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Evaluation of the Antimicrobial Ability of Probiotics Against Nosocomial Infections by Inhibiting Ompa Gene Expression in Acinetobacter Baumannii
Farangis Ghanipour, Razieh Nazari, Seyed Soheil Aghaee, Parvane Jafari,
Volume 24, Issue 6 (February & March 2022)
Abstract
Background: and Aim Acinetobacter baumannii causes various nosocomial infections and has a high antibiotic resistance. Probiotics can produce metabolites with antimicrobial properties. This study aims to evaluate the antimicrobial ability of probiotics against nosocomial pathogens by inhibiting the ompA gene expression effective in biofilm formation in Acinetobacter baumannii.
Methods & Materials: The antimicrobial properties of probiotics against nosocomial pathogens were evaluated phenotypically. The polymerase chain reaction (PCR) technique was used to identify the ompA gene in Acinetobacter baumannii. After treatment with Bacillus licheniformis supernatant, the ompA gene expression was compared before and after treatment with real-time PCR technique.
Ethical Considerations This study was approved by the ethics committee of Islamic Azad University, Qom branch (Code: IR.IAU.QOM.REC.1398.004).
Results: Among the study probiotics, Bacillus licheniformis supernatant had the best antimicrobial properties against nosocomial isolates of Acinetobacter baumannii A52, Acinetobacter baumannii ATCC19606, Kelebsiella pneumonia ATCC70063, and Pseudomonas aeruginosa PAO1. Bacillus licheniformis supernatant also significantly reduced the biofilm formation and ompA gene expression in Acinetobacter baumannii.
Conclusion: Bacillus licheniformis can produce substances with antimicrobial and antibiofilm properties. It can be used for controlling the causative agents of nosocomial infections. 

Examining the Prevalence of Hydatid Cyst in Patients Referred to Imam Reza, Imam Hossein, and Bisotoon Hospitals in Kermanshah City, Iran, During 2014-2018
Nadia Fakhri, Naser Nazari, Tooran Nayeri,
Volume 25, Issue 1 (April & May- 2022)
Abstract
Background and Aim This study aimed to investigate the clinical and laboratory characteristics of hydatid cyst disease in patients admitted to Imam Reza, Imam Hossein, and Bisotoon hospitals in Kermanshah City, Iran, from 2014 to 2018. 
Methods & Materials In this descriptive study, we studied and analyzed the medical records of 350 patients with hydatid cysts who were hospitalized and underwent surgical treatment in Kermanshah hospitals from 2014 to 2018. Also, the demographic characteristics of patients, including gender, age, occupation, place of residence, and affected organs, were extracted and recorded.
Ethical Considerations The Ethics Committee of Kermanshah University of Medical Sciences approved this study (Code: IR.KUMS.REC.1398.366).
Results In total, 350 patients with a Mean±SD age of 43.2±19.7 in women and 43.3±20.7 in men were admitted with a diagnosis of hydatid cyst. The highest and lowest prevalence of hydatid cysts were in the age groups of 41-50 (16.5%) years and 1-10 (4.8%) years, respectively. The prevalence was 181 (51.7%) in women and 169 (48.2%) in men. The organs mostly infected with hydatid cysts were the liver, lung, and brain, with 241 cases (68.8%), 55 (15.7%), and 24 (6.8%), respectively. 
Conclusion This study shows that hydatid cyst disease is an important disease, especially in rural areas of Kermanshah Province, Iran.
The Loud Silence of Nurses: Is Our Voice Being Heard?
Mir Amirhossein Seyednazari, Amir Mohammad Dorosti,
Volume 28, Issue 3 (8-2025)
Abstract
In global healthcare systems, nurses are recognized as the main pillars of care, but their voices, despite their vital role, are often lost amidst a cacophony of loud silences. This silence does not signify tranquility, but rather reflects hidden pressures, unexpressed fears, and an imposed passivity in the face of structures that limit the freedom of expression.
"Organizational silence," a concept recognized for years in the fields of management and organizational psychology, has become a global crisis in nursing. According to a qualitative meta-synthesis, over 91% of nurses have experienced organizational silence at least once in their professional careers [1].
The causes of silence among nurses are multifaceted. Part of it stems from defensive silence, meaning a nurse refrains from speaking up before superiors or in hierarchical structures for fear of negative consequences. At other times, we encounter acquiescent silence, where the nurse believes that speaking out is futile and will not bring about any change. Previous experiences of having concerns ignored or autocratic leadership styles reinforce this feeling [1,2]. Furthermore, in some cultures, such as Japan or Egypt, prioritizing group harmony over individual expression leads to the normalization of silence [3].
Silence is not just an individual reaction but a response to an inefficient work environment. Nurses who feel their voices are not heard eventually experience job burnout, decreased motivation, and ultimately, leave the profession [2,3,4]. In a study from Spain, half of the nurses surveyed had considered leaving the profession [3,5]. Job burnout not only harms the nurse's mental health but also reduces the quality of patient care. Fatigue, reduced concentration, and impaired communication with patients increase the risk of clinical errors [1,6].
This vicious cycle of silence and its consequences creates a downward spiral in healthcare organizations:
Silence on staff or resource shortages → Increased stress and workload → Job burnout → Decreased quality of care → Intensified dissatisfaction → More silence.
If nurses feel that their concerns are ignored even when expressed, silence becomes an adaptive strategy [4].
Meanwhile, the financial impact of nurse turnover is also significant. According to estimates, the turnover cost for a single nurse in the United States is over $44,000, and hospitals lose an average of $3.6 to $6.1 million annually due to nurse turnover [7]. This substantial figure provides an economic incentive for systemic interventions to reduce silence and retain human resources.
Solving this problem is not possible through individual training or psychological resilience alone. Although strengthening skills like professional assertiveness can be effective, it will not be sustainable without structural and cultural support [4]. Creating psychological safety in the workplace—where nurses can freely express their concerns without fear of punishment—is a vital starting point for change [6].
Leaders of healthcare organizations play a key role in shaping or dismantling a culture of silence. When managers interact with nurses with empathy, a listening ear, and responsiveness, trust is built, and the space for expression becomes safer. A transformational leadership style, participation in decision-making, and the creation of professional growth paths are among the most important factors in retaining nurses and reducing silence [8].
There is also a need for macro-level policymaking at national and international levels. Programs like the "Global Nursing Workforce," which focuses on supporting the sustainability of the profession, can be effective in addressing the root causes of the problem [7]. Moreover, new guidelines from bodies such as The Joint Commission on preventing workplace violence (effective July 2024), which define requirements for reporting and accountability, can serve as models for combating silence on other issues as well [8].
Ultimately, organizational silence in nursing is not just a communication issue; it is an alarming indicator of the ethical, psychological, and systemic health of healthcare institutions. This phenomenon should be considered an "organizational vital sign." The healthcare system has a duty not only to listen but to act. The voices of nurses must lead to decisions, policies, and structural reforms, so that their silence is no longer loud, but is transformed into an effective cry on the path to improvement.
 
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