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Herein, we provide the ecological niches of gastrointestinal nematode infections in Guilan, Mazandaran, and Golestan provinces. For this purpose, 2688 fecal specimens of sheep and cattle were subjected to the flotation method. For modeling procedure, the results were analyzed by considering 23 bioclimatic and environmental variables as well as 96 points/locations. Maximum entropy (model MaxEnt) was used to visualize the spatial distribution of gastrointestinal nematodes. The relative importance of all variables was also assessed by using jackknife analysis. The highest proportion of sheep infection with strongyle-type egg was observed in Golestan province (57.8%) and the lowest in Guilan province (49.5%), and eggs per gram (EPG) was around 21–29. The parasites with the highest proportion of infection in both domestic animals included strongyle-type eggs. Among the different bioclimatic and environmental variables, the biggest contributor to habitat suitability of the gastrointestinal nematode presence was found to be minimum temperature of the coldest month (Bio6), precipitation of driest quarter (Bio17), precipitation of coldest quarter (Bio19), and altitude. The MaxEnt model was able to provide a suitable guidance for predicting the probability distribution of gastrointestinal nematodes under bioclimatic and environmental variables, and the findings pave way for integrated gastrointestinal nematode surveillance and control strategies in the southern strip of Caspian Sea. In addition, the low intensity of gastrointestinal nematodiasis in ruminants may be associated with the frequent administration of anthelmintic drugs, where actions are needed to investigate drug resistance in the areas concerned and to provide anthelmintic drugs administration in a targeted manner.

Introduction Spinal anesthesia is a commonly used anesthetic technique for lower extremity surgery. Despite its widespread use, the acceptable frequency of repeated spinal anesthesia for a patient is unclear. Therefore, herein, we report a patient who frequently received spinal anesthesia. Case presentation A 21-year-old man with severe head and leg injury was admitted to the hospital after a motorcycle accident. On admission, he had a tracheal tube and GCS score of six. After emergency vascular and orthopedic surgeries under general anesthesia, he was transported to the ICU. Within 12 days of admission to the ICU, he was extubated with full awareness. After consultation with a neurosurgeon for spinal anesthesia, the patient received seven spinal anesthesia procedures for his lower extremity injury in a period of 15 days. Spinal anesthesia was performed at the L3 - L4 or L4 - L5 interspace with 24 or 25-gauge Quincke needles in the sitting position (12 - 15 mg of 0.5% hyperbaric bupivacaine) by four anesthesiologists. Despite performing several spinal anesthesia procedures, no neurologic sequelae were observed. Finally, he was discharged in a good overall condition. At a four-month follow-up, the patient was in a stable situation without any neurological complications. Conclusions This report emphasizes that spinal anesthesia with hypertonic bupivacaine could be used several times for a patient in some situation.

The present study aimed to determine the number of cases of animal fascioliasis per district in the southern littoral of Caspian Sea and to model suitable ecological niches for Fasciola infection in the region. Stool samples (n = 2688) were collected from cattle and sheep in Guilan, Mazandaran and Golestan provinces. The samples were tested using flotation method, and the number of parasite eggs per gram (EPG) of feces was recorded for each sample. Occurrence-only data of Fasciola were collected from the field. A total of 96 points/locations were used to model the ecological niche of Fasciola in maximum entropy (MaxEnt) and geographical information system (GIS). The spatial layers were compiled from 23 bioclimatic and biophysical variables for modeling analysis. Jackknife analysis was used to determine the relative importance of all variables in the model. In the present study, the proportion of fascioliasis in both hosts was highest in Guilan province (sheep: 12.34%, cattle: 15.16%), followed by Mazandaran (sheep: 7.3%, cattle: 6.25%) and Golestan (sheep: 0%, cattle: 0.94%) provinces. The Area Under Curve (AUC) value of the model was 0.909, indicating a good predictive power of the model. Our modeling results indicate that four variables, which were markedly incorporated into the model, are the major predictors of the presence probability of Fasciola spp. in the region: Bio17 (Precipitation of driest quarter; 45.5%), Bio14 (Precipitation of driest month; 24.8%), aspect (9%), and altitude (7.2%). The data presented herein show expansion of the potential high-risk areas of fascioliasis in the northern part of Iran, located at the southern littoral of Caspian Sea, especially in Guilan province. However, the extent of the predicted risk zones varied between the different areas of the region and within provinces, such that at the present, many parts of Golestan province are less environmentally suitable for Fasciola distribution than other areas in the region.

Dicrocoeliasisis caused by the small lancet fluke ( Dicrocoelium spp.), mainly Dicrocoelium dendriticum in domestic and wild ruminants. The small liver fluke is the probable predisposing cause of economic burden. The impact of geographic and climatic factors on the incidence of dicrocoeliasis has been severely ignored in different geographical areas. Due to the lack of data regarding dicrocoeliasis in Iran, this study aimed to investigate the prevalence and intensity of ovine and bovine Dicrocoelium infection in the coastal strip south of the Caspian Sea. Fecal samples were obtained from the cattle and sheep in three provinces of Guilan, Mazandaran and Golestan at the littoral of the Caspian Sea. All collected samples were then tested by flotation methods for determining the number of eggs per gram of feces (EPG). Moreover, we applied maximum entropy niche-based modeling (MaxEnt), coupled with remote sensing and the Geographical Information System (GIS) to visualize the spatial distribution and risk factors of Dicrocoelium dendriticum at the littoral of Caspian Sea. A total of 2688 stool samples were collected from cattle (n = 1344) and sheep (n = 1344) in coastal provinces of the Caspian Sea including Guilan (n = 1280), Mazandaran (n = 768) and Golestan (n = 640) provinces. Based on the data presented here, the highest rate of infection was observed in Guilan and Mazandaran provinces. The results revealed the prevalence rates of 36.72% and 6.09% for sheep and cattle in Guilan province, respectively. This rate was 22.4% for sheep and 3.91% for cattle in Mazandaran province. However, the rate of sheep infection was 80% in some point locations. Dicrocoelium infections were found to be significantly different between three provinces in sheep (P Dicrocoelium was observed in sheep (36.72%) and cattle (6.09%) in Guilan province. Our findings exhibited a high reliability of the MaxEnt model, and area under the curve (AUC) values of the training and test data sets were determined to be 0.852 and 0.818, respectively. Jackknife analysis showed the relative variable contribution to the model performance, where four variables were found as key influential factors that highly affected the habitat suitability of the presence of the lancet fluke including the precipitation of driest quarter (Bio17), altitude, temperature seasonality (Bio4), and precipitation of driest month (Bio14). The findings of this study demonstrated a high presence rate of Dicrocoelium infection at the littoral of Caspian Sea, Iran. Moreover, climatic variables can be considered as important predictive factors affecting the distribution of infection in the studied areas. Further studies based on the findings of the GIS are also very important in the country for planning control programs.