[ rare case of pulmonary TB patient with more than seven cutaneous leishmaniasis active lesions]

T.B [Tuberculosis] is one of the oldest diseases and it has been considered as one of the causes of human mortality and morbidity. Some of TB patients simultaneously are involved with other co morbidities such as leishmaniasis, and it slows down the treatment procedures of the secondary disease. This study was about a TB patient with more than seven leishmaniasis active lesions in her ferent organs. The patient was a 73 years old female residing and from Moshk-Abad village from the central county of the Qom province who referred to Qomrood health care center for treatment for the first time. We became suspicious to TB because of the poor healing of the leishmaniasis lesions and also positive history of cough for more than two weeks and severe cachexia. The sputum samples were obtained and sent to the laboratory, and all the three samples were positive for AFB [acid-fast bacillus] and besides meglomin antimonite, DOTS [Directly Observed Treatment Short course] was started for the patient. Based on findings of this study, in patients with cutaneous leishmaniasis which are drug resistant or failure to treatment, according to their clinical symptoms, other diseases that weaken the immune system such as tuberculosis should be considered

[ epidemiologic status of scorpion stings in Qom province, 2001-2011]

In the tropical regions of Iran, scorpion stings are one of the most important medical and health problems. Knowing about their epidemiologic aspects might lead to the employment of appropriate preventive methods. Therefore, these studies were done in Qom province for this purpose. This research is a descriptive cross-sectional study which has been done in all of the urban and rural areas of Qom province from 2001 to 2011, and all the cases which were referred to the only available hospital were assessed, examined, treated and subsequently followed. Finally, a questionnaire including demographic, epidemiologic and clinical data was completed for the patients. Chi square tests were used for the evaluation of the hypothesis. In total, 790 cases of scorpion stings were referred to the hospital during the period of study. Most of the cases were males [60.25%] in the 10-24 age groups. The most cases occurred during spring and summer. Hands and feet were the most common location of scorpion stings. 18.7% of envenomed cases were due to black scorpions. 74.4% of cases were from rural regions. 77.2% of the sufferers slept outdoors and on the ground. 20.5% of cases were surrounded by timber, dust and building materials. Based on these findings, scorpion stings are considered a public health problem in Qom province. Consequently, it is necessary to introduce health education programs for personal protection, in order to prevent possible injuries from scorpions, especially for the boy students that reside in rural areas. Also the villagers should use proper beds to sleep in the outdoors.

[Epidemiology of cutaneous leishmaniasis in Qom province, Iran, during 2003-2009]

Cutaneous leishmaniasis [CL] is a parasitological disease that is transmitted by sand flies. This disease is endemic in different areas of Iran. This study was designed to determine the epidemiological aspects of CL in Qom Province during 2003-2009. This was a cross-sectional study. Geographical and epidemiological data of all patients from 2003 to 2009 with clinical and microscopic diagnosis were monitored and followed up, and their medical records were surveyed. Of 1812 patients with leishmaniasis 1047 cases [57.78%] were male and 765 [42.22%] were female. The prevalence rate of disease was 25.8 in 100,000. The most frequent age group was above 15 years old [74.5%]. 50.39 of the patients were living in urban areas and the rest lived in rural areas, especially in central county villages. 52.65% of the patients had no positive history of traveling to leishmaniasis endemic areas during the previous year. 24.5% of the patients had 3 or more lesions. The most common location of lesion was on their hands [49.08%]. Based on our findings, men in working age group are more likely to have the disease; the number of patients without any history of traveling to endemic areas in Iran during the previous year is very considerable; therefore, we can conclude that leishmaniasis is endemic in Qom Province including in central-part villages. So, the high prevalence rate requires further control and prevention measures

[ co- infection of crime Congo hemorrhagic fever and brucellosis: a case report]

Crimean-Congo Hemorrhagic fever [CCHF] is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are: encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis. In this article, we've discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. [AST] was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10-which were carried out in pasture Institute-were reported to be positive. According to the patient's history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. [Wright=1.320, 2ME=1.160] The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City

[ epidemiology of pediculus is humanus capitis infestation and effective factors in elementary schools of Qom province girls 2010, Qom, Iran]

Nowadays pediculusis [Head-louse infestation] is one of the dermal infections with a Global distribution, and is prevalent worldwide. Head-louse infestation is highly common in collective centers such as schools, garrisons and champuses; in schools, specially in feminine elementary schools which is dramatically high. The current study has been conducted to determine the prevalence of Head-louse and to assess the epidemiologic features of the disease. This descriptive cross-sectional study was done over 1725 feminine elementary students from 75 schools in rural counties and total urban districts of Qom province by a multi stage random sampling. Data collection was done by questionnaires and physical exams of the hair. Analysis was done by Chi-square and Multivariate logistic regression model test. [Significant level with p<0.05 objected]. 131 of 1725 survived students, were infected by pediculusis. [7.6%]. The statistical meaningful relation was observed between the habitat, father's job and literacy, mothers literacy, family size, students grade, bath in home, bath times, daily comb, record of infestation in years ago, hygiene corrector in school, access or no access to primary health care and pediculusis [p<0.05 objected]. But no meaningful relation was detected between mother's job, head hairs length, type of school, residing status [private, rental and other site] and the prevalence of Pediculusis. Pediculusis is still a health burden in societies with low health and life standards. The high prevalence of pediculusis among students in the majority of schools in Qom province is attributable to inadequate access to health educator and sanitation facilities and inattention to personal health and related factors else

[ rare case of crimean-congo hemorrhagic fever]

Crimean- Congo Hemorrhagic fever [CCHF] is a viral disease that transmitted to human by the bite of mature tick vectors, contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. Eighty percent of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of this disease is equal to 20% to 50%. It is a Case Report. The patient was an Iranian 55 years-old housekeeper woman who was resident of Qom province. The obtained epidemiologic data showed that this patient had the close contact to fresh animal corpse and their secretions within five to six days before her death. Clinical history of this patient was as follows: sudden onset of symptoms, sever fever, myalgia, diarrhea, bleeding diathesis and anal hemorrhage during hospitalization. The first serum diagnostic test by RT-PCR was positive. Crimean-Congo haemorrhagic fever diagnosis could be considered for the referred patients with acute symptoms suddenly such as high fever with muscle pain, diarrhea and bleeding diathesis

Mosquito [diptera: culicidae] fauna of Qom province, Iran

There is very little information about the mosquito fauna of Qom Province, central Iran. By now only three species; Anopheles claviger, An. multicolor, and An. Superpictus have been reported in the province. To study mosquito fauna and providing a primary checklist, an investigation was carried out on a collection of mosquitoes in this province. To study the mosquito [Diptera: Culicidae] fauna, larval collections were carried out from different habitats on 19 occasions using the standard dipping technique during spring and summer 2008 and 2009. In total, 371 mosquito larvae were collected and morphologically identified including 14 species representing four genera: Anopheles claviger, An. marteri, An. turkhudi, An. superpictus, Culex arbieeni, Cx. hortensis, Cx. mimeticus, Cx. modestus, Cx. pipiens, Cx. territans, Cx. theileri, Culiseta longiareolata, Cs. subochrea, and Ochlerotatus caspius s.l. All species except for An. Claviger and An. Superpictus were collected for the first time in the province. All larvae were found in natural habitats. The association occasions and percentages of the mosquito larvae in Qom Province were discussed. There are some potential or proven vectors of different human and domesticated animal pathogens in Qom Province. The ecology of these species and the unstudied areas of Qom Province need to be investigated extensively

[ case report of a rare leishmaniasis patient with more than 29 acute lesions]

Leishmaniasis is one of the parasitic diseases causing a limited number of skin lesions in patients suffering from it; but in some patients a greater number of these lesions are observed which need systemic treatment and active follow -up. The patient is a 56 years old female suffering from lesihmaniasis who lives in Farajabaad village from the central district of Qom province. She referred to Qomrood health center for treatment. This patient had more than 29 lesions in her different organs, while The leishmaniasis patients usually have limited number of wounds [maximum 5 lesions in most cases]

Malaria situation and anopheline mosquitoes in Qom province, central Iran

The aims of this study was to analysis the current situation of malaria and to find the distribution of anopheline mosquitoes, as probable vectors of the disease, in Qom Province, central Iran. This study was carried out in two parts. First stage was data collection about malaria cases using recorded documents of patients in the Province health center, during 2001-2008. The second stage was entomological survey conducted by mosquito larval collection method in 4 villages with different geographical positions in 2008. Data were analyzed using Excel software. Of 4456 blood slides, 10.9% out were positive. Most of cases were imported from other countries [90.4%], mainly from Afghanistan [56.5%] and Pakistan [16.3%]. Slide positive rate showed a maximum of 16.9% and a minimum of 2.9% in 2008 and 2007, respectively. Plasmodium vivax was causative agent of 93.75% of cases, followed by P. falciparum [6.25%]. More than 15 years old age group contained the most malaria reported cases [66.7%]. Two Anopheles species, An. superpictus and An. claviger were collected and identified. This is the first report of Anopheles claviger in Qom Province. Malaria is in the control stage in Qom Province. The rate of local transmission is very low [only 1 case], shows Anopheles superpictus, as the main malaria vector of central part of Iran, can play its role in malaria transmission in the area