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Background: Prevalence and incidence of end stage renal diseases requiring renal replacement therapies such as dialysis and kidney transplantation is on the rise. However, no qualitative research studies have been done to explore the experiences of people living with dialysis and kidney transplant in depth. Therefore, this qualitative study was done to explore the experiences of patients living with dialysis and those with kidney transplant. Materials and Methods: This qualitative study was carried out through content analysis approach. Sampling was done from the beginning and continued until data saturation. Semi-structured interviews were tools of data collection. A total of 18 participants were interviewed. The interviews were analyzed through Graham and Landman content analysis method. Results: After analyzing the data, two main themes including, dialysis, a grueling event, and renal transplantation, a normal life with healthy kidney transplant, were reported. Conclusion: Compared with hemodialysis, receiving a kidney through transplantation provides a significantly more pleasant quality of life for patients. However, there are certain obstacles in transplantation and graft survival in the views of transplantation patients. Hence, it is suggested that health officials design programs to provide support and instruction to facilitate the process of kidney transplantation for eligible patients even before entering the dialysis stage.

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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: Multiple sclerosis, an immune-mediated demyelinating disorder, is one of the most common diseases of the central nervous system. Two-thirds of patients with multiple sclerosis are women in their child bearing age, 20s and 30s. Multiple sclerosis is followed by neurological disability in young people. The purpose of this study was to determine pregnancy outcomes in patients with multiple sclerosis and compare them with healthy pregnant women. Materials and Methods: In this cohort study,37 pregnant women with multiple sclerosis and 73 healthy pregnant women were compared in terms of pregnancy, child birth, and infant variables. Patient information was collected through questionnaires and evaluated using independent t-test, Chi-square, and Mann-Whitney test. Results: The results showed that pregnancy complications like preeclampsia and gestational symptoms in women with multiple sclerosis were higher than the control group (p=0.001). Instrumental delivery was more in women with multiple sclerosis (p=0.05) and there was not a significant difference between the two groups in terms of neonatal outcomes. Conclusion: The resultsof this study show that some of the complications of pregnancy are higher in women with multiple sclerosis. Also, normal delivery and instrumental vaginal delivery were more in women with multiple sclerosis that couldbe due to fatigue in this population. Hence, these findings should be taken into consideration in planning andmanaging pregnant patients.

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Background: Nowadays, international concern about the impact of antibiotic residues on the environment increased and their removal has received a lot of consideration. The aim of this study was to investigate the efficiency of Fenton’s advanced oxidation process (H2O2/Fe+2) in sulfadiazine antibiotic removal from aqueous solutions. Materials and Methods: An experimental-laboratory scale study was done on a synthetic wastewater containing sulfadiazine antibiotic with 0.079, 0.19, and 0.47 mM concentrations under Fenton’s process. Then optimal values of affecting parameters, such as initial antibiotic concentration, molar ratio of reagents, [Fe+2] and [H2O2] concentration, detention time, and pH, were determined. The discharged effluent analyzed by HPLC-UV to identify the antibiotic residues. Results: The results showed that the optimal parameters in the Fenton’s oxidation process to remove the sulfadiazine included antibiotics at pH 3.5, molar ratio of [H2O2] / [Fe +2] equal to 1.5, and contact time of 15 minutes, respectively. In these optimal conditions, the efficiency of removal of antibiotic in concentrations of 0.079, 0.19, and 0.47 mM were 99.82%, 97.97% and 78.23% and the wastewater COD removal degrees were 83.33%, 78.57%, and 78.57%, respectively. Conclusion: The experiments showed the efficient removal of sulfadiazine antibiotic in wastewater by Fenton’s oxidation process. The efficiency of this method can also be considered in eliminating other antibiotics resistant to biological treatment

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Background: Deaths due to cancer have been increasing in many countries in recent years. Probiotics are live microorganisms that have beneficial effects on consumer’s health. The aim of this study was to investigate antimutagenic and anticancer effects of Lactobacilli strains isolated from Tarkhineh in order to select potential probiotic strains. Materials and Methods: In this experimental study, 25 strains of Lactobacillus that had previously been isolated from Tarkhineh were used. Antimutagenicity test was performed based on proposed method of Ames. The results of the test were individuated after comparison between samples (suspensions of Lactobacilli) and positive (sodium azide) and negative (distilled water) controls. SPSS version 16 was used for statistical analysis. Results: Antimutagenic activity was observed only in four strains of Lactobacilli. The inhibitory percentage in the four strains of Lactobacilli, in its highest level was equal to 60.38 and in its lowest percentage equal to 39.37%. Also, the inhibitory percentage of mutation among the four strains in the presence of microsome were significantly different (P<0.05) than the absence of microsome. Adding the microsome of rat liver (S9) proved the anticancer effects of four Lactobacilli strains. Conclusion: Of the 25 strains of Lactobacilli, 4 strains which had the highest antimutagenicity effects were chosen as the potential probiotic strains.

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Background: Transient hip tenosynovitis is one of the common causes of pain and limping in children and includes 0.4% to 0.9% of admissions in emergency wards. The aim of this study is to evaluate this disease in terms of clinical presentations, age and sex distribution, and six-month recurrence. Materials and Methods: In this cross-sectional study, 51 children with diagnosis of transient hip tenosynovitis were investigated. Inclusion criteria were physician's clinical suspicion of acute tenosynovitis according to clinical presentations, physical exam, and age range of 3 to 8 years. Results: Among the 51 children with tenosynovitis, 34 patients were male with age of 61.70±19.1 months and 17 patients were female with mean age of 48.35±20.49 months that presented a significant statistical difference (p=0.026). The most common complaint was hip pain and the most commonly involved joint was the hip. Also, most of the patients had the history of viral diseases. Conclusion: Transient hip tenosynovitis is more common in boys. The right hip is the most involved joint and the majority of patients have the history of recent viral diseases.

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Background: Poly chlorinated biphenyls (PBCs) are the group of organic chemical materials that have a great chemical stability. These compounds are hazardous pollutants which pose various occupational and environmental problems. This study was conducted to determine the effect of microwave rays, hydrogen peroxide, Tio2 catalyst, and ethanol on the decomposition of PBCs. Materials and Methods: In this experimental study, a vessel reactor (250ml volume)that was connected with a tube connector to thecondensor system was used. A microwave oven with a fixed frequency of 2450 MHZ was used to provide microwave irradiation and ray powers used at 540, 720 and 900w. pH and temperature of the samples were continuously monitored and the experiments were repeated three times. Askarel oils were analyzed by GC-ECD. Results: The mean of total PCBS degradation at 540, 720, and 900w was 83.88±1.63, 89.27±2.44, and 95.98±0.81%, respectively. The mean of total PCBS degradation in terms of ratio to solvent with oil transformer in 1:1, 2:1, and 3:1 was 53.8±3.26, 79.04±1.24, and 95.08±1.69%, respectively. The mean of total PCBS degradation in terms of not using H2o2/Tio2 and using H2O2 (20%) and 0.05, 0.1, 0.15, and 0.2 g of Tio2 concurrently was 71.47±0.81, 87.9±2.16, 89.48±1.69, 91.7±1.24, and 93.07±3.09 %, respectively. Conclusion: Using microwave irradiation in the presence of H2O2 oxidant and Tio2 catalyst leads to the reduction of PCBS.

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Background: Avicennia marina (Forssk.) Vireh. or gray mangrove tree, belonging to the family Avicenniaceae, has long been used as a remedy to treat ulcers and skin diseases. In the present study, the antimutagenic activities of young and mature leaf extracts of Avicennia marina against the mutated bacterium Salmonella typhimurium TA100 were investigated. Materials and Methods: In this experimental study, the bacterial strain was checked for the intended genotypes. Leaves were isolated, dried, and chopped finely using a blender and they were extracted with 80% ethanol or water using a Soxhlet extractor. Metabolic activation was prepared from male rat homogenized liver. Antimutagenic effect of the extracts was tested using Ames test in the presence of a mutagen. Results: The number of mutant colonies decreased in the presence of both ethanol and water extracts with (+S9) and without (-S9) metabolic activation. The ethanolic extract exhibited a higher antimutagenic activity than the water extract. There were no inter-assay differences in the presence and absence of the S9 mixture. The highest (71%) and the lowest (24%) inhibition rates of Salmonella typhimurium TA100 bacterial growth were observed with the ethanolic extract of mature leaves from Bordekhon region and the aqueous extract of young leaves from Assaluyeh region, respectively. Conclusion: The findings of the present study suggest that Avicennia marina (Forssk) Vireh. leaf extracts may contain bioactive compounds that can inhibit mutation, and that biotic and/or abiotic stress might have an effect on the antimutagenic potential of these leaf extracts in the two regions.

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Background: Diabetes mellitus is one of the most important health problems in the world. B-cells are susceptible to damage by free radicals. Noticing the mechanism of cupping, this study was carried out to evaluate the effect of cupping together with drug therapy on biochemical factors and oxidative stress. Materials and Methods: In this clinical trial, 5ml of intravenous blood was obtained from diabetic patients in beginning and late stages of this disease who referred to a diabetes center. In addition to receiving metformin and glibenclamide, the patients underwent cupping after one month and were analyzed one month later. Blood samples obtained one month before and after the treatment were compared in terms of diabetes and oxidative stress indicators. To evaluate lipid peroxidation, TBA method was used and FRAPS method was employed to measure total serum antioxidants and blood factors by Pars Azmon kit. Results: Hemoglobin A1C, fasting blood sugar, blood sugar 2 hours after fasting, triglycerides, cholesterol, and low-density lipoprotein as well as high-density lipoprotein showed significant increases. Aspartate transferase in diabetic patients significantly decreased after phlebotomy (p<0.05). Conclusion: Cupping improves blood factors in diabetic patients and it is recommended to be used as a complementary treatment in patients with diabetes type II.

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Background: Heat stress reduces reproductive performance in farm animals. The aim of this study was to determine the effect of heat stress and different concentrations of melatonin on nuclear maturation of ovine oocytes. Materials and Methods: In this experimental study, ovary collection and oocyte recovery were carried out by standard methods. Oocytes culture was in A: TCM199+10% FBS, 5µg/ml FSH, 0.01IU/ml LH, 100 IU/ml penicillin, and 100 IU/ml streptomycin, B: A+heat stress at 40 C0, and C and D:B+1 and 10 µM melatonin, respectively. Results: Heat stress significantly (P<0.05) decreased nuclear maturation in the treatment group in comparison with the control group (60.60 vs. 84.89). Also, 1 and 10 µM melatonin could improve oocytes to reach metaphase-II stage (60.60 vs. 76.92, 78.82, respectively). However, increasing the melatonin dose from 1 to 10 µM did not alter oocytes maturation. Conclusion: Overall, this study showed that melatonin improves ovine immature oocytes maturation during heat stress.

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Background: Gastric cancer is the second leading cause of mortality due to cancer worldwide and it is the most common type of cancer in Iran. The aim of this study was to assess the effects of prognostic factors on the survival of patients with gastric cancer using the penalized spline in Cox model and compare it with Cox proportional hazards model. Materials and Methods: In this retrospective study, information obtained from a total of 216 gastric cancer patients who underwent surgery at Taleghani Hospital of Tehran between 2003 and 2008 years was included. Cox proportional hazards model and penalized spline in Cox model were used. R software was used for data analysis. The efficacy of these models was compared according to Akaike information criterion. Results: The five-year survival rate was 30% and the mean follow-up time was 16.60±15.28 months. Survival mean and median were 46 and 30 months, respectively. The analysis of Cox proportional hazards and penalized spline models resulted in age at diagnosis and tumor size as prognostic factors for survival time (P<0.05). Also, Akaike information criterion and survival curve for patients with a tumor size over 35 mm and age at diagnosis over 45 years were equal in both models. Conclusion: Cox proportional hazards and penalized spline models generated similar results thus, it is more appropriate to use Cox proportional hazards model because of its ease of interpretation and capability of modeling both continuous and discrete covariates. This study also showed if gastric cancer is diagnosed early, the relative risk of death will reduce.

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Background:Anterior interosseous branch of median nerve injury is the most common nerve injury in displaced humerus supracondylar fractures but it is rare in undisplaced ones. This study reports a case of undisplaced humerus supra condylar fracture with median motor nerve injury. Case: The patient was a 4.5 year-old child with elbow pain and swallowing due to trauma to his right elbow. The examination of distal of humerus showed significant tenderness and limitation in range of motion. Flection and pulp to pulp test of first and second fingers were abnormal and all other sensory but motor examinations of wrist and fingers were normal. Radiographic study of humerus showed an undisplaced extension fracture in the distal of humerus. Complete :::union::: of fracture site was seen after treatment by splint for 3 weeks and nerve injury was fully resolved after physiotherapy. Conclusion: Although nerve injury in undisplaced fracture of humerus is rare, despite pain and emotional condition of child and his/her parents, accurate sensory and motor nerve examination is very important.

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Background: For calculating intraocular lens (IOL) power required for cataract surgery, ultrasonic biometry is used and the axial length of the eye is the most important error in this estimation. Therefore, the aim of this study is to evaluate the final refractive power based on the axis length of the eye in patients undergoing phacoemulsification cataract surgery.

Materials and Methods: In this cross-sectional study, from June 2010 till December 2011, 446 eyes which underwent phacoemulsification cataract surgery were investigated. Biometry was performed before cataract surgery to achieve emmetropia in all eyes. Based on the axis length of the eye, patients were classified into four groups: less than 22 mm, 22-24.5 mm, 24.5-26 mm, and more than 26 mm.

Results: There was not a significant difference in mean absolute value of final refractive power deviation from zero. The highest amount of mean absolute value of final refractive power deviation from zero was in myopia group which was equal to 1.52±1.17 diopter. However, there was not a significant difference in the amounts of mean absolute value of final refractive power deviation from zero according to axial length of the eye (p=0.081).

Conclusion: With increases in axial length of the eye, intraocular lens power calculation decreases, but the absolute difference of means is not significant in two apparatuses.

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Background: Noticing the particular importance of timely detection of scoliosis due to its progression over the time and associated complications such as non-symmetric appearance, movement restrictions, and sometimes disturbance in cardiac or respiratory function, this screening study was designed to investigate the prevalence of scoliosis in pupils aged 9-16 in Arak.

Materials and Methods: In this cross-sectional study, 984 students aged 9-16 years in Arak, Iran, who were randomly selected by clustering method, were screened for scoliosis by Adams test and suspected pupils were examined by orthopedics and PA X-ray was applied for them. For diagnosis confirmation, the Cobb angle was calculated and angle>6 was considered as scoliosis.

Results: Based on the results, the prevalence of scoliosis was 1.52% and 1.21% in female students and 3.21% in male students. The Cobb angle of about 67% of the cases was less than 10 which indicated minor scoliosis.

Conclusion: The results of the present study necessitate school-based scoliosis screening so that early detection of the disease allows for implementation of a suitable treatment program which can prevent the development of the disease and the financial burden of surgery and its complications.

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Background: Food insecurity is defined as the limited or uncertain availability of enough food for an always active and healthy life. Diabetes mellitus, one of the most common metabolic diseases, has been associated with significant morbidity and mortality and it is considered a health priority in Iran. Recent studies indicate the widespread prevalence of food insecurity and diabetes mellitus in Iranian society. This study reviews the status of food insecurity and effective socio-economic factors in people with type 2 diabetes.

Materials and Methods: This cross-sectional study was performed on 135 patients, aged between 30 and 55, who had recently been diagnosed with type 2 diabetes. Demographic and socioeconomic characteristics and food insecurity status were assessed using demographic and the 18-item USDA household food security questionnaires, respectively. Physical activity also was evaluated by MET, physical activity questionnaire. Data were analyzed by Chi-square, t-test, and logistic regression.

Results: Prevalence of food insecurity was 66.7%. Food insecurity was significantly associated with economic status, education level, income, having child under 18 years of age, family size, and number of children (p<0.05) however, there was not a significant relationship between food insecurity and occupation, marital status, family history of diabetes, high blood pressure and heart disease, age, and the amount of physical activity.

Conclusion: Considering the higher prevalence of food insecurity in diabetic patients, it can be said that it is likely that the incidence of diabetes is higher in food insecure people.

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Background: Exercise can counteract the negative effects of stress, but variations in exercise protocols and intensities have generated different results. The purpose of this study was to investigate the effect of immobilization stress on cognitive performance and the moderating role of exercise.

Materials and Methods: In this experimental study, adult Albino-Wistar rats were randomly assigned to 5 groups. The animals underwent immobilization stress (2 hours per day×7 day), exercise (30 minutes per day×7 day), or no intervention. The rats were trained and tested using Morris water maze.

Results: The control group had better performance than the stress group in acquisition (p<0.01) and recall (p<0.05) in Morris water maze. There was not a significant difference between exercise-stress and control groups in water maze performance. Stress increased corticosterone levels (p<0.001), but exercise had a significant effect on decrement of corticosteron levels (p<0.001). Also, despite the absence of a significant difference between sham and exercise groups in the acquisition stage, the exercise group had a better performance in the recall stage (p<0.05).

Conclusion: Immobilization stress can impair acquisition and mild exercise has a protective effect against stress-induced negative effects. Corticosterone may be a major mediator in the protective effect of exercise against stress-induced cognitive impairment. In addition, the role of exercise in retrieval of past experiences is more prominent than their acquisition.

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Background: Idiopathic nephritic syndrome (INS) is one of the chronic illnesses in children. Therefore, clinical and laboratory factors that influence the clinical course of this disease are very important. Among these factors, low birthweight due to reduction of the number of congenital nephrons and subsequent glomerular hyperfiltration has been postulated as an important factor. This study was conducted to evaluate the clinical course of INS in patients with lowbirth weight in comparison to patients with normal birth weight.

Materials and Methods: In this descriptive-analytic study, 170 children with INS were selected from hospitals in Kermanshah, Urmia, Hamedan, Qazvin, and Ahvaz and divided into two groups of low birth weight (<2500gr) and normal birth weight (>2500gr). Then, the clinical course of these patients was evaluated by reviewing their medical records.

Results: Of the 170 patients, 22 had low birth weight and 148 had normal birthweight. Statistical analysis revealed no correlation between low birth weight and INS course except for age of presentation (P=0.014).

Conclusion: According to the results of this study, there is not any correlation between body birth weight and the clinical course of INS except for age of presentation.

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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: Focal dystonia is a chronic disease with unwanted side effects. In addition to physical symptoms, some psychological problems, particularly depression, anxiety and stress are common in patients with focal dystonia. The aim of this study was investigating the effectiveness of medication in comparison to medication plus EMG biofeedback on depression, anxiety and stress in females with chronic focal dystonia.

Materials and Methods: This was an experimental/interventional study with pre, post, and follow-up phases. The sample was consisted of 20 female patients with spasmodic torticollis and 10 patients with blepharospasm. All of the patients have been already diagnosed by neurologist They were randomly selected and assigned into medication and medication plus EMG biofeedback groups. Both of the groups were treated with botulinum toxin type A and the second group in addition to receiving the drug for 10 weeks also participated in 20 sessions of EMG biofeedback treatment. Data were collected through the DASS-42 questionnaire which was completed in the pre-test, post-test, and follow-up phases.

Results: The mean of DASS-42 score in the Medication plus EMG biofeedback group showed a significantly higher decrease compared to the medication group (p<0.05).

Conclusion: The results suggested that medication plus EMG was more effective than medication alone in decreasing depression, anxiety and stress in females with chronic focal dystonia.

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Background: The most important pathogen in nosocomial infections are microorganisms in the patient's body. 90 percent of nosocomial infections caused by bacteria. Medlar is an medicinal plant that its therapeutic effects has historically been emphasized. The aim of this study was to evaluate the antibacterial effect of methanolic and ethanolic leaf extract of medlar against bacteria isolated from hospital environment.

Materials and Methods: In this experimental study, the Nosocomial bacteria were obtained from Shahid Mostafa Khomeini hospital, Ilam, Iran. Soxhlet extraction method was used for medlar leaf extract. Disk diffusion method was used to study the effect of antimicrobial and broth microdilution method were used to determine the minimum inhibitory concentration (MIC) and Minimum Bactericidal Concentration (MBC).

Results: Two strains of Pseudomonas aeruginosa, three strain of Staphylococcus aureus and five strains of Escherichia coli were isolated from hospital. The results showed that the methanolic extract of Medlar leaf inhibited the growth of all strains of pseudomonas aeruginosa and four strain of Staphylococcus aureus and also inhibits the growth of all strains of Escherichia coli strains except E4 strain. The maximum antimicrobial activity was against E2 strain that zone diameter around it was 19/67 Millimeters. Quantities of minimum inhibitory concentration for all three strains P1, P2 and P3 and E2, E3, E5, S1, S2 and S3 strains was equals with 125 mg/ml.

Conclusion: Medlar leaf methanolic extract possesses significant antibacterial activity against bacteria causing nosocomial infections and so this extract can be considered in the control of infectious diseases.