[ 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

[Susceptibility of dangerous scorpions of hormozgan province to WHO recommended insecticides]

Hormozgan province is the second most important foci of scorpion stinging specially by Hemiscorpius lepturus. Currently chemical control is the most efficient way and susceptibility level of important vectors should be chequed to find their resistance to some chemicals. Our aim was to investigate on the susceptibility or resistance of the most dangerous scorpions of Hormozgan province to the WHO recommended insecticides. In this cross-sectional study, 843 specimens of Scorpio were captured. Susceptibility tests were achieved using the method of Cockroaches, susceptibility. Each dose of insecticides was tested in two replicates and killing dose of each specimen was calculated. Killing dose of Cypermethrin [EC 2.5%] was 0.001 micro l/cm2 for Mesobuthus eupeus, H. lepturus and Odontobuthus doriae and was 0.009 micro l/cm2 for Androctonus crassicauda. That dose was calculated as 0.001 and 0.0003 micro l/cm2 for M. eupeus and H. lepturus, respectively, for Deltamethrin [EC 2.5%]. All species were killed at dose of 0.39 mg/cm2 for Carbaryl [WP 85%]. None of Lindane doses [WP 25%] could make 100% mortality in all species. Mortal dose of Malathion [EC 57%] was 1.029 micro l/cm2 for A. crassicauda and H. lepturus and 0.284 micro l/cm2, and 0.515 micro l/cm2 for M. eupeus and O. doriae, respectively. The studied scorpion species were susceptible to the Pyrethroids. These insecticides can be used in an "Integrated Vector Management" program to control Malaria and scorpions. These species probably are resistance to Malathion and Lindane

Mass rearing of anopheles stephensi on human blood by artificial feeding under laboratory conditions

In order to control the diseases that are transmitted to human and animal by arthropod vectors, it is necessary to investigate vectors and to recognize control methods as well. These studies are applicable by rearing the colonies of arthropod blood-feeders like malaria and leishmaniasis in laboratory. The purpose of this study was to produce mass production of Anopheles stephensi [Lis.] by artificial feeding with human blood in insectary. We prepared an apparatus composed of a digital thermostat with sensor, element, contractor and magnet in order to blood-feed An. Stephensi. The Para film "M" and a human whole blood unit were used as a membrane and nutrient source for artificial feeding, respectively. The blood was placed in a soft lid and its surface was covered with Para film "M". The soft drink lids with blood were placed on the cage surface and indirectly warmed by element. An. Stephensi fed from blood. Three consecutive generations were reared without blood-feeding on host alike from the egg of mother colony. Female mosquito feeding rate was 47.7% to 64%. The average females feeding and ovipositing times were 10 and 9 times, respectively. No mortality was seen among the larvae. All of the pupae emerged to the adult. The second and third generation of population ratios to first population generation was 6 and 25 folds, respectively. Our findings showed that artificial feeding by human blood, especially in the investigational projects was completely efficient and suitable for increasing mosquitoes' population in specific time

[Quality gap in primary healthcare services in Bandar Abbas: women's perspective]

The Service quality gap is the gap between customer expectations and the perceived quality of the service delivered. The basic step in eliminating this gap is recognizing customers' perceptions and expectations of service quality and determining the quality gap. The aim of this study was to determine the quality gap in primary healthcare services in the health centers of Bandar Abbas. This was a cross-sectional study and the target population consisted of women attending the health care centers of Bandar Abbas. We selected a total of 400 women according to the order of their attendance. The SERVQUAL measurement instrument was used to determine the gap in service quality. The instrument comprises five dimensions: tangibles, reliability, responsiveness, assurance and empathy. Data were analyzed by the SPSS software. There were quality gaps in all the five dimensions of service quality. The smallest gap [-0.76] was in the assurance and the greatest gap was observed for the empathy [-0.98]. There were significant differences between the mean of service quality gap in all dimensions [P<0.0001]. The negative gap in service quality indicates that client expectations are higher than their perceptions. Thus, there is a need for improvement across all the five dimensions

IUD survival and its determinants; a historical cohort study

IUD is one of the safest and most widely used reversible methods of contraception. The purpose of this study was to determine IUD survival and reasons for early discontinuation in Bandar Abbas, south of Iran. Probability of IUD continuation rate and factors associated with discontinuation were assessed in a historical cohort study of 400 women records from March 2002 to February 2004. Data were collected from documents in health centers and interview with subjects. Life tables, Kaplan-Meier, log-rank test and cox regression model were used for data analysis. The continuation rate of using IUD at 6, 12, 18, 24, 30, 36, 42 and 48 month were 92%, 87%, 81%, 75%, 69%, 62%, 56% and 50%, respectively. Counseling and desire to becoming pregnant were associated with continuation rate [P < 0.03]. Furthermore the most important reasons for IUD discontinuation were side effects of IUD followed by pregnancy tendency, health concerns, expulsion, and unsatisfied with the method. Conclusion: This study suggested that women should be fully informed about side effects of IUD before inserting it as well as during its using