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Introduction: Nosocomial  infection  is  responsible  of  over  20.000  mortality  in  year  and  about  60%  admission  in  hospital  cause  nosocomial  infection. Thus  it  is  necessary  to  evaluate  attitude, knowledge  and  practice  of  nursing  staff  about  prevention  of  it.
Materials  and  Methods: In  this  study, 100  nursing  staff of  teaching  hospitals  in  Bushehr  were  selected  in  a  multistaging  random  sampling. A  questionnaire  used  for  determination  of  attitude, knowledge  subjects  and  practice  was  assessed  by  check  list  which  reliability  and  validity  of  it  assessed  by  pilot  study. The  questioner  had  15  questions  of  attitude  based  on  likret  scale. In  data  analysis  of  attitude  scores  aet  in  rang  of  15-75, the  high  scores  indicate  positive  attitude  and  the  lowest  scores  indicate  negative  attitude. The results  divided  in  to  three  group:  negative, positive  and  no  idea  and  showed  that  most  staff  had  positive  attitude(85.5%) about  infection  control. In  analysis  of  knowledge  and  practice  scores, score  100  consider  the  highest  level  and  below  50  no  acceptance.
Results: Showed  that  44%  nursing  staff  had  optimal  knowledge  related  to  nosocomial  infection  and  most  of  them  practice  poor  inprocedures  such  as  change  dressing (84%), tracheal suctioning (81%), bladder catheterization (83%)  and  change  venous  site (78%. There  was  seen  statistical  relationship  between  knowledge  and  academic  degree,  position, and  years  in  practice. The  last  variable  had  negative  relationship  (p<0.01, r=-0.276). In  addition  there  was  seen  relationship  between  practice  and  experience  in  critical  care  unit, family  history  of  infection  disease  and  participation  in  teaching  session (p<0.01)
Conclusion: This  study  results  showed  poor  knowledge  and  practice  of  nursing  staff  nosocomial  infection  control  in  study  society  and  must  be  attention  to  it  in  this  group  and  similar  societies.

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Background: Job satisfaction is regarded as an individual's opinion of his or her job. Noticing the key role of hospital personnel in giving health services to patients, this study was designed to determine job satisfaction of hospital personnel in Arak. Materials and Methods: This cross-sectional study was carried out on 702 hospital personnel through simple sampling method. The means of gathering data were demographic and Herzberg's job satisfaction questionnaires. Job satisfaction was categorized in three levels. Results: Results in eight domains showed that most personnel's satisfaction of job environment (%75.2), relationship with co-workers (%49), salary and benefits(%75.1), job position(%60.5), job security (%64.6), supervision(%64),management policy(%59.2)and personal life relations (%65.7)were at average levels. Overall, %82.2 of the personnel had an average satisfaction with their jobs. The greatest level of satisfaction was with relationship with co-workers and the lowest level of satisfaction was related to job difficulty benefits, establishment of justice and fairness, discrimination and lack of facilities. X2 statistical test revealed significant differences amolay sex, level of education, type of employment, type of job and work shift. Conclusion: Overall, Job satisfaction in this study was at an average level. Increasing salaries, job difficulty benefits, on time payment and providing welfare facilities are essential for the improvement of job satisfaction in this group.

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Background: This study was designed to investigate the quality of life in staff and hospital personnel of Arak University of Medical Sciences and to gain basic information for carrying out interventions for improving their quality of life. Materials and Methods: This cross-sectional study was done to determine quality of life of 300 staff and hospital personnel in Arak University of Medical Sciences. Data gathering tools were demographic and standard quality of life (SF-36) questionnaires. Results: Of the 275 participants who had completed the questionnaires, 127 (%46.2) were staff and 148 (%53.8) were hospital personnel. The means of age and years of experience were 36.797.02 and 12.297.39 years, respectively. The mean of different dimensions of quality of life in the staff was significantly much higher than that in the hospital personnel (p<0.05). In terms of physical performance, vitality, social performance, general health, physical and mental health domains, significant differences were found among personnel with different employment status. There was also a significant difference between men and women in terms of physical restriction factors, physical agony, vitality, sanity, mental and physical health. Conclusion: The mean of different dimensions of quality of life in hospital personnel was lower than the staff while this value was lower in women than men. Specific longitudinal studies are needed for investigating the causes of these differences.

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Background: Psychological interventions may improve the quality of life in females with temporal lobe epilepsy through affecting their bio-psycho-social dimensions. This aim of this study was to aim assess the efficacy of cognitive-behavioral stress management (CBSM) group education on improvement of quality of life in epileptic patients. Materials and Methods: This was a case-control study with pre-post-and follow-up tests. The sample population included 26 patients, already diagnosed with temporal lobe epilepsy by neurologist and through electro-encephalography, that were randomly selected and assigned to experimental and control groups. Data were collected through the Quality Of Life Questionnaire for Epileptic patients (QOLIE- 89) that was administered in the pre-test, post-test, and follow-up test. CBSM group education was given to the experimental group in ten sessions during two months. Results: The mean of QOLIE-89 score in the experimental group showed a significantly higher increase in comparison to that in the control group (p<0.05). Conclusion: The results demonstrated the effectiveness of CBSM group education on the improvement of quality of life in females with temporal lobe epilepsy.

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Background: In pyoderma infections, the density of pus is related to desoxiribo-nucleoproteins. The use of streptodornase (DNase) in combination with streptokinase can help dissolve purulent secretions of infections which results in healing the wound through the discharge of pus from the necrotic tissue. The aim of this study was to produce recombinant streptodornase from group A strain of Streptococcus pyogenes which is highly efficient in terms of active streptodornase production using expression vector. Materials and Methods: In this applied-fundamental study, genomic DNA of streptodornase gene (sd) was extracted by phenol-chloroform. Then by using specific primers of streptodornase gene, it was amplified through PCR. The resulting streptodornase gene was cloned in pGEX4T1-sd transformer for expression and the pGEX4T1-sd plasmid was transferred to the sd. E.coli BL21. Protein production was done by induction via IPTG and optimization of the conditions. The recombinant protein was purified using the glutathione sepharose 4B kit. Results: The nucleotide sequence of PCR and group A streptodornase Streptococcus was totally the same. The production of the streptodornase recombinant protein was done by inducing pGEX4T1-sd plasmid via Isopropyl β-D-1-thiogalactopyranoside. Protein purification was done through affinity-chromatography by using glutathione sepharose 4B. The recombinant protein was reacted with anti-streptodornase mouse serum through Western-Blot method. Conclusion: Recombinant streptodornase can be produced by pGEX4T1 in E. coli. The recombinant protein maintains its antigenic property desirably. Noticing the domestic need in Iran, low rate of production, and pathogenesis of streptococci, production of this recombinant product is feasible.

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Background: Brucellosis, especially if caused by Brucella melitensis, remains one of the most common zoonotic diseases worldwide with more than 500,000 human cases reported annually. In Iran, brucellosis was first recognized in 1932 and control of small ruminant brucellosis began in 1963. The aim of this study is to give an overview of the National Sheep and Goat Brucellosis Control Program in Iran. Materials and Methods: In this cross-sectional study, data were collected from Iran Veterinary Organization over a period of 45 years. The national control program was based on kid and lamb vaccination and testing and slaughtering infected animals. Results: B.melitensis biotype I in sheep, goat, and man was the predominant local infective biotype. This disease was reported in sheep, goat, cattle, horse, camel, and human. In addition, the prevalence of small ruminant brucellosis was estimated around 2.1%. Conclusion: Prevention of brucellosis is dependent upon increasing public awareness of ranchers through health education programs and more active co-operation between health and veterinary medicine organizations as well as animal movement control in the borders.

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Background: Brucellosis is a zoonotic disease in humans and animals that its control is dependent on the prevalence of diseases in animal populations. The purpose of this study was to compare the sensitivity and specificity of common diagnostic tests for brucellosis. Materials and Methods: In an analytical cross-sectional study, 297 serum samples from an infected herd that had a history of abortion were prepared and evaluated through standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests. In addition, microbial culture was done for positive serum samples, lymph nodes, and infected organs. Results: Based on the total 297 serum samples tested, the sensitivities for standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests were 89, 81.5, 75.3, 89.7, and 93.2% , whereas specificities were determined to be 97.4, 94, 96, 98, and 99.3%, respectively. Conclusion: The findings of this study show that the standard tube agglutination test, complement fixation test, and ELISA are more sensitive than other tests. Moreover, ELISA test was the most sensitive and specific serological test for diagnosis of brucellosis in the present study

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Background: Vasomotor disorders are one of the most painful menopausal complications that negatively affect the quality of life in menopausal women. This study investigated the effects of omega3 fatty acid on vasomotor disorders in menopausal women. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial study was done on 83 menopausal women aged 45-60 years that had met the inclusion criteria. The participants were randomly assigned to omega3 or placebo groups. Fish oil capsules (containing 300 mg of omega3) or placebo capsules were prescribed to the participants one capsule a day for 8 weeks. Of the 83 patients enrolled, 68 completed the study (omega3 supplement, n=34 placebo n=34). Data collection was done through demographic questionnaire, daily self report, and food frequency questionnaire (FFQ). Data were analyzed by t-test, Chi square, Fiedman, and Mann-Whitney tests using SPSS software version 18. Results: After 8 weeks of intervention, there was a significant difference in HF frequency (p=0.003) and nightsweats frequency (p=0.001) between the two groups. There was no significant difference in HF intensity between the two groups (p=0.2) but reduction of nightsweats intensity was significant between the two groups (p=0.003). Conclusion: Omega3 affected the reduction of HF frequency and nightsweats frequency and intensity but it did not have a significant effect on the severity of HF.

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Background: Enterotoxigenic Escherichia coli bacterium is the most important bacterial agent causing diarrhea. Specific virulence factors, such as enterotoxins and colonization factors, distinguish ETEC from other classes of diarrheagenic E.coli. In this study, heat-labile toxin was purified which could be utilized for anti-toxin assay in GM1 gangelioside receptor-ELISA based method and for identification of ETEC producing toxin. Materials and Methods: In this experimental study, bacterial strain producing heat-labile toxin was first cultivated for production and purification of toxin. Then supernatant soluble proteins were precipitated with ammonium sulfate and purified using biochemical methods. Finally, purified protein was dialyzed against Tris 0.02 mM pH 8 and analyzed on gel electrophoresis. GM1 gangelioside receptor-ELISA based method was used for detection and assessment of the purified toxin. Through this method, the effect of anti-recombinant heat-labile toxin B subunit neutralization on heat-labile toxin was investigated. Results: Toxin purification was revealed by the presence of 12 and 28 KD protein bands. This study demonstrated that anti-recombinant heat-labile toxin B subunit antibody can detect the purified toxin and can inhibit its binding to GM1 receptor up to 80%. Conclusion: Purification of heat-labile toxin and gangelioside receptor-ELISA assay can be used for accurate detection and epidemiological study of clinical isolates.

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Background: Nowadays, one of the basic problems of tuberculosis treatment is drug resistance. This study was done to determine the drug resistance of mycobacterium strains isolated from patients with pulmonary tuberculosis to anti-tuberculosis drugs and determine the affecting factors. Materials and Methods: In a cross-sectional study, all patients with tuberculosis who were covered by Markazi Province Health Center (917 persons) during 2005 to 2010 were included in this study. For all patients with resistant pulmonary tuberculosis, culture and antibiogram by standard method (proportional) were done. Effective factors in drug resistance were identified by logistic regression model using SPSS software. Results: Overall, the rate of resistance in patients with smear-positive was 7.3% and the rate of MDR-TB was equivalent to 4.3%, and 0.5% of smear positive patients were resistant to all five drugs. The most resistant strains were isoniazid (68.8%), rifampin (62.5%), pyrazinamide (25%), ethambutol (21.9%), and streptomycin (21.9%), respectively. The highest rate of resistance was in the 15-45 years age group. The incidence of resistance was significantly associated with sex, grade of smear positivity, relapse of TB, and HIV infection. Conclusion: The study of drug resistant mycobacterium strains over six years showed a growing trend. Therefore, close attention to prevent the production and dissemination of resistant strains is very essential.

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Background: Noticing the sensitivity of measles virus to temperature and light, maintaining its stability is highly important in live vaccines. The aim of the study is to evaluate the stability of measles vaccine produced by AIK-C strain. Materials and Methods: In this experimental study, three lyophilized vaccine vials were incubated at 37˚C for one week and their stability was evaluated via accelerated test. In addition, reconstituted vaccines were incubated at 4˚C, 25˚C, and 37˚C for 0, 4, 8, 12, 16 hours after reconstitution and their remaining infectious virus titer was measured using CCID50 method. Half-life of the reconstituted measles vaccine was evaluated according to linear regression analysis. Results: When the reconstituted vaccine was incubated at 4˚C, 25˚C, and 37˚C, the titer loss per hour was equal to 0.05, 0.1 and 0.2 Log10 CCID50, respectively. Also, the half-life of this vaccine at these temperatures was 5.31, 2.26, and 1.36 hours, respectively. Conclusion: The loss of potency for measles vaccine produced by AIK-C strain is 0.33 Log after storage at 37°C for one week, while the reported amounts for commercial vaccines such as Mevilin-L, Attenuvax, Edmonston-Zagreb, and Rimevax are 0.7, 0.7, 1 and 0.78, respectively. Lyophilized and reconstituted vaccine containing AIK-C strain is more stable in comparison with Edmonston B, Schwartz, Biken-CAM, and Leningrad strains. The stability of the reconstituted AIK-C strain vaccine is similar to Moraten strain at 37˚C.

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Background: Differentiation of M. tuberculosis complex organisms were assigned to one of three genotypic groups based on the combinations of polymorphisms at katG codon 463 and gyrA codon 95. Early identification of strains belonging to any particular group is very important. This study was planned to identify major genetic groups of clinically isolated Mycobacterium tuberculosis. Materials and Methods: In this cross sectional study 33 sputum samples were collected from tuberculosis patients of the Markazi province. DNA purification from isolated samples was performed by Chelex 100. Identification of isolates was confirmed by detection of katG gene and the mutation in KatG463 by using PCR method and RFLP respectively. Finally 620-bp of katG gene and 194-bp of gyrA gene purified from PCR product were sequenced. Results: Amplification of 620-bp fragment of katG gene was a good way to confirm the detection of bacteria as a molecular approach. Results of sequencing codon GyrA95 in combination by results of PCR-RFLP determined type of the major genetic group (MGG). Therefore it showed that among the 33 Mycobacterium tuberculosis isolates 12 samples were MGG 1, 15 Samples were MGG2 and 6 samples were MGG 3. Results revealed that MGG 2 was dominant form of M. tuberculosis strains of Markazi province by frequency of 45.5%. Conclusion: Based on the results of this study MGG2 occurrence was more frequent among clinical strains in Markazi province that its accordance with susceptibility of these strains to conventional antibiotics is notable. In this study, three applicable benefits from the test as: MGG typing, molecular detection of M. tuberculosis and bacterial resistance to Isoniazid were proven.

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Background: Enterococcus is known as an important pathogen in Iran like all around the world. The increasing use of vancomycin makes vancomycin-resistant enterococci (VRE) an important nosocomial pathogen. Vancomycin in combination with an aminoglycoside can provide effective treatment for severe enterococcus infections, while resistance to vancomycin antibiotic is increasing in enterococci. In this study, the pattern of antibiotic resistance and prevalence of vancomycin resistance enterococci have been explored. Materials and Methods: In this experimental study, after isolating and identifying 150 strains of enterococci from clinical specimens, the antibiotic resistance pattern of these strains to erythromycin, teicoplanin, vancomycin, ciprofloxacin, tetracycline, gentamicin, co-trimoxazole and linezolid was examined. The MIC test by using micro dilution broth method was performed for the vancomycin resistance enterococci specimens with the vancomycin and teicoplanin antibiotics. Results: Antibiotic susceptibility test showed 14% and 5.3% of the samples were resistant to vancomycin and teicoplanin respectively. Resistant to erythromycin, co-trimoxazole, ciprofloxacin, tetracycline, linezolid and gentamicin were 64, 40, 38.6, 6.6, 0, 38.76 percent respectively. Fourteen samples had high resistance to vancomycin which MIC were ≥ 256 µg/ml. Conclusion: Based on the results of present study, there are vancomycin-resistant enterococci in Arak as well as other parts of the world. The percentage of vancomycin resistance enterococci is high in Arak and appropriate treatment of infections caused by enterococcus is essential

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Background: Tuberculosis is an old problem that is currently considered a great challenge. Noticing Iran’s borders with Afghanistan and Pakistan, which are among the 22 high burden countries around the world, the present study was conducted to analyze the current molecular epidemiology of TB and survey genetic diversity of Mycobacterium tuberculosis strains in Markazi province, Iran. Materials and Methods: In this experimental study, 57 sputum specimens from smear positive patients admitted to health centers in Markazi province were cultured on specific mycobacterial culture media. Genomic DNA was extracted by standard protocols of WHO and digested separately by PvuII and AluI. Electrophoresis was performed and DNA fragments were transferred to positively charged nylon membrane by southern blotting method and hybridization by PGRS probe. The hybridized strains were subsequently detected by enzymatic reaction and analyzed. Results: Genotyping of the isolates by PGRS-RFLP with Pvu II and AluI displayed a wide range of genetic diversity so that 50 and 45 genotypes were identified, respectively. Conclusion: Noticing the great diversity of PGRS in the Mycobacterium tuberculosis strains, it can be concluded that in the study population, the majority of the patients hadtuberculosis with different etiologies. Therefore, it seems that reactivation of latent infection has had the main role in the spread of tuberculosis

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Background: Measurement of service quality is a basic prerequisite for improving quality. Studies show that consumers are in close contact with services quality better than any other group. This study was conducted with the aim of measuring service quality based on patients’ expectations and perceptions teaching hospitals in Arak, Iran. Materials and Methods: This cross-sectional study was done on 260 patients at under auspices of Arak University of Medical Sciences. For data collection SERVQUL questionnaire was employed to measure quality of services. The reliability and validity of this questionnaire had already been confirmed by studies both in Iran and other countries. Results: The results showed that there were significant differences between patients’ expectations and perceptions in all dimensions of quality. The accessibility dimension constituted the most serious problem at hospitals. Conclusion: The negative scores show that it is necessary to promote all quality services dimensions at hospitals. For reducing the qualitative gap among all dimensions, it is recommended that hospital managers take patients’ needs into account and provide desirable services for them.

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Background: Mycobacterium Tuberculosis usually infects the lungs but organs other than the lungs may also be involved. This study is an analysis of the situation of extra-pulmonary tuberculosis in the central province of Iran.

Methods and Materials: In this cross-sectional study, the information in the registration software of tuberculosis in health centers collected and for analyzing of data statistical software SPSS16 was used.

Results: In the survey a total of 1787 TB patients were identified, of which 24.2% were diagnosed with extra-pulmonary tuberculosis and 1.9% of patient with extra-pulmonary TB were associated with HIV infection. Female to male sex ratio is equal to 1.3. The 82.5% of the patients were Iranian citizen and mean age of patients were 43.3 years. Tuberculosis of the lymph nodes, skletal and pleural tuberculosis had the highest prevalence. Also extra-pulmonary tuberculosis in females, age 15-55 was more and the diagnosis delay was more in extra-pulmonary tuberculosis and relapse was more in pulmonary tuberculosis.

Conclusion: Because of more diagnosis delay in extra-pulmonary tuberculosis it is necessary to train physicians and other healthcare workers in the field of extra-pulmonary TB diagnosis and more planning to do about learning of it.

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Background: Survey and control of nosocomial infections in the world is a global priority that The objective is to minimize infections in addition to decreased length of hospitalization And also significantly reduce the cost of health care .The aim of this study was evaluating the knowledge, self-efficacy and Practice of nursing staff in Disciplines Standard Precautions in order to prevention of nosocomial infection.

Materials and Methods: This Cross-sectional and analytical study that was carried out on 130nursing staff selectedin in Arak university of medical sciense in 2013. Data collected with validity and reliebility questionnaire including of knowledge, self-efficacy and Practice of nursing staff in Disciplines Standard Precautions in order to prevention of nosocomial infection. Data was analyzed by using descriptive and analytical statistical methods and pearson correlation.

Results: The mean knowledge was 46.92±14.66 and Practice 49.46±6.96 and average self-efficacy was 52.2±10.81 about infection prevention. There was not significant relationship between knowledge and Practice. But there was a significant relationship between self-efficacy, knowledge and Practice and marriage. Moreover there was a significant relationship between knowledge and gender. (p<0.05).

Conclusion: Despite moderate self-efficacy majority of Nurses do not have appropriate knowledge about prevention of nosocomial infection based on the findings of this study. Considering the important role of nurses in nosocomial infection prevention, training is necessary to increase nurses prevention behaviors. Therefor paying more attention by authorities to apply the necessary actions for training of nurses.

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Background: Multidrug resistance is the main reason for unsuccessful chemotherapy. The important reason of drug resistance is ATP dependent pumps shus as MDR1 that extrude drugs from the cell. MDR1 is high polymorphic. It seems that polymorphisms influent on gene expression and response to treatment. The aim of this study was investigation of C1236T polymorphism MDR1 gene and it’s association with response of treatment in childhood acute lymphoblastic leukemia.

Materials and Methods: In this descriptive study, C1236T polymorphism of MDR1 was investigated in 44 acute lymphoblastic leukemia childhood and 40 healthy individual by ARMS-PCR technique. Association of this polymorphism with response to treatment was also investigated. Data were analyzed using Chi-squre test and SPSS software. P values <0.05 were considered to be statistically significant.

Results: There was no significant difference in frequencies of C1236T polymorphism between patients and healthy group (p=0.876). Frequency of C1236T polymorphism of MDR1 between responder and non responder was not significant (p=0.304).

Conclusion: It seems that there is no correlation between C1236T polymorphism of MDR1 gene and response to treatment. So the role of C1236T polymorphism in gene expression MDR1 in childhood acute lymphoblastic leukemia and response to treatment is still controversial.

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Background: The importance of maintaining and enhancing the quality of life in (tuberculosis TB) patients is essential. The purpose of this study was to use N - acetylcysteine to improve the quality of life in patients with tuberculosis.

Materials and Methods: This study is a double-blind clinical trial that performed on 88 patients on anti-TB treatment that aged over 50 years in the central province of Iran within 15 months. Data collection tools included a demographic questionnaire and the Short Form Quality of life (SF12). Data were analyzed using SPSS software and t-test, Chi-square, Mann-Whitney, ANOVA and Pearson correlation analysis were used. p less than 0.05 was considered significant.

Results: This study showed that the two groups before the intervention in different features were not significantly different, but in quality of life at the end of the first month. The intervention group compared with the control group in physical subscale score (p=0.0068) and psychological subscale scores (p=0.0284) and quality of life score (p=0.0112) were better. Also, our study showed that age of patients (p=0.0331), duration of disease (p=0.0416), and serum CRP mean (p= 0.0234) and type of tuberculosis (p=0.0372) were significantly related to total score of quality of life at the end of the first month in the intervention group.

Conclusion: According to this survey results we hoped to combine the use of adjuvant therapy with N-acetylcysteine and standard tuberculosis treatment improves quality of life and increase life expectancy of patients.