Southern Iran Research Articles

Data on four species of Longidorus Micoletzky, 1922 (Nematoda: Longidoridae) from southern and southeastern Iran, including description of a new species.

Four species of the genus Longidorus were recovered from southern (Bushehr province) and southeastern (Southern Khorasan province) Iran. The first species, L. paratabrizicus n. sp. represents a new member to the genus and is characterised by 4.8-5.6 mm long females with anteriorly flattened lip region separated from the rest of the body by depression, amphidial fovea pocket-shaped without lobes, tail conical, dorsally convex, ventrally almost straight with bluntly rounded tip and males in population. By having similar lip region and tail shape, the new species most closely resembles five species viz. L. artemisiae, L. globulicauda, L. patuxentensis, L. sturhani, and L. tabrizicus. It represents the cryptic form of the last species. The second species belongs to L. mirus, recovered in both southern and southeastern Iran, representing the first record of the species after its original description. As an update to the characteristics of this species, it's all juvenile developmental stages were recovered and described. The criteria to separate L. mirus from two closely related species, L. auratus and L. africanus, are discussed. The third species belongs to L. persicus, a new record in southern Iran. The fourth species, L. orientalis was recovered in high population density in association with date palm trees in Bushehr province. The phylogenetic relationships of the new species and recovered populations of L. mirus and L. persicus were reconstructed using two ribosomal markers and the resulted topologies were discussed.

Living in urban or rural environments affect the sleep quality of the elderly in Bushehr (Southern Iran): emphasizing the active and inactive of the elderly.

Sleep disorders have a significant negative impact on mental and physical health, especially among the elderly. Various factors can affect the sleep quality of elderly people. The aim of this research to investigate the effect of urban and rural environments on the sleep quality of elderly people with emphasis on physical activity. Four hundred and thirty-nine elderly people (226 city residents and 213 village residents) in urban and rural areas of Bushehr (Southern Iran), volunteered to participate in the present study. Information was collected via the General information questionnaire and Petersburg Sleep Questionnaire. The results showed that active elderly women (p < 0.001), and total active elderly (male + female) (p < 0.001) living in urban areas compared to inactive elderly and also in rural areas active elderly women (p < 0.001), active elderly men (p < 0.001) and total active elderly (male + female) (p < 0.001) had better overall sleep quality in compared to inactive elderly. Also, elderly men (p < 0.001) and the total elderly (male + female) (p < 0.001) living in urban areas had better sleep quality than the elderly in rural areas. Based on the findings, it can be concluded that the way of life (being active) as well as the living environment can affect the sleep quality of elderly people, so that active elderly people and also elderly people living in urban environments had better sleep quality.

Introducing a novel approach for assessment of groundwater salinity hazard, vulnerability, and risk in a semiarid region

The application of machine learning approaches to improve groundwater salinity risk mapping is limited despite all potential advantages. Therefore, there is an ongoing need for investigations that present new techniques, like machine learning, validated against conventional methods. These advances are particularly important for arid and semiarid regions, such as the Bakhtegan Basin (southern Iran), where groundwater use may far outweigh recharge, but groundwater management improvements are essential. To address these needs, groundwater salinity hazard, vulnerability, and risk maps were investigated using an integrated application of statistical (i.e., frequency ratio and statistical index models), machine learning (i.e., random forest and classification and regression trees algorithms), and decision-making models (fuzzy analytic hierarchy process (FAHP)). Results showed that the risk of groundwater salinity was high in the central areas of the region as well as at the margins of Bakhtegan Lake and irrigated farming lands. Based on the modeling results in the testing phase, it was found that the frequency ratio and random forest models exhibited better performance, with Nash–Sutcliffe efficiency metrics of 0.73 and 0.70, respectively, compared to the classification and regression trees and statistical index models, which had Nash–Sutcliffe efficiency metrics of 0.65 and 0.63, respectively. The innovative techniques developed in the current work accurately identified variables such as normalized difference salinity index, distance from mines, and land use associated with the highest weight values (0.59, 0.14, and 0.11, respectively) compared to other variables to identify groundwater salinity areas of vulnerability. The application of the fuzzy analytic hierarchy process method in developing vulnerability maps, integrating them with hazard maps, and developing groundwater salinity risk maps was innovative in this study. The innovative approach is transferrable for groundwater salinity susceptibility, vulnerability, and risk assessments globally in the study area and similar settings.

Comparison of numerical calculations and ALOHA modeling in consequence assessment of chlorine gas emissions from ethylene dichloride reactors.

Incidents involving chemical storage tanks in the petrochemical industry are significant events with severe consequences. Within the petrochemical industry, EDC is a sector that produces ethylene dichloride through the reaction of chlorine and ethylene. The present research was conducted to evaluate the consequences of chlorine gas released from the EDC reactor in a petrochemical industry in southern Iran. Data regarding reactor specifications were obtained from the factory's technical office, while climatic data was acquired from the Meteorological Organization. The consequences of chlorine gas release from the reactor were assessed in four predefined scenarios using numerical calculation methods and modeling with the ALOHA software. The numerical calculation method involved thermodynamic fluid path analysis, discharge coefficient calculations, and wind speed impact analysis. The hazard radius was determined based on the ERPG1-2-3 index. Results showed that in the scenario of chlorine gas release from EDC reactors, according to the ALOHA model, an increase in wind speed from 3 to 7m/h led to an expanded dispersion radius. At a radius of 700m from the reactor, the maximum outdoor concentration reached 3.12ppm, decreasing to 2.27ppm at 800m and further to 1.53ppm at 1000m. The comparison of numerical calculations and modeling using the ALOHA software indicates the desirable conformity of the results with each other. The R2 coefficient for evaluating the conformity of the results was 0.9964, indicating the desired efficiency of the model in evaluating the consequences of the release of toxic gasses from the EDC tank. The results of this research can be useful in designing the site and emergency response plan.

Effects of World War II on Infectious Diseases in the Persian Gulf.

With the allied invasion, the southern half of Iran became the scene of a large presence of British and American occupation forces. The negative consequences of the styling of foreign elements during all the years of war and even afterward affected these areas in various dimensions of their health. The negative consequences of the occupation of southern Iran, the health and healthcare system of this part of Iran suffered problems in various forms of shortage of medicines, equipment, and treatment staff, especially the spread of various infectious and communicable diseases. The article aims to examine the effects of World War II on the southern, southwestern, and eastern regions of Iran from 1939 to 1945 and its consequences in the spread of infectious diseases in these regions. The research with an analytical-historical method relies on the library method and is based on the study of the data of unpublished documents from the archives of the National Archives and Library Organization, medical and economic social publications, and various local and public newspapers of Iran during this period. The study of documents and publications shows that due to Allied restrictive policies and successive waves of famine and widespread malnutrition, epidemic diseases, and drug monopoly, these areas experienced a period of severe decline in public health and spread of various infectious diseases.

The Frequency of Celiac Disease and Its Association with Infertility in Women Attending Infertility Clinics: A Case-Control Study in Southern Iran

Background: Celiac disease (CD) is a multifactorial systemic disease that causes enteropathy and can lead to a wide spectrum of disorders related to infertility. Objectives: This case-control study aimed to evaluate the frequency of celiac disease (CD) and its association with infertility in women. Methods: This study was conducted on women referred to Ghadir Mother and Child Hospital in Shiraz. Women with infertility served as the case group, while fertile women comprised the control group. Blood samples were collected from participants, and tissue anti-transglutaminase (Anti-TTG Ab) levels were measured. Patients with elevated Anti-TTG Ab levels were referred for duodenal biopsy. Results: One hundred subjects were enrolled in the case group and 200 in the control group. Eight patients in the case group tested positive for serology, and four of these had duodenal biopsies confirming CD. In the control group, one individual tested positive for serology, but the duodenal biopsy was negative (P for between-group differences: 0.001 for serology and 0.012 for biopsy results). There was a significant association between high levels of Anti-TTG Ab and infertility (odds ratio = 17.30, 95 % CI: 2.13 - 140.39), which remained even after adjusting for age and body mass index (odds ratio = 9.92, 95 % CI: 1.17 - 84.21). Conclusions: The frequency of CD was higher among infertile women compared to fertile women. Increased levels of Anti-TTG Ab were independently associated with infertility.

Investigating the Professional Commitment and its Correlation with Patient Safety Culture and Patient Identification Errors: Evidence from a Cross-Sectional Study from Nurses' Perspectives

Introduction Nurses' professional commitment is crucial to their qualifications, impacting patient safety. This study aims to explore the relationship between nurses' professional commitment and patient safety culture, specifically focusing on patient identification errors. Methods A cross-sectional study was conducted in 2022 involving 340 nurses working in educational medical hospitals in southern Iran. Data collection instruments included questionnaires on nurses' professional commitment, patient identification errors, and patient safety culture. Descriptive and inferential statistics, such as t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression, were performed using SPSS software version 23, with a significance level set at p = 0.05. Results The mean scores for professional commitment, patient safety culture, and errors in patient identification, as perceived by the nurses, were 77.64 ± 14.32 (out of 130), 2.71 ± 0.78 (out of 5), and 16.41 ± 4.58 (out of 32), respectively. There was a statistically significant correlation between professional commitment and errors in patient identification (r = -0.577, p &lt; 0.001) as well as patient safety culture (r = 0.456, p &lt; 0.001). Regression analysis revealed that nursing job satisfaction, understanding of nursing, self-sacrifice for the nursing profession, and engagement with the nursing profession were predictors of patient safety culture and errors in patient identification (p &lt; 0.05). Conclusion Nurses' professional commitment was found to be at a moderate level. Furthermore, the dimensions of professional commitment significantly influenced patient safety culture and errors in patient identification. To enhance nurses' professional commitment, and subsequently improve patient safety culture and reduce identification errors, it is recommended to implement management mechanisms that increase job satisfaction, understanding, engagement, and professional self-sacrifice among nurses.

Development of rheological models depending on the time, temperature, and pressure of wellbore cement compositions: a case study of southern Iran’s exploratory oilfields

Development of rheological models depending on the time, temperature, and pressure of wellbore cement compositions: a case study of southern Iran’s exploratory oilfields

The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran

BackgroundGiven the destructive nature of addiction and its relapse after quitting, the present study aimed to investigate the factors affecting substance abuse relapse based on the Theory of Planned Behavior (TPB) in male addicts covered by addiction treatment centers in Shiraz, Iran.MethodsThis cross-sectional study was conducted on 400 male addicts covered by addiction treatment centers in Shiraz, Iran, in 2021–2022. The data collection tool was a researcher-made questionnaire. Data were analyzed using SPSS-22 software through descriptive statistical methods, linear regression, and binary logistic regression.Results190 people (47.50%) were aged 31–40 years, 265 people (66.25%) were married, 224 people (56%) lived with their spouses, and 192 people (48 percent) had their first use at the age of 16–20. The substance respondents used were methamphetamine (59.5%), heroin (53%), opium (48%), and alcohol (40%). 138 people (34.5%) had their first place of consumption at friends’ houses (Tables 1 and 2).342 people (85.5%) had a history of relapse, and 172 people (50.29%) had 1–5 relapses. Marital status, occupation, and income were among the demographic risk factors, and addicted friends and close relatives were among the behavioral risk factors for drug relapse among people with a history of relapse. Personal desire and the insistence of friends were also among the individual and interpersonal factors of drug use among participants. The regression results showed that the constructs of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention were predictors of drug relapse among addicts (P < 0.05).ConclusionThe current study’s findings indicate that among the behavioral risk factors for drug relapse in individuals with a history of relapse are addicted friends and close relatives, while marital status, occupation, and income are among the demographic risk variables. Among the individual and interpersonal factors influencing drug usage among participants were personal desire and friends’ insistence. Furthermore, the findings indicated that the TPB’s structures might be used to predict drug relapse in addicts.

Perspectives on Cirrhosis in Southern Iran: A Temporal Comparative Study from 2009 to 2022

Background: The epidemiology of cirrhosis, a significant public health issue, remains poorly understood in Iran. Objectives: This study aimed to evaluate the characteristics, etiologies, complications, and outcomes of patients with cirrhosis who were registered in the Shiraz cirrhosis registry in Iran. Methods: In this descriptive-analytical study, a total of 2937 patients with cirrhosis from 2009 to 2016, and 683 patients from 2017 to 2022 were enrolled at Shahid Motahhari clinic in Shiraz and included in our database. Demographic, clinical, and laboratory data were collected at baseline and every six months thereafter. Mortality, hepatocellular carcinoma, and liver transplantation occurrences were monitored biannually. Statistical differences between groups were assessed using the Mann-Whitney U test, chi-square test, or Fisher's exact test, depending on the data distribution and the nature of the variables. Results: The average age of patients during the first period was 47.4 ± 21.5 years, and for the second period, it was 54.8 ± 14.1 years. Biochemical levels and the prevalence of most complications were higher in the second period compared to the first. Ascites was the most common complication in the first group (52.1%), while esophageal varices were more prevalent in the second (40.1%). Hepatitis B and C were common among patients, especially in men. Patients registered in the earlier period had higher mortality and liver transplantation rates than those in the later period. Conclusions: The findings suggest that patients registered in the later period displayed better laboratory and clinical outcomes, likely due to improved management strategies over time. Viral hepatitis B and C were identified as the predominant etiologies among the patients with cirrhosis included in the study.

Development of a finite element groundwater flow model to test drainage management strategies for the expansion of the Dareh-Zar open pit mine, Iran

A finite-element groundwater flow model was developed for the expanding Dareh-Zar open pit mine in southern Iran, to simulate groundwater inflow into the excavation and mine wall pore pressure dynamics. The model was used to test the effectiveness of implementing different drainage management strategies to reduce groundwater inflow rates and mine wall pore pressures, including abstraction wells and horizontal drains. Model predictions suggest the implementation of abstraction wells will reduce groundwater inflow rates by 75% during the first 12 years of mining and 50% during the subsequent 5 years relative to a ‘no drainage’ management scenario, with further reductions in groundwater inflow achieved through horizontal drain installation. Furthermore, the installation of horizontal drains was found to be necessary to reduce mine-wall pore pressures from destabilizing the mine walls. Groundwater management of the decommissioned pit mine was also evaluated, with simulation results suggesting that backfilling the excavation would restore the groundwater level within the open pit mine region to ~2,442 m above sea level, representing a net restoration of ~204 m relative to the water table prior to mine closure.

Five-factor model personality traits, exclusive breastfeeding, and self-efficacy: a mediational analysis

BackgroundDespite the World Health Organization’s (WHO) emphasis on exclusive breastfeeding, the documents show a declining trend worldwide. Studies assert that the mother’s personality traits appear to have an impact on this issue. This study aimed to investigate the potential influence of personality traits on exclusive breastfeeding, which might be channeled by self-efficacy as a mediator variable.MethodsData were analyzed from the cross-sectional study. The exclusive breastfeeding scale, the breastfeeding self-efficacy questionnaire, and the Five-Factor Model questionnaire (as follows: neuroticism, extraversion, openness experience, agreeableness, and conscientiousness) were completed by120 Iranian volunteer mothers with an infant aged 6–12 months referred to health centers in Shiraz (a major city in southern Iran) between May to December 2019. The structural equation modeling (SEM) approach was used to obtain the direct and indirect effects of personality traits and self-efficacy on exclusive breastfeeding.ResultsThe study showed the significant direct effect of some personality traits (agreeableness, extraversion, and consciousness) and self-efficacy on exclusive breastfeeding. The indirect effect of extraversion on exclusive breastfeeding through self-efficacy was also obtained from the result of SEM analysis. The model fit the data satisfactorily, according to the fit indices criteria extracted from the mediational analysis.ConclusionsSelf-efficacy appears to be a significant predictor of exclusive breastfeeding. Therefore, exclusive breastfeeding could be enhanced by safe education in pregnancy, reinforcing the self-efficacy of pregnant women and considering their personality traits.

Provenance of the Bronze Age lapis lazuli pieces from the Early Urban Center of Konar Sandal, Jiroft, Southern Iran

The sources of lapis lazuli objects found in the Bronze Age of the Iranian Plateau and its trade routes have been a subject of interest and a research question. Four archaeological pieces of lapis lazuli recovered from a stone-working workshop in the Bronze Age site of Konar Sandal South (Jiroft Plain), southern Iran, were analyzed using X-ray diffraction (XRD) and scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) techniques to characterize the mineralogical composition and the possible provenance of raw materials. Results showed that these objects are identical based on their composition, presenting diopside and specific trace element proportions as provenance markers. Comparison with available data from Iranian archaeological sites and ancient resources from Central Asia revealed that these finds may have been imported from lapis lazuli mines located at Badakhshan in Afghanistan, as they were supplied raw materials for ancient lapis lazuli objects of Iran.

Identifying the Risk Factors of Adverse Pregnancy Outcomes among Women with COVID-19: A Population-Based Case-Control Study in Southern Iran.

Pregnant women and their fetuses are considered as high-risk groups during the COVID-19 pandemic. The aim of this study was to identify the risk factors of adverse pregnancy outcomes among women with COVID-19. This case-control study was conducted among pregnant women who delivered live infants at least 60 days before data collection in Hormozgan Province, south of Iran, 2021. The case and control groups included women with and without the history of COVID-19, respectively. A 47-item checklist including demographic information of the mothers, maternal current and past medical history, maternal and fetal prenatal and post-natal outcomes; and other COVID-19 related outcomes was used. The logistic regression analysis was used for data analysis. A total of 1337 women (668 in case and 669 in control groups) participated in this study. The mean (SD) gestational age in the case and control groups were 32.83 (84.64) and 23.75 (6.93) weeks respectively. Maternal age and the incidence of abortion, obesity, and multiple pregnancies was higher in the COVID-19 group compared with the control group. The most common COVID-19 symptoms were myalgia (24.8%), cough (19.3%), fever (17.5%) and olfactory disorder (14.3%). The preventive factors against COVID-19 adverse pregnancy outcomes were low and normal body mass index, influenza vaccination history, and multivitamin consumption, while the risk factors were multiple pregnancies, abortion and preterm labor. This study showed that pregnant women were to COVID-19. The identified risk factors for COVID-19 adverse pregnancy outcomes can be used to prioritized pregnant women in receiving COVID-19 related health services.

Target zone selection for hydraulic fracturing using sedimentological and rock mechanical studies with the support of the machine learning method of cluster analysis

Appropriate zone selection is crucial for hydraulic fracturing as it can significantly impact the success of the treatment and the overall cost. Many parameters affect true zone selection for hydraulic fracturing but lithology and geomechanical parameters are the most important. In this study, geological and geomechanical studies were incorporated with statistical approaches to determine geomechanical zones and intervals, which are brittle and can be candidates for hydraulic fracturing for the Sarchahan, Zakeen, and Faraghan formations (Silurian to Permian) in the deepest well in southern Iran Offshore. Based on sedimentological studies, five sedimentary facies were recognized: Sandstone, Shale, Red Mudstone, Mudstone, and Carbonate. In the next step, rock mechanical parameters were extracted from petrophysical logs and experimental tests. Six Rock Mechanical Facies (RMF) were determined based on main rock mechanical parameters including Young's modulus (E), Poisson's ratio (PR), uniaxial compressional strength, internal friction, and cohesion along with statistical clustering approaches. Then, nine geomechanical units (GMU), including GMU A to GMU I, were extracted from RMFs and were correlated with geological studies. Brittleness index (BI) was calculated based on E and PR and was correlated with variation of Al2O3 and SiO2 from XRF analyses. Brittleness index, GMUs rock mechanical properties, homogeneity of GMUs, and their geological characteristics are used to determine possible candidate GMUs for hydraulic fracturing. Three GMUs are recognized as the best GMUs for hydraulic fracturing in the studied well.

Clavibacter tessellarius causing bacterial mosaic of wheat establishes in the Old World

AbstractThe genus Clavibacter (family Microbacteriaceae) includes gram‐positive actinobacterial species infecting diverse agricultural crops such as alfalfa, maize, pepper, potato, tomato and wheat. Clavibacter tessellarius, causing bacterial mosaic of wheat, was reported for the first time in 1976 in Nebraska (United States). Since then, the pathogen was thought to be restricted to North America (Canada and the United States). While bacterial strains suspected to be C. tessellarius have occasionally been isolated from wheat samples outside North America, occurrence of the pathogen in the Old World has not yet been confirmed by the plant protection authorities. In spring 2020 (January to May) dozens of wheat fields with young plants showing leaf chlorosis and mild mosaic symptoms were surveyed and sampled in southern Iran. Among 192 surveyed wheat fields, gram‐positive, orange‐pigmented actinobacterial strains were isolated from samples of 53 fields. Altogether, 61 bacterial strains were identified as C. tessellarius based on the phenotypic features, PCR‐based molecular tests and pathogenicity assays. Multilocus sequence analysis of five housekeeping genes (atpD, dnaK, gyrB, ppk and rpoB) using 10 representative strains from diverse geographic areas in southern Iran confirmed the phylogenetic status of the strains within C. tessellarius. Our data indicate that the bacterial mosaic pathogen occurs in four southern Iranian provinces including Bushehr, Fars, Kerman and Khuzestan. Thus, occurrence of C. tessellarius outside North America is confirmed. Potential risks associated with the emergence of the pathogen in the Old World, and the need for strict quarantine measures in the area, is further discussed.

Epidemiology of measles in Southern Iran: trends, challenges, and vaccination insights

Background: Measles, a highly contagious and vaccine-preventable disease, continues to present global public health challenges. This retrospective study focused on measles outbreaks in Hormozgan province, southern Iran, spanning from 2014 to 2019. Methods: Between 2014 and 2019, patients suspected of having measles, as reported by medical centers in Hormozgan, were subject to a comprehensive evaluation. The diagnosis of measles was conclusively established through the use of Real-Time Polymerase Chain Reaction (RT-PCR) testing. A detailed collection of pertinent data was undertaken. SPSS software, version 21, was employed for statistical analysis. Results: In the current study out of 1291 clinically suspected measles cases, 151 were PCR-confirmed, with an average age of 16.77 years (±10.46), comprising 50.9% males and 49.1% females. The annual distribution showed varied incidence: 8.4% in 2014, peaking at 18.8% in 2015, then fluctuating to 11.4% in 2016, 0.8% in 2017, and 17.9% in 2018, with no cases in 2019. Among confirmed cases, 16.5% were vaccinated, while 68.2% were not, and 15.23% had unknown vaccination status. Conclusion: This retrospective study highlights the ongoing challenge of measles in Hormozgan province, Iran, from 2014 to 2019. Despite measles being preventable by vaccination, a significant number of cases were confirmed among both vaccinated and unvaccinated individuals, indicating gaps in immunization coverage and effectiveness. The fluctuating annual incidence, with a peak in 2015 and no cases in 2019, suggests variable success in disease control efforts. This underscores the need for enhanced surveillance, improved vaccination strategies, and public health interventions to effectively combat measles outbreaks in this region.

Seroprevalence of visceral leishmaniasis among pregnant women in Jahrom city in Fars province, southern Iran

BackgroundVisceral leishmaniasis (VL) is a public health issue in endemic countries with poor sanitation facilities. In this study, the seroprevalence rate and associated risk factors of VL were investigated during September 2020 to February 2021 in pregnant women referred to Ostad Mottahari and Peymanieh hospitals in Jahrom county, Fars province, southern Iran. Material and methodsA total of 220 serum samples of pregnant women were assessed for the presence of Anti-Leishmania infantum antibodies by direct agglutination antigen (DAT). The associated risk factors were obtained using questionnaires. ResultsThe overall seroprevalence of VL in pregnant women was 12.72% (28/220). Considering the antibody titer, titer 1:1600 was detected in 23 samples, titer 1:3200 in 4 samples, and titer 1:6400 in one sample. All 5 women with titer >3200 had mild fever. As such, there was a statistically significant difference regarding the age (≥39 years old with p-value: 0.01). ConclusionsWe recommend an appropriate health education program for pregnant women and serological screening of VL before pregnancy in endemic cities. Moreover, we believed a need for more epidemiological studies for better understand the status of VL in pregnant women.

Micro- and Macrovascular Complications of Type 2 Diabetes in Southern Iran

Objectives: Type 2 diabetes mellitus (T2DM) is one of the most common diseases worldwide, imposing a great burden on the community by its complications. This study evaluates micro-and macrovascular complications of T2DM and the associated factors in the south of Iran. Methods: This cross-sectional study was conducted on T2DM patients referred to the Diabetes Clinic of Shahid Mohammadi Hospital in Bandar Abbas City, Iran, in 2018. Patients’ age, sex, marital status, smoking status, diabetes medications, cardiovascular disease, and duration of T2DM were recorded. Weight, height, and blood pressure were measured and body mass index was calculated for every participant. Also, all patients were evaluated regarding diabetes complications, including retinopathy, nephropathy, and neuropathy. Serum fasting plasma glucose (FPG), lipid profile, glycated hemoglobin, creatinine levels as well as urinary albumin were also measured in the patients. Results: Of the 263 T2DM patients included in the current study with a mean age of 55.32±13.09 years, 109 (41.4%) were male. The most common T2DM complications were chronic kidney disease (CKD) (49.8%) and nephropathy (36.5%), followed by neuropathy (30.8%), retinopathy (19%) and ischemic heart disease (8.7%). Elevated systolic blood pressure was significantly correlated with the presence of all complications. Patients with ischemic heart disease, CKD, neuropathy, and retinopathy were significantly older than subjects without such complications. Diabetes was significantly more prolonged in patients with ischemic heart disease and CKD. Elevated FPG was only correlated with CKD (P=0.019) and nephropathy (P=0.003), while increased glycated hemoglobin and decreased high-density lipoprotein were significantly associated with retinopathy (P=0.050 and P=0.001, respectively). Moreover, a significant relationship was observed between elevated urinary albumin with retinopathy and neuropathy. Discussion: Diabetic kidney disease was the most common complication of T2DM in the current study. Increased systolic blood pressure is the most important risk factor for the development of diabetic complications.

High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study.

Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).