 Iranians with insurance completed the study, of whom 327 (54.5%) were male and 273 (45.5%) were female. The mean age of the participants was 41.48 years (standard deviation [SD], 14.60 years). Meanwhile, the mean duration of education was 12.36 years (SD, 4.68 years). The mean EQ-5D score was 0.74 (SD, 0.16). The most common health problems in the participants were anxiety/depression (42.3%), followed by pain/discomfort (39.2%). Sex, age, years of schooling, income, chronic disease, and body mass index had a significant effect on HRQoL (p<0.05). Healthy insured individuals, on average, had a HRQoL score 0.119 higher than that of people with a chronic disease, all else being equal (p<0.001). CONCLUSIONS: Among all determinants of HRQoL, chronic disease was found to be the highest priority for interventions to improve the health status of Iranians with insurance. This finding can help policymakers and health insurance organizations improve their planning to promote the HRQoL of individuals with insurance and society as a whole in Iran.
Body Mass Index ; Chronic Disease ; Education ; Female ; Humans ; Insurance ; Insurance, Health* ; Iran* ; Least-Squares Analysis ; Male ; Methods ; Quality of Life* ; Statistics as Topic

PURPOSE: We aimed to investigate the utility of sympathetic skin response (SSR) test for evaluating vasculogenic erectile dysfunction (ED) which is the most common type of impotence. MATERIALS AND METHODS: Men in the age group of 28 to 60 years and suffering from vasculogenic ED, as confirmed by a papaverin test and color Doppler sonography, at least for 6 months referred from our university urology department were included. We used the International Index of Erectile Function (IIEF-5) for grading severity of dysfunction and recorded the SSR of every patient from the median, tibial, and dorsal nerves of the penis. One-way analysis of variance (ANOVA), independent t-test and Pearson's correlation coefficient were used for comparing quantitative variables, and Fisher's Exact test was used for comparing qualitative variables. The Mann-Whitney U Test and the Kruskal-Wallis test were performed for analysis of data that were not normally distributed. A p value of less than 0.05 was considered significant. RESULTS: Forty-two patients were recruited for the study. We found a strong statistical relationship between the IIEF score and the pathologic SSR registered from every mentioned nerve. Patients with abnormal SSR had more severe ED according to IIEF score (p<0.001). In addition, the IIEF score had a significantcorrelation with diabetes mellitus and cardiovascular disease (t-test; p<0.05). CONCLUSIONS: Our results confirmed the presence of autonomic dysfunction in patients with vasculogenic impotence via an SSR test. We suggest evaluating the efficacy of the SSR test in patients with vascular impotence for treatment response monitoring in future studies.
Autonomic Nervous System ; Cardiovascular Diseases ; Diabetes Mellitus ; Electrodiagnosis ; Erectile Dysfunction* ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Penis ; Skin* ; Urology

Feature outcome of hippocampus and extra-hippocampal cortices was evaluated in melatonin treated lithium-pilocarpine epileptic rats during early and chronic phases of temporal lobe epilepsy (TLE). After status epilepticus (SE) induction, 5 and 20 mg/kg melatonin were administered for 14 days or 60 days. All animals were killed 60 days post SE induction and the histological features of the rosrto-caudal axis of the dorsal hippocampus, piriform and entorhinal cortices were evaluated utilizing Nissl, Timm, and synapsin I immunoflorescent staining. Melatonin (20 mg/kg) effect on CA1 and CA3 neurons showed a region-specific pattern along the rostro-caudal axis of the dorsal hippocampus. The number of counted granular cells by melatonin (20 mg/kg) treatment increased along the rostro-caudal axis of the dorsal hippocampus in comparison to the untreated epileptic group. The density of Timm granules in the inner molecular layer of the dentate gyrus decreased significantly in all melatonin treated groups in comparison to the untreated epileptic animals. The increased density of synapsin I immunoreactivity in the outer molecular layer of the dentate gyrus of untreated epileptic rats showed a profound decrease following melatonin treatment. There was no neuronal protection in the piriform and entorhinal cortices whatever the melatonin treatment. Long-term melatonin administration as a co-adjuvant probably could reduce the post-lesion histological consequences of TLE in a region-specific pattern along the rostro-caudal axis of the dorsal hippocampus.
Animals ; Axis, Cervical Vertebra* ; Axons* ; Dentate Gyrus ; Entorhinal Cortex ; Epilepsy, Temporal Lobe* ; Hippocampus* ; Melatonin* ; Neurons* ; Rats ; Status Epilepticus ; Synapsins ; Temporal Lobe*

OBJECTIVES: This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran.METHODS: Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants.RESULTS: The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems (‘some’ and ‘severe’ problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index.CONCLUSIONS: Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.
Adult ; Chronic Disease ; Cross-Sectional Studies ; Education ; Family Characteristics ; Humans ; Iran ; Life Style ; Linear Models ; Male ; Medically Uninsured ; Motor Activity ; Quality of Life ; Self Care ; Smoke ; Smoking ; Social Class ; Visual Analog Scale

OBJECTIVES: This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran. METHODS: Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants. RESULTS: The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems (‘some’ and ‘severe’ problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index. CONCLUSIONS: Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.
Adult* ; Chronic Disease ; Cross-Sectional Studies* ; Education ; Family Characteristics ; Humans ; Iran ; Life Style ; Linear Models ; Male ; Medically Uninsured ; Motor Activity ; Quality of Life* ; Self Care ; Smoke ; Smoking ; Social Class ; Visual Analog Scale

Objectives: This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran. Methods: We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study. Results: A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93–51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63–216.66) and 168.57 (95% CI, 126.41–210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic. Conclusion Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021.

PURPOSE: Epidemiologic evaluation and investigating the causes of visual impairment in any society is a matter of concern and has a direct effect on the country's health care planning. In this study we describe causes of low vision and blindness in Iranian patients referred to rehabilitation clinics for taking vision aids. METHODS: In this cross-sectional study, visual acuity was classified based on best-corrected visual acuity in the better eye according to the World Health Organization definition (blindness, visual acuity [VA] < 20 / 400; severe visual impairment, VA < 20 / 200-20 / 400; mild to moderate visual impairment, VA < 20 / 60-20 / 200). The causes of blindness and low vision were determined using the 10th version of International Classification of Diseases based on the main cause in both eyes. To describe data, we used mean +/- SD and frequency. RESULTS: The study included 432 patients, 65% male, with a mean age of 43.6 +/- 25.5 years (range, 3 to 92 years). Mild to moderate visual impairment, severe visual impairment and blindness were present in 122 (28.8%), 196 (46.4%) and 105 (24.8%) of the patients, respectively. The main causes of visual impairment were retinal and choroidal diseases (74.5%), optic nerve and optic tract diseases (9.8%), vitreous and globe disorders (5.3%), congenital cataract (3.1%), and glaucoma (2.6%). The distribution pattern of the causes was similar in all age subgroups. CONCLUSIONS: Diseases of the retina and choroid are the main cause of visual impairment among patients referred to an academic visual rehabilitation clinic in Iran.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Audiovisual Aids ; Blindness/*epidemiology/rehabilitation ; Child ; Child, Preschool ; Choroid Diseases/*epidemiology/rehabilitation ; Female ; Humans ; Iran/epidemiology ; Male ; Middle Aged ; Optic Nerve Diseases/epidemiology/rehabilitation ; Referral and Consultation/*statistics & numerical data ; Rehabilitation Centers/*statistics & numerical data ; Retinal Diseases/*epidemiology/rehabilitation ; Vision, Low/*epidemiology/rehabilitation ; Young Adult

The mainstay therapy against leishmaniasis is still pentavalent antimonial drugs; however, the rate of antimony resistance is increasing in endemic regions such as Iran. Understanding the molecular basis of resistance to antimonials could be helpful to improve treatment strategies. This study aimed to recognize genes involved in antimony resistance of Leishmania tropica field isolates. Sensitive and resistant L. tropica parasites were isolated from anthroponotic cutaneous leishmaniasis patients and drug susceptibility of parasites to meglumine antimoniate (Glucantime(R)) was confirmed using in vitro assay. Then, complementary DNA-amplified fragment length polymorphism (cDNA-AFLP) and real-time reverse transcriptase-PCR (RT-PCR) approaches were utilized on mRNAs from resistant and sensitive L. tropica isolates. We identified 2 known genes, ubiquitin implicated in protein degradation and amino acid permease (AAP3) involved in arginine uptake. Also, we identified 1 gene encoding hypothetical protein. Real-time RT-PCR revealed a significant upregulation of ubiquitin (2.54-fold), and AAP3 (2.86-fold) (P<0.05) in a resistant isolate compared to a sensitive one. Our results suggest that overexpression of ubiquitin and AAP3 could potentially implicated in natural antimony resistance.
Amino Acid Transport Systems/*genetics/metabolism ; Antimony/*pharmacology ; Antipruritics/*pharmacology ; *Drug Resistance ; Humans ; Leishmania tropica/drug effects/enzymology/*genetics/isolation & purification ; Leishmaniasis, Cutaneous/*parasitology ; Protozoan Proteins/*genetics/metabolism ; Ubiquitin/*genetics/metabolism

Background & Objective: This study aimed to find a biomarker to predict the development of multiple sclerosis (MS). Serum levels of vitamin D3, C-reactive protein (CRP) and melatonin and their ratio were evaluated to find the valuable cut-off point. Methods: Serum levels of vitamin D3, CRP and melatonin were evaluated using commercial ELISA kit in newly diagnosed MS patients and compared with healthy controls. Results: Serum CRP level significantly increased and serum melatonin level significantly decreased in MS patients in comparison to controls. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the cut-off point of CRP/melatonin ratio ≥ 78.29087 were 80%. Conclusion: CRP/melatonin ratio ≥ 78.29087 may be used for prediction of MS in an at risk population