ABSTRACT
The goal of this study was to know the identity of Leishmania species responsible of cutaneous leishmaniasis [CL] in Pars Province, southern Iran. Five counties of Shiraz, Firouz Abad, Ghir-Karzin, Farashband and Larestan were prospected. Forty-four patients exhibiting cutaneous lesions were selected. Samples collected on skin le sions were examined both microscopically [after Giemsa staining] and molecularly [after PCR-RFLP]. On the 44 examined patients, 39 exhibit Leishmama sp. by microscopical examination, all confirmed by PCR. For five patients with negative microscopical examination, PCR was positive for three of them. Among these 42 positive samples, 3 [7%] were infected by L tropica and 39 [93%] by L. major. Leishmania major is the most prevalent species in prospected area and L. tropica occurs in Shiraz and Ghir-Karzin counties
ABSTRACT
Zoonotic Cutaneous Leishmaniasis [ZCL] is a parasitic disease which caused by a protozoan belongs to the genus Leishmania. ZCL is of great public health importance in many countries and also in endemic parts of Iran. Leishmania major is the causative agent, Phlebotomus papatasi as the main vector and Rhombomys opimus is the most important reservoir of the disease. Species identification of Leishmania in a large scale of human samples is necessary to conduct a useful program for controlling the disease outspread. This study was done to identify the Leishmania using microscopic and molecular methods in suspected patients of Cutaneous Leishmaniasis by targeting ITS-rDNA gene, Golestan province, Iran. 121 smears collected from suspected patients of ZCL, in Eastern region of Golestan province, Iran during 2009-10, stained and examined under a light microscope. DNA of parasites extracted directly from smears and ITS-rDNA gene amplified. Positive samples digested with BsuRI restriction enzyme, according to RFLP method and subsequently the parasite was identified. After sequencing the ITS-rDNA gene, Molecular software was applied for verification of RFLP results. The achieved results were definitely approved by this procedure. 113 out of 121 and 92 out of 121 samples detected as Leishmania positive using microscopic examination and molecular method respectively. All 92 molecular positive samples digested with BsuRI endonuclease and 90 individuals identified as Leishmania major. In order to final verification, 8 samples of Leishmania major sequenced and confirmed by molecular software analysis. Unfortunately, sequences of two samples which were not Leishmania major were not readable, and consequently, these could not be identified. Comparison of obtained sequences of current study with Gene Bank sequences confirmed L.major in human from Northern Iran. Other species of Leishmania were not identified in this investigation but detection of two other samples, which were not L.major, could indicate the role of other Leishmania species causing infection in human in Eastern region of Golestan province, northern Iran. These findings should be considered to improve the disease control programs, which can be led to increase the rate of public health in Golestan province
Subject(s)
Humans , Male , Female , DNA, Ribosomal/genetics , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/geneticsABSTRACT
Unless performing a timely and appropriate correction, congenital anomalies can conduce to irrecoverable complications. There are different reasons for delay in referring such patients to physician for surgery. By understanding these considerations, we can make an effective approach to reduce the severity of this problem in our community and this is the aim of our study. In a cross sectional study, all 359 eligible cases [neonates and infants suffered from a correctable anomaly which were referred to our centers] and 110 physicians were included for a period of 15 months [2000-2001]. Two main hospitals in our city were set as the data collection centers [Al-Zahra]. Parents' views were extracted by interview. Physicians' knowledge about study subject was assessed by self administered MCQs. In this study 65 percent of all cases who were operated on had been taken to hospital with delay [male to female ratio was 4:1]. Among the cases who received delayed surgical treatment, inguinal hernia was the most prevalent one [39 percent]. Surgery in 32 percent of cases who had delay in their operation caused some degrees of complications. Physicians' misadvise [42 percent], economic problems [25 percent], and hospital terror [17 percent] were accounted as the most prevalent reasons for delayed referrals. Physicians' knowledge about the correctable congenital anomalies in infants was estimated very poor [3 score from 10]. Delay to refer for operation in correctable congenital anomalies is an important dilemma in our community. Public education and also health professional education about this matter can play an admissible role improving the situation. Also, it is needed to make decisions for improving assurance supports in such cases