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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: Doxorubicin (DOX) is a widely used anticancer drug, but its use in clinical chemotherapy is limited due to its side effects, including testicular toxicity. The aim of this study was to investigate the protective effect of nano-zinc oxide (nZnO) on DOX-induced reproductive toxicity in male rats.

Materials and Methods: In this experimental study, adult male Wistar rats were randomly divided into four groups, including one control and three experimental groups. They received saline, DOX (6 mg/kg), nZnO (5 mg/kg), and nZnO followed by DOX (i.p), respectively. Treatment was performed for 3 days. After 28 days, post-administration histological changes and reproductive indices were studied.

Results: Administration of DOX induced a significant reduction in seminiferous tubules diameter and thickness of germinal epithelium. Also, fertility and fecundity indices, number of litters and epididymal sperm concentration, decreased, whereas degenerated Leydig cells and deformed Sertoli cells increased.

Conclusion: Coadministration of nZnO significantly improved DOX-induced changes. These findings show the protective role of nZnO in DOX-induced reproductive toxicity.

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Background: Considering the fact that more than one third of the world’s population is infected with Mycobacterium tuberculosis bacteria, identifying individuals with latent tuberculosis infection (LTBI) is vital for controlling TB. Tuberculin skin test (TST) and IFN-gamma release assays are practical methods used for screening people with LTBI. Due to the insufficiency of data on endemic tuberculosis region and the need for evaluation of these methods in a high-risk population, this study was performed in Zahedan.

Materials and Methods: This descriptive study was carried out on 75 individuals, including 21 health care workers (HCWs) as well as 54 family members of patients with active TB. IFN-&gamma release assay and TST were also carried out on the participants.

Results: Of the 75 participants, 26 had positive IFN-&gamma release assay results and 49 persons showed negative results. TST was also performed and 12 participants did not show up for taking the results. Among the remaining 63 participants, 60.31% had more than 10 mm indurations. The results in 32.25% of the participants were positive for both IFN-gamma release assay and skin test, whereas 34.92% of the participants presented negative tests results for both IFN-gamma release assay and skin test. The agreement between these two tests was 66.67 % (P=0.001, K=0.36, 95% Confidence Interval).

Conclusion: The results showed a weak agreement between the two tests.

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Background: Brucellosis is a debilitative disease that imposes heavy costs on the economy and society. Therefore, using the most accurate and efficient method to diagnose this disease is essential. In Iran, Brucella melitensis is the common causative agent for brucellosis and BP26 protein of this bacterium has a good level of antigenicity. Thus, the aim of this study is to produce Brucella melitensis recombinant BP26 protein with a PET28a expression vector.

Materials and Methods: In this applied-fundamental study, genomic DNA was isolated from bacterial culture through proteinase K (pK) and phenol/chlorophorm protocol. Then, two pairs of primers were designed based on the known sequence in the gene bank for amplification of Brucella melitensis bp26 gene and PCR reaction was set up and optimized. The PCR product was cloned first into PTZ57R/T vector and accessed on the PET28a vector and sequenced. The recombinant vector was transformed and expressed into E. coli BL21 (DE3). Then, the recombinant protein was purified with Ni-NTA column of chromatography against His tag.

Results: The size of PCR product was in accordance with the part of bp26 gene size in the gene bank. The bp26 gene without adding IPTG had little expression and 3 hours after adding IPTG with a 1 Mm concentration to culture media, extreme expression was observed.

Conclusion: The production of recombinant BP26 protein from isolated Brucella melitensis native to Markazi province was done. Noticing the importance of BP26 protein and its significance for future studies on providing brucellosis diagnosis kits, its production was made possible.

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Background: Familiarity with different methods and medications in anesthesia and producing sufficient depth of anesthesia are very important in anesthesia practice. Due to the central analgesic and sedative effect of lidocaine in the presence of the sufficient blood level, it can be used for general anesthesia. This study was carried out to compare the effect of halothane with lidocaine infusion on BIS during maintenance of anesthesia.

Materials and Methods: In this randomized double-blind controlled clinical trial, 66 patients scheduled for elective inguinal herniorrahaphy were randomized into two equal groups. For maintenance, one group received halothane (1%) with O2-N2O and another group received lidocaine infusion (100 &mug/kg/min). BIS was checked every 5 minutes for half an hour. Statistical analysis of data was done by Chi-square and T-test through SPSS software. P-values less than 0.05 were considered meaningful.

Results: Mean of BIS was 65.72 in the lidocaine group and 56.7 in the halothane group during the first 30 minutes. There was a significant statistical difference between the two groups (p<0.05).

Conclusion: Mean of BIS in lidocaine group was higher than that in the halothane group. If this indicates the presence of a light level of anesthesia, increasing the dose of hypnotics and opioids leads to an increase in the depth of anesthesia. However, since there is not any device for monitoring the effect of opioids on the central nervous system and the level of anesthesia, simultaneous monitoring of BIS and hemodynamic parameters seems to be a more reasonable idea.

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Background: Funnel plot is a graphical tool for investigating publication bias in meta-analysis studies. The aim of this study is to introduce another application of funnel plot that is monitoring one of the Iranian family performance indices and determining the position of each health center of Markazi province in terms of patient referral rates by general practitioners to specialists and to compare it with bar and caterpillar plots.

Materials and Methods: In order to draw the funnel plot, the average monthly percent of referrals for each district of Markazi province in 2011 was computed. In this study, Iranian Ministry of Health and Medical Education standard figure of 10% was considered as the limit of referral to the second level of Iranian health services. The 99% confidence interval of the control limit for each district was computed according to 3 standard deviations of the percent of referrals relative to the total patient visits.

Results: Based on funnel plot results, five out of ten districts were in the expected range of referral (Ashtian, Saveh, Tafresh, Khomein, and Komijan). However, in other five districts, the referral rate was greater than the expected rate (Arak, Shazand, Zarandiyeh, Delijan, and Mahallat). Mahallat district had the highest rate of referral.

Conclusion: The funnel plot was more informative than the other two plots Thus, it can be viewed as a useful tool in monitoring health programs throughout the country.

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  Background: Due to the lack of efficient anti-HIV vaccine, anti-HIV pharmaceuticals play an important role in controlling HIV infection. Also significant rise in drug resistance and drug toxicity has caused increased interest in finding new anti-HIV agents. In this study, a nano-sized version of lamivudine based on PEGylated chitosan was synthesized.

  Materials and Methods: In this research, nanoparticles of chitosan were efficiently PEGylated for increasing their stability in water and then the anti-HIV drug, lamivudine, was loaded on these PEGylated nanoparticles. After purification and lyophilization of new synthesized nanoparticle, the raw materials and final product were sampled and FTIR, HNMR and CHN analyses were done.

  Results: Results of HNMR spectroscopy showed that chitosan nanoparticle was successfully PEGylated. HNMR data confirmed FTIR results and indicated that lamivudine was conjugated on chitosan nanoparticle. In addition, CHN analysis data also confirmed both HNMR and FTIR data, and demonstrated that a high yield of chitosan nanoparticle PEGylation (approximately 97%) was done and illustrated a high capacity of lamivudine conjugation on nano-sized PEGylated chitosan (30% _W/W chitosan).

  Conclusion: In this study, lamivudine drug was successfully synthesized, based on PEGylated chitosan nanoparticle.

 

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Background: SLC26A4 gene mutations are the second currently identifiable genetic cause of autosomal recessive non syndromic hearing loss (ARNSHL) after GJB2 mutations. In databases, several potential STR markers related to this region have been introduced. In this investigation, the identity and informativeness of D7S2459 CA repeat STR marker in SLC26A4 gene region was examined in five ethnic groups of the Iranian population.

Materials and Methods: The research study was accomplished by genotyping the locus in 165 individuals of five different ethnic groups including Fars, Azari, Torkaman, Gilak and Arab using polymerase chain reaction (PCR) followed by polyacrylamide gel electrophoresis (PAGE) and fluorescent capillary electrophoresis. In this study, results were analyzed by GeneMarker HID Human STR Identity software, GenePop program and Microsatellite Tools software.

Results: Analysis of the allelic frequency revealed the presence of 8 alleles for D7S2459 marker in the Iranian population. Among all, allele 148bp at the D7S2459 locus with 31% frequency was the most frequent. The Azari ethnic with 84.8% observed heterozygosity was the highest among all ethnic groups. Finally, analysis of PIC value revealed that D7S2459 marker could be considered as a highly informative marker in each ethnic of the Iranian population (PIC value above 0.7).

Conclusion: Our data suggested that D7S2459 could be introduced as a highly informative marker in molecular diagnosis of SLC26A4 based ARNSHL by Linkage analysis.

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Background: Monitoring of facial nerve function during surgery help surgeons to preserve the nerve during parotid gland surgery. EMG is currently the standard method for monitoring, however, the rates of facial nerve paresis and paralyses are 68-18% and 3%, respectively. The disadvantages of this method are its cost and lack of access to it everywhere. Unipolar alternating electric current stimulation of the facial nerve causes contraction of the muscles and the nerves, and the damage can be avoided.

Materials and Methods: In this study, patients in the years 1388 to 1390 using monopolar electrocautery was undergoing parotidectomy and one month after surgery, the facial nerve injury were examined. During the study period, twenty patients had undergone total or superficial parotid gland resection and one excluded due to facial nerve involvement before surgery.

Results: In this study, 19 patients were studied. The mean age of patients participating in this study, 43.1 ± 13.9 years and 63.2% of them (12 cases) were female. A temporary palsy (5.4%) was observed and there was no paralysis.

Conclusion: Due to its availability and low cost, using electrocautery devices compared with standard facial nerve monitoring, EMG, is beneficial and the treatment results are also satisfactory.

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Background: Considering that pre-diabetes is one of disorders that increases developing of diabetes, this study was performed to investigate the effect of L-Arginine supplementation on antioxidant enzyme activity, total antioxidant capacity, and body composition in patients with pre-diabetes.

Materials and Methods: A double-blinded randomized clinical trial was performed on 46 pre-diabetic patients. Patients in intervention (n=23) and  placebo groups received  3g/day L-arginine and placebo (three 1gr L-arginine capsules), respectively for 8 weeks. Anthropometric, body composition, and dietary intake assessments, and also biochemical tests were done at baseline and end of study. Total Antioxidant Capacity (TAC), glutathione peroxidase enzyme and superoxide dismutase activity were measured. Paired t-test, independent t-test and ANOVA were used to analyze quantitative variables.

Results: Thirty eight patients (19 subjects in each group) completed the study. After adjusting confounding factors, no significant difference in body composition, anthropometric indices and dietary intake was observed at the end of study (p<0.05 in all factors), but a significant difference in TAC level was observed in the intervention group at the end of study (p<0.001).

Conclusion: Supplemenation with 3gr/day L-arginine for 8 weeks led to raised serum TAC level without changes in body composition in pre-diabetic patients.

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Background: One of the amendments made in Iran's Health System was family physician program were introduced in 2004 . This study aimed to describe the experiences of physician and other health team members about general interest of this program.

Materiasl and Methods: This study is a qualitative and data collection method was in-depth interviews (semi-structured). Groups participants including 15 physicians, 15 midwives and 25 healthworker declare their experiences about of general advantage in this program. In total, 55 interviews were carried out in population. Purposive sampling fand content analysis with comparative of the methods were used.

Results: In this study, after continuous analysis of data 376 initial codes were obtained. After integration of theses codes 30 the secondary cods come out which consist of public or general interest and economic benefit, respectively. Moreover 4 sub-categories (improve of index of public health and care, health folder, insurance for rural, low referral to expert of physican), were created.

Conclusion: Based on the results the use of electronic folders instead of traditional folder and accelerate to acsess of information patient for promotion of care and finally delivery some facilitate for health team worker recommended.

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Background: Mir-210 is proangiogenic microRNAis endothelial cells. This microRNA, causes the repression of some genes and proteins target so cause angiogenesis process. The purpose of this study was to determine the effect of a High Intensity Interval Training (HIIT) on Mir-210 and EphrinA3 receptor genes expression in soleus muscles of male rats.

Materials and Methods: In this experimental study, Twelve Wistar male rats(ageof eightweeks, average weight of 210.5±9.77)were randomly divided into exercise(n=6)and control (n=6) groups. High Intensity Interval Training was formed five days a week for eight weeks to taly including three Intervals (four minutes with an intensityof 90 to 100%VO2max and two minutes with an intensityof 50 to 60%VO2max).24 hours after exercise protocol, the rats were dissected and separated soleusmuscle. Mir-210 and EphrinA3receptor genes expression was performed by Real Time-PCRtechnique. Mir-210 and EphrinA3receptor genes expression were calculated by using the2∆∆CT and in dependentt-test to determine the significance of variables.

Results: Results showed that HIIT there had no significant effects on Mir-210 gene expression (p=0.16) Whe ars EphrinA3 gene expression in the exercise group was statistically significant (p=0.000).

Conclusion: It seems that a non-significant increase of Mir-210 and reduce in EphrinA3 gene expres sion, causes proangiogenic Operation ofendothelial cells and an increase in VO2max of rats following eight weeks of HIIT performance can be due to increased angiogenesis process.

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Background: Cancer stem cells are subpopulation of cancer cells that show self-renewal potential and the capacity to differentiate into diverse populations comprising a tumor. One of the characteristics of CSCs is their ability to form floating spheroids under anchorage-independent conditions in a serum-free media. The aim of this study was isolation of colon cancer stem cells by sphere formation assay and characterization of them in human colonic adenocarcinoma HT-29.

Materials and Methods: In this experimental study, colon CSCs markers including CD44 and EPCAM in spheroid and HT-29 cells were analyzed by flow cytometry. The expression levels of stemness genes in both spheroid and HT-29 cells were investigated using real-time PCR. Tumorigenic potential of spheroid cells was evaluated using in vivo xenografts assay.

Results: Our data showed over 92% of spheroids were CD44+/EpCAM+, while HT-29 cells only have expressed 37% of CD44/EpCAM markers. In compared with the HT-29 cells, expression levels of ‘‘stemness’’ genes, like Sox2, Oct4, Nanog, C-myc, and Klf4 were significantly increased in spheroid cells (p< 0.05). Further, As little as 2500 spheroid cells were sufficient to obtain tumor growth in nude mice, while 1x106 of HT-29 cells was needed to form tumor.

Conclusion: Our data suggest that spheroid formed by colon cancer cell lines highly enriched in CSCs and showed increasing expression of stemness genes and tumorigenic in nude mice.

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Background: Diabetes mellitus is a common metabolic disorder that is associated with many complications such as peripheral neuropathies. This study was designed to investigate the effect of Brassica juncea on peripheral neuropathic pain in diabetic rat.

Materials and Methods: In this experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic (control, B. juncea extract at doses 150 and 300 mg/kg) groups. Experimental diabetes was induced by the intraperitoneal injection of streptozotocin (60 mg/kg). After four weeks treatment, animals were subjected to Tail-flick test to evaluate pain threshold and data were analyzed using SPSS software. Statistical significance was considered at p<0.05.

Results: The results of this study showed that diabetes significantly decreased pain threshold in the rats. Also diabetes-induced hyperalgesia was significantly decreased by treatment with extracts of B. juncea at doses 150 and 300 mg/kg (p<0.05 and p<0.01, respectively).

Conclusion: Our observation indicates that B. juncea could be a therapeutic option for control and treatment of hyperalgesia associated with diabetic neuropathy in diabetic patients. However, further studies are required to elucidate the antinociceptive effects of B. juncea.

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Background: Nanomaterials have gained increasing attention because of their novel properties, including a large specific surface area and high reaction activity. This study was designed to investigate the cytotoxic effects of CuO nanopaticles on brain, spleen, and embryo NMRI pregnant mice.

Materials and Methods: In this experimental study, forty two female NMRI mice of (weighting 30±3.0 g) were randomly divided into six groups (four experimental groups, one sham group and one control group).The experimental mice on days 3 and 12 of pregnancy received CuO nanoparticle with concentrations 50, 100, 150, 200 mg/kg intraperitoneal injection. On day 17 pregnancy, brain, spleen and fetus weights were measured.Tissues for histopathological evaluation were stained with hematoxylin and eosin.

Results: Based on the macroscopic observations of embryos weight with increasing concentration of nanoparticle compared to control reduces its toxicity increased (p&le0.05). Spleen only at concentration of 600 mg/kg showed significant changes compared to control (p&le0.05). Histopathologic examination on brain and spleen following IP administration of CuO nanoparticle showed signs of cytotoxicity (congestion, necrosis, inflammatory cell infiltration, vacuolar degeneration) and (congestion, necrosis, increased hemosiderin) compared to control group, respectively.

Conclusion: The present study clearly showed that CuO-NPs can produce the histopathological abnormalities on brain and spleen tissues of NMRI mice in a dose-dependent manner.

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Background: The type of dressing used has great effct on pain relief when dressing patients is changed. So this study is performed to compare the effect of Acticoat dressing and normal dressing on pain of burn patients during dressing change.

Materials and Methods: This clinical trial was done on 64 patients with second and third degrees burn wounds in Vali-asr hospital. The patients were randomly divided in two groups (receiver of the Acticoat) and control (the receiver of silver sulfadiazine cream 1%) for 15 days. Pain was examined during dressing change by using numerical evaluation of the degree of pain on the first, seventh and fifteenth days. Finally, the data was examined by using statistical tests, Chi-square, Mann-Whitney tests, RM ANOVA.

Results: The results showed that there was no significant differences between the groups in baseline pain intensity statistically (p=0.20). Pain intensity had statistically significant difference in the experimental group and control group in the seventh and fifteent days of the study (p>0.001) so that the experimental group experienced less pain.

Conclusion: Acticoat dressing is a simple and practical method in burn patients according to the present results of study which is preferred in terms of reducing pain during dressing change compared to the conventional method.

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Background: Phacoemulsification is a modern cataract surgery that developed surgery from large incisions into smaller incision size and lead to faster wound heal and earlier visual rehabilitation. The purpose of this study was to compare the outcomes and complications of 3.2 and 2.65 mm main Incisions in phacoemulsification .

Materials and Methods: In this clinical study in Amir Kabir Hospital of Arak, 78 patients with senile cataract were divided into two groups. Half of them experienced 3.2 mm main incision (first group) and the others were under main incision with 2.65 mm (group 2). Immediately after operation if patients had a wound leak, the standard stromal hydration was used and a suture was placed. A day after operation, the patients were examined in the light of iris prolapse, if it existed, then a suture would be palced.

Results: The occurrence of anterior chamber wound leak was 7.7% and 2.6% in group 1 and group 2, respectively. Stromal hydration was needed 5.1% and 3.2% in group 1 and group 2 respectively. In fact, suture was needed 2.6% and 0.0% in group 1 and group 2, respectively. There was no iris prolapse in both groups.

Conclusion: There was no statistically significant difference between two groups from the point of view of wound leak and the need for suture and the rate of iris prolapse (p>0.05). Also, in low or intermediate nuclear density grade, the smaller and the more permanent incision with 2.65 mm is preferred.

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Background: Gentamicin is an aminoglycoside antibiotic that broadly is used to treat gram negative bacteria infections, although it has side effects such as nephrotoxicity. According to antioxidant, anti-inflammatory and vasodilatory properties of Zataria Multiflora, the effects of co-treatment with zataria Multiflora and hydroalcholic extract on gentamicin induced nephrotoxicitj were investigated.

Materials and Methods: In this study, male rats of Vistar race were divided into 4 groups: control group, co-treatment with gentamicin and vehicle group, co-treatment with gentamicin and zataria Multifiora extract group, and co-treatment with zataria Multiflora extract and normal saline solution group. Zataria Multiflora hydroalcoholic extract was added to drinking water as 800 PPm concentration. They, systolic blood pressure and renal blood flow (RBF) were measured. Also, the amounts of urea, creatinine, sodium, potassium and osmolarity were measured in plasma and urine samples

 Results: In co-treatment group with zataria Multiflora extract, the amounts of urea, creatinine, absolute sodium excretion and relative sodium and potassium excretion and malondialdehyde (MDA) that have been inceased in treatment with gentamicin, significantly were reduced. Creatinine clearance, urine osmolarity, RBF and FRAP that was decreased in gentamicin group in compare to control group, significantly increased.

Conclusion: Co-treatment prevents nephrotoxicity induced by gentamicin and attenuates oxidative-stress associated renal injury by reducing oxygen free radicals and lipid peroxidation, So it can be effective to cure rats receiving gentamicin.

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  Background: The effect of exercise training on body weight and visceral fat have been examined in several studies, whereas those of aerobic training along with the different dosages of intramuscular vitamin D on body weight, visceral fat and food intake are unknown. The main objective of the study was to assess the effect of aerobic training and different doses of intramuscular vitamin D on body weight, visceral fat and food intake in female Wistar rats.

  Materials and Methods: In this experimental study, seventy-two female Wistar rats were divided into 9 with 8 rats in each group, one group: aerobic training (3 days/week for 8 weeks), three groups: aerobic training and vitamin D supplementation (in high, moderate and low doses ), three groups: vitamin D supplementation ( in high, moderate and low doses ) and two control groups. One-way ANOVA and repeated measures ANOVA test were used to analyze the data.

  Results: Results showed that body weight and visceral fat in aerobic training with high dose vitamin D supplementation group was significantly lower than other groups. Also, the mean food intake in three groups of (aerobic training with low dose vitamin D supplementation , low dose vitamin D supplementation and control) w as significantly higher than other groups.

  Conclusion: It seems that aerobic training with high dose vitamin D compared to using each of the strategies is more effective in decreasing body weight, visceral fat in female Wistar rats .

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Background: Obesity is a complex, multifaceted disease resulting from a combination of genetic, environmental, and lifestyle backgrounds, and is associated with increased risk of diseases, such as hypertension, dyslipidemia, and type 2 diabetes. MiRNAs have been reported to be associated with chronic diseases such as obesity. The present study is the first investigation that examines the possible association of rs2910164 polymorphism in mir-146a gene with overweight and obesity in Iranian women.

Materials and Methods: This case-control study was conducted on 133 overweight, 75 obese and 173 healthy control women with normal weight. The rs2910164 polymorphism genotypes of mir-146a gene were determined by the Tetra-ARMS PCR method. Also, logistic regression analysis was used to estimate the association between genotypes and obesity risk.

Results: There was a significant association between GC (OR: 1.8, 95%CI: 1-3.3, p: 0.04) and CC (OR: 4.5, 95%CI: 1.6-12.6, p: 0.004) genotypes with susceptibility to obesity. In the dominant genetic model of the C allele (comparison between CC+GC vs. GG), CC+GC genotypes were associated with the risk of obesity (OR = 2.1, 95% CI: 1.2–3.7, p= 0.01).

Conclusion: This study showed that mir-146a gene rs2910164 polymorphism is associated with obesity risk and the C allele may act as a dominant allele and increase the obesity risk in Iranian women.

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