Iranian Journal of Public Health
Volume:52 Issue: 12, Dec 2023

The current and ongoing conflict imposed in Gaza has led to severe environmental challenges in Gaza, resulting in a health crisis that demands immediate attention and intervention. A comprehensive study has evaluated the pressing mental health, water and sanitation, access to healthcare, and infectious disease challenges plaguing the region. Mental health issues, particularly among children and adolescents, have surged in the wake of the conflict, with trauma-related symptoms expected to persist. The water and sanitation crises pose severe public health hazards, with an overwhelming majority of water unfit for consumption and escalating infectious diseases. Shortages of medicines, fuel, and breakdowns have profoundly affected access to healthcare in healthcare facilities, significantly impacting women and girls. The academic society is responsible for conducting research, providing education, and training, and advocating for policy changes. At the same time, the united nation’s (UN) role is vital in providing aid, advocating for policy changes, and monitoring human rights and health situations. Urgent action is imperative to stabilize the environmental and health impacts and allow humanitarian aid into Gaza to alleviate the severe health problems. This study underlines the critical need for international support and intervention to address the multifaceted health crises in Gaza and prevent further deterioration.

Medical tourism is a leading industry of South Korea. Since the transition from the latest health pandemic to endemic, foreign patients have been on a rapid increase. The Korean government regards medical tourism as a major national industry and pursues medical, legal, and policy strategies with the goal of attracting 700,000 foreign patients by 2027.

Examining objective data and statistics as well as academic articles, we investigated the strengths and advantages, which might persuade foreign medical tourists to visit South Korea by performing a comparative analysis with high-income or medically advanced countries among Organization for Economic Co-operation and Development (OECD) and other competing Asian countries.

Cancer is one of the leading causes of death in the world. Compared with other advanced countries and Asian competitors in cancer treatment, South Korea shows excellent result of major cancers treatments, accessibility to hospitals and medical professionals, and competitiveness in terms of surgery and treatment costs.

South Korea has excellent competitiveness both in price and in cancer treatment with the outstanding results of cancer mortality rates and 5-year survival rates. The achievement of Korea's cancer treatments is due to accurate diagnosis with the advantage of PET-CT, 64-sllice CT, 3.0 TESLA MRI, etc., and the use of cutting-edge equipment, such as CyberKnife and Da Vince robotic surgery. Besides, the Korean central and local governments actively support for the promotion of Korea's medical tourism industry, such as issuance of visas for foreigners, the hospital certification system, and medical tourism convergence cluster project.

We aimed to investigate the intervention effect of mindfulness-based interventions (MBIs) in patients with postpartum depression.

The method of computer and manual keyword retrieval was used to search PubMed, Web of Science, Cochrane Library. Literature included in the study was assessed for quality and meta-analysis was performed using RevMan 5.3 software.

Twelve articles were finally included in the study and the meta-analysis showed that 6 articles used the Edinburgh Postnatal Depression Scale (EPDS) to compare MBIs with conventional therapy, and the statistical heterogeneity between the combined results was low (P=0.18, I2=32%). The level of depression in postpartum depression patients was lower in the MBIs group than in the conventional group [MD=3.13, 95%CI (2.57, 3.70), P<0.00001]. Based on the Beck Depression Inventory (BDI), the comparison between MBIs and conventional therapy had low statistical heterogeneity between the combined results (P=0.56, I2=0%). The level of depression in patients with postpartum depression who received MBIs was significantly lower than in the conventional care group [MD=5.89, 95%CI (4.88, 6.91), P<0.00001]. Subgroup analysis showed that the best intervention duration for MBIs for postpartum depression was within 4 weeks (SMD=-1.785), each session≦60 minutes (SMD=-1.435), and participants had to complete the best three times per week (SMD=-2.185).

MBIs can alleviate depression in women, thereby facilitating their adjustment to new life. It is recommended to practice mindfulness meditation for 30 minutes per day.Mindfulness

The use of electronic systems supported by text-mining software applications that support the End TB strategy’ needs to be explored. This study aimed to address this knowledge gap, and synthesis of evidence.

The PubMed database was searched for structured review articles published in English since 2012 on interventions to control and manage TB. Nine hundred twenty-five articles met the inclusion criteria. The included articles were synthesized using the text and content analysis software Leximancer. The themes were chosen based on the hit words that emerged in the frequency and heat maps. After the themes were chosen, the concept built the themes based on likelihood.

The framework resulting in the study focuses on early detection and treatment to minimize the chance of TB transmission in the population, especially for highly susceptable populations. The main area highlighted is the appropriate screening and treatment domains. The framework generated in this study is somewhat in line with the WHO Final TB Strategy. This study highlights the importance of improving TB prevention through a patient-centered approach and protecting susceptible populations.

Our findings will be helpful in guiding TB practice, policy development and future research. Future research can elaborate the framework and elicit feedback from TB management stakeholdesr to assess its utility.

Meat and meat products are introduced as one of the carriers of Clostridioides difficile. This study aimed to determine the prevalence and antibiotic resistance of C. difficile isolates in meat and meat products using a systematic review and meta-analysis.

It was performed a literature search in the primary international and bibliographic databases such as MEDLINE (PubMed), Cochrane Library, Embase, Scopus, and Web of Science to achieve all articles related to the prevalence and antibiotic resistance rates with no time restriction. A total of 54 studies examined C. difficile in 15,010 samples and its resistance to 10 antibiotics.

The pooled prevalence of C. difficile was 3.4% in all samples. C. difficile pooled prevalence was detected in fish, poultry, and red meat samples with 6.9%, 5.2%, and 3.2%, respectively. Regarding antibiotic resistance, the highest pooled prevalence was for ciprofloxacin (86.6%), followed by clindamycin (42.6%) and erythromycin (34%). The lowest pooled prevalence was observed in metronidazole (7.6%), vancomycin (6.6%), and chloramphenicol (6%). We found low resistance to commonly used drugs for C. difficile infection treatment.

Every antibiotic can be a risk factor for CDI development, and drugs such as clindamycin, cephalosporins, and lately fluoroquinolones carry the highest risk. Therefore, we recommend the rational use of antibiotics in veterinary and human medicine

Working in hot environments can cause diseases and reduce performance by upsetting the balance of physiological parameters of workers' bodies. Bakers are among the people exposed to heat stress continuously and daily. This review study aimed to investigate the effect of heat stress on bakers.

In this review study, the related articles based on keywords were reviewed using “IranMedex”, “Science Direct”, “PubMed”, “Scopus”, “Web of Science”, “SID”, “Google Scholar”, and “Magiran” databases from the years 2000 to 2021. The used search terms were "Heat stress", "Heat strain", "Heat exposure", "Heat waves", "Workplace", "Baker", and "health effects". In order to extract the required data, all parts of the articles have been reviewed.

Out of the 16 studies reviewed in this study, 43.75% were cross-sectional, 25% were descriptive cross-sectional, and 31.25% were performed according to other study designs. In all of the studies, the WBGT index was used to assess ambient heat stress. In most studies, the mean exposure temperature was higher than the WBGT-ACGIH limit, especially among traditional bakery workers. The findings showed that exposure to thermal stress significantly affects some hematological parameters of blood, oxidative stress, heart rate, and body temperature.

The situation of heat stress in the bakery environment is worrying in terms of health and reduced productivity of employees. Therefore, it is essential to take the necessary preventive and control measures to reduce heat stress and the resulting strain.

Various factors are effective in the development of minimal residual disease (MRD), one of which is MicroRNAsmiRNAs miRNAs and their dysfunction in gene expression have influential role in the pathogenesis of leukemia. Nowadays, treatments that lead to the suppression or replacement of miRNAs have been developed. Focusing on the role of miRNAs in managing the treatment of leukemia, in this review article we have investigated the miRNAs and signaling pathways involved in the process of apoptosis and cell proliferation, as well as miRNAs with oncogenic function in malignant leukemia cells. Among the studied miRNAs, miR-99a, and miR-181a play an essential role in apoptosis, proliferation and oncogenesis via AKT, MAPK, RAS, and mTOR signaling pathways. miR-223 and miR-125a affect apoptosis and oncogenesis via Wnt/B-catenin, PTEN/PI3K, and STAT5/AKT/ERK/Src signaling pathways. miR-100 also affects both apoptosis and oncogenesis; it acts via IGF1 and mTOR signaling pathways.

As the elderly population increases, interest in life satisfaction in old age is increasing. We aimed to verify the relationship between social capital, smartphone use motives, and digital literacy and life satisfaction in Koreans aged 50-69 yr.

The data of 7,521 late-middle-aged and older adults from the 2019 survey on smartphone overdependence conducted by the National Information Society Agency were analyzed by hierarchical multi-regression analysis.

A hierarchical multiple regression analysis indicated that income(β=0.062) and educational background(β=0.054) were positively related to life satisfaction. Among the smartphone use motives, lifestyle motive(β=-0.069) was negatively related to life satisfaction. Digital literacy(β=0.145) and Social capital(β=0.425) were positively related to life satisfaction.

Digital literacy and social capital were positively associated with life satisfaction. In addition, this study considered the effects of lifestyle-based apps, while past studies only focused on communication- and leisure-based smartphone activities as factors influencing life satisfaction in adults in their 50s-60s. This study can provide a theoretical framework for therapeutic interventions to improve life satisfaction in the elderly.

Teenagers are more prone to mobile phone addiction than other age groups due to their lack of self-control. This addiction to mobile phones severely affects their physical and mental health, causing irreversible harm as they grow older. As such, exploring suitable psychotherapy for their physical and mental development needs is essential, in ways that effectively change teenagers’ mobile phone addictive behaviors.

An experimental study was conducted on 910 teenage volunteers recruited from 5 communities in Gansu, Hebei, and Liaoning Provinces in China from May to July 2023. The participants were screened using the Mobile Phone Addiction Index Scale (MPAI). On the basis of the evaluation results, 56 individuals were selected based on the evaluation results and randomly divided into experimental and control groups, each comprising 28 individuals. The experimental group underwent an 8-week mindfulness-based mental health education therapy. Both groups were measured before and after the intervention.

The mobile phone addiction score of the experimental group was significantly lower than that of the control group (P<0.001). The cognitive tendency score and mental wellbeing score of the experimental group was significantly higher than those of the control group (P<0.001).

Mindfulness-based mental health education therapy effectively alleviates teenagers’ mobile phone addiction and improves their cognitive tendencies and mental health. This approach serves as a valuable reference for effectively preventing and managing mobile phone addiction among teenagers.

The decrease in the frequency and duration of participation in leisure activities has negative effects on the physical, cognitive and psychological health of individuals. In this context, identifying the obstacles, which prevent individuals from participating in leisure activities, may offer important clues to institutions and organizations in taking measures to increase participation.

The bibliometric analysis method was used in this study. The research was carried out with 306 articles scanned from the Web of Science (WoS) core database between 1991 and 2019.

Studies conducted in leisure area increased systematically according to 5-year periods and mostly authors from USA, Australia and Canada produced them. The mainstream subjects, which attracted the attention of researchers during recent years, are detected to be self-efficacy, segmentation, mental health and fear related to intrapersonal constraint topics.

In order to cope with physical and mental health problems resulting from aging of the world population, and technological developments, and negative effects generated by inactive modern life style, priority should be given to studies on leisure constraints to be conducted on a more comprehensive basis. Another suggestion is to encourage health policies and applications which can increase participation in leisure activities.

There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey.

Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given.

Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women.

Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging.

This study analyzed physical health awareness, self-esteem, and depression as mediation factors in the effect of exercise on school life satisfaction. It compared these between Korean children and adolescents.

Based on the 2020 Survey on the Human Rights of Children and Adolescents in Korea, data were extracted on 2,896 children in grades 4 to 6 and 5,727 adolescents in grades 7 to 12. A structural equation model was designed and multi-mediation analysis was conducted using phantom variables. To verify the differences between children and adolescents, latent means, path coefficients, and mediating effect confidence intervals were analyzed.

Structural modeling and bootstrapping revealed that the direct and indirect paths were significant in both groups (P<0.01). Comparing the mean differences, children showed higher means than adolescents did in all variables. Among the direct paths, the paths of physical health awareness from exercise practice and school life satisfaction from physical health awareness were higher in adolescents (P<0.01), and the path of school life satisfaction from exercise practice was higher in children (P<0.01). The indirect paths showed that the mediating effect of health awareness between exercise and school life satisfaction was stronger among adolescents.

Physical and mental health directly and indirectly affect school life satisfaction, with different patterns in children and adolescents. This study emphasizes the need for different strategies for children and adolescents who are experiencing physical and mental health problems and difficulties adjusting to school life.

Colon adenocarcinoma (COAD) is one of the most common cancer happened in gastrointestinal tract, with the overall incidence rate of 4%-5% among human beings. Like most malignancies, we uncovered the exact mechanisms of the pathogenesis of colorectal cancer yet. Therefore, there is an urgent need to explore the molecules that can be used as diagnostic maker at early stage. In addition, we also need to define the essential factors that related to the prognosis and treatment of the colon carcinoma.

The study was conducted at the Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China in September 2020. The R language was used to identify the differentially expressed genes. We performed receiver operating characteristic curve analysis to determine the diagnostic markers for COAD. The machine learning strategy was used to assess the effectiveness of genes in the diagnosis of COAD. The molecular mechanism and prognostic value of genes were explored by bioinformatics analysis and molecular experiments.

The expression level of heat shock factor 4 (HSF4) was significantly elevated in COAD patients (P=1.89×10-29), according to The Cancer Genome Atlas (TCGA) database. Additionally, survival analysis showed the higher expression level of the HSF4 was correlated with the poor prognosis in COAD.

The HSF4 was the target gene of zinc finger protein 692(ZNF692). HSF4 might promote the progression of COAD through the apoptosis pathway. It was diagnostic and prognosis maker of COAD. Furthermore, the upstream gene of HSF4, ZNF692, promotes the progression of colorectal cancer by regulating HSF4 expression.

Dietary pattern may be one of the determinants of cardiovascular health. This study aimed to examine the relationship between a heart-healthy diet, the phytochemical content of a diet, and Mediterranean diet and cardiovascular disease (CVD) risks.

This study was conducted with healthy volunteers (n=1446) from Turkey between August 2022 and September 2022. As risk assessment systems to determine CVD risks, SCORE (Systematic Coronary Risk Evaluation) and ASCVD (Atherosclerotic Cardiovascular Disease) were used. We utilized MEDFICTS (Meats, Eggs, Dairy, Fried foods, Fat in Baked Goods, Convenience Foods, Fats Added at the Table, and Snacks) to establish the suitability of the current diet for heart health, and MEDAS (Mediterranean Diet Adherence Screener) to examine the Mediterranean diet characteristics of the current diet. The phytochemical content of the diet was determined using the Phytochemical Index method developed by McCarty.

The lifetime and 10-year risk scores of SCORE and ASCVD were positively correlated with the MEDFICTS score (r=0.12, P<0.001; r=0.06, P=0.020; r=0.10, P=0.001, respectively). Mediterranean diet characteristics were correlated with lower CVD risk as per the SCORE categories (r=-0.07, P=0.009). A one-unit increase in MEDFICTS scores increased high-to-very high CVD risk and 10-year moderate-to-high CVD risk by 1.01 times, while a one-unit increase in the Mediterranean diet score decreased high-to-very high CVD risk and 10-year moderate-to-high CVD risk by 0.91 times and 0.95 times, respectively. In addition, high values of body weight, body mass index, waist circumference, waist-height ratio, and neck circumference were associated with higher CVD risk (P<0.001).

Adopting a Mediterranean diet and a heart-healthy diet may be a good strategy to reduce CVD risks.

Whole viral genome sequencing with next generation sequencing (NGS) technique is useful tool for determining the diversity of variants and mutations of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). In this study we have attempted to characterize the mutations and circulating variants of the SARS-CoV-2 genome during the 4th wave of COVID-19 pandemic in Tehran, Iran in 2021.

We performed complete genome sequencing of 15 SARS-CoV-2 detected from 15 COVID-19 patients during the 4th wave of COVID-19 pandemic with NGS. Three groups of the patients at the beginning, middle and the end of the 4th wave were compared together.

We detected alpha and delta variants during the 4th wave of the pandemic. The results illustrated a dominance of amino acid substitution D614G in spike, and the most frequent mutants were N -R203K, G204R, S235F, nsp12-P323L, nsp6-G106del, G107del and F108del.

The detection of the virus mutations is a useful procedure for identifying the virus behavior and its genetic evolution in order to improve the efficacy of the monitoring strategies and therapeutic measures.

A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) is a superfamily of extracellular proteinases found in both mammals and invertebrates. Although there is some evidence about the role of ADAMTSs in ocular diseases such as glaucoma and ectopia lentis, but there is little information about the expression patterns of ADAMTS-1-20 and ADAMTS-like (ADAMTSL-1-6 and PAPLN) genes in human ocular tissues. This study aimed to evaluate the expression profiling of ADAMTS(L) superfamily of genes in different ocular tissues based on age.

In 2019, nine human donated eye globes were provided from the Central Eye Bank of Iran, and were divided into three different groups based on age (under 3 yr old, between 20 to 50 and upper 50 yr old). To assess expression patterns of ADAMTS(L) genes in different ocular tissues including trabecular meshwork, lens, retinal pigment epithelium, macula, and optic nerve in the three age groups, total RNA was extracted from the tissues and reverse transcription polymerase chain reaction followed by Real-time PCR was performed.

We demonstrated not only each member of ADAMTS(L) superfamily shows different expression pattern between the five investigated ocular tissues, but also some members have differential expressions among the investigated age groups in same tissues.

Differential expression of ADAMTS(L) genes in ocular tissues from different age groups could explain some functional aspects of the tissues and also may be used as prognostic and diagnostic biomarkers for ocular diseases and pathologies. Further studies are required to explore their functional roles associated with ocular pathologies.ADAMTS Proteins

In May 2014, the Iranian government announced it would cover all uninsured Iranians. Despite free-of-charge insurance, the studies found that the coverage still needed to be completed (93%). This study aimed to understand why certain population groups remain without insurance despite the accessibility of free-of-charge coverage. This issue is not unique to Iran; it is prevalent in many other countries where, despite free coverage, not all individuals avail themselves of it, thereby exposing themselves to risks.

In a matched case-control study, 89 non-insured patients were compared with 178 hospital-based controls with health insurance (2:1). The samples were recruited at one of the leading public hospitals in the country (Imam Khomeini Hospital Complex in Tehran) in 2019. Two insured controls were selected and matched for age (± five years) and sex for each person without insurance. A conditional logistic regression was performed to assess the magnitude of effects and the goodness of fit test used to examine the model.

Unemployment (Odds Ratio (OR)=8.33, 95% Confidence interval (CI): 1.05-50.0), being single (OR=3.69, CI: 1.18-11.55), low economic status (OR=1.85, CI: 1.02-3.33) and attitude towards performance of health insurance (OR=0.86, CI: 0.75-0.99) were affected not having health insurance.

Approaches that cover the entire population may struggle to ensure no one is left without needed services. There is a need for greater focus on vulnerable groups to achieve universal health coverage conscientiously. Moreover, improved services and education can positively shape public perceptions of insurance efficacy, affecting their enrollment choices.Health sector reform

Osteoarthritis is one of the principal causes of chronic joint disease and may progressively engender disability in elderly individuals. The present study aimed to identify differentially expressed genes and associated signaling pathways in end-stage osteoarthritis.

Differentially expressed messenger RNAs in the early and end stages of osteoarthritis were examined through gene expression omnibus 2R (GEO2R) in the GSE32317 dataset. Subsequently, gene ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) analyses were conducted. Furthermore, microRNAs targeting hub genes were investigated using the miRcode database. This study was conducted jointly at Bam University of Medical Sciences and Rajaie Cardiovascular, Medical and Research Center on October 2022.

Differentially expressed data demonstrated downregulation in 134 genes and upregulation in 189 genes in end-stage knee osteoarthritis. The results of the enrichment and PPI analyses determined 4 end-stage knee osteoarthritis-related hub genes: IL-1B, CD19, CACNA1G, and ALDH18A1. The knee osteoarthritis-related key genes were involved in the Wnt signaling, B cell receptor signaling, calcium signaling, circadian entrainment, arginine and proline metabolism, axon guidance, and cytokine-cytokine receptor pathways. Additionally, the microRNAs targeting the 4 aforementioned genes were predicted.

The present study is the first to provide fresh insights into the potential therapeutic targets of key genes, namely CD19, CACNA1G, and ALDH18A1, differentially expressed in end-stage osteoarthritis and their relevant signaling pathways and interactive microRNAs.

Cardio-respiratory fitness (CRF) is a strong predictor of overall health and is considered a key physiological measure in health care settings. Maximal oxygen uptake (VO2max) is considered the gold standard for measuring CRF. Non-exercise VO2max regression equations provide a safe, simple and relatively accurate means of measuring CRF in the general population. This study aimed to develop first native regression equations to predict of CRF without exercise test in Iranian healthy boys.

Laboratory gold standard CRF and anthropometric variables were measured in 597 healthy boys (8-17 yr) in Hmadan City, Iran in 2019. Multiple regression analysis was used to generate CRF regression equations. Cross validation of the CRF regression equations was assessed using PRESS statistics, Pearson correlation, Bland-Althman plot and paired t-test

CRF regression equations based on age, body mass index, body fat and resting heart rate were developed (R2=0.602 – 0.639, SEE = 3.42 – 3.73 ml/kg/min). PRESS statistics show that, shrinkage of the R2 (0.04 – 0.06) and the increment of SEE (0.18 – 0.25 ml/kg/min) is minor. There was strong correlation (R =0.847–0.883, P<0.001) and no significant difference (min diff= 0.09–0.18 ml/kg/min, P>0.05) between measured and predicted CRF. The Bland-Altman plot illustrates the strong agreement between the two values.

We introduced simple and satisfactorily accurate CRF regression equations based in healthy boys. Prediction of CRF of the boys by regression equations would provide a simple tool for assessing cardiorespiratory fitness in large studies including Iranian boys.

Recent evidence provides the facts behind the perceptions about women researchers participating in health research (HR). Women scientists as almost half of active researchers in HR fields have important and fundamental role. The present study aimed to analyses the situation of women participation in HR of Iran.

The present study comprised three complementary phases intended to identify and analysis challenges and problems of women participation in health research in Iran (2021-22). Following a review phase, using the content analysis approach through semi-structured interviews data gathered from key stakeholders of health research. At final step, aimed to aggregate and conclude the main key findings, through an expert panel all of the results analyzed to clarify the main messages of the study, focus on reflection to the target group.

The results reveal considerable gender differences in research contribution between Iranian men and women. The need for legal infrastructure and support for the active participation of women in HR was the main extracted point of study. The need for transparent documentation and implementation of related research that demonstrates the necessary challenges and gaps was another major point.

Findings may help illuminate policy makings to promote participation of women in the country research. The optimal management of HR require facilities can play an important role in improving the quality and quantity of health studies and achieving scientific competitive positions at the regional and global levels.

Despite the declining trend, salmonellosis is still an important preventable cause of death in Iran and the world, especially in certain age and occupational subgroups, and the need for preventive measures, especially raising awareness of at-risk groups, is necessary.

Data were obtained from the Ministry of Health covering the years 2013 to 2019. The data were then stratified by year, season, month, and province of death as well as sex, age group, belonging to rural vs. urban communities and cause of death and were then analyzed using SPSS to report differences in age, sex, seasonal patterns, and spatial distribution.

Non-typhoid salmonellosis (NTS) and typhoid were recorded as the cause of 800 and 32 deaths, respectively, with the highest number in 2015 and 2013. Septicemia was the cause of 87.3% of deaths due to NTS, whereas typhoid was the cause of 62.5% of its respective cases. The highest percentage of death related to both occurred in spring (P<0.001). NTS mortality rates were higher in the 70-80 and 80-90 age groups, while typhoid mortality was greatest in the under 10 yr age group. NTS mortality was higher in urban while typhoid mortality was higher in rural areas (P<0.001). Most deaths occurred in Ardabil, Sistan and Baluchistan and Khorasan Razavi provinces and Sistan and Baluchistan, West Azerbaijan and Khorasan Razavi related to NTS and typhoid, respectively.

Salmonella remains a preventable cause of death, especially among the elderly and children, the data gathered in this study provides important information for priority setting in specific subpopulations and food safety policy.

Human dirofilariasis is currently considered a zoonotic infection, a mosquito-borne disease caused by the filarial nematodes of dogs, mainly Dirofilaria repens and D. immitis. Human dirofilariasis has been reported from many parts of the world, including Africa, Australia, the Americas, Europe, and Asia. The climate of Bandar Abbas in Hormozgan province, Sothern of Iran, has favorable conditions for the growth and reproduction of different types of vector mosquitoes. A 20 yr old woman from Bandar Abbas, visited a surgeon where the presence of a nodule was diagnosed in the forehead. In histopathological examination, cross-sections of a worm surrounded by necrotic tissues were observed. By evaluating the sections, Dirofilaria sp. was the probable diagnosis. To our knowledge, in Iran, this is the first human dirofilariasis occurring in the forehead. Human cases of dirofilariasis need to be reported so that physicians could consider dirofilariasis in their differential diagnoses.