Cockroaches are considered to be important reservoirs for protozoan and helminth parasites ,particularly an emerging Lophomonas spp., protozoan parasite. German cockroaches, Blattella germanica (B. germanica), are domestic pest distributed worldwide. However, little information is available regarding the burden of Lophomonas spp. infestation among domestic cockroach population worldwide. The present study investigated parasitic agents, emphasizing Lophomonas spp. infestation among B. germanica in northern Iran. During spring and summer 2018, a total of 496 adults B. germanica (265 males and 231 females) were trapped by hand and glass traps from the teaching hospitals in Mazandaran, Sari, northern Iran. All cockroaches were identi ed using taxonomic keys. Each cockroaches was anesthetized with chloroform and the alimentary tract removed. Each section was smeared onto a glass slide. All the smears were examined under light microscopy to determine the presence of the parasites. Ten genera of parasites were identi ed from the trapped B. germanica; overall, 233 (47%) were found to be positive for helminths (n=135) and protozoa (n=98). The helminths included Aspiculuris tetraptera egg ( 67/233, 28.7%), Oxiuros sp. (39/233; 16.7%), Dentostomella translucida (17/233; 7.3%), and nematodes Ova (12/233; 5.2%). The protozoan parasites identi ed Gregarina sp. (61/233; 26.2%), Entamoeba sp. (19/233; 8.2%), Blastocystis sp. (5/233; 2.1%), Lophomonas (4/233; 1.7%), Nyctotherus sp. (4/233; 1.7%), unclassi ed agella (5/233; 2.1%). Lophomonas spp. was detected within the gut of B. germanica, for the rst time, in Iran. It has previously been identi ed in the gut of cockroaches a long time ago, however, thisis the rst attempt to detect Lophomonas in cockroaches housing in hospitals. Thereby, it possibly presenting pose a serious respiratory infection risk for patients and health care personnel.

The use of maggot therapy (MT) is proving effective in the treatment of complicated diabetic foot ulcers (DFUs). Most of the previous studies have focused on the comparison of MT and routine treatment approaches for the management of DFUs. The aim of this study was to add MT to routine treatment line of DFUs as a new approach. In this study, the principal expectation from MT method was to prepare wound bed for continuation of the treatment with other measures. This study was designed as a before-after observational study. Twenty-five out of the initial 47 volunteers who presented with DFUs to our wound clinic were included in our study. In the present study, a total of 27 DFU cases were managed with maggot therapy using the Karaj Strain of Lucilia sericata (L. sericata). MT was added to routine treatments as a complementary therapy. Surface areas of the necrotic tissues and granulation tissues over time were calculated. Satisfaction of patients and physicians was evaluated with a questionnaire. There was a significant reduction in the surface area of necrotic tissues and increase in the surface area of granulation tissues (p < 0.0001) as early as four days after the initiation of maggot therapy. After adjusting for confounding variables, statistical analysis confirmed a significant reduction in the size of necrotic tissues and increase in granulation tissues formation (p < 0.001). About 96.3% of the physicians and patients involved in our study were satisfied with the results of the treatment. The time for significant reduction of the size of necrotic tissues was less than in similar studies. This study confirmed that effective, faster and satisfactory results can be achieved when MT is added to routine treatments as a complementary therapy for healing DFUs. This approach can be introduced as a new treatment modality for healing DFUs with high rate success.

Zoonotic cutaneous leishmaniasis (ZCL) is a form of disease, which is mostly caused by Leishmania major (L.major ) in the Old World with high incidence through early life. Recently, the high incidence of CL has been reported in Jajarm County, northeastern Iran. The aim of the present study was to investigate the epidemiological aspects of CL and to identify Leishmania spp. in the area. Between 2012 and 2018, patients with active lesions suspected of CL were examined. Diagnosis was performed by methods of clinical examination and direct smears. Conventional kDNA polymerase chain reaction (PCR) was used to identify species of Leishmania . During the seven-year study period, 629 subjects were diagnosed as CL cases by clinical and microscopic examination. Considering the population of the study area, the average incidence rate was 237.8 per 100,000 population. Most (29.4%) of the subjects with ZCL were aged <10 years. Most of the patients (58.7%) were male and the rest were female. Most ulcers were observed on the face (32.2%) and hands (23.7%), respectively. Most patients (90%) had two or more ulcers on their body. The highest incidence was in the autumn in October (32%). Our data revealed that an ongoing reemergence of ZCL focus caused by L.major has arisen in the study area. Moreover, direct PCR on the smears for identifying Leishmania showed 100% specificity, and the species was identified as L. major using species -specific kDNA PCR. The use of conventional PCR on skin smears seems to provide a valuable method for confirming the clinical diagnosis of ZCL, which is very specific and sensitive particularly for clinical correlative studies. Further investigations are needed to improve planning strategies of vectors and reservoirs populations.

In the present study, the efficiency of two formulations of maggot therapy: free-range larvae on the wounds and larvae in a special bag (larval-bag), was compared for healing diabetic ulcers with Wagner 2 diabetic ulcer. This study was conducted as a parallel randomized clinical trial. Out of 281 patients with Wagner grade 2 diabetic ulcers referred to the wound clinic, 54 patients who met the inclusion criteria were randomly assigned to intervention groups. The disinfected larvae of Lucilia sericata were put on the wounds with 2 methods, free-range larvae and larval-bag. Follow up was done at every 48 h interval until the full appearance of granulated tissues. The main measures were wound bed preparation, removing of necrotic tissues, appearing of granulated tissues, and removing of bacterial infections in the wounds. Statistical analysis based on the Kaplan–Meier curve and the Wilcoxon (Breslow) test showed a significant reduction in wound healing time by using free-range larvae in comparison with larval-bag ( P = .03). The median time to debridement was 4 days in the free-range larval group (95% confidence interval: 3-9 days) while it was 9 days in the larval-bag group (95% confidence interval: 5-16 days). Debridement rate (proportion of removed necrotic tissue surfaces) at any time in the free-ranged larvae group was 1.78 times that of the bagged larvae group (95% confidence interval 1.01-3.15, P = .036). There was no significant difference between free-range larval use and larval-bag in the acceptability of maggot therapy by patients ( P = .48). It can be concluded that both of two formulations of the larval therapy (free-range larvae and larval-bag) could be recommended for cleaning out and bed preparation of diabetic ulcers. However, using free-range larvae is hardly recommended on the wounds which are eligible to use.

Introduction: The present study aimed to prepare Nanoemulsions of Mentha piperita and Eucalyptus globulus essential oils and comparison of the repellant activity of them with normal essential oils and DEET in the field conditions. Methods: To determine the protection and failure time of the essential oils and DEET in the field condition against natural population of night biting culicid mosquitoes, 4 human volunteers participated in night biting test. GC-MS was used to determine the essential oil components and the Dynamic Light Scattering device was used to measure droplet size and zeta potential. Results: The relative abundance of more common species captured in this study was 40.09% and 31.65% for Anopheles superpictus, and Culex pipiens, respectively. Based on the results, the protection time of nanoemulsions of M. piperita 50% against night biting mosquitoes was 4.96±0.21 h. Also, the protection for nanoemulsions essential oil 50% of E. globulus was 6.06±0.20 h. Comparison of the results showed that the protection time of nanoemulsions of M. piperita and E. globulus was significantly higher than of their normal essential oils (P˂0.01). Also, the protection time of DEET (as a gold standard) was significantly higher than of normal essential oil and nanoemulsions of M. piperita (P˂0.01), but there is no significant difference between DEET and nanoemulsions of E. globulus (P˃0.01). Conclusion: Due to the safety and biocompatibility of the nanoessential oils, and also relatively adequate and acceptable protection time, nanoemulsions of E. globulus and probably M. piperita can be considered as good repellents. It is recommended to do more research on these nanoemulsion repellents, as they may be good alternatives to DEET.