Larval therapy vs conventional silver dressings for full-thickness burns: a randomized controlled trial.

BACKGROUND: This is the first clinical trial to investigate the effectiveness of maggot debridement therapy (MDT) for full-thickness burn injuries in comparison to conventional silver dressings. METHODS: Thirty-one cases with full-thickness (grade III based on ICD-10 classifications version 2019) burns were assigned into larval therapy (15 cases) and conventional treatment (16 cases) groups. Participants in the MDT group have received loose larvae on days 0, 2, 4, and 6, while controls received a conventional regimen comprised of sharp debridement, silver sulfadiazine, antibiotic therapy, and offloading every day. The primary and secondary outcomes were defined as the time to debridement (from admission to skin autograft) and time to healing (from admission to complete healing post-skin autograft). Patients in two groups were also compared in terms of necrosis resolution, granulation, and granulation/necrosis (g/n) ratio during study time periods. RESULTS: Participants who received larvae had significantly decreased necrosis on days 2 (p = 0.028) and 4 (p = 0.023) compared to those who received control treatment. Significant differences (p < 0.001) were also observed for granulation between the two groups in favor of MDT and the fold changes of g/n in the larvae group were 5, 15, and 13 times higher than that for the conventional regimen on days 2, 4, and 6 of treatment, respectively. Strikingly, a subgroup analysis of high necrotic burns (necrosis > 50%) revealed a significant improvement (p < 0.001) for MDT compared to the control treatment. There were also significant differences (p < 0.001) for the time to debridement and time to healing between the two groups. However, bacterial contamination did not show significant changes between the two treatment regimens. CONCLUSIONS: Our findings revealed that MDT has a favorable superiority over conventional regimen for the treatment of grade-III burns, and thus further clinical trials with larger sample size are warranted to confirm these results.

Mapping current and future risk of scorpion sting from a species with low medical concern, Mesobuthus phillipsii (Scorpiones: Buthidae) in Iran.

Scorpion stings are one of the most important health challenges and high priority research topic in public health. In this study, we aimed to model habitat suitability of the Mesobuthus phillipsii (Pocock 1889), a species with low medical concern, under current and future climatic conditions in Iran. We also identified vulnerable populations to scorpion stings in the country. Scorpion sting risk modeling was done using an ensemble approach by considering two species distribution modeling methods: MaxEnt and Random Forest methods. Distribution modeling was performed using the sdm R package. The results showed that due to climate change in 2070, the high-risk areas will increase from 20,839 to 79,212 km2. Habitats with a moderate risk of scorpion stings will also increase from 139,347 to 222,833 km2. Consequently, the number of villages in high-risk areas of scorpion stings will increase from 2,870 to 7,017, while this number will increase from 12,759 to 20,104 in the case of medium-risk villages. The results of this study can be used for scorpion stings management in Iran. This study can be used as an example for similar studies on scorpions with high medical emergency.

The therapeutic effect of larval saliva and hemolymph of Lucilia sericata on the treatment of Leishmania major lesion in BALB/c mice946.

BACKGROUND: Treatment of cutaneous leishmaniasis (CL) remains a major challenge for the public health and medical community. It has been claimed that natural compounds derived from fly larvae have anti-leishmania properties against some species of Leishmania. The present study aimed at assessing the in vitro effects of larval products of Lucilia sericata against the promastigote and intracellular amastigote forms of Leishmania major. Also, the therapeutic effect of larval products on lesions induced by L. major infection was evaluated in BALB/c mice models. METHODS: Parasite specimens and macrophage cells were exposed to varying concentrations of larval products for 24-120 h. Lesion progression and parasite load were investigated in the models to assess the therapeutic effects of the products. RESULTS: The larval products displayed more potent cytotoxicity against L. major promastigotes. The IC50 values for larval saliva and hemolymph were 100.6 and 37.96 ug/ml, respectively. The IC50 of glucantime was 9.480 ug/ml. Also, the saliva and hemolymph of L. sericata exhibited higher cytotoxicity against the promastigotes of L. major but were less toxic to the macrophage cells. Treatment with leishmanicidal agents derived from larvae of L. sericata decreased the infection rate and the number of amastigotes per infected host cell at all concentrations. Lesion size was significantly (F (7, 38) = 8.54, P < 0.0001) smaller in the treated mice compared with the untreated control group. The average parasite burden in the treated mice groups (1.81 ± 0.74, 1.03 ± 0.45 and 3.37 ± 0.41) was similar to the group treated with a daily injection of glucantime (1.77 ± 0.99) and significantly lower (F (7, 16) = 66.39, P < 0.0001) than in the untreated control group (6.72 ± 2.37). CONCLUSIONS: The results suggest that the larval products of L. sericata were effective against L. major parasites both in vivo and in vitro. However, more clinical trial studies are recommended to evaluate the effects of these larval products on human subjects.

Prevalence of Pediculosis Among Primary School-Aged Students in Iran: an Updated Comprehensive Systematic Review and Meta-Analysis.

In this study, a systematic investigation was performed to estimate the prevalence of head lice infestation, and to determine the factors affecting the prevalence of heterogeneity among primary school-aged children in Iran. A comprehensive search was fulfilled in international databases, including MEDLINE, Scopus, Web of Science, and Embase, to identify the articles on the prevalence of pediculosis. So, all the cross-sectional epidemiological studies evaluating the prevalence of pediculosis were covered without any restrictions. A random-effects model was used to assess the pooled prevalence. A meta-regression method was applied to determine the factors affecting the heterogeneity among the studied population. An analysis was performed on 67 studies with a total sample size of 358,053. The total pooled estimate for the prevalence of pediculosis in boys and girls was 7.52% (95% CI: 6.15-9.03), 1.99% (95% CI: 1.25-2.89), and 8.97% (95% CI: 721-10.91), respectively. The highest and lowest pooled prevalence was in Hormozgan (southern Iran) (29.21%; 95% CI: 8.89-55.34) and Isfahan (Central Iran) (0.69%; 95% CI: 0.59-0.80), respectively. Based on the results of the univariate meta-regression, gender and father's job showed a significant direct association with the prevalence of pediculosis, but the sample size had significant inverse relations with the prevalence of pediculosis. This study demonstrated that pediculosis is a common public health problem affecting school-aged children with a relatively high prevalence in Iran, especially among girls.

Policy options for strengthening evidence-informed health policy-making in Iran: overall SASHA project findings.

BACKGROUND: The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in Iran based on steps of planning. METHODS: This study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase. RESULTS: We identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the "generation of evidence" (push side), 41 on the "use of evidence" (pull side) and 21 on the "interaction between these two" (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions). CONCLUSION: The policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country's EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability. Video abstract.

A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2).

In the present study, the efficiency of two formulations of maggot therapy: free-range larvae on the wounds and larvae in a special bag (larval-bag), was compared for healing diabetic ulcers with Wagner 2 diabetic ulcer. This study was conducted as a parallel randomized clinical trial. Out of 281 patients with Wagner grade 2 diabetic ulcers referred to the wound clinic, 54 patients who met the inclusion criteria were randomly assigned to intervention groups. The disinfected larvae of Lucilia sericata were put on the wounds with 2 methods, free-range larvae and larval-bag. Follow up was done at every 48 h interval until the full appearance of granulated tissues. The main measures were wound bed preparation, removing of necrotic tissues, appearing of granulated tissues, and removing of bacterial infections in the wounds. Statistical analysis based on the Kaplan-Meier curve and the Wilcoxon (Breslow) test showed a significant reduction in wound healing time by using free-range larvae in comparison with larval-bag (P = .03). The median time to debridement was 4 days in the free-range larval group (95% confidence interval: 3-9 days) while it was 9 days in the larval-bag group (95% confidence interval: 5-16 days). Debridement rate (proportion of removed necrotic tissue surfaces) at any time in the free-ranged larvae group was 1.78 times that of the bagged larvae group (95% confidence interval 1.01-3.15, P = .036). There was no significant difference between free-range larval use and larval-bag in the acceptability of maggot therapy by patients (P = .48). It can be concluded that both of two formulations of the larval therapy (free-range larvae and larval-bag) could be recommended for cleaning out and bed preparation of diabetic ulcers. However, using free-range larvae is hardly recommended on the wounds which are eligible to use.

Molecular analysis of the mitochondrial markers COI, 12S rDNA and 16S rDNA for six species of Iranian scorpions.

OBJECTIVES: Annually, 1.2 million humans are stung by scorpions and severely affected by their venom. Some of the scorpion species of medical importance have a similar morphology to species with low toxicity. To establish diagnostic tools for surveying scorpions, the current study was conducted to generate three mitochondrial markers, Cytochrome Oxidase I (COI gene), 12S rDNA and 16S rDNA for six species of medically important Iranian scorpions: Androctonus crassicauda, Hottentotta saulcyi, Mesobuthus caucasicus, M. eupeus, Odontobuthus doriae, and Scorpio maurus. RESULTS: Phylogenetic analyses of the obtained sequences corroborated the morphological identification. For the first time, 12S rDNA sequences are reported from Androctonus crassicauda, Hottentotta saulcyi, Mesobuthus caucasicus and M. eupeus and also the 16S rDNA sequence from Hottentotta saulcyi. We conclude that the mitochondrial markers are useful for species determination among these medically important species of scorpions.

The leishmanicidal effect of Lucilia sericata larval saliva and hemolymph on in vitro Leishmania tropica.

BACKGROUND: Leishmaniasis is a major parasitic disease worldwide, except in Australia and Antarctica, and it poses a significant public health problem. Due to the absence of safe and effective vaccines and drugs, researchers have begun an extensive search for new drugs. The aim of the current study was to investigate the in vitro leishmanicidal activity of larval saliva and hemolymph of Lucilia sericata on Leishmania tropica. METHODS: The effects of different concentrations of larval products on promastigotes and intracellular amastigotes of L. tropica were investigated using the mouse cell line J774A.1 and peritoneal macrophages as host cells. The 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and direct observation and counting method were used to assess the inhibitory effects and cell cytotoxicity of the larval products. The effects of larval products on the amastigote form of L. tropica were quantitatively estimated by calculating the rate of macrophage infection, number of amastigotes per infected macrophage cell, parasite load and survival index. RESULTS: The 50% cytotoxicity concentration (CC50) value of both larval saliva and hemolymph was 750 µg/ml, and the 50% inhibitory concentration (IC50) values were 134 µg/ml and 60 µg/ml for larval saliva and larval hemolymph, respectively. The IC50 for Glucantime, used a positive control, was (11.65 µg/ml). Statistically significant differences in viability percentages of promastigotes were observed for different doses of both larval saliva and hemolymph when compared with the negative control (p ≤ 0.0001). Microscopic evaluation of the amastigote forms revealed that treatment with 150 µg/ml larval hemolymph and 450 µg/ml larval saliva significantly decreased the rate of macrophage infection and the number of amastigotes per infected macrophage cell. CONCLUSION: Larval saliva and hemolymph of L. sericata have acceptable leishmanicidal properties against L. tropica.

Evaluation of Efficiency of Ivermectin Lotion in Comparison with Permethrin Shampoo and Dimethicone Lotion for Treatment of Head Lice (Pediculus humanus capitis) in Areas Covered by Health Centers of Islamshahr City, Tehran, Iran in 2019.

Background: Head lice infestation is known as a serious health problem in developing and developed countries. The prevalence of pediculosis in children and females is higher than others. The infestation may cause the absence of student from school and make their parents upset. The aim of current study was to evaluate the WHO recommended insecticides for control of head lice in Islamshahr health center. Methods: In the current study infested individuals were older than 6 years old and have been diagnosed with at least 3 head lice adult and 10 live nits from less than 0.7 cm scalp. The pediculicides was applied randomly among groups. Permethrin shampoo as a golden standard was used. Dimethicone lotion 4% and Ivermectin lotion was compared with it. This study was conducted on 179 infested people. Results of infestation were evaluated after one month of intervention. Different indicators such as: present of head lice adult or live nit, redness and irritation in head skin were invested. Results: All the participants were female and 72.6% of them were in the age group of 6-11. The result revealed that aging not only decreases the infection rate but also raised the recovery percentage. The results showed that 79.5% permethrin receiver, 83% of people who treated with Dimethicone lotion and 90.6% of Ivermectin receiver had no head lice. There was no significant difference among these three pediculicides. Conclusion: There was no significant difference among tested pediculicides. An appropriate pediculicide can be selected by training people.

Anaplasma Infection in Ticks in Southeastern Region of Iran.

BACKGROUND: Anaplasmosis and Ehrlichiosis are the most important tick-borne diseases. This study was conducted in three cities of Kerman Province in Iran to investigate the circulation of the bacteria in ticks collected from sheep. METHODS: Ticks were collected from animals using Srkj forceps and transferred to the Entomology lab in cold chain. After specimen's identification, they kept at -70 °C. Tick DNA was extracted using Bioneers DNA extraction kits followed by Nested PCR technique to amplify ribosomal 16S rRNA gene to detect Anaplasma infection in ticks. RESULTS: 472 sheep were examined from which 349 ticks were collected and identified in laboratory using valid keys. Tick specimens belonged to two genera and four species; Hyalomma marginatum (62.47%) was the most frequent and Hylomma asiaticum (5.73%) showed the least abundance. The infestation rate to different tick species was different in three regions of Kerman Province. Observation revealed that 24 specimens (58.3%) were positive for Anaplasma. There is a significant difference between male and female infection rate. However, there is no significant difference between these variables in each of these cities. CONCLUSION: This study shows high infection rates to Anaplasma in hard ticks. It is essential for health and veterinary authorities and farmers to use appropriate strategies to control ticks to reduce the infestation.

Epidemiological Characteristics of Scorpionism in West Azerbaijan Province, Northwest of Iran.

BACKGROUND: There are four medically important scorpion species (Mesobuthus eupeus, Mesobuthus caucasicus, Androctonus crassicauda and Hottentotta saulcyi) in the West Azerbaijan Province, northwestern Iran. scorpionism is considered as a health problem in this region, because there is no information about scorpion envenomation, this study was designed to study epidemiological characteristics of scorpionism to optimize prevention and treatment of scorpion sting in northwest of Iran. METHODS: All the data from epidemiological surveys completed in West Azerbaijan hospitals over four years (2014-2017) for scorpion victims were collected. This information includes the number of victims, sex, age, signs and symptoms, site of sting, body parts of victims, history of previous sting, the condition of the patient in terms of recovery and death, and the time to receive anti venom, all data were analyzed by the Excel software. RESULTS: A total of 2718 cases of scorpionism were reported from March 2014 to March 2017 in the study area. The most cases occur in both sexes in the age groups of 25 to 34 years old. In urban areas 40.3% of people and in rural areas 59.7% of them have suffered. The Poldasht and Chaldoran cities, had the most and least incidence respectively. CONCLUSION: In this study, the high risk areas in the case of scorpion stings were identified. Results of this study can be used to design preventive programs to educate more people about dangerous areas to prevent scorpion sting and even death.

Effect of Meteorological Factors on Hyalomma Species Composition and Their Host Preference, Seasonal Prevalence and Infection Status to Crimean-Congo Haemorrhagic Fever in Iran.

BACKGROUND: The impact of environmental factors and host on Hyalomma spp. community structure and abundance in the main Crimean-Congo haemorrhagic fever (CCHF) foci of Iran is largely unknown. METHODS: Biotic and abiotic factors, including host, temperature, humidity, altitude, Köppen-Geiger climate types, season, and precipitation on Hyalomma spp. community structure and abundances in 11 provinces of Iran were investigated. Additionally, the possible infection of ticks with CCHF virus was evaluated using reverse transcription PCR technique. RESULTS: Species analyses demonstrated the presence of Hyalomma anatolicum, H. marginatum, H. dromedarii, H. asiaticum, H. detritum and H. schulzei in the study area. Hyalomma anatolicum was the dominant species in the southern and northern parts, whereas H. dromedarii was distributed mostly in central parts of the country. The highest tick infestation was recognized in hot season. Spatial variation in tick relative density was observed between habitat types where more ticks were collected in deserts, semi-deserts, and Mediterranean habitats. Except for H. dromedarii, which was more prevalent on camel (P= 0.044), there were no significant variations in the frequencies of other Hyalomma species on different hosts. Hyalomma anatolicum, H. dromedarii frequencies had significant positive and negative association with temperature and precipitation respectively. Also humidity has positive impact on H. asiaticum frequency. CONCLUSION: Data presented here will help improve ecological models to forecast the distribution of Hyalomma spp. ticks, to evaluate the risk of CCHF and other tick-borne diseases, and to design proper vector control measures to suppress Hyalomma populations in Iran.

Efficacy of Maggot Therapy on Staphylococcus aureus and Pseudomonas aeruginosa in Diabetic Foot Ulcers: A Randomized Controlled Trial.

PURPOSE: This study was conducted to evaluate the antimicrobial effects of medicinal maggots of Lucilia sericata on Staphylococcus aureus and Pseudomonas aeruginosa on diabetic foot ulcers (DFUs). DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The sample comprised 50 adult patients from the clinic of the Academic Center for Education, Culture and Research of Tehran University of Medical Sciences, Iran. All participants who had at least 1 DFU present for at least 12 weeks, an arterial brachial index value of more than 0.6, and a hemoglobin A1c value of less than 8% were included in this study. METHODS: Subjects were randomly selected for the maggot-treated (treatment) or conventional treatment (control) group. Conventional treatments such as antibiotic therapy, debridement, and offloading were done for both groups, but maggot therapy (MT) was added to the protocol of the treatment group. Bacterial burden was monitored and compared for both groups using cultures collected using swab technique. Wound secretions were measured and compared in both groups. RESULTS: The number of infected cases with S aureus in the treatment group was significantly reduced after 48 hours in comparison with the control group (P = .047). The number of infected cases with P aeruginosa was significantly reduced after 96 hours (P = .002). We also found that wound secretions in the treatment group were significantly higher than in the control group (P < .00). CONCLUSIONS: Our findings indicate that MT is a safe and efficacious treatment of DFUs.

Diversity of Arthropods in Municipal Solid Waste Landfill of Urmia, Iran.

The present study was designed for identification of arthropods species in Urmia city municipal solid waste (MSW) landfill in 2014. The specimens were collected by hand and with sweep net. After the initial classification at the order level, genus and species identification were done using morphological identification keys. In total, 1,913 arthropod samples were collected. The samples were classified into four different classes. The most abundant species of arachnids was Steatoda paykulliana Walckenaer (Araneae: Theridiidae) and Agelenopsis spp. Giebel (Araneae: Agelenidae). Out of nine insect orders, Coleoptera, Diptera, and Hymenoptera were the most prevalent, all of which include medically important species. Sixteen families and 25 genera of insects were collected, including the muscid genera, Musca, Muscinia, Phannia, and Stomoxys. Musca, Psyllabora, and Phania were the most prevalent insect genera. In total, 33 species of arthropods were collected from MSW landfill in Urmia. Five insect species were heterometabolic including medically important species, Periplaneta americana Linnaeus (Blattodea: Blattidae) and Shelfordella lateralis Walker (Blattodea: Ectobiidae). Determination of the fauna in MSW landfill will be helpful in the control of possible vector borne disease epidemics.

Scorpion composition and scorpionism in a high-risk area, the southwest of Iran.

BACKGROUND: Scorpions are usually defined as predatory arachnids having venomous and painful stings. Scorpionism is considered as one of the health and medical problems in undeveloped tropical and subtropical countries in the world that endangers thousands of people annually. OBJECTIVE: This study was done for identification of scorpion fauna and scorpionism location in a high-risk area in southwest of Iran. METHODS: This study was carried out in Andimeshk district located in Khuzestan province which has the highest frequency of scorpionism in Iran. In total, 4 urban and 15 rural areas with various climates and topography were selected for monthly scorpion collection in 2016. Additionally, clinical data was obtained from questionnaires over a 5-year period (2012 to 2016) which were completed by physicians and health staff in hospitals and health centers. The data were analyzed by IBM-SPSS Version 20. RESULTS: A total of 850 scorpion samples with the most frequency in rural areas were collected. Eight species belonging to three families; Buthidae, Scorpionidae and Hemiscorpiidae were identified. A. crassicauda was the dominant species followed by H. lepturus. The largest collection due to scorpion's activity was recorded in summer. The five-year prevalence of scorpion sting were 9.1/1000 inhabitants. The highest frequency of scorpionism was observed in the male age group of 25-34 years. Most cases had been treated with polyvalent scorpion antivenom within 6-12 hours of the sting. CONCLUSION: Based on the findings, six species of medically important scorpions that were previously reported from Iran were also collected and caught in this study area. The findings of this study can be useful for policymakers at the Andimeshk Healthcare Center to prevent scorpionism and provide appropriate treatment for scorpionism cases.

A Retrospective Study on Scropionism in Iran (2002-2011).

BACKGROUND: Scorpion sting is a common medical emergency in Iran. The epidemiological features and control of such cases vary from south to north. This review will provide new information about the epidemiology of scorpion stings in different provinces of Iran. METHODS: In this descriptive retrospective study, data on scorpionism including incidence rates, mortality as well as locality from 2002 to 2011were collected. RESULTS: Overall, 433203 victims of scorpion stings had been referred to health centers from of all of the 31 provinces. The incidence of scorpion stings in 100000 populations was from 54.8 to 66. The highest rate of scorpion stings occurred among the 25-34 yr old group. The highest incidence of scorpion stings during 2011 was observed in Khuzestan Province and the lowest number in Mazandaran Province. The peak number of human cases (scorpion stings) was recorded during May to August. CONCLUSION: Scorpion stings in Iran are high. It is necessary that physicians and health care professionals should be familiar with local scorpions, especially those that are potentially more dangerous than others, the effective treatment protocols, and supportive care as well as their control of scorpionism.

Spatial Distribution of Medically Important Scorpions in North West of Iran.

BACKGROUND: Scorpions are one of the most important medical arthropods in Iran. This study aimed to determine the fauna, spatial distribution and some morphological characteristics of these venomous arthropods in the study area. METHODS: Scorpions were collected using Ultra Violet light, rock rolling and digging methods in West Azerbaijan, East Azerbaijan, and Ardabil Provinces during 2015-2016. The specimens were preserved in 75% ethyl alcohol and transferred to the laboratory for species identification and morphological studies. RESULTS: Distribution maps were produced using ArcGIS 10.3. Totally, 368 specimens from two families of Buthidae (97.1%) and Scorpionidae (2.99%) were collected and identified as Mesobuthus eupeus (80.16%), Androctonus crassicauda (10.60%), M. caucasicus (4.89%), Hottentotta saulcyi (1.35%) and Scorpio maurus (2.99%). CONCLUSION: The presence of medically important species, including the deadly black one in northwestern Iran requires health educational and control programs for reduction of these public health problems.

Anti Leishmania activity of Lucilia sericata and Calliphora vicina maggots in laboratory models.

Use of sterile fly larvae (maggots) of blow flies for the treatment of many different types of skin and soft tissue wounds is called Maggot debridement therapy (MDT). The larvae of blow flies secrete a broad spectrum of compounds with diverse mechanisms of action in the gut and salivary glands called excretion/secretion (ES) products which showed to have antimicrobial activities against Gram negative and positive bacteria. Cutaneous leishmaniasis (CL) which is the common form of leishmaniasis is difficult to treat. In this study, the effect of ES from 2nd and 3rd stages of L. sericata and C. vicina larvae on in vitro Leishmania major amastigote growth in macrophage was evaluated. The effect of ES on Leishmania growth was estimated by assessing the rate of macrophage infection and the number of amastigotes per infected macrophages. In addition, the anti Leishmania activities of larval and ES of L. sericata and C. vicina on the skin lesion induced by L. major infection was evaluated in susceptible BALB/c mice. The results showed that ES of both flies reduced the number of infected macrophages; 2.6 and 1.5-fold using L. sericata ES and C. vicina ES, respectively, and inhibited amastigotes growth in macrophages; 2.03 and 1.36-fold by L. sericata ES and C. vicina ES, respectively as compared to the control group. The results showed that L. sericata ES was significantly more effective than C. vicina ES to inhibit in vitro L. major amastigotes growth, The size of lesion was significantly smaller in BALB/c mice treated with L. sericata ES than treated with C. vicina ES. The results of in vivo experiments suggested that pre-treatment with ES derived from L. sericata may have some protective effects on the development of L. major lesion. Therefore, it seems that maggot ES might be considered as a possible candidate for the treatment of cutaneous leishmaniasis.

Epidemiological aspect of scorpion sting in Bandar Abbas, Iran, during 2009-2011.

INTRODUCTION: People in tropical and semi-tropical areas are in danger of scorpion sting, and this can be a serious problem for them. Mortality due to scorpion sting in the tropical and semi-tropical areas of Iran is about 75%, and this makes scorpion sting in these areas a serious medical problem. Because of this problem, our aim was to assess the epidemiological aspects of scorpion sting in Bandar Abbas, Iran, during 2009-2011. METHODS: In this cross-sectional retrospective study, epidemiologic data of 698 scorpion sting cases, who were referred to the Shahid Mohamadi Hospital of Bandar Abbas in Hormozgan Province collected from 2009 until 2011. The data included demographic and individual information, such as age, gender, geographic location, bite site, when the incident occurred, and anti-venom consumption. The required data were extracted from the patients' recorded information in the Hospital, and we recorded data in a special checklist and imported the data into the computer for statistical analysis using of SPSS software, version 21.0. Descriptive statistics, including mean, standard deviation, frequency, and percentage, were used for data analysis. RESULTS: Two hundred and sixty-one (37.4%) of the cases were urban and 437(62.6%) were rural. Males comprised 50.1% of the cases, and women comprised 49.9% (p >0.05). Twenty-five point two percent of scorpion sting cases occurred among people in the 21 to 30 age group, and there were very few cases among people in the 51 to 60 age range (p<0.05). Most of cases were recorded in April and October, and the fewest cases were recorded in July and January (p<0.05); also 32.2% of scorpion sting cases occurred after midnight and in the early morning hours. CONCLUSION: Our survey showed that there was a high incidence of scorpion stings in rural areas, among 21-30 age group, among housekeepers, and among students. These results indicate the need for public education programs and better sanitation services in the rural areas around Bandar Abbas city. Prospective studies can help to health and medicine organization for prevention and treatment of scorpion sting.

Spatial Distribution of Scorpion Sting in a High-Risk Area of Southern Iran.

Scorpion sting is a public health problem in south and southwestern parts of Iran, with about 36,000 cases recorded annually. This study aimed to find the spatial distribution of scorpions and their stings in Bandar Abbas County. Monthly scorpion sting cases at the village level were obtained and used for mapping. Scorpions were collected from 14 collection sites using a UV lamp at night and searching under stones during the day time. During the study period, a total of 3,971 cases of scorpion sting were recorded, most of them were found in mountainous areas and affected individuals aged 25-44 yrs. In total, 18 scorpion species belonging to 10 genera were collected and identified. The peak of scorpion sting cases occurred from July to September. The northern part of the mountainous areas had a richer species composition. Hemiscorpius persicus and Hemiscorpius gaillardi were collected for the first time in the area. There were 22 scorpion species in the area across studies; among them, 10 were most dangerous. Hemiscorpius genus is the main etiologic agent in Bandar Abbas County. Mapping dangerous species allows the health system to provide relevant anti-scorpion venom serum accordingly and more cost-effectively.