Journal of Arak University of Medical Sciences

A Systemic Review on Bacillus Subtilis Spore Structure and Its Applications in the Development of Mucosal Vaccines and Adjuvants

Gholamreza Ahmadian

Background and Aim Surface display technology enables the binding of proteins and peptides to the surface of living cells, including mammalian cells, yeast, bacteria, and spores. Among the various systems used for surface display, Bacillus subtilis spores have advantages such as resistance to adverse environmental conditions such as heat, radiation and chemicals, safety for humans and no need for the heterologous protein to pass the membranes for binding to spores.
Methods & Materials This study is a review that investigates the structure of the Bacillus subtilis spore, spore surface display, and its application in the development of mucosal vaccines and adjuvants.
Ethical Considerations All Ethical principles in writing this article have been observed according to the instructions of the National Ethics Committee and the COPE regulations.
Results Heterologous proteins can be displayed genetically and non-genetically on the spore surface. The surface display is a promising strategy for the development of whole-cell factories with many industrial and biotechnological applications, leading to significant advances in the production of biocatalysts, the development of live vaccines, bio-adsorbents and sensors, epitope mapping, inhibitor design, and protein/peptide library screening.
Conclusion It is hoped that oral vaccines of Bacillus subtilis spores will be of significant help in the prevention and treatment of diseases including COVID-19 in the future.

A Systematic Review of Genetically Challenging Changes of SARS-CoV-2 Variants; Escaping the Immune System and Vaccine Effectiveness

Javad Sarvmeili

Background and Aim So far, extensive research has been conducted on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus and its disease in different regions of the world. The aim of these studies is to present practical findings and suggestions about more familiarity with the characteristics of this virus, including its structural and genetic characteristics, origin of genesis, evolution, genomic changes, biological cycle and pathological function, that can be used to adopt efficient strategies in controlling and treating the pandemic.
Methods & Materials In order to perform genomic analysis, the complete sequence of the desired coronaviruses with accession numbers obtained from GenBank or GISAID was stored from databases such as NCBI and BV-BRC, and then the sequences were aligned with Workbench CLC Main software. In the next step, the phylogenetic tree was drawn by Neighbor-Joining method with 1000 repetitions (bootstrap) by MEGA X software and FigTree version 1.4.4 was used to display the tree more clearly.
Ethical Considerations All ethical principles in writing this article have been observed according to the instructions of the National Ethics Committee and the COPE regulations.
Results In the current study, mutations and the effect they may have on transmissibility, pathogenicity and vaccine effectiveness, molecular features, epidemiology and the place of emergence of coronaviruses, focusing on variant of concern (VOC) including alpha (B.1.1.7), beta (B.1.351), gamma (P.1), delta (B.1.617.2) and omicron (B.1.1.529) are presented.
Conclusion The occurrence of mutations and continuous evolution have led to the rapid and simultaneous emergence of different variants, each of these changes can contribute to the escape of therapeutic methods such as neutralizing antibodies (Nab) and convalescent plasma, as well as reducing the effectiveness of vaccines. Therefore, increasing monitoring for documentation, understanding the spread of different lineages and more detailed study of these mutations in identifying variants and effectively dealing with them is of great importance.

The Antiamoebic Effect of Oliveria Decumbens and Peganum Harmala Extract on Acanthamoeba

Ahmad Abolghazi

Background and Aim Acanthamoeba is one of free-living amoebas, which are very abundant in nature. As a free-living amoeba, this parasite has a very high lethality, especially in people with underlying diseases, so researchers are always looking for a way to combat it. Drug plants are a good way to fight Acanthamoeba species. In this study, we aimed to investigate the lethal effect of the extract of Oliveria decumbens vent and Peganum harmala alcoholic extract on Acanthamoeba.
Methods & Materials In this study using the extract from an extract of Oliveria decumbens vent and Peganum harmala with concentrations of 1.25, 2.5, 5, 10, and 20 mg/ml to investigate the lethal effect of this extract. The plant was treated with Acanthamoeba amoebae after three times (24, 48, and 72) hours.
Ethical Considerations This study was approved by the Ethics Committee of the Jahrom University of Medical Sciences (Code: IR.JUMS.REC.1398.029).
Results The present research showed that using different concentrations at three times (24, 48, and 72) hours the effect of the extract on trophozoites and cysts of Acanthamoeba was shown. The highest lethality is related to the concentration of 20 mg/ml using a combination of both extracts at the time 72 hours and the lowest lethality is related to the concentration of 1.25 mg/ml of Oliveria decumbens vent at the time 24 hours.
Conclusion Observations indicate that the alcoholic extract of Oliveria decumbens vent and Peganum harmala had a perfect effect both separately and in a combination of both extracts. These two extracts had a synergistic effect on the lethal effect of Acanthamoeba amoeba.

Efflux Inhibition in Clinical Isolates of Pseudomonas Aeruginosa Using Sertraline for Ciprofloxacin Resistance Breakdown

majid Akbari

Background and Aim The efflux pump in Pseudomonas aeruginosa inhibits the effect of ciprofloxacin by releasing quinolones out of the cell. It is important to find compounds to inactivate or inhibit its activity to continue using the antibiotics. The present study was done to investigate using sertraline as an efflux pump inhibitor in P. aeruginosa to reduce antibiotic resistance.
Methods & Materials P. aeruginosa strains were isolated from clinical sources and identified by routine microbiological methods. Resistance of the isolates to ciprofloxacin was evaluated by Kirby–Bauer test. Resistance breakdown was investigated by adding sertraline to the Moller Hinton agar medium and determining the zone of inhibition of ciprofloxacin. Minimum inhibitory concentration (MIC) by microplate dilution method and Minimum bactericidal concentration (MBC) by culture and MTT method were done for the isolates and ATCC 27853. The presence of the efflux pump was evaluated by the phenotypic method using sertraline and serial dilution method of the liquid medium in a microplate, on ciprofloxacin-resistant strains. The presence of the producing gene of this pump was determined by the genotyping method in resistant strains by performing PCR. The standard PAO1 strain of P. aeruginosa was used as a positive control.
Ethical Considerations This study was approved by the Ethics Committee of the Faculty of Medical Sciences of Islamic Azad University, Brojerd Branch (Code: IR.IAU.B.REC.1401.011).
Results Based on Kirby–Bauer test results, three strains were considered resistant to ciprofloxacin. MIC of drug-resistant strains was between 32 and 64 mg/ml and MBC was between 16 and 32 mg/ml. By performing electrophoresis on the PCR products, it was determined that the tested strains contained the mexA gene encoding the efflux pump. In the agar medium without sertraline, the zone of inhibition around the ciprofloxacin disc was zero, but after adding sertraline, the diameter of the halo increased to 25 mm. The minimum inhibitory concentration of ciprofloxacin in the isolates before adding 25 µg of sertraline was 128 µg/ml and after adding sertraline, it was 4 µg/ml.
Conclusion It was concluded that sertraline inhibited the efficiency of the efflux pump in resistant P. aeruginosa isolates and reduced ciprofloxacin resistance.

Comparison of Sleep Quality in Pregnant Women With Preeclampsia and Control: A Case-Control Study

Maryam Moradi

Background and Aim Preeclampsia is a common complication of the second half of pregnancy. Sleep disorders can cause high blood pressure by causing oxidative stress and endothelial dysfunction. Therefore, the present study was performed to determine the relationship between sleep disorders and preeclampsia.
Methods & Materials This is a case-control study that was performed on 240 women referred to the affiliated university hospitals in Mashhad. Sampling was performed in the case group of hospitalized women with a definite diagnosis of preeclampsia (n=90) and in the control group (n=150) among pregnant women without preeclampsia referred to the obstetrics clinic. Data collection tools included demographic information questionnaire and gynecological/obstetric records, Pittsburgh Sleep Quality Questionnaire and clinical evaluation form to determine the symptoms and severity of preeclampsia. Data analysis was performed using SPSS statistical software (version 22) and Mann-Whitney, Chi-square and Fisher tests. A P value of less than 0.05 was considered significant.
Ethical Considerations The present paper is the result of a research project approved by the Vice-Chancellor for Research of Mashhad University of Medical Sciences (Code: IR.MUMS.NURSE.REC.1397.042).
Results The mean amount of real sleep at night in the group of healthy individuals (8.4±2.3) was significantly higher than patients (8.0± 2.2) (P = 0.028). In terms of loud snoring, waking up in the middle of the night was most frequent in the affected group (P <0.001). There was a statistically significant difference between the two groups in terms of sleep quality score level (P <0.001) based on logistic regression test in women with severe sleep problems at risk of preeclampsia (P <0.001, 95% CI 2.9-42.2, OR : 11 / 11) (11/11) was equal compared to healthy women.
Conclusion The present study showed that sleep disorders in pregnancy are associated with an increased risk of preeclampsia.

Identification and Prioritization of Factors Affecting Knowledge Concealment By Managers in Guilan University of Medical Sciences by AHP Hierarchical Method

Saied Baghersalami

Background and Aim Hiding knowledge in the organization is a new topic in the field of knowledge management. The purpose of this study is to identify and prioritize the factors affecting knowledge concealment by managers in Guilan University of Medical Sciences by AHP hierarchical method.
Methods & Materials The research is applied in terms of purpose and based on a qualitative-quantitative approach. The statistical population of the study included philosophical experts in the field of management and experimental experts of the University of Medical Sciences who were selected as a sample by purposive sampling method and snowball technique until the theoretical saturation was reached. The data collection tool was a semi-structured interview. After enumerating the indicators affecting knowledge concealment and then by hierarchical analysis (AHP) method and using Expert Choice11 software, the identified factors were prioritized.
Ethical Considerations In this research, prior to interviewing the experts, written consent was received from them regarding the confidentiality of the research (Code: IR.IAU.LIAU.REC.1401.002).
Results The research findings showed that among the 7 effective factors considered by experts, the power-seeking factor has the greatest impact on knowledge concealment by managers in the University of Medical Sciences and emotional intelligence has the least weight or importance.
Conclusion Accordingly, by reducing power-seeking, in addition to creating a transparent and reliable atmosphere, it is possible to establish knowledge sharing in the University of Medical Sciences.

Feeding Patterns in One-year-old Children Referred to Urban and Rural Health Care Centers in Rafsanjan City in 2017

Seyed Zia Tabatabaei

Background and Aim The early years of life are the most critical stage in the growth and development of children. While the optimal development of children depends on a complex set of factors, the pattern of breastfeeding and complementary feeding of infants is of undeniable importance. Therefore, the present study conducted to investigate the factors related to the feeding patterns of one-year-old children referred to healthcare centers in Rafsanjan city.
Methods & Materials his descriptive study was performed on 600 mothers with one-year-old children under the auspices of healthcare centers in Rafsanjan city in 2017. Volunteered mothers with active health records were selected randomly. The required information was collected through a questionnaire containing demographic characteristics and questions related to the feeding of children and was analyzed by SPSS software, version 18.
Ethical Considerations The Ethics Committee of Rafsanjan University of Medical Sciences (RUMS) approved the present study (Code: IR.RUMS.REC.1396.179).
Results About 95% of mothers participating in this study started breastfeeding their children up to one hour after delivery, but 56.7% of them completed breastfeeding by one year of age. The results show that most mothers had started supplemental feeding with two or three spoons in each meal, and about 90% of them followed the health worker's advice. Also, the most important reasons for feeding children with powdered milk are disorders in the child's development (34%), inadequate breast milk (17%), maternal disease (14%), do not take the mother's breast (11%) and children being twins (8%).
Conclusion Despite face-to-face training for mothers in health care centers for feeding their children, still there are some difficulties in commencing complementary feeding and its continuation. Therefore, need for more health and nutrition education regarding the best ways for feeding children to mothers by personnel of Rafsanjan health care centers.

Comparison of the Effectiveness of "Cognitive Behavioral Therapy" and "Acceptance and Commitment Therapy" on Sexual Function in Postmenopausal Women

Mohammad Ghamari

Background and Aim Sexual function is an important part of menopausal women's lives, and changes in it, especially during menopause, can affect their health. The aim of this study was to compare the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on the sexual function of postmenopausal women.
Methods & Materials This research was a quasi-experimental with pre-test, post-test and follow-up design with control group. The statistical population of the study included postmenopausal women who referred to Zanjan Health Center in 2020 to receive services. Among them, 45 were selected using the available sampling method and were randomly assigned to three groups of 15, and control group using randomly assigned block allocation method. Therapeutic sessions were held in 8 sessions and each session was held for 2 hours. Data were collected by FSFI (Female Sexual Function Index) and were analyzed using ANOVA with repeated measures analysis via SPSS software, version 24.
Ethical Considerations This study was approved by the ethics committee of the Zanjan University of Medical Sciences (Code: IR.ZUMS.REC.1398.328).
Results In the post-test and follow-up phase, there was a significant difference between both CBT and ACT methods compared to the control group in sexual function respectively (P<0.05, F=17.857), (P<0.05, F=12.115). That is, treatment with CBT and ACT improved the sexual function of postmenopausal women, which had a lasting effect for three months, and there was no significant difference between the groups involved in sexual function (P>0.05, F=0.494).
Conclusion Cognitive-behavioral therapy and acceptance-based therapy have improved sexual function in postmenopausal women, so it is recommended that these therapies be used to improve the sexual function of postmenopausal women in health centers.

Investigate of Tooth Decay and Its Relationship With Knowledge, Attitude and Performance (Kap) in High School Students in Islamabad-E-Gharb City

Nooshin Salimi

Background and Aim Oral and dental health plays an important role in people's general health and is affected by various factors such as knowledge and attitude of a person regarding oral and dental health. Improving people's Knowledge and attitude in this regard will lead to more attention towards oral and dental health. therefore, the present study was conducted to determine the rate of tooth decay and its relationship with knowledge, attitude and performance in high school students in the Islamabad-e-Gharb city.
Methods & Materials This study was a cross-sectional study conducted among 348 high school students in Islamabad-e-Gharb. Which were selected through sampling in two stages, cluster and random. Data were collected using clinical examination and standard questionnaire and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Sheffe post hoc test and Spearman's correlation coefficient at a significance level of less than 0.05 using SPSS software, version 22.
Ethical Considerations This study was approved by the Ethics Committee of the Kermanshah University of Medical Sciences (Code: IR.KUMS.REC.1397.548).
Results The Mean Decay-Missing-Filled Teeth (DMFT) index 6.07±3.47 and Mean teeth decayed were 5.31± 2.90 respectively and 96.3 percent of the students had dental carries. Both DMFT index (r=-0.124, P=0.021) and teeth decay (r=-131, P=0.015) had a significant relationship with students' performance regarding oral and dental health. There was no significant difference between DMFT index and the number of teeth decayed with students' knowledge and attitude regarding oral and dental health (P<0.05). No significant relationship were found between either DMFT index (P=0.749) and teeth decay (P=0.614) with gender.
Conclusion In this study, DMFT index and teeth decay were relatively high and this shows the need to design educational interventions in adolescents to prevent teeth decay.

The Relationship of Pragmatic Language Competency and Self-Esteem in Hearing-Impaired Children

Maryam Tarameshkou

Background and aim: It is suggested that hearing impaired children with hearing aids and cochlear implant, showed poor pragmatic abilities. Pragmatic is the most related language component to social interaction. Further, it has effect on personality development and self-esteem. The main aim of the present study is investigating the relationship between pragmatic abilities and self-esteem in hearing impaired children.
Materials and methods: Sixty hearing impaired children with hearing aids or cochlear implant were included into this study according to inclusion and exclusion criteria. Then parents or other caregivers were asked to fulfill Children’s Communication Checklist (CCC) and self-esteem questionnaire. The participants were divided into three groups based on hearing impairment severity, including: severe, moderate and mild. The relationship between pragmatic ability and self-esteem was examined in three groups and without considering categorization, by Pearson correlation coefficient, significant level was 0.05.
Ethical considerations: This project is approved in Arak university of medical sciences with ethical registration code IR.ARAKMU.REC.1399.150. All parents gave written informed consent form.
Findings: the results illustrated that there is significant relationship between pragmatic abilities and self-esteem in all hearing impairment children without considering categorization (p<0.05). By considering categorization, significant relationship was showed in self-esteem and pragmatic abilities in moderate and mild groups (p<0.05).
Conclusion: according to our analysis, pragmatic abilities and self-esteem are related. This relationship is more obvious in low severity impairment.

Comparison of the Effect of 6 Weeks of Creatine and Ginseng Supplementation on Blood Ammonia, Lipoprotein and Homocysteine of Male Players of Iran's EPE Fencing Team in 2021

Tahereh Bagherpoor

Background and Aim Food and sports supplements are used by athletes all over the world, and correct and optimal consumption improves performance and prevents sports injuries. In this regard, creatine and ginseng supplements can be effective on physiological indicators and sports performance. Therefore, considering that no research has been done on the use of these supplements on blood indicators on fencers. The present study compares the effect of creatine and ginseng supplements on blood ammonia, HDL, LDL and homocysteine indices of the male players of the Iranian Epe fencing team.
Methods & Materials In the present study, 14 male players of the Epe national fencing team were divided into two creatine supplement groups (7 people) and ginseng supplement group (7 people). Subjects in two groups performed their normal exercises with the team during the research, and on the day before the measurement, after a specific activity in a sitting position, blood was taken from the arm vein of the subjects by a specialist. The statistical significance difference was determined at the level of P ≥ 0.05 and ANCOVA test was used to determine the differences between groups and the data was analyzed by SPSS software, version 25.
Ethical Considerations This article was approved by the Ethics Committee of Islamic Azad University, Shahrood Branch (Code: IR.IAU.SHAHROOD.REC.1400.073).
Results The results showed that after six weeks, there is a significant difference between the creatine and ginseng groups in the blood indices of ammonia, LDL, HDL and homocysteine (P≥0.05). so that the average of creatine supplement group in ammonia, LDL, HDL and homocysteine index in terms of mg/dL respectively (2.56±0.83, 1.16±0.33, 7.45±0.48, 8.89±0.18) and Gensing group (2.05±0.29, 1.46±0.78, 8.11±0.27, 7.63±0.45).
Conclusion The results showed that there is a significant difference in the average of blood ammonia, HDL, LDL and hemocytin between the creatine supplement group and the ginseng supplement group. Therefore, the role of ginseng supplement in reducing blood ammonia and homocysteine and in increasing HDL was more than that of creatine supplement, and the role of creatine supplement in reducing LDL was more than that of ginseng supplement. So it can be concluded that the role of ginseng supplement in the changes of blood ammonia, homocysteine and HDL is more than the role of creatine supplement.

Investigating the Causes of Body Dysmorphic Disorder in Women: Content Analysis

Mohammad Javad Asghari Ebrahimabad

Background and Aim There is almost no accurate information about the causes of body dysmorphic disorder. Many patients with body dysmorphic disorder who apply for plastic surgery show a negative response to these treatments and sometimes the symptoms get worse. The purpose of the present study was to investigate the causes of body dysmorphic disorder in women.
Methods & Materials The present research was a qualitative study with a content analysis type. Variables and categories were obtained by interviewing 15 experts and eight people with body dysmorphic disorder and reviewing 71 articles. Also, to diagnose body dysmorphic disorder, Yale Brown’s Practical Obsession Questionnaire was used in addition to the interviews. The sampling method in this research was purposive sampling. Data analysis was done in three stages: open, central, and selective coding. The validity of the components was checked by calculating the content analysis index.
Ethical Considerations In the research, before the interview, written consent was received regarding the specificity and confidentiality of the research (Code: IR.UM.REC.1401.105).
Results The influential factors in body dysmorphic disorder were: a. Cultural and social factors b. Psychological factors, and c. Biological factors.
Conclusion According to the obtained results, several factors play a role in the occurrence of body dysmorphic disorder, and their identification in different environments, cultures, and societies provides the possibility of developing preventive measures, and designing and developing a suitable treatment model. However, to increase the external validity of the research, it is suggested to conduct similar research in other societies.