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BACKGROUND: Recent studies suggest that shift work may cause liver dysfunction. OBJECTIVE: This study aimed to examine the relationship between different patterns of shift work and elevated level of liver enzymes. METHODS: In this cross-sectional study, 1910 workers aged 35 to 70 years were selected with simple random sampling from 9978 participants of the recruitment phase of Shahedieh PERSIAN cohort study. Level of serum liver enzymes (ALT, AST, ALP, and GGT) and ALT/AST ratio was compared between shift workers and non-shift workers, and among employees working in different patterns of shift work. Data were analyzed by SPSS (version 21.0) using Student's T test, Mann-Whitney U test, chi-square test, Kruskal Wallis test, and logistic regression. RESULTS: Among 1347 males (71%) and 563 females (29%) with a mean age of 40.4±7.4 years, 469 were shift workers. Fixed evening type shift was the most common (30.3%) and fixed night-shift was the least common (0.9%) type of shift work. The mean blood levels of liver enzymes was not significantly different between shift workers and non-shift workers. In comparison between different patterns of shift work, the mean serum level of GGT was significantly higher in individuals with slow rotating shifts than those with fixed evening shifts, rapid rotating, split and fixed 24 hour shifts (p≤0.001). After adjusting for confounding factors only elevated AST was significantly higher in shift workers. CONCLUSION: There was only a significant association between shift work and elevated AST, and no relationship was found with ALT, ALP, GGT, and ALT/AST ratio. [ABSTRACT FROM AUTHOR]

Noise and solvents are two occupational exposures with possible hearing effects. We aimed to assess the effect of exposure to noise and organic solvents on acoustic reflex. This cross-sectional study was conducted on three groups: 80 workers exposed to impermissible amounts of organic solvents (mainly styrene), 78 workers exposed to loud noise and 67 subjects as a control group. The hearing status of the subjects was assessed by pure tone audiometry and acoustic reflex. Data were analysed by SPSS (ver. 20) (SPSS Inc., Chicago, IL) using Student's t-test, chi-square test and ANOVA. The mean hearing threshold at high frequencies was significantly higher in the noise group, followed by the solvent group, compared to the control group (p<.0001). Mean acoustic reflex was higher in the solvent group, followed by the noise group (p<.05). The frequency of absent acoustic reflex was also significantly higher in noise and solvent groups than in controls (p<.05). This study suggests that exposure to organic solvents alone without simultaneous noise, despite a normal hearing threshold, can affect acoustic reflex, so conducting preventive hearing tests such as acoustic reflex test, in workers exposed to organic solvents, may be one of the effective ways to prevent occupational hearing loss in these workers. [ABSTRACT FROM AUTHOR]

Purpose: Leishmaniasis comprises various clinical forms mainly including cutaneous, muco-cutaneous, and visceral leishmaniasis; caused by Leishmania species. Antimoniate is the first-line treatment but some cases showed no response to treatment in the worldwide. In this study, mitogen-activated protein kinase (MAPK) and aquaglyceroporin 1 (AQP1) gene expressions were assessed in treatment failure clinical isolates of Leishmania major. Also, molecular and phylogenic analyses of the mentioned isolates were performed. Methods: Samples were obtained from the patients with suspicious CL referred to the laboratory of Diagnosis Center, Gorgan Province, Iran, from October 2016 to December 2019. Detection and identification of the parasite was performed. The genes expressions of MAPK1 and AQP1 were done using SYBR Green real-time PCR. The AQP1 gene from the isolates with treatment failure was sequenced and analyzed using BLAST and multiple alignments. The phylogenic analysis was done using MEGA7. The statistical analysis was done using SPSS 16.0 by non-parametric Mann–Whitney U test. Results: All clinical isolates were detected L. major. The mean AQP1 and MAPK1 gene expressions in treatment failure isolates were 58.71 and 6.139 fold less than the ones in treatment response isolates, respectively. Based on the AQP1 gene sequence, a nucleotide change of aspartic acid with asparagine at the site 234 was observed. Phylogenic tree analysis showed three groups with the minimum dissimilarity of 0.008 between TF isolates with the standard L. major strains. Conclusion: We showed that MAPK1 and AQP1 may have critical roles in response to antimoniate in clinical isolates L. major in this study. [ABSTRACT FROM AUTHOR]

Background: The species complex of Echinococcus granulosus sensu lato (s.l.) causes cystic echinococcosis distributed worldwide. There is no genotype information from hydatid cysts in the intermediate hosts in Central Iran. Therefore, in this study, we analyzed the hydatid cysts in livestock slaughtered in an abattoir in this region. Six hundred fifty-seven hydatid cysts were isolated from 97 animals, including sheep, cattle, camels, and goats slaughtered in Yazd abattoir from September 2018 to January 2020. The demographic data was collected as well as cyst location, fertility, and viability. Out of 657 samples, 164 samples were genotyped. Then, phylogenetic analysis was performed using MEGAX. Statistical analyses were done using SPSS version 16.0 by chi-square with a significant difference of less than 0.05. Results: Out of 164 samples, the G1-G3 complex genotype had the most frequency in samples, with 135 cases recognized. The G6/G7 was observed in 19 isolates and G5 was reported in nine samples. One sample was detected as Taenia hydatigena. Conclusions: This study showed that G1-G3 and G6/G7 genotypes were presented in all animals, but G5 was reported only in cattle, goats, and camels. It is the first molecular identification of cystic echinococcosis in Central Iran. Hence, reporting G5 in livestock in this area should be considered due to transmission to humans. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is a prevalent tropical disease caused by more than 20 Leishmania species (Protozoa, Kinetoplastida and Trypanosomatidae). Among different clinical forms of the disease, cutaneous leishmaniasis is the most common form, with an annual 0.6-1 million new cases reported worldwide. This disease's standard treatment is pentavalent antimonial (SbV) that have been used successfully since the first half of the 20th century as a first-line drug. However, treatment failure is an increasing problem that is persistently reported from endemic areas. It is important to define and standardize tests for drug resistance in cutaneous leishmaniasis. SbV must be reduced to its trivalent active form (SbIII). This reduction occurs within the host macrophage, and the resultant SbIIIenters amastigotes via the aquaglyceroporin1 (AQP1) membrane carrier. Overexpression of AQP1 results in hypersensitivity of the parasites to SbIII, but resistant phenotypes accompany reduced expression, inactivation mutations, or deletion of AQP1. Hence, in this study, a phylogenetic analysis using barcode gene COXII and kDNA minicircle and expression analysis of AQP1 were performed in treatment failure isolates to assess the isolates' molecular characteristics and to verify possible association with drug response. Methods: Samples in this study were collected from patients with cutaneous leishmaniasis referred to the Diagnosis Laboratory Center in Isfahan Province, Iran, from October 2017 to December 2019. Among them, five isolates (code numbers 1-5) were categorized as treatment failures. The PCR amplification of barcode gene COXII and kDNA minicircle were done and subsequently analyzed using MEGA (10.0.5) to perform phylogenetics analysis of Treatment failures (TF) and Treatment response (TR) samples. Relative quantification of the AQP1 gene expression of TF and TR samples was assessed by real-time PCR. Results: All samples were classified as L. major. No amplification failure was observed in the cases of barcode gene COXII and kDNA minicircle amplification. Having excluded the sequences with complete homology using maximum parsimony with the Bootstrap 500 method, four major groups were detected to perform phylogenetic analysis using COXII. The phylogenetic analysis using the barcode target of minicircle showed that all five treatment failure isolates were grouped in a separate sub-clade. Conclusions: We concluded that the barcode gene COXII and the minicircle kDNA were suitable for identification, differentiation and phylogenetic analysis in treatment failure clinical isolates of Leishmania major. Also, AQP1 gene expression analyses showed that treatment failure isolates had less expression than TR isolates. The isolate with TF and overexpression of the AQP1 gene of other molecular mechanisms such as overexpression of ATP-binding cassette may be involved in the TR, such as overexpression of ATP-binding cassette which requires further research. [ABSTRACT FROM AUTHOR]

Background: There is a growing concern about the high prevalence of vitamin D deficiency and its relationship with variety of diseases worldwide. The objective of this study was to determine the prevalence of vitamin D deficiency and its relationship with pregnancy adverse effects in Yazd. Methods: This was a cross sectional study conducted among 200 nulliparous women from October 2013 to April 2014. Data containing socio-demographic and personal details, vitamin D level, pregnancy complications and growth situation of newborns were collected and analyzed using Mann-Whitney, Kruskal-Wallis and Pearson's correlation coefficient by SPSS. p<0.05 was considered statistically significant. Results: The mean serum 1, 25 (OH)2D3 concentration was 20.3±10.8 µg/l. Totally, 78% of the women had less than sufficient levels. Mean of vitamin D was significantly higher in natural or elective cesarean in comparison with abortion and emergency cesarean (p=0.040). Risk of abortion was 3.1(1.39-6.8) and higher in severely deficient group in comparison to women with vitamin D deficiency (p=0.017) and mean of vitamin D group was significantly lower in women who had oligohydramnios or polyhydramnios complication (p=0.045). Conclusion: The study findings revealed that vitamin D deficiency is prevalent in pregnant women and it is significantly associated with elevated risk for abortion, and oligohydramnios or polyhydramnios. Probably, a targeted screening strategy can be suggested to detect and treat women at high risk of vitamin D deficiency in early pregnancy as a simple way to reduce the risk of these adverse pregnancy outcomes in Yazd. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on predictors of students' oral health behaviors, using variables based on the Health Promotion Model in an attempt to identify influential variables that may be addressed through intervention efforts. Methods: A non-probability sample of 300 high school students was recruited from 4 high schools in Shahrekord City, Iran. The study took place between January and March of 2008. Appropriate instruments were used to measure the variables of interest. The statistical analysis of the data included bivariate correlations, t-test, one-way ANOVA and linear regression. Results: The cognition variables - perceived self-efficacy, perceived benefits, perceived barriers and activity-related affects, and commitment to a plan of Oral health behaviors, were significantly related to oral health behaviors among the respondents. A negative association was found between oral health behaviors and perceived barriers. Interpersonal influences, such as modeling and norms, and situational influences were found to be significantly related to increased oral health behaviors. All of the Health Promotion Model variables were statistically significant predictors of oral health behaviors, and accounted for 65.1% of the variation. Conclusion: Promotion of interpersonal modeling and the students' perceived self-efficacy should be priorities of any programs aimed at promoting oral health behaviors among students. It is also concluded that the Health Promotion Model may be used in developing countries, like Iran, as a framework for planning intervention programs in an attempt to improve the oral health behaviors of students. [ABSTRACT FROM AUTHOR]

The aim of this study was to screen for and estimate the prevalence of intimate partner violence (IPV) among women in Kazeroon, Iran. In November 2007, multistage cluster sampling was employed to recruit 702 women to participate in the study. A descriptive, cross-sectional design was employed. The prevalence of physical, psychological, and sexual abuse against women was 43.7%, 82.6%, and 30.9%, respectively, and there was a significant relationship between IPV and family income, education level, and level of religious commitment in both women and husbands. The study suggests that major strategies for prevention of IPV are empowering women and improving their status in the society by promoting of sexual equality in all rights, especially in employment and education. [ABSTRACT FROM AUTHOR]

Hospital waste contains large quantities of hazardous materials. In Iran, as in many developing countries, not much attention has been paid to this matter. Little information is available regarding the generation and disposal of medical waste in Iran, and this fact hinders planning for a better management of the aforementioned waste. This paper describes a survey performed on the collection and disposal of waste in the university hospitals of the Fars province, which are the medical referral centres in the southern half of the country, and the results obtained are fully discussed. The lack of separation between hazardous and non- hazardous waste, an absence of necessary rules and regulations applying to the collection of waste from the hospital wards and the on-site transport to a temporary storage location, a lack of proper waste treatment, disposal of hospital waste along with municipal garbage, insufficient training of personnel, insufficient personal protective equipment and lack of knowledge regarding the proper use of such equipment, were the main findings. For a rapid improvement of existing conditions, performing extensive research for the assessment of present situation in the hospitals of this country, compilation of rules and establishment of standards along with effective training for the personnel is recommended. [ABSTRACT FROM AUTHOR]

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren''t any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field. [Copyright &y& Elsevier]

Background: The relationship between current pet keeping and allergic diseases, including bronchial asthma in adolescents, is controversial. This study was conducted to evaluate these associations among children aged 13-14 years in Yazd. Methods: This study is part of a multicenter cross-sectional study of the Global Asthma Network (GAN) in Yazd, Iran, in 2020, in which 5141adolescents enrolled. Information on respiratory symptoms and pet-keeping (dog/cat/birds) was obtained by a questionnaire derived from the GAN standard questionnaire. Results: Of 5141 participants who completed the study, 1800 (35%) children kept pets during the last year. Birds were the most common pet kept by adolescents (88%). Severe asthma was more common in bird and cat keepers (P = 0.003 and P = 0.034, respectively) than dog keepers. Furthermore, there was a statistically significant association between study-defined current asthma and cat keeping, but not bird or dog ownership (P = 0.02). Moreover, we found that current any pet-keeping (birds, cats, dogs) was associated with a higher prevalence of asthma-related symptoms, including wheezing, night dry cough, and exercise-induced wheezing in the past year (P = 0.002, P = 0.000 and P = 0.000 respectively) Conclusion: Current any pet-keeping is associated with asthma-related symptoms. Additionally, cat keeping had a significant association with study-defined current asthma. The current keeping of birds, as the most common pet in our area, or cat keeping increases the risk of severe asthma in adolescents. Therefore, as an important health tip, this needs to be reminded to families by health care providers. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is caused by Echinococcus granulosus sensu lato. In Central Iran, no molecular information is available on CE in humans. Therefore, in this study, we identified the genotyping of hydatid cysts obtained from patients with CE in central Iran using mitochondrial cytochrome c oxidase subunit I (cox1) gene. Patients and Methods: Hydatid cysts were obtained from 19 patients referred to Shahid Sadoughi, Mojibian, and Mortaz Hospitals, Yazd, Iran from 2018 to 2020. Informed consent was obtained from all included patients. After DNA extraction, amplification was done using cox1 gene. Phylogenetic analysis was performed using MEGA7. Results: Of the 19 patients, 11 (57.9%) were male and eight (42.1%) were female. The mean age of the patients was 35.645 ± 2.55 years old. Regarding cyst location, of eight isolates from lung, six and two belonged to G1 and G6, respectively; and all liver cysts were G1 genotype. The spleen and neck cysts had G1 and G6 genotypes, respectively (p > 0.05). All cysts with a diameter in the range of 5-10 cm (n = 9) and large cysts (>10 cm; n = 5) were identified as G1 (p = 0.002). The maximum likelihood tree topology demonstrated the maximum similarity of G1 among Iran and worldwide (99%-100% likelihood). Conclusions: Based on our results, it seems that the sheep-dog cycle in the infection of humans by Echinococcus granulosus in this study area has the most important role compared with the other cycles such as the camel-dog one. [ABSTRACT FROM AUTHOR]

Echinococcus granulosus sensu lato causes Cystic echinococcosis. This study investigated the bacterial and fungal species in the liver and lung hydatid cysts obtained from sheep, goats, cattle, and camels slaughtered in Yazd abattoir, Central Iran. In this study, 84 hydatid cysts were obtained from 20 sheep, 13 goats, 25 cattle, and 26 camels. The fertility and viability rates were assessed using light microscopy and eosin staining, respectively. The aspirated hydatid cysts were cultured to detect the presence of any bacteria and fungi. Bacterial isolates were identified by biochemical tests. DNA was also extracted from germinal layers, and then genotyping was carried out targeting the cox 1 gene. The statistical analysis was performed by SPSS version 16.0. This study showed that 22.62% (19/84) of hydatid cysts had bacterial occurrence, and none of the samples had fungal species. Among the fertile cysts, 52.6% had bacterial occurrence, of which 40% were viable. Most bacteria detected in hydatid cysts included Staphylococcus saprophyticus, Escherichia coli, and S. epidermidis. Hydatid cysts with bacterial occurrence were identified as G1-G3, G5, and G6/G7. The bacterial species occurrence in hydatid cysts had no significant relationship with fertility and viability (P > 0.05), without any significant relation with viability (P > 0.05), animal species (P > 0.05), involved organ in animals (P > 0.05), and hydatid cyst genotypes (P > 0.05). It should also be mentioned that this is the first study to assess the relationship between hydatid cyst genotyping and the occurrence of fungal and bacterial species., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Asthma, as the most common chronic disease in children, encompasses substantial health and socioeconomic burden worldwide. This study aimed to evaluate the prevalence, severity, and management of asthma in adolescents aged 13-14 years. This cross-sectional study, which was part of the Global Asthma Network (GAN) 2020 survey, was conducted in early 2020 in Yazd, Iran. A total of 48 schools in Yazd city were selected by cluster sampling. In this study, 5141 students, including 3069 (59.7%) females and 2072 (40.3%) males participated. Prevalence of ever and current wheezing was 19% and 9% respectively. The former was significantly higher in males than females (p<0.001). About 2% of the participants, which was 22.1% of students with current wheezing, had severe asthma. The prevalence of severe asthma was significantly higher in males (p=0.026). Our results showed that 4.8% of students had confirmed asthma by a doctor, significantly predominant in males (p<0.001). The prevalence of using inhaled medicines in the past 12 months was 3.8%, which was significantly higher in males than females (p<0.001). The prevalence of using short-acting β-agonists (SABA) and long-acting β-agonists (LABA) was 2.3% and 1.4% among the students, respectively, with a male predominance (p=0.019). About 1.2% and 0.8% of participants were using inhaled corticosteroids (ICS) and the combination of ICS and LABA, respectively, which was significantly higher in male participants (p<0.001). According to our findings and in comparison to the previous ISAAC study in Yazd, the prevalence of severe asthma has decreased which indicates better management of asthma during the past two decades.

Historically, many important secondary metabolites including antibiotics used in clinic are purified from the cultural broths of Actinobacteria, which were inhabited in soil. Yazd is located in the center of Iran, the south of the Dasht-e Kavir and the west of the Dasht-e Lut; accordingly it has a hot, dry climate with long summers. In the present study, 18 strains of Actinobacteria isolated from 60 soil samples from Yazd-Iran. Pure isolates were screened for antibacterial activity against the ATCC strains by using two methods: single line streak method and spot inoculation method. ATCC strains include four antibiotic resistant ATCC strains (Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae and, Acinetobacter baumannii) and three antibiotic sensitive strains (Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli) and, Bacillus subtilis. Seven isolates exhibited antimicrobial activity against the ATCC strains (38.8%). Identification of type I and type II polyketide synthases (pksI, pksII) and nonribosomal peptide synthetase (NRPS) genes were done for these 7 isolates and all of 7 strains, possessed at least one of these genes. The results of this study confirm that soil Actinobacteria bear a great ability to produce antibacterial compounds against resistant and sensitive test organisms.

Synbiotic (probiotic bacteria and prebiotic) has beneficial effects on the gastrointestinal tract. This study was designed to investigate the effect of synbiotic supplementation on the growth of mild to moderate failure to thrive (FTT) children. A randomized, triple-blind, placebo-controlled trial was conducted involving 80 children aged 2-5 years with mild to moderate FTT, who were assigned at random to receive synbiotic supplementation (10 9 colony-forming units) or placebo for 30 days. The weights, height, and BMI were recorded in a structured diary, and the questionnaires were completed to monitor the numbers of infection episodes, gastrointestinal problems, admission to hospital, and appetite improvement during the study. Sixty-nine children completed the study. There were no differences in the demographic characteristic between the two groups. The mean weight was similar at baseline. After 30 days of intervention, the mean weight of the participants in the synbiotic group increased significantly than those in the placebo group (600 ± 37 vs. 74 ± 32 g/month P 0.000). BMI changes in synbiotic and placebo group were 0.44 and 0.07 kg/m 2 , and that the differences among the two groups were significant.(P 0.045) Furthermore, the height increment in synbiotic and placebo group was 0.41 and 0.37 cm respectively with no significant difference (P 0.761). Administration of 30-day synbiotic supplementation may significantly improve weight and BMI in Iranian children with mild to moderate FTT, but there is no effect on the height in this study. Further studies should be designed to found out the effect of synbiotic on growth parameters in undernourished and well-nourished children.

Background: Cancer incidence rate is increasing in the world particularly in developing countries. The awareness regarding cancer incidence and distribution helps policy makers and researchers to design comprehensive plan for controlling cancer. The aim of this study was to determine the incidence rate and trend of cancer in Yazd Province, central Iran., Methods: Data from Yazd cancer registry were derived from 2005 to 2009. Direct standardization through world standard population produced by the world health organization was used and Age- Standardized Incidence rate (ASR) was calculated. Data were analyzed using ASR, by EXCEL and SPSS software., Results: The new cases of cancer were 4631 patients from 2005 to 2009. Mean age of these patients was 57.98 ±27.49 years and 53.5% were male. Female patients were approximately 5 years younger than males. The most frequent cancer was breast in women followed by skin, colorectal, hematologic system and stomach. The 5 most frequent cancers in men were skin, bladder, colorectal, stomach and prostate. The ASR in 2005 to 2009 was respectively 85.2, 86.1, 92.6, 102.2 and 104.7 per 100,000 populations., Conclusions: ASR of cancer is increasing rapidly in Yazd Province. It is necessary to have a comprehensive health policy for prevention and control of this problem.

Objective: We aimed to compare the features of intensive care units (ICUs), their antimicrobial resistance patterns, infection control policies, and distribution of infectious diseases from central Europe to Mid-West Asia., Methods: A cross-sectional point prevalence study was performed in 88 ICUs from 12 countries. Characteristics of ICUs, patient and antibiotic therapy data were collected with a standard form by infectious diseases specialists., Results: Out of 749, 305 patients at least with one infectious disease were assessed and 254 patients were reported to have coexistent medical problems. When primary infectious diseases diagnoses of the patients were evaluated, 69 had community-acquired, 61 had healthcare-associated, and 176 had hospital-acquired infections. Pneumonia was the most frequent ICU infection seen in half of the patients. Distribution of frequent pathogens was as follows: Enteric Gram-negatives (n = 62, 28.8%), Acinetobacter spp. (n = 47, 21.9%), Pseudomonas aeruginosa (n = 29, 13.5%). Multidrug resistance profiles of the infecting microorganisms seem to have a uniform pattern throughout Southern Europe and Turkey. On the other hand, active and device-associated infection surveillance was performed in Turkey more than Iran and Southeastern Europe (p < 0.05). However, designing antibiotic treatment according to culture results was highest in Southeastern Europe (p < 0.05). The most frequently used antibiotics were carbapenems (n = 92, 30.2%), followed by anti-gram positive agents (vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline; n = 79, 25.9%), beta-lactam/beta lactamase inhibitors (n = 78, 25.6%), and extended-spectrum cephalosporins (n = 73, 23.9%)., Conclusion: ICU features appears to have similar characteristics from the infectious diseases perspective, although variability seems to exist in this large geographical area., (Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)