ahmad raeisi

Inflammation is a key feature of coronavirus disease 2019 (COVID-19). Atorvastatin may help reduce inflammation and limit viral infection.

This study aimed to evaluate the effects of atorvastatin on inflammatory biomarkers and the clinical progression of COVID-19.

In this double-blind, randomized controlled trial (RCT), 81 PCR-confirmed COVID-19 patients with moderate pulmonary involvement were recruited. Participants were randomly assigned to receive atorvastatin (40 mg) or placebo daily for 14 days after fulfilling the inclusion criteria. Primary outcomes (inflammatory markers) and secondary outcomes (laboratory factors and clinical progression) were assessed every 7 days.

No significant differences were observed between groups in the need for supplemental oxygen and oxygen saturation (SpO 2 ) levels. However, the time to clinical improvement was shorter in those receiving atorvastatin, leading to earlier discharge. Nevertheless, no obvious differences were observed in laboratory parameters between groups. Our findings revealed that atorvastatin could meaningfully attenuate the inflammatory markers and improve lipid profiles, whereas the placebo group showed no significant changes, except for C-reactive protein (CRP) and interleukin-6 (IL-6).

Atorvastatin significantly and safely improved the inflammatory state of moderate COVID-19 infection. These findings suggest that atorvastatin may be considered as part of the treatment and/or follow-up protocol for such patients.

Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The primary diagnostic tool for pediatric COVID-19 patients is polymerase chain reaction (PCR). Chest imaging findings in pediatric COVID-19 cases are often normal or mild. The correlation of lung ultrasound (LUS) with chest computed tomography (CT) and chest X-ray (CXR) in pediatric COVID-19 patients has not been extensively studied.

This study aimed to assess the correlation of LUS with chest CT and CXR in detecting COVID-19 pneumonia in children.

This single-center cross-sectional study included patients under 18 years of age diagnosed with COVID-19 by PCR or by abnormal chest CT findings suggestive of COVID-19, admitted to Mofid Pediatric Hospital between December 2021 and August 2022. All patients underwent LUS. Approximately half of the patients also had a chest CT, and CXR was performed on 35 patients. Lung ultrasound and CT scores were calculated, and the correlation between these scores was evaluated. The correlation between LUS and CXR was also analyzed.

Sixty patients were included, of whom 21 were female, with a mean age of 4.9 ± 4.0 years. A significant correlation was observed between LUS and CT scores (correlation coefficient = 0.467, P = 0.011). Lesion distribution was similar between LUS and CT. However, no significant correlation was found between LUS scores and CXR findings (P = 0.392). Sixteen out of 19 patients with normal CXRs had LUS scores ≤ 4. Notably, three patients with normal CXRs had LUS scores of 8, 14, and 14.

Lung ultrasound was more sensitive than CXR and demonstrated a significant correlation with CT. Lung ultrasound may serve as a safe alternative to CT for detecting COVID-19 pneumonia in pediatric patients.

Remdesivir is the first approved antiviral against severe acute respiratory syndrome coronavirus 2 (SARSCoV2) with a promising effect both on in-patient and out-patient settings. Regarding the acceleration program for the development of COVID-19 therapies and emergency use authorization, reporting new adverse events other than those mentioned in the first package inserts and beyond clinical trials is expected. Medication infiltration is one of the postmarketing reported remdesivir adverse events. The present study reported four new cases of remdesivir infiltration, their clinical courses, management, and outcomes. Moreover, all other reported cases were collected to identify event risk factors and provide recommendations for reducing the condition burden. All patients received non-pharmacological interventions and conservative therapy, which included aspiration, catheter removal, limb immobilization, nonocclusive dressing, and warm compresses. Intralesional triamcinolone acetonide was also administered for three cases. The remdesivir infusion continued through another intravenous line, and the event did not reoccur for the same patient. All patients recovered without sequels. The present study attempted to address all the factors that affect remdesivir infiltration and provide clinical recommendations to reduce the incidence and event burden. The principal step in prevention and successful management is staff education. After establishing staff instructions, event severity was significantly reduced in the studied center. Furthermore, non-pharmacological intervention and intralesional corticosteroid administration could prevent local reaction extension and could probably accelerate the healing process.

 A key strategy in the global fight against malaria, endorsed by the World Health Organization (WHO), is mass drug administration (MDA). Evaluating the impact of this initiative on malaria transmission reduction is crucial.

 This study aimed to assess the effectiveness of MDA combined with primaquine (PQ) in the southern Iranian region of Jask, specifically in Lirdaf.

 Primaquine was chosen as the antimalarial drug for this intervention. A total of 168 Pakistani individuals receiving MDA were evaluated over an eight-week period from September to December 2021.

 Three cases of vivax malaria were identified. Among the 168 patients receiving PQ, 26 were found to have a deficiency in the enzyme glucose-6-phosphate dehydrogenase (G6PD), leading to the exclusion of thirty participants from the trial. Additionally, three individuals were withdrawn from the project due to restricted access (two cases) and family-related issues (one case). One participant, initially asymptomatic and positive, later tested positive again, and this case was excluded from the analysis. Regular follow-up assessments were conducted on all participants, revealing no cases of relapse throughout the project duration.

 Our findings suggest that employing MDA in combination with supplementary interventions during the elimination phase holds promise for malaria control efforts.

Although indigenous malaria cases have dramatically declined over the past decades, the COVID pandemic has continued to affect the programs designed to combat malaria, particularly in those countries where hydroxychloroquine and chloroquine have been used as medications for treating COVID. Two immigrants entered Iran illegally from neighboring countries (i.e., Afghanistan and Pakistan). This study mainly aimed to assess the effects of coronavirus disease (COVID-19) on these cases from all aspects (i.e., case-finding, diagnosis, and treatment).

Both cases presented withcommonsymptoms such as fever and shaking chills. In addition, they had no sign of COVID-19, and their oxygen level and CT images were normal in some cases, but they were mistakenly treated as COVID-19 patients long after the onset of malaria symptoms. One of the suspected coronavirus cases was given chloroquine on a voluntary basis for one day, which may have been responsible for the possible relapse in vivax or resistance of plasmodium vivax to chloroquine and the recurrence of parasitemia in falciparum.

The active case detection of malaria was affected by the COVID-19 pandemic. Case finding was dramatically decreased with the onset of coronavirus, thereby causing a spurt in malaria incidence. Moreover, the malaria treatment strategywasnegatively affected by the misdiagnosis of COVID-19.

Background and

Public vaccination was highly recommended during the COVID-19 pandemic. The lack of evidence-based data made inflammatory bowel disease (IBD) patients hesitant to receive the vaccine. In this study, clinical and laboratory outcomes of COVID-19 vaccination were investigated in patients with IBD.

This retrospective study was conducted on patients with IBD who referred to gastroenterology clinics across Sari during 2021-2022. Patients' information including demographic data and laboratory parameters were recorderd. Clinical outcomes of IBD based on the partial Mayo score in ulcerative colitis and the Harvey-Bradshaw index in Crohn's were compared before vaccination and within three months after receiving the second vaccine.

A total of 111 patients with IBD, including 100 ulcerative colitis patients and 11 Crohn's patients met the inclusion criteria for the study. The two groups were matched for distribution of age, gender, and disease extent. In addition, there was no significant difference between the groups in COVID-19 infection frequency, COVID-19 severity, type of vaccines received, and vaccine injection frequency. No significant differences were observed in clinical outcomes and laboratory parameters between the patients before being vaccinated and after receiving the second dose of vaccine. There were no changes in the type of IBD drugs within three months after getting the second vaccine, except for steroid prescription increase in ulcerative colitis patients (4% vs. 10%, P<0.01). Moreover, a statistically significant correlation was found between steroid necessity and partial Mayo score (r=0.658, P<0.001).

Receiving at least two doses of COVID-19 vaccines did not change the clinical outcomes and laboratory parameters of IBD patients. The results of this study are promising and can reduce possible concerns in IBD patients regarding the use of vaccines against COVID-19.

Although malaria is endemic in some areas of southeastern Iran, following the successful national malaria elimination plan (NMEP), the local transmission area has been shrunk. This study was aimed to evaluate the effect of climate change on the distribution of main vectors.

All documents related to research investigations conducted in Kerman Province on malaria vectors published during 2000–2019 were retrieved from scientific databases. Spatial distributions of the main vectors were mapped and modeled using MaxEnt ecological model. The future environmental suitability for main vec-tors was determined under three climate changes scenarios in the 2030s.

Five malaria vectors are present in Kerman Province. The best ecological niches for these vectors are located in the southern regions of the province under the current climatic condition as well as different climate change scenarios in the 2030s.

Climate change in 2030 will not have a significant impact on the distribution of malaria vectors in the region. Entomological monitoring is advised to update the spatial database of Anopheles vectors of malaria in this malaria receptive region.

Birth Satisfaction is a woman's evaluation of her childbirth experience that be influenced by perceived stress. The aim of this study was to determine the rate of birth satisfaction and its relationship with perceived stress in pregnant women Admitted in Hospital Shahrekord, 2022

This descriptive-correlational study was conducted on 200 pregnant women with inclusion criteria and were hospitalized in Hajar Shahrekord's Hospital. Data collection tools were demographic and obstetric characteristics form, Cohen's Perceived Stress Scale and the Birth Satisfaction Scale-Revised Indicator (BSS-RI). At first, the participants were selected as convenience and entered the study after obtaining a written informed consent; then, the midwifery-demographic characteristics form and perceived stress in labor was completed through interviews and also by referring to the client's file. In the next step, the Birth Satisfaction Scale-Revised Indicator was completed by the client 12 to 24 hours after vaginal delivery and in the emergency cesarean section until discharge. The data was analyzed using SPSS version 16 software and statistical regression test. The significance level was considered P<0.05.

According to the results, the mean score of birth satisfaction and perceived stress were (6.80±2.08) and (17.20±4.35) respectively; Also, the average score of two dimensions of Birth Satisfaction Scale, namely emotional pressure experienced during pregnancy and quality of care, were 4.1±8.84 and 2.1±72.33, respectively; In addition, no statistically significant relationship was observed between perceived stress (P=0.526) and demographic and obstetric characteristics (P<.05) with birth satisfaction.

Paying attention to the two dimensions of birth satisfaction tool and trying to increase their average score can have a positive effect on increasing overall satisfaction with childbirth. One of the ways to achieve this goal is to hold related workshops such as communication skills, stress management and clinical workshops related to the field for midwifery personnel and health care providers of pregnant mothers

COVID-19 is a pandemic and infectious disease with high morbidity and mortality rates as well as a global spread. This study aimed to investigate the clinical outcomes for patients afflicted with COVID-19 and treated with remdesivir.

In this clinical trial study, patients with severe COVID-19 confirmed by molecular testing and hospitalized at Hajar Hospital of Shahrekord in Iran were divided into standard care group (including 52 patients) and standard + remdesivir group (including 51 patients). The patients were examined for clinical symptoms, laboratory data, as well as mortality and recovery rates during the treatment period. Then the data were analyzed by SPSS version 23 using chi-square, independent t-test and repeated-measures ANOVA.

Clinical and laboratory monitoring on days 5, 10, and 14 showed that there was no significant difference between two groups (P>0.05). In addition, there was no significant difference between the two groups in terms of hospitalization duration and ICU rate (58.8% versus 51.9%, P=0.48). The trend of Lymph count and platelet decreased significantly in the standard group (P=0.003, P=0.04, and P=0.03, respectively).

Patients with severe COVID-19 were investigated and it was concluded that remdesivir produced no improvement in the remdesivir group compared to the standard group.

Malaria resurgence has occurred in the northern half parts of Iran. Factors such as the continual move ment of local people from problematic malaria foci in southeastern Iran toward the Caspian Littoral and wide use of pesticides in the agriculture sector were led to establish the diseases in the prone area. There are no new data on the re sistance status of main malaria vectors in the Caspian Littoral, and this study was aimed at renewal data on conventional insecticides.

The field strain of adult Anopheles superpictus and Anopheles maculipennis were collected using the hand catch method and transferred to the laboratory. The susceptibility tests were carried out against DDT 4%, Malathion 5%, Permethrin 0.75%, Deltamethrin 0.05%, and Lambda-cyhalothrin 0.05%, followed by the WHO’s procedure.

The primary malaria vector in Caspian Littoral is An. maculipennis, which still resistance to DDT and mortali ty rate, LT50 and LT90 of female mosquitoes were 75.0%, 54.2, minutes and 111.3 minutes. The under ’verification re quired’ status of An. maculipennis was also revealed to Lambda-cyhalothrin based on recent WHO’s criteria. The ma laria vector An. superpictus is also considered the second malaria vectors in the west parts of the studied area, which shown to be susceptible to all insecticides tested.

DDT resistance is persisted in An. maculipennis despite stopping residual spraying with DDT since 1978 in the Caspian Littoral, but the occurrence of pyrethroid under ’verification required’ status is a progressive threat to the possible development of cross-resistance in the future.

Malaria is the third most important infectious disease in the world. WHO propose programs for control ling and elimination of the disease. Malaria elimination program has begun in first phase in Iran from 2010. Climate factors play an important role in transmission and occurrence of malaria infection. The main goal is to investigate the spatial distribution of incidence of malaria during April 2011 to March 2018 in Hormozgan Province and its association with climate covariates.

The data included 882 confirmed cases gathered from CDC in Hormozgan University of Medical Sciences. A Poisson-Gamma Random field model with Bayesian approach was used for modeling the data and produces the smoothed standardized incidence rate (SIR).

The SIR for malaria ranged from 0 (Abu Musa and Haji Abad districts) to 280.57 (Bandar–e-Jask). Based on model, temperature (RR= 2.29; 95% credible interval: (1.92–2.78)) and humidity (RR= 1.04; 95% credible interval: (1.03–1.06)) had positive effect on malaria incidence, but rainfall (RR= 0.92; 95% credible interval: (0.90–0.95)) had negative impact. Also, smoothed map represent hot spots in the east of the province and in Qeshm Island.

Based on the analysis of the study results, it was found that the ecological conditions of the region (tem perature, humidity and rainfall) and population displacement play an important role in the incidence of malaria. There fore, the malaria surveillance system should continue to be active in the region, focusing on high-risk areas of malaria.

Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic in Iran, the control and management of the epidemic were headed by the National Headquarter for the Control of COVID-19 Epidemic through setting up different scientific committees, including the COVID-19 National Epidemiology Committee. The present study reviews the missions, structures, achievements, and challenges of the Epidemiology Committee. Study design: A rapid review

All relevant reports, documents, guidelines, published literature, and surveillance data related to the establishment, visions, missions, roles, activities, and outputs of the COVID-19 Epidemiology Committee were critically reviewed in this study.

The efforts of the committee’s working groups may have impacted improvements in data registration/usage, provincial data quality at provincial levels, and perception of the epidemic situation in the provinces. The committees have also played role in informing the policies in different stages of the epidemic through routine or problem-based data/evidence analyses, epidemic investigations, and mathematical modeling.

The structure and experience gained by the committee can be used in similar situations within and outside the country. To further improve the impacts of our activities, it is essential to have effective interaction, collaboration, and data flow between the committee and a broad range of organizations within and outside the Ministry of Health and Medical Education.

This study was designed to detect, if there are asymptomatic malaria infections amongst native and immigrant population from Afghanistan and Pakistan countries in Sistan & Baluchistan Province of Iran, where is under the national malaria elimination program.

This cross-sectional study was performed among native individuals and resident immigrants in the southeastern province of Sistan & Baluchistan from May 2016 to Jul 2017. A total of 271 individuals were considered in this cross- sectional study based on microscopical method, Rapid Diagnostic Tests (RDTs) and PCR techniques. Out of 271 native and immigrant participants 140 (52%) and 131 (48%) were male and female, respectively.

None of the prepared samples was diagnosed as malaria positive case when was considered via above mentioned three techniques.

Neither native nor immigrant individuals had asymptomatic malaria, hinting that national malaria elimination program is performed according to planned schedule in the studied areas

Among the human parasitic diseases, malaria is the main cause of morbidity and mortality. To prevent the high mortality and tracking malaria elimination efforts, a prompt and sensitive diagnosis is essential.  This study aimed to compare High-Resolution Melting (HRM) and microscopic methods to diagnose Plasmodium falciparum and P. vivax.

Eighty-one blood samples were collected from patients with clinical symptoms who were suspect to malaria in Chabahar district, southeastern Iran and also, from those who were referred to Malaria National Laboratory in the Tehran University of Medical Sciences, Tehran, Iran. Microscopic examination and HRM method were used to the diagnosis of Plasmodium parasites simultaneously.

Microscopic results revealed 45 positive cases (12 P. falciparum and 33 P. vivax) out of 81 collected samples while according to HRM analysis results 11 and 33 samples were identified as P. falciparum and P. vivax, respectively. HRM analysis also revealed 1 mixed infection of P. falciparum and P. malariae.

HRM analysis provides a promising mean for simultaneous detection and discrimination of the Plasmodium spp. especially in mixed infection cases.

West Nile virus (WNV) can cause a fatal disease in humans and it is mainly transmitted to people through the bites of infected mosquitoes. Vector control using insecticides is a very important goal. Study of Culex pipiens re sistance towards several insecticides in the city of Tehran, Iran was evaluated.

Adult females reared from field-caught larvae from southern part of Tehran and lab strain reared in the insec tary of Tehran University of Medical Science were determined for resistant status by exposing to 4% DDT, 0.1% bendi ocarb, 0.1% propoxur, 1% fenitrothion, 0.05% deltamethrin, 0.75% permethrin, 0.05% lambda-cyhalothrin, 0.5% etofenprox, 5% malathion and 0.15% cyfluthrin papers using the standard WHO susceptibility tests.  

Results clearly showed resistance development of Cx. pipiens against tested insecticides. Mortalities of Cx. pipiens were less than 90% with high resistance, low knock down rate and knock down time (50%) observed against insec ti cides. DDT and Malathion showed the most and least lethal time (LT50) values for the field strain. The results of the knock down test showed that DDT and deltamethrin had the most and least knockdown times (50%) for the field strain, re spec tively, while DDT and lambda-cyhalothrin had the most and least knockdown times (50%) for the lab strain, respectively.

Resistance to mentioned insecticides in Cx. pipiens is widely distributed in southern part of Tehran. Regu lar implementation of susceptibility test in Cx. pipiens mosquitoes will help local public health authorities to develop new and better control strategies.

Some mosquito species which belong to the Culex. pipiens complex are primary vectors for West Nile virus, Sindbis, Dirofilaria immitis, and many arboviruses. Knockdown resistance (kdr) mutations in the voltage-gated sodium channel (VGSC) gene of Cx. pipiens that is inherited, is one of the important threats for the efficacy of pyrethroids insecticides. Knockdown resistance (kdr) mutation, L1014F, is a well-defined mechanism of resistance to pyrethroids and DDT in many insect species. The aim of study was to determine the mechanisms of Insecticide resistance in this species Specimens of Cx. pipiens, the major vector of West Nile virus, were obtained in Tehran, Iran by collecting larvae from polluted wastewater in Qarchak of Tehran. In 2016 Insecticide susceptibility tests were performed according to WHO methods with deltamethrin 0.05%. We focused on determination of this point mutation in the VGSC gene of Cx. pipiens by Real-time PCR. Our results revealed high levels of resistance to deltamethrin 0.05%. The lethal times i.e. LT50 and LT90 for deltamethrin were 2.1530 and 8.5117 h respectively. The result of Real-time PCR confirmed the presence of resistant genotype in all the members of tested population. This study is the first report on kdr genotyping of Cx. pipiens from Tehran and our results on the VGSC gene in position L1014F confirmed the TTA to TTT nucleotide change. This finding will provide a clue for management of insecticide resistance in mosquito which are vectors of arboviruses and decision for replacement of novel approach for vector control.

To date, there is no standard approach to manage and to improve central sleep apnea (CSA). The most applicable therapeutic approaches are positive airway pressure therapy (PAP), bi-level PAP therapy (BIPAP), supplemental O2 and servo ventilation, or a combination of two approaches. Given the high prevalence of heart disease (HF) and/or concomitants of other diseases and opioid use worldwide; it seemingly requires evaluation of patients' conditions in response to each abovementioned approach to select the most effective approach.

This longitudinal cross-sectional study included 64 CSA patients who had undergone continuous PAP (CPAP), CPAP + O2, and BiPAP. Hence, if a patient was nonresponsive to a treatment, the next was applied. If the patient was nonresponsive to all approaches, oxygen alone was administered. The collected data were analyzed with SPSS.

The study of 64 CSA patients showed that frequencies of response to CPAP, CPAP + O2, and BiPAP were 42.2%, 20.3%, and 28.1%, respectively. While 9.4% of patients with histories of congestive heart failure (CHF) and ischemic heart disease (IHD) who were older than others and with the highest apnea-hypopnea index, were nonresponsive to all approaches. CPAP therapy showed more appropriate results in patients with CHF and IHD. Furthermore, patients with the history of opioid use showed the most positive results in response to CPAP and BIPAP.

The results suggest that CPAP and BIPAP are, respectively, the most effective therapeutic approaches to CSA in patients with the histories of HF and opioid use, but CPAP + O2 could be reliable in some conditions as well. Therefore, it may require further studies to be clarified.

The detection of insecticide resistance in natural populations of Anopheles vectors is absolutely necessary for malaria control. CDC bottle bioassay as a new tools has been employed for detecting the insecticide resistance. For a limit number of mosquito vectors, diagnostic doses and diagnostic times for some insecticides have already been deter mined using this new assay. For the first time in the area, susceptibility levels of Anopheles stephensi was done with DDT, deltamethrin, and bendiocarb using CDC bottle bioassay and compared results with WHO standard test method. Anopheles stephensi were collected in larvae stage from the cisterns of drinking water in Chabahar port which considered as old malaria foci, Sistan and Baluchistan province. The field collected larvae were colonized at the insectary of School of Public Health (SPH), Tehran University of Medical Science. The susceptibility tests were carried out on sugar fed female mosquitoes aged 2–3 days, against DDT 4%, bendiocarb 1% and deltamethrin 0.05% using WHO and CDC susceptibility methods. The mortality and knockdown rates, as well as the parameters of regression analysis, includ ing LT50 and LT90, was calculated separately for the WHO and CDC methods.  The 24h mortality rates of An. stephensi were 28.6% and 25.6% for DDT, 60.8% and 64.6% for bendiocarb and 100% for deltamethrin using both WHO and CDC assay at 30 and 60min respectively. The 50% lethal times (LT50) were estimated 44.9 and 66.2min, 38.9 and 81.8min and 0.7 and 15.0min respectively using both WHO and CDC susceptibility tests. The similar results of susceptibility levels were shown for DDT, bendiocarb and deltamethrin. The lethal times (LT50) showed significant difference using both WHO and CDC bioassay methods.

This study aimed at estimating the incidence, mortality, burden, and geographical distribution of malaria between 2002 and 2015 in Iran. DALYs index was used to estimate the burden of malaria. DALYs-related malaria was calculated using a method developed by (WHO) for investigating the Global Burden of Disease (GBD); it was calculated through adding Years of Life Lost (YLLs) due to premature death to Years Lived with Disability (YLDs).The data on the incidence and mortality were collected from the malaria surveillance system in the Center for Com-municable Diseases Control (CCDC), Ministry of Health and Medical Education (MOHME). The incidence of malaria had a decreasing trend over the studied period and it reduced from 15378 cases in 2002 to 777 cases in 2015. Overall, 28 cases of mortality were observed between 2002 and 2015. In addition, disease burden decreased from 90.78 DALYs in 2002 to 22.38 DALYs in 2015.Overall, there were 949.2 DALYs due to malaria from 2002 to 2015. The incidence and burden of malaria were not equally distrib-uted among all the provinces in Iran and some areas were suffering from the highest burden of the disease. The incidence and burden of malaria have had a decreasing trend over the years of the study and Iran has little to do in order to eradicate malaria. Since the disease is not equally distributed among various provinces of Iran, health policymakers must direct health resources towards specific areas of the country (Sistan and Baluchistan, Kerman, and Hormozgan) with high concentration of cases of malaria.

Malaria continues to be a main vector-borne public health problem in Iran. The endemic foci of the dis ease are mainly located in south-eastern part of the country. Iran is now launching the elimination of malaria. Studies on the bioecology and susceptibility of malaria vectors to insecticide are essential in this phase. The literature on bio-ecology of Anopheles superpictus s.l. Grassi was reviewed in Iran in more than half a century. Different aspects including, distribution, key identification, larval habitats, flight range, seasonal activities, irritability/susceptibility to insecticides, and anthropophilicity index were identified. The adult females of An. superpictus s.l. were susceptible to all WHO-recommended imagicides except DDT. Distribution, morphology, sibling species, larval habitat, flight range, Irritability tests, sustainability index, blood feed ing preference and related factors were discussed in details Results of the evaluating will help for decision making of authorities for vector control.

For many years, malaria was a major life-threatening parasitic infection in Iran. Although malaria elimination program is implementing in the country, still some cases annually are reported from malaria-endemic areas.
This study was conducted in five malaria endemic districts of Sistan and Baluchistan Province, southeastern Iran, neighboring Afghanistan and Pakistan countries. Overall, 170 and 38 vivax malaria and falciparum malaria infected patients were enrolled in the study from 2013-2014. All the cases were selected according to criteria of the WHO guideline for in vivo drug sensitivity tests in malaria parasites. Evaluation of drug sensitivity test was conducted with some modifications.
The patients with vivax malaria responded to the regimen of chloroquine in 37.4(±15.9), 40(±13.8) and 42(±17.7) h for Pakistani, Iranian and Afghani nationalities respectively based on MPCT evaluation. The results showed a considerable difference between them and Iranian subjects. MPCT for the patients with falciparum malaria was calculated as 28(±18.05), 26(±12.03) and 36(±16.9) h for Iranian, Pakistani and Afghani nationalities respectively. There was a marginally significant difference between Afghani and other nationalities and between males and females.
Treatment of all the patients resulted in ACPR and MPCT of P. vivax showed that the parasite became more sensitive to chloroquine than previous years in studied areas.

Long-term anesthesia applied in some operations, especially in neurosurgical operations leads to unwanted complications. This study aimed to compare the effect of intraoperative labetalol and lidocaine injection on the rate of changes in postoperative blood pressure and heart beat in patients undergoing brain operation.

This is a simple double-blind randomized clinical trial study conducted in Al-Zahra and Kashani Hospitals on 90 patients' candidate for craniotomy operation with the age range of 18–65 years, Glasgow Coma Scale (GCS) ≥13 before anesthesia, physical class of American Society of Anesthesiologists I, II, insensitivity to labetalol who were divided into two groups of 45 individuals in the random allocation method. To start anesthesia, fentanil 1.5 mg per 1 kg of body weight, midazolam 5 mg, propofol 2 mg/kg and then, atracurium 0.15 mg/kg and lidocaine 1.5 mg/kg were used. The rate of patients' bucking and blood pressure were checked at GCS time after operation and in patients' recovery in terms of 0, 5, 10, 20 and 30 min after arrival in the recovery room and 1 h later.

There was no significant difference in terms of hemodynamic parameters during the period of operation and recovery and at the time of extubation and during the study, no case of bradicardia, hypotension, tachycardia or hypertension was observed in the patients of both groups.

Using labetalol in craniotomy surgery is helpful for two main reasons that are the proper control of intraoperative and postoperative blood pressure and prevention of postoperative reactions, especially cough and if there is no contraindication for using it, it is recommended.

The aim of this study was to evaluate different concentrations of deltamethrin combined with formulated piperonyl butoxide (PBO) synergist on various surfaces against the wild strain of Anopheles stephensi, the main malaria vector in Southern Iran under semi-field condition.
Four concentrations of deltamethrin WG 25% (Tagros) and PBO 800EC-UV (Endura) were prepared and sprayed on the pre-designed surfaces in accordance with WHO alliance line of the IRS Micronair®. The WHO’s rec­ommended bioassay kit and method was used during this study.
Comparing the mortality rate of mosquitoes, the results showed a significant difference between months after treatment of IRS (Indoor Residual Spraying) (P 0.05).Statistical test revealed a significance difference between mortality rate of mosquitoes in exposing to concentrations of 1 and 4 (P This research as the first semi-field trial on deltamethrin added to different concentrations of formulated PBO for IRS, indicates that deltamethrin흅 PBO is more effective than other concentrations. Therefore, using syner­gists can be suggested as a new tool for prevention of pyrethriod resistance, although more studies are recommended.

Malaria is a major global public health problem and a leading cause of morbidity and mortality in many countries. Malaria elimination is the common goal of World Health Organization and the health system in Iran. Following a decline in malaria cases in recent years, the malaria elimination program, technically supported by the WHO, has initiated since 2009 in Iran. In order to successfully implement a malaria elimination program, all positive cases particularly low parasitemia and asymptomatic cases are required to be detected. The main objective of this study was to identify asymptomatic malaria infection in a low transmission area in Rudan district, Hormozgan Province, southern Iran.
In this cross-sectional study a total of 200 blood samples were randomly collected from symptomless residents of Rudan to evaluate Plasmodium infection rate where microscope, RDT and nested-PCR techniques were used.
According to the analysis of microscopic methods, RDT and Nested-PCR, no asymptomatic cases were seen among the participants.
The results of this investigation reveal that Malaria Elimination Program is administrable in Rudan district irrespective of low-parasitemia and asymptomatic cases.

The ob­jective of this study was to find an appropriate approach to asymptomatic malaria in elimination setting through a systematic review.
A broad search was conducted to find articles with the words ‘malaria’ in their titles and ‘asymptomatic’ or ‘submicroscopic’ in their texts, irrespective of the type of study conducted. The Cochrane, Medline/PubMed, and Scopus databases, as well as Google Scholar were systematically searched for English articles and reports and Iran’s databases- IranMedex, SID and Magiran were searched for Persian reports and articles, with no time limitation. The study was qualitatively summarized if it contained precise information on the role of asymptomatic malaria in the elimination phase.
Six articles were selected from the initial 2645 articles. The results all re-emphasize the significance of asymptomatic malaria in the elimination phase, and empha­size the significance of diagnostic tests of higher sensitivity to locate these patients and perform interventions to re­duce the asymptomatic parasitic reservoirs particularly in regions of low transmission. However, we may infer from the results that the current evidence cannot yet specify an accurate strategy on the role of asymptomatic malaria in the elimination phase.
To eliminate malaria, alongside vector control, and treatment of symptomatic and asymptomatic pa­tients, active and inactive methods of case detection need to be employed. The precise monitoring of asymptomatic individuals and submicroscopic cases of malaria through molecular assays and valid serological methods, especially in regions where seasonal and low transmission exists can be very helpful at this phase.