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Background: Vibrio cholerae is a gram-negative bacterial pathogen that causes diarrheal disease cholera. One of the most pathogenic factors of Vibrio cholera is pili. Pili plays an important role in colonization and persistence of bacteria in small intestine. Materials and Methods: In this study, pili A (tcpA) gene was amplified by Polymerase chain reaction (PCR) method and sub-cloned into expression vectors such as pGEX4T-1. Escherichia coli competent cells were transformed by recombinant plasmids and the expression of protein with IPTG. The recombinant proteins were purified by affinity chromatography (GST) and immunoblot analysis was used for evaluation of new recombinant proteins antigenicity. The concentration of recombinant proteins was measured according to Bradford assay. Results: The results of this study indicated that recombinant proteins were expressed successfully in competent cell of E. coli, such as E. coli BL21 (DH3). The recombinant protein was purified by affinity chromatography (GST). The immunoreactivity pattern of anti-Tcp antibody with recombinant proteins of TcPA showed that the recombinant proteins had antigenic properties. Conclusion: Because these recombinant proteins are antigenic, these proteins may be considered as tentative candidates for designing cholera vaccine.

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Background: Brucellosis is a major cause of zoonosis disease and is endemic in hamadan Province in Iran. The purpose of this study was to isolate Brucella species from brucellosis patients and identify different species of this bacterium in order to determine the prevalence of the species.

Materials and Methods: This study was descriptive- cross sectional and fifty blood samples were obtained from brucellosis patients with clinical symptoms. The samples were cultured in BACTEC system and incubated for 14 days. Then, the samples were cultured on Brucella agar and biochemical tests were done for identification of bacteria. Finally, Polymerase Chain Reaction (PCR) applied for confirmation and isolated identification with specific primers.

Results: Seven Brucella strains were isolated from 50 blood samples of the patients with brucellosis by blood culture and PCR. The PCR results on blood specimens showed 4 positive in spite of the negative results of blood culture. PCR and biochemical methods revealed that all the 11 isolated bacteria were Brucella Melitensis.

Conclusion: This study was designed to evaluate PCR technique as a diagnostic tool for brucella spp in comparison to conventional techniques. This study showed a high prevalence of brucellosis due to Brucella Melitensis in Hamadan Province and efforts in this region should be aimed at the eradication of this bacterium.

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Background: Human &beta-defensin 126 (12kDa) is a small cationic glycoprotein that is highly rich of cysteine. DEFB126 gene is located on the subtelomeric end of 20p1.3 in human. High expression of this protein is reported in epididymis. This polypeptide coats the plasma membrane of sperm during epididy‌mal transit. It is likely that &beta -defensin 126 might have role in unexplained male infertility since it involves in sperm maturation and capacitation. The current research designed to investigate if there is relation between &beta-defensin 126 gene mutation and unexplained male infertility.

Materials and Methods: In this case-control study we followed a two cytosine nucleotides deletion of &beta-defensin 126 gene in 35 Iranian men with unexplained infertility and 40 fertile men with normal spermogeram as control group. Standard PCR, SSCP(Single strand conformational polymorphism), and sequencing were used to detect genetic alteration of &beta-defensin 126. ELISA was performed for the assessment of the protein expression on sperm cells.

Results: Analysis of genetic data revealed 28.6% homozygote deletion in unexplained infertile men while this deletion was detected in 7.5% of controls. The deletion frequency was statistically higher in infertile patients than normal control group (p<0.05). The protein expression was less in men with del/del genotype compare to the other genotypes (p<0.005).

Conclusion: Our study shows that this common sequence variation of &beta-defensin 126 takes part in impairment of male reproductive function. Consequently, men with the del/del genotype are significantly less fertile than men who carry the wild type allele.

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Background: Pseudomonas aeruginosa is one of the most common nosocomial pathogens with high mortality rates. OprD is the major resistance mechanism to carbapeneme antibiotics. The aim of this study was to determine the expression of the genes encoding these efflux pumps using qRT-PCR.

Materials and Methods: This study examined 100 strains of Pseudomonas aeruginosa isolated from patients admitted to various hospitals in the Hamedan. Conventional phenotypic tests were used for identifying the 100 collected samples, then 31 samples were selected based on type of collected specimen and antibiotic susceptibility test i.e. antibiotic disk diffusion method performed for aminoglycoside, quinolone and carbapenem antibiotics. Furthermore, MIC method was performed for imipenem. Finally, RNA was extracted and converted to cDNA for determining the efflux pump genes expression using qRT-PCR.

Results: Among 8 selected antibiotics, the greatest resistance was for levofloxacin (61.2%, n=19) and the lowest one for imipenem (9.6%, n=3). The results of MIC were to imipenem 12 samples (38.7%) resistant, 13 samples (41.93%) intermediate, and 6 samples (19.35%) sensitive. The OprD gene was present in all strains but different expression has been observed. The strains with over expression of OprD gene showed high sensitivity towards carbapenems family antibiotics especially imipenem.

Conclusion: Identifying of bacterial resistance mechanisms is very complicated and extensive due to different mechanisms involved for similar antibiotics. OprD is main cause of attachment to the carbapenems family antibiotics. The more expression of OprD shows the more antibiotic sensitivity.

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Background: Listeria monocytogenes is one of the most important causes of abortion and postpartum infection in newborns. Because of the importance of L . monocytogenes in the health of pregnant women and newborn babies, the aim of this study was to determine the prevalence of these bacteria in pregnant women and to compare the level of prevalence between women with a history of abortion and with no a history of abortion.

Materials and Methods: In this study, 540 samples of pregnant women were provided from Arak Taleghani hospital. The samples were cultured in enrichment media, then L .monocytogenesis was isolated in specific media.

Results: Of clinical samples, 14 cases had Listeria monocytogenes. Of these samples, 8 cases in women had a history of abortion, while women with no history of abortion were 6 Most cases of positive culture were related to the age of 25 to 34 years, including 7 cases, the lowest cases were 35 to 44 years old including 3 women and 4 women were between 17 and 24 years old.

Conclusion: The study showed that Listeria monocytogenes can cause infection in pregnant women. The use of Phenotypic methods and specific media can apparently isolate listeria monocytogenes from healthy pregnant women.

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Abstract

Background: Probiotics are known as a factor for prevention of infectious diseases such as urinary tract infection(UTI). The present study aimed to investigate the positive effects of probiotics on urinery truct infection of cateterized intensive care unit patients.

Materials and Methods: In a triple blind clinical trial, 125 cateterized intensive care unit patients were randomly selected and divided into two groups, Treatment group (n = 63) was well matched with placebo group (n = 62) for age and sex and duration of admission .Case group received one lactocare capsule for 10 days and control group with a same method received placebo for 10 days. In both groups urine analysis and urine culture were measured with a same method at the first day and then twentieth day and finally data were analysed with t-test.

Results: The incidence of urinary tract infection between treatment and control group (respectively 17.4% and 22.5%) had no statistically significant difference (p=0.672). But, in terms of sex, incidence of urinary tract infections in women compared to men with the same condition was significantly different(p=0.002). In treatment group with long term cathetrization, urinary tract infections significantly were significantly different(p=0.041).

Conclusion: Administration of lactocare capsule has no statistically significant impact on the incidence of urinery truct infection of cateterized intensive care unit patients. In comparsion of cateterized men and women receiving probiotics, the reduction of urinary tract infection in women was more than in men. Probiotics had preventive effects on long term catheterization.

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Introduction: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient remains in a state of controlled consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex using awake craniotomy.
Case Report: This report describes the anesthetic management of a 22-year-old male undergoing craniotomy with a fully awake technique. This was the first case of craniotomy performed entirely awake (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, After preoperative preparation and evaluation, scalp nerve blocks targeting the cranial nerves innervating the scalp and head muscles were administered at specific sites. Mild sedation was provided using oxygen supplementation, followed by surgical incision. The lesion was examined intraoperatively while the patient remained awake, and the tumor was safely excised under full wakefulness. A combination of local and regional anesthesia and light intravenous sedation was utilized. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were administered for sedation. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in stable condition, and the patient was transferred to the intensive care unit in good general condition, awake and fully alert.
Conclusions: Although maintaining analgesia and hemodynamic and adequate ventilation during fully awake craniotomy poses challenges, this technique is critical for intraoperative monitoring of cranial nerve function and preventing neurological deficits. By precisely administering scalp nerve blocks and carefully titrating sedatives (propofol, remifentanil, dexmedetomidine), we successfully performed the procedure under full wakefulness. With this method, potential surgical complications are prevented, and the patient also experiences satisfactory painlessness. Applying this technique was satisfactory for our patient.