title: Epidemiology of venomous and semi-venomous snakebites (Ophidia: Viperidae, Colubridae) in the Kashan city of the Isfahan province in Central Iran.
abstract: BACKGROUND
  Information on the epidemiology of venomous snake species responsible for envenomation to humans in Iran has not been well documented. In the Kashan city, venomous snakebite remains a recurring medical problem. Information providing the correct identification of snake species responsible for envenomation in this geographic region would be useful to regional medical clinics and personnel for the effective and optimal management of the patients.
  
  
  METHODS
  In this cross-sectional study, all patient data was collected from Kashan city and its suburbs. The specific data relating to the taxonomic identification of snakes responsible for envenomation were evaluated. A general approach to the diagnosis and management of patients was also provided. Snakes responsible for bites were transported to a laboratory, where their taxonomic classification was confirmed based on key anatomical features and morphological characteristics.
  
  
  RESULTS
  A total of 46 snakes were examined. Of these, 37 (80%) were non-venomous species, and 9 (20%) were identified as venomous. Seven of the nine venomous snake species (78%) were of the family Viperidae, and two specimens (22%) were in the family Colubridae. Specifically, the viperid species were Macrovipera lebetina obtusa, Pseudocerastes persicus, Pseudocerastes fieldi, and Echis carinatus. The two colubrid species were Malpolon monspessulanus insignitus and Psammophis schkari.
  
  
  CONCLUSIONS
  Five different species of venomous snakes responsible for envenomation in the Kashan city region were confirmed. The viper, P. fieldi, was reported for the first time in the central part of Iran.
authors.affiliation: Department of Environmental Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Rouhullah
authors.initials: R
authors.lastname: Dehghani
authors.affiliation: Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Mehrpour
authors.affiliation: Health Center of Kashan University Medical Sciences and Health Services, Kashan, Iran.
authors.forename: Morteza Panjeh
authors.initials: MP
authors.lastname: Shahi
authors.affiliation: Health Center of Kashan University Medical Sciences and Health Services, Kashan, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Jazayeri
authors.affiliation: Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran.
authors.forename: Parissa
authors.initials: P
authors.lastname: Karrari
authors.affiliation: Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis Medical Research Foundation, Minneapolis, MN, United States.
authors.forename: Dan
authors.initials: D
authors.lastname: Keyler
authors.affiliation: Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Zamani
keywords: Epidemiology; iran; kashan city; snake; snakebite