Epidemiology of venomous and semi-venomous snakebites (Ophidia: Viperidae, Colubridae) in the Kashan city of the Isfahan province in Central Iran.

BACKGROUND: Information on the epidemiology of venomous snake species responsible for envenomation to humans in Iran has not been well documented. In the Kashan city, venomous snakebite remains a recurring medical problem. Information providing the correct identification of snake species responsible for envenomation in this geographic region would be useful to regional medical clinics and personnel for the effective and optimal management of the patients. MATERIALS AND METHODS: In this cross-sectional study, all patient data was collected from Kashan city and its suburbs. The specific data relating to the taxonomic identification of snakes responsible for envenomation were evaluated. A general approach to the diagnosis and management of patients was also provided. Snakes responsible for bites were transported to a laboratory, where their taxonomic classification was confirmed based on key anatomical features and morphological characteristics. RESULTS: A total of 46 snakes were examined. Of these, 37 (80%) were non-venomous species, and 9 (20%) were identified as venomous. Seven of the nine venomous snake species (78%) were of the family Viperidae, and two specimens (22%) were in the family Colubridae. Specifically, the viperid species were Macrovipera lebetina obtusa, Pseudocerastes persicus, Pseudocerastes fieldi, and Echis carinatus. The two colubrid species were Malpolon monspessulanus insignitus and Psammophis schkari. CONCLUSION: Five different species of venomous snakes responsible for envenomation in the Kashan city region were confirmed. The viper, P. fieldi, was reported for the first time in the central part of Iran.

Pattern of illicit drug use in patients referred to addiction treatment centres in Birjand, Eastern Iran.

OBJECTIVE: To evaluate the pattern of use of opioid and other illegal drugs in patients seeking addiction treatment in Birjand, eastern Iran. METHODS: The prospective study was conducted from March 21, 2009 to March 21,2010, and comprised all patients referred to the seven addiction treatment centres in Birjand. Data was obtained through pre-designed questionnaires and it was analysed using SPSS 16. RESULTS: Of the 700 substance users referred to the 7 centres and who volunteered to participate, 632 (90.3%) were males and 68 (9.7%) were females. The male/female ratio was approximatly 9.3/1. Mean age was 34+/-10.2 (range: 10-75) years. The type of drugs used included traditional drugs (n= 342; 48.9%) and newer modern drugs (n=314; 44.9 %). The mean age of the first experience with drugs was 21.91+/-7.1 (range=0-60) years. There was significant different between the type of drugs used and the place of residence (p<0.019), age (p<0.0001), martial status (p<0.0001), occupation (p<0.006) and education (p<0.017). CONCLUSION: The prevalence of illicit drug addiction was quite high. There seemed to have been a change in the pattern of drug use and in the type of illegal drugs used in the study area, from traditional drugs to new and modern drugs. As such, identifying risk factors related to addiction and the prevention of addiction should be one of the most important health priorities for the authorities.

A systematic review on status of lead pollution and toxicity in Iran; Guidance for preventive measures.

Lead is an old environmental metal which is presented everywhere and lead poisoning is an important health issue in many countries in the world including Iran. It is known as a silent environmental disease which can have life-long adverse health effects. In children, the most vulnerable population, mental development of children health effects is of the greatest influence. Low level lead exposure can significantly induce motor dysfunctions and cognitive impairment in children. The sources of lead exposure vary among countries. Occupational lead exposure is an important health issue in Iran and mine workers, employees of paint factories, workers of copying centers, drivers, and tile making factories are in higher risk of lead toxicity. Moreover lead processing industry has always been a major of concern which affects surface water, drinking waters, and ground waters, even water of Caspian Sea, Persian Gulf and rivers due to increasing the number of industries in vicinity of rivers that release their waste discharges into river or sea. In addition, lead contamination of soil and air especially in vicinity of polluted and industrialized cities is another health problem in Iran. Even foods such as rice and fishes, raw milk, and vegetables which are the most common food of Iranian population are polluted to lead in some area of Iran. Adding lead to the opium is a recently health hazard in Iran that has been observed among opium addicts. There are few studies evaluated current status of lead exposure and toxicity in the Iranian children and pregnant women which should be taken into account of authorities. We recommend to identify sources, eliminate or control sources, and monitor environmental exposures and hazards to prevent lead poisoning.

Occupational exposure to pesticides and consequences on male semen and fertility: a review.

Exposure to pesticides affects many body organs including reproductive system. Disorder of the reproductive system leads to infertility and therefore has been in the center of attention within the recent decades. Pesticides are one of the compounds that might reduce the semen quality in the exposed workers according to current knowledge. Although many underlying mechanisms have been proposed, the mechanisms of action are not clarified yet. The object of the present review was to criticize all the results of studies which evaluated the pesticide effects on male reproductive system. Results indicate that semen changes are multifactorial in the workers exposed to pesticides as there are numerous factors affecting sperm quality in occupational exposures. Majority of pesticides including organophosphoruses affect the male reproductive system by mechanisms such as reduction of sperm density and motility, inhibition of spermatogenesis, reduction of testis weights, reduction of sperm counts, motility, viability and density, and inducing sperm DNA damage, and increasing abnormal sperm morphology. Reduced weight of testes, epididymis, seminal vesicle, and ventral prostate, seminiferous tubule degeneration, change in plasma levels of testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), decreased level and activity of the antioxidant enzymes in testes, and inhibited testicular steroidogenesis are other possible mechanisms. Moreover, DDT and its metabolites have estrogenic effects on males. Although effect of pesticides on sperm quality is undeniable, well-designed long-term studies are needed to elucidate all the possible affecting variables such as socioeconomic, cultural, nutritional, occupational, physical, and clinical characteristics alongside pesticides.

Survey of factors related to criminal behavior in a sample of Iranian substance abusers.

OBJECTIVES: Many countries including Iran have a high rate of substance abuse. It is essential for public health and law enforcement strategies to know the causes and consequences of substance abuse and its relation to crimes. METHODS: In a prospective case-control study, covering a period of one year starting from March 21, 2010, 125 cases with criminal behavior and 125 cases with no history of criminal behavior were studied. RESULTS: Eight percent of our studied population had a previous history of psychological disorder. Most of our cases were cigarette users (78.4%). Forty-two cases had a history of alcohol abuse (16.8%). Modern drugs were the most common type of drugs (56%) being used. Multivariate analysis using logistic regression revealed that criminal behavior was correlated with divorce (RR = 5.35; 95% CI = 1.59-16.01; P = 0.023), history of alcohol use (RR = 2.63; 95% CI = 1.11-6.22; P = 0.027), history of psychological disorder (RR = 4.97; 95% CI = 1.44-17.20; P = 0.011), Modern drug use (RR = 4.86; 95% CI = 2.01-11.76; P = 0.001) and starting drug abuse at an early age (RR = 0.94; 95% CI = 0.88-0.99; P = 0.03). CONCLUSIONS: Risk factors for criminal behavior among substance abusers include being divorced, history of alcohol abuse, history of psychological disorder, modern drug abuse and starting drug abuse at an early age.