---

Background and purpose: Malta fever is an infectious disease caused by brucella bacteria in humen and animals and it is one of the endemic diseases in Ïran which can causes different clinical manifestations and sever complications like meningitis, endocarditis, nephritis and pancytopenia specially in children. Çansidering the incidence of malta fever in Ïran, specially in our region, we performed this study in children under 12 years of age on the bases of clinical findings, methods of laboratory findings and appopriate line of treatment.
Materials and methods: This case series descriptive study was conducted on the bases of data collected from 100 admitted patients with positive clinical sign,and specific blood culture or positive serological tests in the form of census from Tehran children medical center and Âmirkola children hospital in babol.
Results: 93% of the patients had 10 years old of age or less. The male to female ratio was1.6. Fever & knee pain was seen in 97% and 72% of them respectively. 56% noted a history of dairy products usage. ËSR was less than 50 unit in 96%. Ât last 96% of the patients improved by therapeutic regimen of cotrimoxazole(6wks) and Gentamicin (2wk).
Çonclusion: Âccording to our results, the disease is common under 10 year-old and is seen in the boys more than the girls. Fever & knee pain are of the most common clinical manifestations. More than half of the patients noted the history of dairy products usage. So Malta fever have to be considered as a differential diagnosis for the patients with these manifestations and low ËSR rate. Âny way,the patients had a good respons to cotrimoxazol and gentamicin regimen

---

Background and purpose: Fever of unknown origin is a frequent disorder in pediatric age. The aim of this study was to determine the causes of fever of unknown origin and to evaluate diagnostic tests.
Materials and Methods: Çases were identified by reviewing the medical records of all patients with FÜÔ which were admitted in three medical centers in Tehran during march 1994- 99.
Results: Ïnfection was the most frequent cause of fever of unknown origin. Neoplastic disorders occurred in children older than one year. Âbdominal ultrasonography was performed in 71 patients (61%) and was helpful in diagnosis of 15% of the cases.
Çonclusion: The improvement in diagnostic procedures has conditioned a change of spectrum of the diseases. Ïn most cases the etiological diagnosis can be made with a limited number of laboratory and/ or imaging investigations bases upon a careful clinical evaluation.

---

Background and purpose: Ïn early 2001 an epidemyic of ÇÇHF occurred in sfahan province of ÏRÂN. Âccording to some reports ÏVÏG may be useful some cases of ÇÇHF. The aim of this study was to compare the standard regimen of oral Ribavirin with or without ÏVÏG in ÇÇHF patients.
Materials and methods : 40 proven ÇÇHF patients were included in the study, %30 (12 patients) were administerad ribaverin plus ÏVÏG (case group) and %70 (28 patients) took ribaverin alone(control group). The clinical parameters of all patients were followed up for 8 weeks.
Results: The mean duration for disappearance of fever and other clinical symptoms were 4.6 and 5 days in case and control groups respectively(p= 0.27). The mean time for WBÇ and liver function tests(LFT) normalization were 3.6 and 5.8 and 3.9 and 7.5 days in case and control groups respectively)p= 0.002) and (p=0.001). there was no significant difference in mortality rate.
Çonclusion: Âlthough ÏVÏG administration declined the duration of the dizare and caused earlier improvement in clinical and para- clinical data, it seems that it did not exert any significant effect on outcome of the disease.

---

Fever is considered a common symptom in children. Periodic fever with less luadeuce produces additional complications. In this study, we present a rare periodic fever syndrome which contains aphthus stomatitis, pharyngitis and cervical adenitis (PFAPA) in a 3 year old child with typical symptoms. His fever was present for 2-4 days (100%), in addition, cervical adenitis & pharyngitis associated arthritis (only one tries) was observed. The sedimentation rate was increased. Its treatment consisted of antipyretic and corticosteroids. This lead to a good prognosis and with the passage of time had a complete resolution.

---

Acute rheumatic fever is an acute systemic disease due to autoimmune reaction against some of BHSA. Similarity between bacterial antigens and cardiaciovascular tissue, synovial membrane, joints and subcutaneous tissues and cerebral basal ganglions are the causes of autoimmune reactions and manifestation of the disease. Most of the ARF occur in children (5-14 years old) followed by streptococcal pharyngitis and the disease is very rare in adults. Sydenham's chorea is a late manifestation of ARF and one of the John's diagnostic criteria that is usually revealed when the other criteria are absent. There is often a long latent period between clinical manifestations of the ARF and the onset of chorea as an uncommon initial presentation of acute rheumatic fever. We report the clinical findings, investigations and the course of clinical development of a seventeen-year-old girl, who presented with acute onset of abnormal involuntary movements in her right hand for two days before her admission. She had sore throat and fever three weeks before development of these new problems. Her complaints disappeared with proper treatment. The considerable findings in this case report was co-incidence of Sydenham's chorea with erythema marginatum, fever, severe mitral valve insufficiency, arthralgia in an adult patient that is a very rare case. She was discharged after a 10-day treatment regime.

---

Background and purpose: Crimean-Congo hemorrhagic fever is a zoonotic disease that has been reported from different parts of Iran. The aim of this study was to investigate the Seroepidemiology of Crimean-Congo hemorrhagic fever in high risk professions in Yasuj, Iran. Materials and methods: The present study included 108 subjects at risk 34 butchers, 20 slaughters, 14 slaughter-house workers, 20 waiters, and 20 housewives were randomly selected. After completing the demographic characteristics and history of febrile diseases, blood samples were obtained and specific IgG antibodies against Crimean-Congo hemorrhagic fever virus were tested. The collected data were analyzed with descriptive statistics and percentages and chi-square tests. Results: Of the 108 subjects, 5 (4.6 percent) with positive serology were among restaurant the workers 2 (10 percent) and slaughterers 3 (15 percent), respectively, which was statistically significant. There were no positive serologies in the other groups. Conclusion: The present study showed that the Seroepidemiology of Crimean-Congo hemorrhagic fever in high risk professions is not highly prevalent in Yasuj, Iran. However, the need for further surveillance and prevention programs is still recommended.

---

Leptospirosis is a zoonotic disease in nearly all parts of the world, especially in tropical and subtropical areas and is prevalent in hot and humid areas. Particularly in the northern provinces of Caspian Sea in Iran by having mild and wet weather conditions, this disease is more spread to other parts of the country. Today, with evolution of the Leptospira, disease from traditional village that enhance its prevalence among farmers and fishing, modified to epidemics in urban communities that do not have good health. Thus the purpose of this review is epidemiology, prevention, diagnosis and treatment of leptospirosis. Prevalence of the disease in each zone depends on climate, geography, population, domestic and wild animals, and the abundance of surface water. Laboratory diagnosis of leptospirosis important and Micro Agglutination Test (MAT) in the diagnosis of disease is Valuable. Molecular tests such as PCR can be used in early detection of disease particularly when there are no specific antibodies. ELISA tests are also important in early screening. Disease prevention will be Possible by increasing awareness of the people at risk, regional health systems employees, and prevention from human contact with contaminated materials and vaccination of livestock and animals.

---

Background and purpose: Febrile seizure is a seizureassociated with fever without any evidence of intracranial infection or electrolytic disorder.The age of affected child is more than one month and without any previous seizure or fever. The peak incidence is at 18 months. Treatment is consisting of managing the seizure by anticonvulsant medicines that are administered for preventing of recurrence. In this research, diazepam and clobazam were evaluated for prevention of febrile seizure recurrence in patients admitted in Taleghani hospital. Material and Methods: 150 patients with simple febrile seizure in age range of 6 months to 6 years of old were in two medicinal groups randomly involving diazepam and clobazam after control of seizure. Each group include of 75 patients. Diazepam was taken with dosage of 0.33 mg/kg/8h and about clobazam the dosage was 2.5, 5, 7.5 and 10 mg basis on body weight. The results involving fever episodes in each 3 months, side effects of medicines and recurrence were recorded in a check list and finally were analyzed. Results: 32 patients were removed of study because of having the exclusion criteria and finally 118 patients, 61 cases in diazepam group and 57 cases in clobazam group, were studied. There were 62 males and 56 females in this population. The mean age was 21.05±10.10 months and 21.96±10.74 months in diazepam and clobazam groups, respectively and was 21.49±10.39 in total of population.Recurrence was evaluated relation to medicinal effect, age, sex and family history and personal history of febrile seizure and distance between fever and seizure. Also medicinal side effects involving ataxia, drowsiness and other side effects (vommiting, anorexia and irritability) and their relation to age and sex were evaluated. According to statistic tests, there was not any significant differences between two groups in considered parameters (P>0.05), but there were some differences in some cases clinically. Just drowsiness showed a significant difference between two groups (P= 0.000). Conclusion: Generally, Treatment by clobazam has been caused recurrent and complications less than diazepam, although it has required a larger sample size for confirming these results.

---

Background and purpose: Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease. In Iran human cases of the disease were reported in some regions including Nur County (Mazandaran Province, northern Iran). Therefore, this study investigated high risk behavior of people involved in meat industry and animal husbandry in different districts of Nur County.

Materials and methods: A cross-sectional questionnaire-based study was conducted in 314 livestock and meat industry workers including shepherds and animal keepers, butchers, slaughters, chefs, veterinary physicians and veterinary staff to monitor their high risk behaviors regarding CCHF from July to December 2012 in Nur County. Statistical analyses were performed using Chi-square and binary regression test at 0.05 significance level.

Results: Two hundred eighty nine individuals were interviewed and filled out the questionnaire with an average age of 43.7 ± 14.4 of whom 84.4% were male. Odds ratio (OR) of high risk practices including slaughtering and contact with fresh flesh and blood of livestock of males compared with females was 3.35
(OR = 3.35, CI 95%: 1.73-6.47). High risk individuals living in rural and mountainous areas of Baladeh had significantly longer history of contact with livestock and had more high risk behaviors including slaughtering and contact with fresh flesh and blood of livestock, eating raw liver, and removing ticks from animals' body or squashing them with unprotected hand (P < 0.001). Lack of protective clothing in high risk individuals in highland areas (OR = 9.24, CI 95%: 2.66-32.13) and Baladeh district (OR = 9.80, CI 95%: 2.78-34.53) was significantly higher than the rest of the studied areas.

Conclusion: The results clearly showed extensive high risk practice in individuals involved in livestock in Nur County. Such behaviors and lack of management programs may increase the occurrence and epidemics of CCHF in the region especially in West of Mazandaran Province where current CCHF cases are reported.

---

Background and purpose: Crimean Congo Hemorrhagic Fever (CCHF) is a dangerous viral zoonotic disease. Ticks are the main vector which transmit CCHF virus from livestock to human. The present study was done to provide a comprehensive database on major ticks in the CCHF virus transmission and their geographical dispersal in Iran. This would be of great benefit in planning for intelligent control of the disease based on the budget and personnel in areas where the incidence of the disease is high.
Materials and methods: In this study, the articles published (2003-2017) on five important vectors of the CCHF in Iran were reviewed in electronic databases, including PubMed, Google scholar, SID, Iran Medex, Elsevier, and Scopus, using the following keywords: Tick Fauna, Iran, Ixodidae, CCHF, detection of CCHF and Tick distribution. Then, the data in Excel was exported to ArcGIS 9.3 to provide geographic dispersion and vector infection map.
Results: Distribution map of five important tick species in transmission of CCHF virus including Hyalomma marginatum, Hy.anatulicum, Hy.asiaticum، Hy.dromedarii, and Rhipicephalus sanguineus were drawn. The distribution map of these five tick species and molecular methods indicated that in 8 of 31 provinces CCHF virus was identified in two species, including Hy. marginatum and Hy.anatulicum.
Conclusion: More extensive studies are needed to detect the fauna and distribution of ticks. Also, isolation of disease agents from samples in areas where the disease was reported should be done. Current findings could be used to update the database for prediction and modeling of CCHF based on the effective factors.
 

---

 Background and purpose: Q fever is a worldwide zoonosis which is an endemic in many regions. Its diagnosis is usually missed especially in human. This research aimed at investigating acute Q fever among suspected patients in northern Iran.
Materials and methods: This cross-sectional study was conducted in 56 suspected cases of Q fever selected from 476 febrile patients admitted in Qaemshahr Razi Hospital, Iran 2016, with systemic or respiratory symptoms.  Blood samples and sera were tested for detection of IgG phase II antibodies against C. burnetii by quantitative ELISA. Seroconversion and/or four-fold rise in IgG phase II titers were the diagnostic criteria of acute Q fever infection.
Results: The prevalence of acute Q fever was 5.37% (95% CI: 1.84, 14.61%). Risk factors for Q fever infection included living close to livestock farms and consumption of unpasteurized milk or dairy products. However, these risk factors were not significantly different between patients with Q fever and seronegative cases of Q fever (P<0.612).  In current study, 23.21% of the participants were found with a history of Q fever infection.
Conclusion: Acute Q fever was diagnosed in many cases in north of Iran indicating a high prevalence of the disease. Therefore, Q fever serology must be checked in seronegative suspected brucellosis.

 

---

Background and purpose: Ticks, as ectoparasites, biological vectors and reservoirs of various diseases, are involved in transmission of pathogens to humans and animals. This research aimed at modeling the probability of tick vectors presence in Ahvaz, Hamidiyeh, Bavy, and Karoon in southwest of Iran.
Materials and methods: To perform the modeling, eight criteria (slope, elevation, soil texture, land use, land cover, temperature, humidity, and rainfall) that strongly affect the distribution of ticks were selected. After pairwise comparisons, Super Decision Software was used to determine the significance of each criteria and the weight of sub-criteria was calculated using Expert Choice11. Weighted maps were obtained based on the effect of sub-criteria weights on maps. The final map of the probability of tick vectors presence was prepared based on the weight effect of each criteria in the weighted maps.
Results: Average relative humidity (0.252), average rainfall (0.179), and land cover (0.151) were found to have the greatest effect on the probability of tick presence. Also, the highest probability of tick presence was seen in following cities and rural districts: Ahvaz, Hamidiyeh, Karoon, Bavy, Meshrahat, Karkheh, Qaleh Chenan, and Anafcheh.
Conclusion: In current modelling, considering ecological, topographic, and climatic factors, the probability of the presence of vectors of Crimean-Congo haemorrhagic fever (CCHF) virus was seen to be very high in two rural districts, including Mashrahat (Ahvaz) and Karkheh (Hamidiyeh).
 

---

Background and purpose: Coxiella burnetii infection (causative agent of Q fever) is a public health problem and a zoonotic disease with a global prevalence. The importance of zoonotic diseases and their impact on the health of people in a community is undeniable. The aim of this study was to investigate the prevalence of Coxiella burnetii in hard ticks isolated from livestock in different parts of South Khorasan, Iran.
Materials and methods: In summer 2019, ticks were collected from cattle, sheep, camels, and goats in five counties of South Khorasan province. The genus and species of hard ticks were identified after isolation from livestock. Nested-PCR was used to identify the bacterial genome.
Results: We identified two genera and six species, including Rhipicephalus sanguineus (41. 3%), Hyalomma detritum (8.9%), Hyalomma marginatum (2.2%), Hyalomma anatolicum (3.3%), Hyalomma asiaticum (0.9%), Hyalomma dromedarii (33.5%), and Hyalomma spp. (3.7%). Hyalomma nymphs (n=11, 4.1%) and Rhipicephalus nymphs (n= 3, 1.1%) were also identified. In the present study, none of the samples were infected with Coxiella burnetii.
Conclusion: The present study revealed that South Khorasan province is free from epidemic and endemic foci of Coxiella burnetii.

---

Background and purpose: Violet is a plant that has received interest in complementary medicine due to its anti-inflammatory, antipyretic, and antimicrobial effects. Fever is one of the major symptoms of COVID-19. This study was conducted to determine the effect of violet extract in the form of syrup on fever in patients with COVID-19.
Materials and methods: In this randomized clinical trial, 52 patients with COVID-19 were studied in Intensive Care Unit in Amol Imam Khomeini Hospital (2021). In intervention group in addition to an injection of acetaminophen, 5 cc of violet extract syrup prepared from the aqueous extract of the plant was taken.  The temperature was recorded after 30 and 60 minutes and four hours. The follow-up of the patients continued for three days and the temperature was recorded every six hours.
Results: There was a significant difference between the intervention group (36.84±0.37) and control group (37.13±0.62) in mean temperature at second time in second day of follow-up (P=0.04). Also, the mean temperature was found to be significantly different between the two groups at 30 (P=0.001) and 60 minutes (P=0.05) after the intervention. At other groups, there was no significant difference between the intervention and control groups.
Conclusion: The aqueous extract of violet plant in the form of syrup reduces fever in patients with COVID-19 causing no complication. Due to the ease of access to this herbal product, it can be used to prevent problems caused by fever.

(Clinical Trials Registry Number: IRCT20150916024047N6)

 

---

 Background and purpose: Crimean-Congo hemorrhagic fever (CCHF) is one of the viral hemorrhagic fevers caused by Nairovirus group. Epidemiological investigation and clinical symptoms of the disease in each region can help to identify disease-prone foci and early diagnosis of the disease in epidemic cases. Therefore, the purpose of this study was to investigate the clinical, epidemiological, and laboratory symptoms of patients with CCHF in Mazandaran province in 2014-2018.
Materials and methods: In this cross-sectional epidemiological survey, 135 patients with proven CCHF in Mazandaran province were enrolled in a census manner. The clinical, epidemiological, and laboratory findings in these patients were determined.
Results: In this study, 23% were younger than 30 years of age and 80.7% were men. In hospitalized patients, 33.3% had high risk jobs linked to the disease and 39.3% had livestock exposure. The patients were most affected in spring (45.9%) and summer (42.2%) and less during fall (5.9%), and winter (5.9%). Clinical manifestations, including fever, rash, abdominal pain, bleeding, epistaxis, headache, musculoskeletal pain, cough, and menorrhagia were observed in 88.1%, 11.1%, 23%, 28.9%, 7.4%, 52.6%, 69.7%, 0%, and 0% of the infected subjects, respectively. Thrombocytopenia were seen in 51.9% of the patients and about other laboratory results there were no any specific findings in 29.6%. According to laboratory findings, LFT raise, anemia, leukopenia, leukocytosis, LTF raise plus anemia, and LFT raise plus leukopenia were seen in 13.3%, 5.2%, 27.4%, 9.6%, 3.7%, and 11.1%, respectively.
Conclusion: According to the present study, although the clinical, epidemiological, and laboratory findings in CCHF cases in Mazandaran province are similar to other studies worldwide, so, the regular analysis of CCHF patients is highly recommended.
 

---

Background and purpose: Considering the effects of dengue fever on the health of people in the society and the role of climatic and environmental factors on the spread of this disease, this review study has investigated the climatic and environmental factors affecting the prevalence of dengue fever.
Materials and methods: In this review, the academic papers, in English and persian languages, published until the beginning of August 2022 were investigated. These articles were searched in scientific databasese of Scopus, ScienceDirect, PubMed, Web of Science and Google Scholar, using keywords such as "dengue fever", "dengue vector", "vector mosquito", "Aedes mosquito", "environmental factors", and "weather factors". Endnote X8 software was also used to organize, and study titles and abstracts of the articles.
Results: Considering the impacts of environmental changes on mosquito population and its subsequent effect on the occurrence of dengue fever, the present study showed that changes in climatic factors including air temperature, rainfall, and humidity affect the frequency of dengue disease vectors. Land use and land cover change can affect mosquito population and dengue transmission by changing local ecology. Household waste and its accumulation around residential houses can also hold a significant amount of water as environmental pollutants and can be considered as a habitat for mosquito larvae such as Aedes species.
Conclusion: The analysis of climatic and environmental factors has shown that environmental factors and weather changes can affect the occurrence of dengue fever.

---

Background and purpose: Aedes mosquitoes, especially Aedes aegypti and A. albopictus, due to their special biological and ecological characteristics, have high adaptability and establishment power in different weather conditions, including Iran, and for this reason, they are called invasive mosquitoes. These mosquitoes, which are known as a serious problem for human health, are very important in terms of transmission of very important arboviral diseases such as dengue fever, chikungunya, Zika virus, and yellow fever. Considering the importance of these diseases on the health system and human health, as well as numerous reports of the spread of arboviral diseases through Aedes mosquitoes in different countries, various programs have been proposed to control Aedes mosquitoes. As a result, introducing suitable methods to control Aedes mosquitoes can play a significant role in reducing the transmission of these diseases and maintaining human health. Therefore, in this review, we evaluate the use of each of the Aedes mosquito control methods.
Materials and methods: This article is a narrative review of the introduction and effectiveness of different methods of controlling Aedes mosquitoes. Collecting information about control methods of A. aegypti and A. albopictus has been compiled without time and language restrictions from international scientific databases including Pub Med, Web of Science, Google Scholar, (ScienceDirect, Scopus, Elsevier, Lilacs) and Internal databases including, Scientific Information Database(SID), Iranian Medical Library(MedLib), Magiran, Civilica. The information collected based on the performance of each of the mentioned methods was extracted, categorized, analyzed, and used in compiling this article. Finally, out of a total of 10202 extracted articles, 123 articles were used in this research considering the inclusion and exclusion criteria.
Results: In general, the goals related to the use of different methods of controlling Aedes mosquitoes are different depending on the country, epidemiological conditions, resources, and local priorities. But overall, disease prevention, reduction of mosquito population, stopping of disease transmission, prevention of mosquito establishment, disease spread, reduction of nuisances and finally identification of new invasive species are prioritized. The most appropriate methods of controlling Aedes are divided into five categories: 1. Environmental methods that include reducing the habitats and growth resources of mosquitoes 2. Chemical methods that are based on the use of various insecticides chemicals and insect growth regulators 3. Mechanical methods that include the use of various traps 4. Biological methods that include the use of natural enemies 5. Genetic methods include genetic engineering and mosquito sterilization techniques. It should be noted that each of these methods can play a significant role in the establishment of Aedes mosquitoes and the spread of arboviral diseases, and as a result, reducing the number of cases of infection and death in the health system.
Conclusion: Considering the introduction of different control methods for A. aegypti and A. albopictus and the priority of each of the control methods presented; it is important to mention that the method of controlling Aedes depends a lot on the environmental conditions of the region, the stage of mosquito establishment,  the population phase of mosquitoes and diseases caused by it. Therefore implementation of Aedes mosquito control programs through integrated vector management strategy is recommended, which requires the effective collaboration and coordination of national and local authorities and the general public for cost-effective control and lasting effects.

 

---

Background and purpose: Leptospirosis is an acute febrile illness that affects the whole range of symptoms, the symptoms can be a mild form of the flu-like illness to more severe symptoms such as jaundice, bleeding, kidney failure, and death. In this disease, the skin lesions are usually in the form of macular, maculopapular, urticaria, and petechiae. Due to the variety of symptoms of this disease, to add to our knowledge in this field, we designed a study to evaluate the skin symptoms of this disease in patients admitted with this diagnosis.
Materials and methods: This cross-sectional study was conducted from the beginning of 2014 to the end of 2020. The studied population was all hospitalized patients with leptospirosis whose disease was proven through serological tests. Checklist information includes age, sex, occupation, clinical signs, the first sign of disease onset, skin symptoms including any skin lesion including papules, macules, petechiae, purpura, hemorrhagic rashes, etc. at the beginning of the disease is manifested, and also how it has changed in the course of treatment and also what lesions are valuable to us at the end of treatment. All patient information is recorded on a special form. Data analysis was performed by SPSS software version 20.
Results: 800 people (652 (81.50%) men and 148 (18.50%) women) were examined in this study. The average age of the studied patients was 48.55 ± 16.23 years with a minimum age of 15 and a maximum age of 87 years. The chi-square test was used to check the relationship between skin symptoms and patients' gender and age. the result showed that 150 patients had jaundice (62.76%), which was significantly more frequent than other skin symptoms (P<0.001). This test showed that skin symptoms were significantly higher in women than men (38.51 vs 27.91) (P=0.013). The result, however, showed that there is no significant relationship between the presence of skin symptoms and age (P=0.054). Bonferroni's post hoc test showed that the frequency of jaundice (79.59% vs. 58.42%) and the frequency of ecchymosis in women (16.33% vs. 2.11%) were significantly higher (P<0.05). Also, this test showed that all types of skin symptoms are significantly related to age classification (P<0.001). Also, in the examination of the types of skin symptoms, it has been shown that the highest frequency was related to the symptoms of massage on the fingers (55.56%) (P= 0.637).
Conclusion: In this study, it was shown that most patients present with fever, chills, and myalgia and the rate of skin lesions in these patients is low and most skin lesions occur in the female population. Among skin lesions, jaundice was the most common. Headaches, nausea and vomiting, and myalgia were also more common in hospitalized patients for non-skin symptoms. The frequency of jaundice in women, the frequency of ecchymosis in women, and the frequency of other skin symptoms were higher in men.

---

Background and purpose: Dengue fever is one of the most common mosquito-borne diseases worldwide. The aim of this study was to investigate the knowledge, attitude, and practices (KAP) of health center employees in Kerman, Iran, regarding dengue fever.
Materials and methods: This cross-sectional study was conducted among the employees of health centers in Kerman using a standardized four-part questionnaire in 2022. The first part of the questionnaire focused on demographics, the second on knowledge, the third on attitudes, and the fourth on personnel practices regarding dengue fever. The data were analyzed using descriptive statistics and SPSS software.
Results: A total of 301 individuals participated in the present study. According to the results, 10.1% of the participants were physicians, 62.5% were healthcare employees, 14.5% were environmental and occupational health employees, and 12.8% were managers working in the health centers. The mean knowledge score of the study population was 6.56 ± 2.61. A positive correlation was found between the knowledge score, attitude score, and practice score (P = 0.001). The mean attitude score of the study population was 7.23 ± 1.14, which was positively correlated with age, work experience, knowledge score, and practice score (P < 0.05). The mean practice score of the study population was 6.05 ± 1.74, which showed no significant relationship with demographic variables; however, a positive correlation was observed between the practice score and age, work experience, knowledge score, and attitude score.
Conclusion: The results indicated that the knowledge, attitude, and practice scores of health center employees in Kerman were at an average level. It is recommended that education and re-education on dengue fever be implemented among health center employees, as they are the first line of education and disease prevention.
 

---

Background and purpose: Fever and neutropenia are common complications and significant causes of hospitalization in cancer patients. These conditions can increase the mortality rates among patients. The aim of this study was to investigate the etiologies of fever in neutropenic cancer patients admitted to the teaching hospitals affiliated with Abadan University of Medical Sciences.
Materials and methods: This study was a descriptive-analytical, retrospective investigation. A total of 206 cancer patients presenting with fever and neutropenia, who were referred to the teaching hospitals affiliated with Abadan University of Medical Sciences in 2022, were included in the study. Patient information was collected through medical records and data retrieved from the Hospital Information System (HIS) using a structured checklist, and subsequently analyzed statistically.
Results: The mean body temperature in patients who had received chemotherapy was significantly higher than that in patients who had not undergone chemotherapy (P<0.001). The mean temperature of patients with a fever duration of more than five days was also significantly higher than that of patients with a fever duration of less than five days (P= 0.024). A significant and inverse relationship was observed between body temperature and white blood cell (WBC) count on both the first and last day (P= 0.001 and P= 0.01, respectively). In addition, there was a significant and inverse relationship between body temperature and neutrophil count on both the first and last day (both P = 0.04). A significant relationship was also found between splenectomy and body temperature in patients with fever and neutropenia (P< 0.001).
Conclusion: Overall, fever duration, chemotherapy, and splenectomy were significantly associated with elevated body temperature. In addition, the findings indicated that neutrophil and white blood cell counts on both the first and last day were significantly associated with body temperature, such that this relationship was inverse, a decrease in neutrophils and white blood cells was associated with an increase in temperature.