Phytoremediation of pollutants in oil-contaminated soils by Alhagi camelorum: evaluation and modeling.

Phytoremediation is a cost-effective and environmentally friendly method, offering a suitable alternative to chemical and physical approaches for the removal of pollutants from soil. This research explored the phytoremediation potential of Alhagi camelorum, a plant species, for total petroleum hydrocarbons (TPHs) and heavy metals (HMs), specifically lead (Pb), chromium (Cr), nickel (Ni), and cadmium (Cd), in oil-contaminated soil. A field-scale study spanning six months was conducted, involving the cultivation of A. camelorum seeds in a nursery and subsequent transplantation of seedlings onto prepared soil plots. Control plots, devoid of any plants, were also incorporated for comparison. Soil samples were analyzed throughout the study period using inductively coupled plasma-optical emission spectroscopy (ICP‒OES) for HMs and gas chromatography‒mass spectrometry (GC‒MS) for TPHs. The results showed that after six months, the average removal percentage was 53.6 ± 2.8% for TPHs and varying percentages observed for the HMs (Pb: 50 ± 2.1%, Cr: 47.6 ± 2.5%, Ni: 48.1 ± 1.6%, and Cd: 45.4 ± 3.5%). The upward trajectory in the population of heterotrophic bacteria and the level of microbial respiration, in contrast to the control plots, suggests that the presence of the plant plays a significant role in promoting soil microbial growth (P < 0.05). Moreover, kinetic rate models were examined to assess the rate of pollutant removal. The coefficient of determination consistently aligned with the first-order kinetic rate model for all the mentioned pollutants (R2 > 0.8). These results collectively suggest that phytoremediation employing A. camelorum can effectively reduce pollutants in oil-contaminated soils.

Study on diazinon toxicity reduction by electro-Fenton process: A bioassay using daphnia magna.

The realm of diazinon reduction from polluted water has witnessed a surge in the significance of advanced oxidation processes (AOPs) in recent times. However, there is a dearth of research focusing on the mitigation of its toxicity through AOPs. Thus, the primary objective of this study was to evaluate the effectiveness of the Electro-Fenton process (EFP) in the eradication and detoxification of diazinon in aqueous solutions. Synthetic wastewater samples with concentrations of 2, 2.5 and 3 mg/L were prepared. A total of 27 samples were determined using Box Behnken Design. Reaction time, pH and iron to hydrogen peroxide ratio (Fe2+/H2O2) were examined as operational parameters under a constant current of 5.4 amps. The quantification of diazinon concentration was performed using High-Performance Liquid Chromatography (HPLC). To evaluate the detoxification of diazinon, the Daphnia magna bioassay was employed as a methodology in this study. According to the results, the EFP could reduce the diazinon to zero and the LC50 values are increased by applying the process. The LC50 values for diazinon were determined using the Daphnia magna bioassay, considering initial concentrations of 2, 2.5, and 3 mg/L at a pH of 5, a reaction time of 15 min, and an iron to hydrogen peroxide molar ratio of 2. The recorded LC50 values were 3.039, 3.076, and 3.106, respectively, indicating the lowest frequency of cumulative death in Daphnia magna. In this case, after 96 h, only 3 cases (30%) of Daphnia magna death were observed. However, for all the mentioned concentrations of diazinon, after 96 h of exposure to samples without applying the Daphnia Magna death process, it was observed between 60 and 100%. Reducing the diazinon concentration and increasing the 96-h LC50 showed that the EFP can reduce the toxicity of diazinon on Daphnia Magna at the same time. Therefore, EFP can be considered a superior method with low ecotoxicity.

Toxicity Mechanism of Dangerous Scorpion Stings in Iran.

Background: Considering the importance of scorpions and recognizing the mechanisms of toxicity caused by their medically important species in Iran and adopting the best therapeutic approach based on these mechanisms, this study was performed by reviewing the clinical manifestations of scorpion stings. Methods: The research was conducted by searching for articles and researches in related websites (PubMed, EMBASE, Scopus, Web of Science and CINAHL) and using domestic and international authoritative journals using the keywords of scorpion, clinical manifestations, in a review method. Finally, 104 qualified sources were selected and after reviewing and criticizing these studies, the author's point of view was presented. Results: Clinical manifestations of Scorpion sting toxicity vary due to the existence of two toxic classes of neurotoxins and cytotoxins or hemotoxins in these arthropods in Iran. The number and distribution of species with neurotoxic venom are higher than the scorpions with cytotoxic venom and are reported throughout Iran. Scorpions with cytotoxic venom are mostly widespread in south and southwest of Iran. Conclusion: Treatment and prevention of scorpion stings in Iran and neighboring countries in the Middle East should be planned based on the mechanism of toxicity and the presence of toxic classes with neurotoxic or cytotoxic venoms.

Medically important snakes and snakebite envenoming in Iran.

Snakebite is a relatively common health condition in Iran with a diverse snake fauna, especially in tropical southern and mountainous western areas of the country with a plethora of snake species. The list of medically important snakes, circumstances and effects of their bite, and necessary medical care require critical appraisal and should be updated regularly. This study aims to review and map the distributions of medically important snake species of Iran, re-evaluate their taxonomy, review their venomics, describe the clinical effects of envenoming, and discuss medical management and treatment, including the use of antivenom. Nearly 350 published articles and 26 textbooks with information on venomous and mildly venomous snake species and snakebites of Iran, were reviewed, many in Persian (Farsi) language, making them relatively inaccessible to an international readership. This has resulted in a revised updated list of Iran's medically important snake species, with taxonomic revisions of some, compilation of their morphological features, remapping of their geographical distributions, and description of species-specific clinical effects of envenoming. Moreover, the antivenom manufactured in Iran is discussed, together with treatment protocols that have been developed for the hospital management of envenomed patients.

Toxic reaction of a 3-year-old boy due to Hornet multiple stings in Kerman-Iran province: A case report.

A three-year-old boy was attacked by a group of hornets and the head, arms, back and buttocks of the child were targeted to various stings. The child was first taken to a rural clinic and then to a hospital in Baft city. At arrival to rural clinic, the child was conscious and approximately 30 hyperpigmented, painful and itchy papular lesions was seen on his body. Head and neck weren't erythematous and edematous. However gradually, the face, lips, eyelids, and neck became swollen. The child became restless and itchy in the sting sites. Stress induced hyperglycemia occurred. Despite supportive treatments, the clinical conditions get worse and progressed. He referred to the pediatric ward of Afzalipour hospital in Kerman and admitted to intensive care unit (ICU). The child was ill and oliguric. The treatment was started including: hydration with normal saline and diuretic agent (furosemide), insulin, corticosteroid, dopamine and calcium. But a systemic toxic reaction occurred during the hospitalization. Hemolysis, hematuria, anemia, thrombocytopenia and rhabdomyolysis, myoglobinuria, acute renal failure, hepatic injury, epistaxis and respiratory distress was happened. In order to urine alkalinization, sodium bicarbonate was added to his treatments. Also, plasmapheresis was performed. Then according to acute tubular necrosis (ATN) (due to intravascular hemolysis and rhabdomyolysis), pleural effusion and respiratory distress, intermittent hemodialysis was started one day in between. After five intermittent hemodialysis sessions and nineteen days after hospitalization, the patient was discharged in relatively good general condition.

Determination of potentially toxic metals in depilatory products in the Iranian markets: human health risk assessment.

This study aimed to investigate the concentrations of heavy metals, including lead (Pb), cadmium (Cd), chromium (Cr), zinc (Zn), cobalt (Co), and arsenic metalloid (As), to assess their health risks in the popular depilatory products of the Iranian markets. Twenty-one samples of 7 popular brands of depilatory products, inclusive of cream and powder, were examined. Selected elements were measured by inductively coupled plasma optical emission spectrometry (ICP-OES) using the appropriate procedure for acid digestion and the measurement of heavy metal contents. The differences in heavy metal concentrations were investigated according to the type of product, brand, country of production, and product price using t test and one-way analysis of variance and post hoc Tukey test. Finally, carcinogenic and non-carcinogenic risk assessments were calculated for the studied elements. The results showed that Pb (5.46±2.30 mg/kg) and Co (0.16±0.69 mg/kg) had the highest and lowest concentrations in these products, respectively. In general, the concentration of heavy metals in depilatory creams was less than the concentration of elements in depilatory powders and less than the maximum allowable limits as defined by the Institute of Standards and Industrial Research of Iran (ISIRI). There was a direct and significant relationship between the concentration of heavy metals in depilatory powders and the product's price. Moreover, the amount of As in one of the brands of depilatory powder was determined to exceed the standard value (2 mg/kg). Also, hazard index (HI) and lifetime cancer risk (LCR) were below 1 and 10-6, respectively, which indicated that this mentioned heavy metal had no probable non-carcinogenic and carcinogenic risks for consumers. According to this study, it was evident that the chances of cancer and non-cancer risk using depilatory products were unlikely, but continuous use can be harmful due to the excessive accumulation of these heavy metals.

Fauna and Larval Habitat Characteristics of Mosquitoes (Diptera: Culicidae) in Kashan County, Central Iran, 2019.

BACKGROUND: Mosquitoes are responsible for spreading devastating parasites and pathogens causing some important infectious diseases. The present study was done to better understand and update the fauna of Culicidae and to find out the distribution and the type of their larval habitats in Kashan County. METHODS: This study was done in four districts of Kashan County (Central, Qamasr, Niasar and Barzok). Mosquito larvae were collected from 23 active larval habitats using a standard 350ml capacity mosquito dipper from April to late December 2019. The collected larvae were transferred to containers containing lactophenol, and after two weeks individually mounted in Berlese's fluid on a microscope slide and identified to species by morphological characters and valid keys. RESULTS: In this study, a total of 9789 larvae were collected from urban and rural areas in Kashan County. The identified genera were Anopheles, Culiseta and Culex. In this study larvae of An. turkhudi, Cx. perexiguus, Cx. mimeticus, Cx. deserticola and Cs. subochrea were collected for the first time from Kashan County. CONCLUSION: The results of this study indicate the presence and activity of different mosquito species in Kashan County that some of them are vectors of arbovirus and other vector-borne diseases.

Scorpionism by Hemiscorpius spp. in Iran: a review.

Scorpions are distributed throughout Iran and the genus Hemiscorpius is particularly important in this region. Hemiscorpius lepturus is the most significant species within the genus in the country. Since scorpionism provoked by Hemiscorpius comprises a medical emergency, the present study is focused on this important issue. In order to perform the present work, a review of the medical and health-related literature was carried out in several databases. The current findings indicate that six species of Hemiscorpius are found in 15 states of Iran, mainly in the south and southwest. Deaths caused by stings were reported only for two species. The morphological characteristics and geographical distribution of H. lepturus in Iran, its venom and the toxic compounds, epidemiologic data and clinical manifestations of envenomation as well as treatment for affected people are herein reviewed and described. H. lepturus venom toxicity differs from other Iranian scorpions regarding duration and severity. Scorpionism is an important public health problem in Iran, especially in southwest and south regions and in urban areas. It is more prevalent in children and young people. H. lepturus venom is primarily a cytotoxic agent and has hemolytic, nephrotoxic and to some extent hepatotoxic activity. The use of polyvalent antivenom to prevent scorpion sting symptoms is recommended. A well-planned health education program might be useful in preventing scorpionism.

A Review on Scorpionism in Iran.

BACKGROUND: Scorpions are one of the most important venomous animals in Iran. Their sting has more prevalence in the south and southwest areas. The aim of this study was to introduce their sting agent species in the country. METHODS: Data were extracted by a mini review on scorpion stinging articles in Iran until early 2018 and then the sting agent species in each area were studied. Geographical and provincial distribution of each species also was provided. RESULTS: Twelve scorpion species are causative agents of sting. According to their deadly rate and clinical symptoms, some of them are considered the most dangerous venomous animals in Iran. Some death cases have been reported because of the sting of 3 species of Hemiscorpius lepturus, H. acanthocercus and Androctonus crassicauda. Remaining species have not deadly sting but because of their frequency, they encounter the individuals and cause the stinging. CONCLUSION: The highest number of sting agents is in Khuzestan, however Gilan and Mazandaran have the lowest frequency. Because of the high prevalence of sting agent species in that province, the necessity of providing control and prevention programs is very important.

Scorpionism by Hemiscorpius spp. in Iran: a review

Scorpions are distributed throughout Iran and the genus Hemiscorpius is particularly important in this region. Hemiscorpius lepturus is the most significant species within the genus in the country. Since scorpionism provoked by Hemiscorpius comprises a medical emergency, the present study is focused on this important issue. In order to perform the present work, a review of the medical and health-related literature was carried out in several databases. The current findings indicate that six species of Hemiscorpius are found in 15 states of Iran, mainly in the south and southwest. Deaths caused by stings were reported only for two species. The morphological characteristics and geographical distribution of H. lepturus in Iran, its venom and the toxic compounds, epidemiologic data and clinical manifestations of envenomation as well as treatment for affected people are herein reviewed and described. H. lepturus venom toxicity differs from other Iranian scorpions regarding duration and severity. Scorpionism is an important public health problem in Iran, especially in southwest and south regions and in urban areas. It is more prevalent in children and young people. H. lepturus venom is primarily a cytotoxic agent and has hemolytic, nephrotoxic and to some extent hepatotoxic activity. The use of polyvalent antivenom to prevent scorpion sting symptoms is recommended. A well-planned health education program might be useful in preventing scorpionism.

Scorpionism by Hemiscorpius spp. in Iran: a review

Scorpions are distributed throughout Iran and the genus Hemiscorpius is particularly important in this region. Hemiscorpius lepturus is the most significant species within the genus in the country. Since scorpionism provoked by Hemiscorpius comprises a medical emergency, the present study is focused on this important issue. In order to perform the present work, a review of the medical and health-related literature was carried out in several databases. The current findings indicate that six species of Hemiscorpius are found in 15 states of Iran, mainly in the south and southwest. Deaths caused by stings were reported only for two species. The morphological characteristics and geographical distribution of H. lepturus in Iran, its venom and the toxic compounds, epidemiologic data and clinical manifestations of envenomation as well as treatment for affected people are herein reviewed and described. H. lepturus venom toxicity differs from other Iranian scorpions regarding duration and severity. Scorpionism is an important public health problem in Iran, especially in southwest and south regions and in urban areas. It is more prevalent in children and young people. H. lepturus venom is primarily a cytotoxic agent and has hemolytic, nephrotoxic and to some extent hepatotoxic activity. The use of polyvalent antivenom to prevent scorpion sting symptoms is recommended. A well-planned health education program might be useful in preventing scorpionism.(AU)

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.

Multiple sclerosis-A disease on a dramatically rising trend in Iran: Review of possible reasons.

There has been a global rising trend in recent years in the incidence of multiple sclerosis (MS). Despite being an MS low-risk region, this disease has also been recently on the rise in the Middle East. As part of the Middle East, Iran has not been spared either; however, the cause of this dramatic increase remains to be discovered. This study reviews possible reasons for this increase in Iran. Although many factors such as the increased rate of smoking, lifestyle changes, modernization, and contact with toxic solvents can be proposed as reasons for this sudden rise in the prevalence of MS in Iran, these factors cannot be taken as definite causes and further studies are required to prove their impact.

Epidemiological and clinical characteristics of scorpionism in Shiraz (2012-2016); development of a clinical severity grading for Iranian scorpion envenomation.

Background: Scorpionism is a public health problem in some provinces in Iran. The present study aimed to assess the clinical manifestations of scorpion envenomation in Shiraz and determine a clinical severity grading for Iranian scorpion envenomation in order to suggest a treatment guideline for emergency physicians. Methods: In this analytic retrospective study, all medical charts of patients with scorpion sting admitted in the adult medical toxicology center in Shiraz during July 2012 to July 2016 were assessed. Data regarding the patient's age, gender, sting site, month of envenomation, time of sting, clinical manifestations, vital signs, presence of blood or hemoglobin in urine analysis, duration of admission, color of scorpion, received treatments, and administration of scorpion antivenin were recorded. Results: The scorpions in Shiraz and its suburban area were classified into two groups: yellow scorpions ( Mesobuthus eupeus, Mesobuthus caucasicus , and Compsobuthus matthiesseni) and Hottentotta scorpions (Hottentotta jayakari and Hottentotta zagrosensis). A total of 126 cases of scorpion stings were assessed. About 59% (n=74) were males. The patients aged 8-63 years (mean age, 33.8±11.5 years). About 38.4% (n=48) of the stings occurred during summer. More than 40% of patients (n=51) referred to the emergency department (ED) at night. Localized pain was the most frequent presenting complaint (76.2%). The most frequent general symptom was nausea (6.3%). The most prevalent envenomation site was the lower extremities followed by upper extremities (43.5% and 41.9%, respectively). Based on the clinical severity grading for Iranian scorpion envenomation, 65, 43, and 18 patients (51.6%, 34.1%, and 14.3%) were classified in the grades I, II, and III, respectively. Eighty-one (73%) patients stayed in the ED from 1 to 6 hours, and 30 (27%) patients stayed for >6 hours for observation. Severe localized pain was more prevalent in stings with Hottentotta scorpions than yellow scorpions (P=0.01). The season of envenomation with Hottentotta scorpions was summer in all cases, but envenomation with yellow scorpions was seen throughout the year. All patients received symptomatic treatment, and five were given scorpion antivenin. No death was reported. Conclusion:Hottentotta jayakari is recommended to be listed among the medically important scorpions in Iran. Moreover, scorpion-stung patients in geographical regions where Hemiscorpius lepturus and Androctonus crassicauda are not prevalent may be treated in outpatient departments. The presented grading system can be used for treating patients with scorpion envenomation.

Geographical Distribution of Scorpion Odontobuthus doriae in Isfahan Province, Central Iran.

BACKGROUND: Scorpions are among the world's venomous arthropods, they sting humans every year, suffering painful symptoms or losing their lives because of the venom. Odontobuthus doriae Thorell 1876 (Arachnida: Scorpionida: Buthidae) is a scorpion of medical importance and therefore its geographical distribution in Isfahan Province has been studied. METHODS: This descriptive cross-sectional study was designed between Mar and Jun in 2012 and 2013 in Province of Isfahan, central Iran. Overall, 164 O. doriae scorpions were collected from their natural habitat by identifying the dug burrows. This arthropod's burrows were identified based on the presence of tumuli, particularly between May and Jun at the sloping foothills of pristine embankments. The sampling data was categorized and compared. RESULTS: The relative frequency of collected O. doriae for the counties was Mobarakeh (13.5%), Shahinshahre (11.5%), Borkhar (9%), Shahreza (7.5%), Kashan (7.5%), Naeen (6%), Natanz (5.5%), Isfahan (4.8%), Najafabad (4.8%), Aran and Bidgol (4.8%), Dehaghan (4.8%), Flavarjan (3.7%), Khomeinishahr (3.7%), Tiran (3.7%), Golpayegan (3.7%), Ardestan (3.7%) and Lenjan (2.5%). No O. doriae was collected from other counties of the province. CONCLUSION: The habitats of O. doriae are more often located in central, eastern and northern regions of the province compared to other regions. Counties of southern and western regions are among cold parts of the province.

Factors Influencing Animal Bites in Iran: A Descriptive Study.

OBJECTIVES: Animal bite is a significant health economic challenge worldwide. In Iran, there has been an increase in the number of animal bites in recent years. This study was performed to investigate the epidemiology of animal bites and their influencing factors in Semirom, Iran, from 2008 to 2012. METHODS: This was a descriptive study conducted for 5 years. The data were based on the information sheets presented in health-care centers concerning how to combat against rabies caused by animal bites. The data obtained were classified and analyzed statistically. RESULTS: During the 5-year study period, 1,246 animal bite cases were reported; 60% of the victims belonged to rural areas and the remaining 40% to urban areas. Among various aggressive animals, dogs had the highest rate of attacks (63.4%). The highest rate of animal bite (23.19%) was reported in the age group of 10-19 years and the lowest one (2.32%) was reported in the age group of 0-4 years. The animal bite rates among men and women were 76% and 24%; respectively. The highest and lowest rates were found among students (23.5%) and employees (5.5%), respectively. Regarding the commonly injured organ, the highest (67%) and lowest rates (23%) were for lower extremities and head and face, respectively. Regarding the nationality of the victims, 98% were Iranians and the rest were Afghan. CONCLUSION: Given the increasing number of animal bites reported, there is a need to implement strategies to prevent bite-related complications, which may have health and financial burden on the country. It is also necessary to increase awareness among target groups and to formulate preventive strategies with the help of various authorities to control animal bites.

The Effect of Hemiscorpius lepturus (Scorpionida: Hemiscorpiidae) Venom on Leukocytes and the Leukocyte Subgroups in Peripheral Blood of Rat.

BACKGROUND: The aim of this study was to investigate the effect of Hemiscorpius lepturus venom on leukocytes and the leukocyte subgroups in peripheral blood of rat. METHODS: In this experimental study, sixty N-Mari rats were divided into three groups of 20 rats. Then the rats in each group were divided into four subgroups based on the blood sampling time that was 2, 6, 24 and 48 hours after the venom injection, respectively. The control group did not receive anything, however, the first and the second experimental groups received 0.1 and 0.01mg/kg of venom, subcutaneously. In accordance with a designated four sampling times, the blood sampling was carried out in three groups. After RBC lysis, the leukocytes and leukocyte sub-populations were determined and counted using appropriate hematological standard methods. RESULTS: The leukocyte and the neutrophil count at two (P<0.05), six (P<0.01) and 24 (P<0.05) hours after the venom injection showed a significant decline compared with the control group, this decrease was significant at the dose of 0.1 mg/kg until 48 hours after the venom injection (P<0.05). The lymphocyte count showed a significant decline throughout the all hours of the experiment, compared with the control group (P<0.05). CONCLUSION: Leukocytes are probably affected by the cytotoxicity effect of the H. lepturus venom in a dose-dependent manner. This could be a wakeup call for the medical staff to perform quick and accurate treatment in the least time possible.

Uncommon Human Urinary Tract Myiasis Due to Psychoda Sp. Larvae, Kashan, Iran: A Case Report.

Contamination of human and animal body tissues with flies' larvae and diptera cause myiasis. A 26 yr old female patient refers to Kashan Shahid Beheshti Hospital, central Iran because of urogenital infection, pain in the right part of stomach, smelly and reddish vaginal discharge and frequent urination. In the first checking, urine sample was taken. In the sample, active and alive larvae were seen. The live samples were taken to the Environmental Health Department Lab of Kashan University of Medical Sciences in clean glass jars. In the morphological survey, Psychoda sp larvae were identified. In Iran, this study is the first report of this species of larva that causes urinary myiasis. This fly larva is not carnivore or bloodsucker and feeds on bacterial agents. Observance of personal hygiene especially during defecation and urination is essential to prevent contamination of this type of myiasis.

The Evaluation of Multiple Sclerosis Dispersal in Iran and Its Association with Urbanization, Life Style and Industry.

BACKGROUND: Multiple Sclerosis (MS) is an autoimmune disease with unknown factor. The prevalence and incidence rate of this disease had an upward trend in many regions in the world such as Middle east and consequently in Iran over the recent years. As the risk factors of this increased trend and high-prevalence is unknown in Iran, the current study has been designed to evaluate the correlation between MS dispersal with urbanization, life style and industry, as an ecological research. METHODS: This retrospective study was designed as an ecological approach in 2011. Data were collected from three databases by high precision (CI95%) from national registry plans. The subjects of study were provinces of Iran (n=31). The linear regression was used to perform statistical analyses. RESULTS: The obtained results indicated an ascendant trend of MS during the recent years, as the incidence of this disease reached from 26.24/100000 (CI95%) people in 2006 to 44.53/100000 (CI95%) in 2011. There is a direct correlation (P<0.05) between the percentage of urbanization and the percentage of male smokers with the prevalence of MS in provinces. CONCLUSION: The role of smoking was more highlighted in this study as a probable factor in increasing risk and causing MS disease. Urbanization could be introduced as an augmentative factor, but this is a combination of several complex factors that this effect must be appraised with smaller scale in other researches.