مجله علوم پزشکی رازی
سال بیست و هفتم شماره 6 (پیاپی 196، شهریور 1399)

Increasing participation in sports activities increases the number of people at risk of injury. These injuries should be properly identified and treated, in order to provide the opportunity to participate again in sports activities. The purpose of this study was to evaluate the predictive role of postural, biomechanical and neuromuscular factors in the incidence of lower limb injury in active women.

63 active woman students were selected according to the criteria of entering the research purposefully. The research variables were divided into three groups: neuromuscular, biomechanical (TTB), postural (height of the inner leg of the arch, distance between the knee condyles, the interval between the ankles, the angle of the quadriceps). The data collection form was used to collect information about injuries, force plate to measure TTB,Colice to measure the distance between the condylars and the distance between the ankles, a simple goniometer for measuring angles Q and a digital camera to determine the neuromuscular defects. The researcher participated in the training and competition sessions to complete the injury form in order to record the degree of injury to subjects during a term.
Finally, for statistical analysis, Pearson correlation coefficient test was used to determine the relationship between variables and regression test to predict effective variables at a significance level of 95%.

It showed that the Pearson correlation coefficient between the anterior-posterior TTB and the degree of injury (r = 0.295), between the height of the arch and the degree of injury (r = -0.239), Q angle and injury (301) / 0 = r), ankles and injury (r = 0.331), neuromuscular factors and damage (r = 0.42) were significant. Regarding the muscle neuromuscular factor (β = 0.81).

According to the findings of the study, women with neuromuscular defects most likely to be injured. Since neuromuscular injuries are the most predictive power, it seems that attention to muscle neuromuscular factors to prevent injury before The season of games is practical.

Exercise as a source of positive change in different periods such as childhood, adolescence and puberty can improve the general condition of individuals and create a lifelong learning process. People participating in sports are at a good level in terms of health and well-being and have good mental and emotional conditions. Exercise also has positive social and psychological consequences among individuals.While sports seem to provide numerous benefits to participants around the world, the level of sports participation is declining or stagnant. Various variables affect the path of improving sports participation. Meanwhile, Anderson et al. (2019) pointed out that psychological issues play an important role in attracting people to sports environments.Another important issue for people to participate in sports is fashion. Fashionism is the interaction of individual values and messages that are often understood collectively. Fashionism can lead to a tendency to a certain behavior, or to the consumption of a particular commodity, or to adopt a particular style of life.However, the lack of knowledge about the effects of psychological and fashion dimensions on the tendency to exercise in adolescents has led to the lack of serious and practical activities in this regard today, which has overshadowed the process of improving the tendency to exercise. On the other hand, the research gap in this field has caused that the desired capacities of psychological dimensions have not been used in order to improve the tendency of adolescent sports. Therefore, the researcher seeks to answer the question of whether the psychological and fashion dimensions have a significant effect on the tendency to exercise in adolescents?

The present research is a descriptive-survey and applied research that was conducted in the field. To conduct this research, 8881 people (4129 girls; 4752 boys) were selected from among the first high school students of Saqez city, based on Morgan table, 368 people were selected as a sample. Questions and components (psychological capital, cultural capital, mental health, self-efficacy and self-concept), Safari Sports Orientation Questionnaire (2004) with 30 questions and Kashkar et al. (2017) fashion questionnaire with 31 questions distributed among the sample and 343 A questionnaire was collected. Finally, in order to analyze the data of the present study, the structural equation method was used. The whole process of data analysis was performed in SPSS and AMOS software.

The results showed that psychological and fashion dimensions have a significant effect on the tendency to exercise in adolescents. It was also found that all indicators of research model reporting are in good condition, which indicates the appropriateness of research model fit status.

In line with the findings of the present study, Humphreys et al. (2014) conducted a "study of physical activity outcomes in Canada" and found that regular exercise and regular exercise led to maximizing the potential of exercise in To improve health. This shows that the tendency to exercise as a concern should always be considered. Regular physical activity brings significant physical, mental and social health benefits to young people.The results of the present study showed that by improving the situation of fashion, we can expect that the tendency to adolescent sports to increase quite clearly. Fashionism can lead people to socialize and participate in social activities if it is in accordance with the principles and values of society. Due to the attractiveness of sports environments, fashion can draw people to these environments. In other words, fashion is a reason for people to participate in sports. Among adolescents, the existence of fashion according to the values of society can lead them to participate in sports (17). This issue has led to the present study to determine that fashion has a significant role in improving the tendency to adolescent sports.

Rhinoplasty is among the most requested plastic surgeries. As the surgery site is on the face and some of these surgeries only performed for aesthetic purposes, suture techniques are mainstay of these procedures. Traditionally, non-absorbable sutures such as nilon sutures were used. However, complications of these materials, alongside introduction of new absorbable materials have changed the trends and many surgenos prefer to use absorbable sutures, in most of their operations. It is reported that tensile strength of the suture, the probability of infection, besides its usability in grasping the tissues during different rhinoplasty maneuvers are among the factors, yielding to the decision of the surgen. There are currently some standard protocols in techniques of suturing during a standard rhinoplasty operation. However, there is no consensus on the type of suture, absorbable or non-absorbable one, for these operations. Recent studies have claimed that in spite of using non-absorbable sutures for suturing nose tip, high rates of complications and side-effects, besided non-inferiority of the absorbable suture in comparison with the non-absorbable ones, due to evidence, current trend is using absorbable sutures for this purpose. The aim of this study was to determine the pattern and frequency of using absorbable or non-absorbable sutures among rhinoplasty surgeons and their experienced side-effects and complications due to their usage.

In this survey on behavior, a 10-item questionnaire was used for data collection. The questionnaire was filled by a face-to-face interview with ENT surgens, attending at the Yearly Conference of ENT Surgens. Years of surgeons’ experience, number of monthly operations, types of suture materials, type and frequency of complications they have faced, while using these suture materials, and whether the brand of the suture is important to them or not was asked and recorded. The data were then registered in computer and analysed using IBM SPSS 22.0 for descriptive and analytical reports and graphs.

Totally 100 ENT surgeons were interviewed, with mean 15.5 years of experience in rhinoplasty surgery. The interviewed surgens reported that in average, they had 20 surgeries monthly (range of 5 to 90). In tip plasty, 52 surgeons exclusively were using absorbable PDS sutures, 32 exclusively were using non-absorbable nylon sutures, and 16 of them were using mixed sutures in different sureries. 66 percent of surgens, preferring non-absorbable nylon suture reported that they had at least one complication in using such type of suture. 76% of the complications were due to abscess formation, 22% was related to suture extrusion, and 9% reported skin reaction on the suture site. On the other hand, only 15 percent of the surgens using absorbable PDS sutures reported the experience of facing complication in suture. Among them, there were 7 cases of abscess formation, 3 cases of suture extrusion, and one case with skin reaction in suture site. All of the complications, reported by doctors using mixed absorbable and non-absorbable sutures had happened in cases of using non-absorbable suture, which were abscess formation in 7 cases, and suture extrusion in 2 cases. In more than half of participants, the brand of suture was not important and This insignificance of suture brand was not related to neither years of rhinoplasty experience (t test p-value = 0.12), nor the number of surgeries (t test p-value=0.525), performed in month.78 of the surgens used vicryl, 13 used chromic, and 1 used monocryl sutures for septum sutures. 17 of these experts had experiences of complication in septum suture: 9 for chromic suture and 8 for vicryl suture. In these cases, sense of bad smell (in 11 cases), abscess formation (in 5 cases), and granulation tissue formation (in 1 case) were among the complications.

It seems that a majority of Iranian rhinoplasty surgens prefer using absorbable sutures in their rhinoplasty surgeries. As the responses suggest, surgens using absorbable PDS sutures are facing less complications than those using non-absorbable nylon suture. Moreover, most of the surgenos, interviewed in this study did not pay attention to the brand of the suture they are using, which was not related to the years of experience in rhinoplasty or the number of the surgeries they perform in month.In addition to nose tip suture, a majority of the experts were using vicryl suture for suturing the septum in their surgeries. However, there were no significant difference in the number of complications, experienced with chromic or vicryl sutures. Most of the complications were due to a sense of bad smell, abscess formation, and granulation tissue formation in one case. Additionally, no case of septal necrosis was reported by the experts.

Most sports require strength and endurance, and maximum strength affects both of these factors. In fact, the rate of recall and the speed of activation of motor units increase with the use of heavier loads and faster contractions (3). This is also true in the sport of karate. Because the speed of implementation of techniques and tactics in the sport of karate is very important and decisive at the professional level and is considered an important step in the success of their struggles. In the meantime, the Giakozuki Chudan technique is the first and simplest hand technique in combat. To score a hit, he must hit the opponentchr('39')s chest and abdomen with maximum speed (4). In general, improving athletic performance is an issue that athletes have always faced. For this reason, it is common in men to use commercial supplements and do heavy resistance training to increase muscle mass with the goal of improving proper physical appearance, competition success, or gaining strength (6). Nitric oxide is a signaling molecule that contributes to a number of physiological factors, including mitochondrial and biological respiration, muscle glucose uptake, angiogenesis, and cell calcium regulation. Also, increasing plasma nitrite levels through dietary nitrate increases endurance and performance among athletes (8). Nitrate also affects skeletal muscle contraction and mitochondrial efficiency, glucose homeostasis, and respiration (10). Research has shown that nitrate increases lower extremity blood flow during exercise in rats and directs blood flow to type II muscle fibers. Human studies also suggest that nitrate supplementation can increase explosive force production and maximize voluntary force generation in knee blasting (11).Considering the above and since training causes the comprehensive development of endurance, strength, speed, flexibility and, and considering that in karate the coordination of different body parts and fast and regular movements are very important, the researcher seeks to answer The question is whether the effect of 8 weeks of special strength training with nitrate supplementation has an effect on the speed of Zukkichr('39')s hand and the strength of Karateka menchr('39')s hands.

The present study was a quasi-experimental study with a pretest-posttest design with 3 experimental groups and a control group. To conduct this research, among the karatekas of selected teams in Tehran province in the age range of 22 to 28 years and 3 years of regular karate practice, 40 people were randomly selected and divided into 4 groups: control, strength training, nitrate supplementation and training. And nitrate supplements were divided. Then, 24 hours before the start of the exercises and immediately after the end of the exercises, the desired tests were performed to collect data. The exercises were performed in such a way that first the maximum strength of the subjects was obtained using the 1RM test by McGuigan et al. (1997) in all movements (12). Then, the strength training program was performed in such a way that the subjects practiced their exercises in the evening in 6 movements: chest press, forearm, back arm, leg press, back thigh and front thigh for 8 weeks, 3 sessions per week and Each session performed exercises for 45 to 60 minutes using a dual pyramid method. As the training load increased from 80% to 95% and decreased to 80% again in three sets, the number of repetitions decreased and then increased in proportion to the load (13). Once every two weeks, 1RM test was taken from the subjects and a new program was given to the subjects to observe the principle of overload. In the exercise and nitrate supplement group, in addition to strength training, the subjects consumed one capsule of nitrate at the rate of 5.5 mmol per day with fruit juice (15). The supplement group also used only nitrate supplement. The control group did not exercise and used a placebo. Finally, from the descriptive statistics, Shepherwillek test to check the normality of data distribution and one-way analysis of variance and Tukey post hoc tests using SPSS 21 software at a significance level of 0.05 for data analysis.

The results showed that 8 weeks of strength training with nitrate supplementation on Zouki hand stroke speed (F = 29.896, P = 0.001), hand strength (F = 60.647, P = 0.001), upper body muscle strength (F = 1772.540, P = 0.001) And lower body muscle strength (F = 230.62, P = 0.001) had a significant effect on karateka men. Also, the results of Tukey test showed that there is a significant difference between the control group with the training group, the control group with the training and supplement group, the training group with the supplement group and the supplement group with the training and supplement group, but between the control group and the supplement group. There is no significant difference between the exercise group and the exercise and supplement groups (Tables 1 to 4).

Regarding the effect of strength training on Zoukichr('39')s hand speed, it can be said that resistance training is an important part of the training program in most sports by increasing muscle strength, strength, speed, hypertrophy, muscular endurance, motor performance, balance and Coordination plays an important role in improving athletic performance. To achieve these goals in a strength training program, it is necessary to design a proper training program (17). On the other hand, fast performance is one of the salient features of elite karate. Therefore, good performance in karate depends on speed and agility. Due to the nature of karate, the speed of hand movement and the speed of foot movement are the most important factors for good performance (18).Regarding the effect of strength training on hand strength and upper and lower body muscle strength, it can be said that resistance training usually increases the synthesis of myofibrillar proteins, which leads to increased muscle hypertrophy, especially in type 2 fibers (19). On the other hand, strength is closely related to type 2 fibers and hypertrophy. This may be the reason for the findings of the present study. Regarding the effect of nitrate supplementation on the strength of upper and lower torso muscles, we can mention the mechanism of the effect of nitrate on NO production. Nitrite and nitrate, which are products of NO metabolism; They also act as a NO reservoir (24). On the other hand, studies show the role of NO in regulating neurogenesis in the hippocampus. Neurogenesis is the process by which new nerve cells are produced during fetal development (25). Nitrate may increase the recall of more rapidly contracting muscle units by producing NO and affecting neurogenesis, thereby increasing muscle strength.Generally in skeletal muscle, high levels of Nnos are present to contract muscle and control blood flow to the area. Skeletal muscles have the micro nitric oxide synthase isoform. NO is produced in contractile muscles and by activating soluble guanylyl cyclase, it dilates the smooth muscles of the vascular wall (26). This makes available enough energy for muscle contraction, which may be the main reason for the present study.

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system affecting young adults. MS attacks the myelinated axons in the CNS, destroying the myelin and the axons to varying degrees. The course of MS is highly varied and unpredictable. In most patients, the disease is characterized initially by episodes of reversible neurological deficits, which is often followed by progressive neurological deterioration over time. Twice as many women are affected as men. The disease is diagnosed on the basis of clinical findings and supporting evidence from ancillary tests, such as magnetic resonance imaging (MRI) of the brain and examination of the cerebrospinal fluid (CSF). MS typically present in adults 20 to 45 years of age; occasionally, it present in childhood or late middle age. The cause is unknown, but it appears to involve a combination of genetic susceptibility and a nongenetic trigger, such as a virus, metabolism, or environmental factors, that together result in a self-sustaining autoimmune disorder that leads to recurrent immune attacks on the CNS. Neurologists agree that patients may be grouped into four major categories based on the course of disease: Relapsing–remitting, Secondary progressive, Primary progressive and Progressive-relapsing. RRMS – the most common disease course – is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses or exacerbations are followed by periods of partial or complete recovery (remissions). During remissions, all symptoms may disappear, or some symptoms may continue and become permanent. However, there is no apparent progression of the disease during the periods of remission. RRMS can be further characterized as either active (with relapses and/or evidence of new MRI activity over a specified period of time) or not active, as well as worsening (a confirmed increase in disability following a relapse) or not worsening. Approximately 85 percent of people with MS are initially diagnosed with RRMS. Interferon-beta (IFN-β) medications are commonly used as first-line therapy in multiple sclerosis. Interferons (IFNs) are naturally occurring cytokines possessing a wide range of anti-inflammatory properties. Recombinant forms of IFNβ are widely used as first-line treatment in relapsing forms of MS. The mechanism of action of IFNβ is complex, involving effects at multiple levels of cellular function. IFNβ appears to directly increase expression and concentration of anti-inflammatory agents while downregulating the expression of proinflammatory cytokines. Antibodies can develop during interferon-beta treatment and reduce or abrogate normal biologic and treatment effects. Anti-IFN-β antibodies can reduce both bioactivity and clinical efficacy of IFN-β. Binding antibodies (BAbs) are antibodies that bind to the drug but do not necessarily inhibit its biological action. BAbs may be detected within the first month of therapy. The rate at which they appear is dependent on the type of IFNβ used. Although BAbs do not necessarily inhibit the biological action of IFNβ, as therapy is continued, maturation of the antibody body response may result in the production of high-affinity neutralizing antibodies (NAbs). NAbs are a subset of BAbs which prevent the binding of the IFNβ to its receptor on the surface of cells. When BAbs are detectable it is likely that NAbs are also present, however their concentration and affinity generally increase as the response matures. Enzyme-linked Immunosorbent Assay (ELISA) can potentially be used to characterize the composition of the anti-IFN-beta antibody response. Currently, CinnoVex, a biosimilar product to Avonex produced by CinnaGen Company, Iran, is used to treat MS patients in Iran. The objective of this study was to measure serum anti-interferon antibodies (CinnoVex) in patients with MS and compare it between two groups of patients. The first group is patients with MS that received interferon-beta and responded to it. The second group was patients with MS that received interferon-beta and did not respond to it.

An Indirect ELISA test was used for the measurement of anti-IFN-β antibodies. Sera were studied for anti-IFN-β antibodies from 26 healthy individuals and 52 MS patients (26 patients from each group) treated with Interferon-beta and the obtained results were analyzed statistically.

Patients were considered positive for Anti-IFN-β antibodies, if they had a positive sample with an optical density of more than 0.085. Anti-IFN-β antibodies were found in 4(14%) of MS patients treated with Interferon-beta and responded to it, but in 9 (35%) of MS patients treated with Interferon-beta and did not respond to it.

In this study, we found that the percentage of anti-IFN-β antibodies in the second group was higher than in the first group, so we can conclude that one of the most important factors that caused the patients not to respond to interferon-beta, formation of anti-drug antibodies in the serum that can reduce clinical efficacy and bioavailability of drug.

Type 2 diabetes is one of the chronic metabolic diseases that because of the high incidence and burden of this disease it was introduced as one of the public health problems (1). Complications of diabetes are related to problem in controlling the glycemic level in type 2 diabetic patients which leads to increased mortality and morbidity in these patients (5,6). Quality of lifestyle is one of the main principles of diabetes treatment (7). The results of longitudinal research indicate that exercise is one of the effective therapeutic interventions to treat, prevent and reduce the complications of metabolic diseases (8). One of the methods of aerobic training is Body pump. Although this sport does not have much history, but it has quickly been able to gain a lot of popularity in the must countries of the world, however, not much study has been done about it in Iran. Body pump is a program to improve physical fitness that includes about 60 minutes of training in the classroom with training weights based on predetermined tracks in which various sports movements are preformed with the rhythm of the music (9). In general, Body pump training class is a typical resistance training program with a large number of repetitions that is include low and medium intensities with focuses on endurance (10). On the other hand, one of the items that is in compliance with exercise is intensity, which is impact on the adaptation and obtained from exercise in healthy people and patients (12). It could be considered that the intensity of exercise can be one of the factors affecting metabolic adaptations in diabetic patients. So far a specific study on the role of intensity in Body pump exercises was confirmed as one of the new styles of rhythmic exercises in controlling blood sugar in patients, therefore, the aim of this study is to compare the effect of eight weeks of exercise with two different intensities on controlling the glycemic level in obese women with type 2 diabetes.

In the present quasi-experimental study, 30 women with type 2 diabetes from Ahvaz Diabetes Clinic were selected by random sampling method and randomly divided into 3 groups of 10, including two groups. Intervention Body pump exercises were divided into moderate and high intensities and controls. The training program was performed for 24 sessions for eight weeks and in each session on a daily basis (3 day a weeks), and each training session including 60-90 minutes of Body pump exercise which performed at 9-10 am. In the first group exercise was performed with 55-60 percent of maximum reserved heart rate (moderate intensity training) and in the second group training with 75-80 percent of maximum reserved heart rate (high intensity training). Fasting blood sampling was performed in two stage of pre-test (24 hours before the start of research interventions) and post-test (48 hours after the last training session) and fasting blood sugar levels, fasting insulin, insulin resistance and HbA1c were measured. The statistical analysis of information obtained from the subjects, dependent t-test was used to examine intragroup changes and statistical test of analysis of covariance and LSD post hoc test were used to examine intergroup changes. Statistical analysis was performed with SPSS software version 25 and was considered at a significate level (p≥0.05).

The subgroup analysis showed the significant decrease in the level of fast blood sugar, fast insulin, resistance to insulin and HbA1c in both  groups with medium intensities exercise (p=004; p=0.029; p=0.20; and p<0.001, respectively) and high intensities exercise (p=0.020; p<0.001; p=006; and p<0.001, respectively). No significant difference was observed in the control group with no exercise (p>0.05). To evaluate the effect of the intensity of the training on the variables of the study, significant difference was observed between changing in fast blood sugar (p=0.591), fast insulin (p=0.847), resistance to insulin (p=0.989) between both medium and high intensities training. However, HbA1c changes were significant and it was higher in the high intensities training group in comparison with medium intensities group (p=0.019).

According to the results, both intensities in Body pump training led to decrease in fast blood sugar, fast insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and HbA1c in type 2 diabetic women. Based on previous results, medium (24, 23, 8) and high intensities training (25) led to control glycemic level in type 2 diabetic patients. To analysis the effect of the intensity of the training on variables, it was shown that there is no significant differences between the changes in the level of fast blood sugar, fast insulin and resistance to insulin in both Body pump with medium intensity and high intensity groups. However, changes in HbA1c as a blood sugar average index in Body pump with high intensity group showed a significant difference in comparison with medium intensity group. This results showed the positive effects of training as a variable in control of hypoglycemic level in type 2 diabetic women. According to this result in clinical condition, controlling the blood sugar level and HbA1c level can prevent the complication and mortality and morbidity in type 2 diabetic patients and the Body pump training had a great effect on health promotion and decreasing the diabetic complication. High concentration of HbA1c is related to diabetic neuropathy, diabetic retinopathy and nephropathy in long time (28). In the present study 6.3 % HbA1c and 23.3 % resistance to insulin were decreased in Body pump with medium intensity group. Also, in Body pump with high intensity group, 12.4 % HbA1c and 24.7 % insulin resistance were decreased. It was reported that 1 % decrease in HbA1c is related to 14 % decrease in acute myocardial infraction and 21 % decrease in mortality (29). Based on twice more intensity in high intensity Body pump training group in comparison with medium group, it could be concluded that Body pump training with high intensity is more appropriate for reducing the microvascular and macrovascular complications. It is also recommended for diabetic type 2 patients that have no problems in practicing to do high intensity training.

Infertility can cause psychological, social and economic stress in infertile people. Annually, 60 to 80 million infertile couples are diagnosed worldwide. Infertility treatment is more difficult for men than women, especially in developing countries where few people seek treatment because of the high cost. Oligospermia and azo sperm are the most important factors affecting infertility in men with varicocele. Spermatogenesis is the process of proliferation and differentiation of spermatogonia stem cells (SSCs). These cells are located on the basement membrane of the seminiferous tubules and are surrounded by Sertoli cells. This complex provides an environment that promotes sperm function and survival. Any change in this process leads to changes in the male reproductive system and can lead to male infertility. Therefore, knowing the markers that are involved in the process of spermatogenesis is important and necessary. PLZF is one of the well-known markers of spermatogonia stem cells, which is essential for the maintenance and development of spermatogonia stem cells in culture. PLZF is produced and secreted by Sertoli cells, and a subset of spermatogonia express its receptor. One possible role for PLZF may be to maintain a non-distinctive position. TekT1 is also a group of genes expressed by spermatocytes. This gene is expressed in the tubulin involved in the formation of microfilaments. TEKT1 together with PLZF play an important role in spermatogenesis by stem cells. Studies of these two proteins and their role in spermatogenesis have important implications in in vitro spermatogenesis studies. In this regard, there are modifiable factors such as physical activity and laser therapy that help prevent and treat this disease by regulating and modulating genes that are effective in fertility. Among aerobic exercises, low-intensity aerobic exercise is one of the exercises that is safe and usable in different physiological conditions and due to its intolerance of weight in water compared to non-water sports in most physiological, biochemical and reaction studies. Molecular ions are used. Laser treatment is also a non-invasive treatment. Recent research shows that alterations in key molecules or signaling pathways and gene expression in the process of spermatogenesis through non-invasive methods such as exercise and laser therapy can affect fertility in infertile individuals. Although possible mechanisms have been proposed for the effect of physical activity and laser therapy on male infertility, the results of studies on the relationship between physical activity and laser therapy, especially low-power expression of the PLZF, TekT1 gene in the animal model of spermatogenesis, are very limited. Be. Therefore, the aim of the present study was to investigate the changes in PLZF and TekT1 gene expression in azo sperm rats following 8 weeks of low-intensity swimming training and low power laser.

The research method is experimental with post-test design. In this experimental study, 25 adult male Wistar rats aged 6 to 8 weeks with an average weight of 202.85 ± 62 15.62 g from Pasteur Institute Were purchased. The protocol of this research was performed according to the international laws on laboratory animals with the code of ethics IR.IAU.SARI.REC.1398.149 and was approved by the ethics committee of the Islamic Azad University of Sari. After creating the azo sperm model, the mice were divided into five groups: healthy control, azo sperm, training + azo sperm, azo sperm + laser, and training + azo sperm + laser. Exercise + azoospermia group, one month after an azo sperm, performed low-intensity swimming exercises for 8 weeks, five days a week for 30 minutes each day. In the laser intervention group, low-power lasers with a wavelength of 8.632 nm and a power of 10 mW and an energy of 3 joules were applied in three replications throughout the study period once a week at intervals in the testis of azo spermic mice. One-way analysis of variance was used to analyze the data.

The results showed that a period of swimming training program in the exercise + azoospermia group became a significant decrease in the expression of PLZF (p=0.001) and TekT1 (p=0.001) genes in relation to healthy control groups, respectively. There was also a significant decrease in the expression of PLZF and TekT1 genes in the exercise + azoospermia + laser group compared to the healthy control group (p≤ 0.001) and an increase compared to the azoospermia group, exercise + azoospermia and azoospermia + laser (p≤ 0.001).

In the present study, the effect of 8 weeks of low-intensity swimming training on PLZF and TekT1 gene expression in azo sperm mice was investigated. One of the important results of the present study is a significant decrease in the expression level of PLZF and TekT1 gene in azo sperm rats compared to the healthy group. Decreased levels of SSCs receptors inhibit the production and expression of spermatogonia stem cells. Therefore, it seems that reducing receptors and increasing inflammation in azo sperm patients can reduce the expression level of PLZF and TekT1 genes. Another important result of the present study is the increase in PLZF and TEKT1 gene expression levels in training + azo sperm + laser rats compared to the intervention and azo sperm groups. Exposure of laser beams to defective sprays increases the concentration of calcium in the cell and the amount of energy, which leads to increased motility and fertility. Based on the results of this study, it is suggested that an executive instruction be developed to develop low-intensity swimming exercises for people with azo sperm in order to prevent the effects of this disease. Also, due to the effect of a low-intensity low-intensity laser swimming training session on PLZF and TEKT1 gene expression, it is recommended that patients with azo sperm benefit more from low-intensity swimming sports activities. In general, the results of the present study indicate that alteration of key molecules or signaling pathways and gene expression of male germ cells in the process of spermatogenesis can reduce fertility and increase infertility, but regular aerobic exercise such as swimming with intensity Low with low power laser helps in inhibit the effects of infertility diseases by increasing the maintenance and development of spermatogonia stem cells.

Seizure is a transient occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Seizures are described as sudden abnormal neuronal discharges that are clinically manifested by behavioral, autonomic, motor, and sensory disturbances. Seizure is the most common neurologic problem in children. On the other hands, the most common nutritional problem in developing countries is iron deficiency. Due to the high incidence of seizures in children and its role in causing mortality and morbidity in this age group, recognizing and controlling the factors affecting seizures can have a significant impact on reducing mortality and morbidity. After the first seizure of unknown origin in children the risk of recurrence is about 50% and after the second seizure of unknown origin, the risk of recurrence is 80% epilepsy may be diagnosed only after a child has had two or more seizures of unknown origin over a period of more than 24 hours. The term of unknown origin implies that there was no close association between seizures and disease, electrolyte disturbances, fever, or acute brain injury. On the other hand, the most common microelement deficiency is iron deficiency, which affects at least 1.3 percent of the worldchr('39')s population. The most common clinical manifestation of iron deficiency is anemia, but other organs may also be affected. The possibility of lowering the seizure threshold and increasing the risk of seizures by anemia has been investigated in many studies in patients with febrile seizures, but A few studies has pointed to association between iron deficiency and the first unprovoked seizure without fever. Also the results of these studies are controversial. The effects of iron deficiency in an evolving brain include: changes in the evolutionary mechanism of hippocampal neurons, impaired energy metabolism, delayed myelin maturation, decreased visual and auditory stimulus potentials, and changes in synaptic neurotransmitter systems including norepinephrine, dopamine , Glutamate, GABA (gamma aminobutyric acid) and serotonin, which can cause iron deficiency symptoms. The results of some studies have shown that iron deficiency may increase the seizure threshold because iron lipid peroxidation by the brain can lead to seizures. In addition, the uptake and release of dopamine, gamma-aminobutyric acid, and other neurotransmitters by cell membranes can be affected by iron. Therefore, the seizure threshold increases following iron deficiency. Iron deficiency anemia reduces the activity of excitatory neurotransmitters such as monoamine oxidase and aldehyde oxidase, resulting in neuronal stimulation and a lower risk of seizures. Research on the relationship between iron deficiency and seizures has shown conflicting results regarding iron status in children with febrile seizures and non-febrile seizures due to the high prevalence of iron deficiency anemia and Due to the effects of anemia and the possibility of its effect on the occurrence of seizures in children this study was carried out to determine the relation of iron deficiency anemia with first unprovoked seizure

This study is a case-control study. The study population included 172 children aged 3 months to 16 years old who referred to the neurology clinic of Hazrat Ali Asghar (AS) Childrenchr('39')s Educational and Medical Center in Tehran Sciences due to their first afebrile seizure during 2017-2019. Samples were divided into case and control groups based on the reason of hospitalization Control group included of 86 children (3month-16years old) referring for other causes to this center from 2017-2019. Non-febrile seizures based on clinical manifestations in the form of cyanosis, rotation of the head or eyes, clonic movements of the seizure in the face or limbs, a sensory disturbance such as paraesthesia or localized pain in a specific area, increased tone or stiffness, loose or decreased movements, stiffness and Rhythmic muscle relaxation is defined as a disorder or lack of consciousness without fever before and after a seizure. All selected cases were infants and children with non-febrile seizures for the first time in which there were no underlying problems.The children with fever or any type of chronic systemic disease (cardiac, renal, metabolic, confectious) and the children with the history of using drugs or blood iron transfusion for treatment of anemia were excluded. Cell blood count (CBC), Serum ferritin, iron and total iron binding capacity (TIBC) were measured in all of children. Iron deficiency anemia was diagnosed by the values of CBC, ferritin, serum iron and TIBC based on the Nelson text book of pediatrics.To analyze the data, descriptive analysis including statistical indices of frequency, frequency percentage, mean and standard deviation was used. Also for analytical analysis, demographic findings and mean hemoglobin and ferritin were compared between the control and case groups. Data were analyzed by chi-square and independent T-test and SPSS 22 software and the significance level was considered less than 0.05.

From 172 participants, 73 (%42 ) were girls and 99 (%57) were boys, the average age in case  group was 6.4±3.75 years old, and in control group was 5.79 ±3.65 years old. From 86 patients with seizure 34 (%0.39) were girls and 52 (%0.60) were boys. In case group serum iron average was 55.1±28.4 µg/dl. Hb in 24 persons (%27.9) and ferritin in 14 persons (%16.3) was in the lower limits of normal. In the control group serum iron average was 51.8±25.79 µg/dl. Ferritin in 20 persons (%23.3) and Hb in persons (%27.9) was in the lower limits of normal. In the case group14 persons (%16.3) and in the control group 20 persons (%23.3) had iron deficiency anemia .the difference statistically was meaningless. (P value >0.05)

In this study, the prevalence of iron deficiency anemia in the group with the first febrile seizures of unknown origin was not higher than the group referring to other causes.There was no statistically significant differences between the first unprovoked seizure without fever and iron deficiency anemia in our study. However the more comprehensive studies should be done in this regard.

In the first minutes of life it’s important to assess newborn condition very fast but effective and decide about medical intervention as needed. Umbilical artery blood gas analysis and Apgar scoring are the most common assessment systems which studies are trying to more sensitive and accurate way.in this study we compare Apgar scoring system and umbilical blood gas analysis correlation with delivery prognosis. In the study of LU et al., Ph, pco2 and base excess indices decreased with decreasing Apgar score. Also, in infants with arterial acidity below 7.2, the Apgar score was 100%. Also, arterial acidity below 7.2 has reached 77.7% in Apgar scores 4-7 and 59.31% for 8-10 scores. (8) In the study of Yeh et al, The mean pH of the umbilical cord was 7.22. The risk of adverse neurological outcomes ranged from 0.16% to 0.36% and for people with a pH less than 7, this increased risk was about 2.95%. However, more than 75% of children with neurological disorders had an arterial pH of less than 7.10. (9)The study by Ahmadpour et al. Showed that a decrease in the pH of the umbilical artery was associated with increased frequency of resuscitation, increased need for NICU, longer hospital stay, greater delay in oral feeding, and increased prevalence of seizures and ischemic hypoxic encephalopathy. (10)In the Collaborative study, the pH of the umbilical artery had a positive relationship with the amount of base excess and both indices had a significant relationship with the neonatal Apgar score. Also, the pH of umbilical arterial blood gas had a significant correlation with organic lesions. (11)

This cohort study was conducted among Shahid Akbar Abadi maternity hospital in Tehran in 1396 . Sampling was convinced nonrandomized and based on sample size calculated with epidemiologist. All cases that lead to mismatch of the babychr('39')s Apgar score with arterial blood gases, such as: umbilical vein sampling instead of umbilical artery, umbilical cord prolapse, acute fetal bleeding, severe fetal heart failure, congenital neuromuscular diseases of the baby, severe prematurity (gestational age below 30 weeks) was excluded from the study and the initial evaluated indicators included PH, HCO3, PCO2, PO2, Base excess as well as demographic indicators, maternal age, gestational age, type of delivery, Apgar score, weight and sex of the infant by reviewing their file . Other data was calculated during admission. In this study, 116 newborns participated, and Apgar scores were calculated at 1 and 5 minutes after birth. At birth, the umbilical cord arterial blood sample is extracted by experienced personnel and analyzed by the hospital reference laboratory.The Apgar score was determined by a neonatologist or senior shift resident who had taken the course.  Data were analyzed by SPSS software and leve of significance was considered below 0.05. Ethical principles were considered in this study and the patientchr('39')s name and issues related to the patientchr('39')s file were not mentioned anywhere.

  One hundred and sixteen newborns participated in this study, of which 46% were girls and 54% were boys. 53 deliveries with a frequency of 45.6% were performed by natural childbirth and 63 deliveries (54.4%) were performed by cesarean section. 19 deliveries were performed 30-35 weeks with a frequency of 16.3% and 97 deliveries with a frequency of 83.4% were performed over 35 weeks. The mean neonatal weight was 2961.840 7 710 g. The mean age of newborns was 49.10 4. 4.1 cm, the mean head circumference was 34.1 8 2.8 cm, the mean fetal age was 37.63 3.5 3.5 weeks and the mean age of mothers was 28.97 6. 6.9 years. In this study, 6 infants with a frequency of 5.1% underwent positive pressure ventilation, 17 infants with a frequency of 14.65% underwent PPV and intubation, 6 infants with a frequency of 5.1% underwent intubation and cardiac massage and PPV. One infant also needed adrenaline injections after intubation and cardiac massage and PPV. The average Apgar score of the first minute is 6.23 1. 1.9 and the average score of the 5 minute Apgar score is 2.20 ± 6.73. The mean bicarbonate of umbilical cord samples was 16.05 6. 6.1, the mean base excess was 8.8 9. 9.8 - the mean pco2 was 24.23 ± 5.824 and the mean pH was 7.14. 0.14. The results of analytical analysis show that there is a correlation between the first minute Apgar score with pH r = 0.45) p = 0.007) but there is a relationship between the first minute Apgar score and base excess (p = 0.07) and bicarbonate (p = 0.16) There is no meaning. There was also a correlation between 5 minute Apgar and arterial pH (p = 0.009 and r = 0.44) and also between 5 minute Apgar and base excess r = 0.50) and p = 0.0025). But there was no relationship between Apgar score of 5 minutes and bicarbonate (p = 0.11) Also, there was a significant relationship between the need for resuscitation with Apgar, pH and base excess at 1 and 5 minutes (p = 0.004) and between birth weight and 5 minute Apgar and base excess (p <0.001). But there was no significant relationship between maternal age, type of delivery and sex of the baby with Apgar score, pH and base excess at 1 and 5 minutes. The limitations of the study included cases in which the pediatrician was called for resuscitation after the first minute and the Apgar score of the first minute was not determined by the pediatric team, which was excluded from the study to address these limitations.

 This study was performed to clarify the importance of the analyzed components of umbilical artery blood gases in predicting fetal asphyxia. Finally, our study showed that there is a significant relationship between Apgar score of 5 minutes and pH and basal excess of umbilical artery blood, which, like other studies mentioned, can predict the next condition of the baby and the risk of asphyxia. Contribute to hospitalization and the need to follow up on the possible consequences of asphyxia.

Rheumatoid arthritis is a debilitating autoimmune disease and the chronicity of this disease has a very large effect on the physical and psychological variables of these patients. The prevalence of this disease is estimated to be 0.5 to 2.4%, which is two to three times more common in women It is from men. The prevalence of this disease increases with age and the difference in sexual prevalence decreases with age. This disease causes progressive damage to the musculoskeletal system and leads to irreversible pain and destruction of bone and cartilage, which have different reactions. Ruminant is one of the problems that patients with rheumatoid arthritis are involved with and rumination is a significant predictor of depression in these patients. Ruminant thought is a repetitive thought and is a cognitive process that greatly increases the risk of developing symptoms of psychopathology. The aim of the present study was to compare the effectiveness of acceptance and commitment-based therapy and positive psychology on rumination in women with rheumatoid arthritis.

The research method was quasi-experimental with pre-test and post-test design with control group. The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019 who used the sampling

The statistical population of the study included all women with rheumatoid arthritis in Khorramabad in 2019. Using the sampling

60 people were selected and randomly divided into three experimental groups 1 (act therapy), experimental group 2 (positive psychology), and the control group (20 people in each group) was replaced.  Under the same conditions, the pretest was performed with a rumination questionnaire from all three groups. The experimental groups were treated with acceptance and commitment (group 1) and positive psychology (group 2) in 8 sessions of 90 minutes, but the control group did not receive any treatment. Then post-test was performed from all three groups. Data were analyzed by descriptive and inferential methods. Multivariate analysis of covariance, univariate analysis of covariance and Bonferroni post hoc test were used in descriptive statistics of frequency, percentage, mean and standard deviation and in inferential statistics. Data were analyzed by SPSS-24 statistical analysis software.

The results showed that both acceptance and commitment-based treatments and positive treatment reduced rumination in women with rheumatoid arthritis and there was a significant decrease between the mean rumination in pre-test and post-test in the two experimental groups. Using analysis of covariance, it was found that this decrease was statistically significant (p <0.05). In order to evaluate which treatment method was more effective, Bonferroni post hoc test was used, which showed that the treatment of acceptance and commitment was more effective in general rumination and distraction component. However, no significant difference was observed between the two experimental groups in the components of meditation and meditation.

Based on the obtained results, it can be said that the treatment of acceptance and commitment and positive psychology reduces rumination in women with rheumatoid arthritis and the treatment of acceptance and commitment was more effective. The results of the present study were compared with similar and consistent results that the results of these studies indicated the effectiveness of any treatment based on acceptance and commitment on rumination and variables such as: depression, anxiety, stress and anxiety. The effectiveness of acceptance and commitment therapy can be explained by the processes that govern it; Thus, the component of desire and acceptance allows the person to accept unpleasant inner experiences without trying to control them, and doing so makes those experiences seem less threatening and have less impact on the personchr('39')s life. This skill helps the person to consciously turn her attention to what is most useful and therefore helps the person to pass tempting thoughts through the mind and guide her mind towards a higher goal. Also, the practice of suppressing thinking in acceptance and commitment therapy, which is especially for people with rumination, helps therapists to get rid of annoying rumination or cognitive cognitions. No research has been done on the effectiveness of positive treatment on rumination, but research background shows that positive treatment has been effective on issues such as depression and stress. One of the components of positive psychology that affects rumination is the cognitive level of individuals and the effort to achieve positive emotions and happiness. In this study, based on the goals of positive psychology, an attempt was made to emphasize positive emotions, positive characteristics of people and their abilities and virtues, and people were encouraged to pay special attention to positive emotions and try to prevent emotions. Negatives increase the amount of positive emotions in their lives, because according to the falsification hypothesis, positive emotions also have the capacity to neutralize or nullify long negative emotions. On the other hand, people learn with this approach to be flexible and try to take steps to solve weaknesses by not focusing on weaknesses. Therefore, due to the effectiveness of treatment based on acceptance and commitment and positive treatment on rumination in women with rheumatoid arthritis, these treatments can be used along with medical treatment to improve the condition of these patients.

It was shown that several pathogenic bacterial effector proteins including Helicobacter pylori CagA, Anaplama phagocytophilium AnkA, enteropathogenic Escherichia coli (EPEC) Tir protein, Chlamydia trachomatis Tarp, Haemophilus ducreyi LspA protein, and Bartonella henselae Bep proteins contain the Glu-Pro-Ile-Tyr-Ala (EPIYA) or a similar sequence. These bacterial EPIYA effectors are delivered into host cell via type III secretion system (or TTSS) or type IV secretion system (TFSS), where they undergo tyrosine phosphorylation at the EPIYA (or a similar sequences). The bacterial EPIYA effectors trigger interaction with huge number of host cell SH2 domain-containing proteins and thereby, they enable to manipulate host cell signaling for more effective infection. The EPIYA (or a similar sequence) of pathogenic bacterial effector proteins was discovered in H. pylori CagA. It was shown that cagA+ H. pylori strains significantly increase the risk of developing severe gastritis and gastric carcinoma. On the base of the geographic region, four distinct EPIYA-sites have been described, EPIYA-A, -B, -C, and -D, each of which is conserved. Remarkably, the EPIYA-A and EPIYA-B sequences are found in strains throughout the world, but EPIYA-C is mainly present in strains from Western countries (Australia, Europe and North America) and some Asian countries (India and Malaysia), while the EPIYA-D sequence predominates in China, Japan and Korea. Different numbers of EPIYA (or similar sequence) can appear at the C-terminal of CagA variants. CagA proteins were tyrosine phosphorylated by Src family kinases (SFKs) and then by c-Abl kinase. It was shown that EPIYA-A, -B, and -C (or –D) segments can interact with SH2 domain-containing protein tyrosine phosphatase 1 (SHP1), SH2 domain-containing protein tyrosine phosphatase 2 (SHP2), phosphatidylinositol 3-kinase (PI3K), growth factor receptor bound protein 2 (Grb2), growth factor receptor bound protein 7 (Grb7), growth factor receptor bound protein 10 (Grb10), the C-terminal Src kinase (Csk), Ras GTPase activating protein 1 (RasGap1), Crk like proto-oncogene, adaptor protein (CrkL). Moreover, it was found that H.pylori induced a characteristic morphology of host epithelial cells, which has been referred to as the hummingbird phenotype. It was revealed that the hummingbird phenotype was resulting from regulation of both the actin cytoskeleton and focal adhesion and it may be involved in carcinogenesis. Notably, it was well established that CagA injection induces the elongation morphology of host cell. Furthermore, the roles of the EPIYA (or a similar sequence) in perturbation of eukaryotic signal transduction pathways for the other pathogenic bacterial effector proteins were investigated.  A. phagocytophilum AnkA contains four different types of EPIYA segments termed EPIYA-A, -B, -C and –D. These EPIYA sequences were phosphorylated by either SFKs or c-Abl kinase and it can interact with SHP1. SHP1 phosphatase activity in infected neutrophils was deregulated after SHP1/AnkA complex formation. EPEC Tir was tyrosine phosphorylated at EPIYA similar sequences and it was able to interact with the SH2 domain-containing adaptor protein Nck and Nck/Tir complex formation promotes actin polymerization. C. terachomatis Tarp was tyrosine phosphorylated at the EPIYA similar sequences resulting the rearrangements of the cytoskeletal of host cells. The EPIYA similar sequences of H. ducreyi LspA were tyrosine phosphorylated by SFKs and it was found that tyrosine-phosphorylated LspA inhibited SFKs activity.  SFKs are responsible for tyrosine phosphorylation of B. henselae Bep at EPIYA similar sequences.  After tyrosine phosphorylation B. henselae Bep at EPIYA similar sequencse, they acquire the ability to interact with Csk and SHP2. From the other side, it was also shown that a large number of mammalian proteins contain EPIYA (or a similar sequence). Until now, functional EPIYA (or a similar sequence) was found only in two mammalian proteins (Pragmin and P140Cap). Pragmin (or SGK223), a cytoplasmic pseudokinase, contains a functional EPIYA sequences in its N-terminal region. It was found that Pragmin is tyrosine-phosphorylated at EPIYA sequence by SFKs, Csk or in response to external stimuli such as epidermal growth factor (EGF). Moreover, P140Cap (or SRC kinase signaling inhibitor 1) contains two functional EPIYA sequences (EPLYA, EGLYA) in its N-terminus and it was tyrosine-phosphorylated at EPLYA and EGLYA sequences by c-Abl kinase. Tyrosine phosphorylation at EPIYA sequences enable them to interact with Csk (a SH2-domain containing protein) specifically. Also, it was found that the overexpression of Pragmin in AGS cells induced the elongated cell morphology. In this regard, it was previously shown that SGK223/Pragmin expression were increased in pancreatic cancer cells and overexpression of SGK223/Pragmin promotes elongation of cell morphology and migration of cells in pancreatic cancer cells. It was proposed that the mammalian EPIYA motifs might have been exploited by pathogenic bacteria and they act as pathogenic “Master keys” to perturb multiple signaling pathways through promiscuous binding with SH2 domain-containing proteins. Also, it was found that EPIYA sequences in some bacterial effector proteins (such as EPEC Tir and H.pylori CagA) to be unfolded and they showed structural flexibility features. So, it would be interesting to determine whether the other bacterial EPIYA effectors (such as A. phagocytophilum AnkA, C. terachomatis Tarp, H. ducreyi LspA, and B. henselae Bep) have disordered features at EPIYA (or similar sequences). In mammals, the structure of proteins containing functional EPIYA (or similar sequences) has not investigated yet. It seems that mammalian proteins containing functional EPIYA sequences do not have disordered features at EPIYA (or similar sequences) and thereby, they unable to interact with multiple SH2-domain containing proteins. Notably, the most of mammalian proteins containing functional EPIYA (or similar sequences) are unknown and there is no information about them. By using PhosphoSite, it was explored the EPIYA (or similar sequences) in mammalian proteins and it was predicted that the most of mammalian proteins containing EPIYA (or similar sequences) showed no tyrosine phosphorylation at the EPIYA (or similar sequences). It seems that the EPIYA (or similar sequences) of mammalian proteins are not available for related kinases because of possible their restricted and inflexible structures. Up to now, the structure of mammalian host proteins containing EPIYA motifs is not revealed. In this review, we investigate the roles of functional EPIYA sequences as key sequences in several pathogenic bacterial effector proteins and mammalian proteins to perturb cell signal transduction pathways that it was associated with a large number of diseases including cancer.

Nosocomial infections can be a major challenge for medical staff and health care providers when it comes to antibiotic-resistant bacteria. Enterococcus faecalis is one of the bacteria that play an important role in nosocomial infection. Therefore, it is important to study the prevalence and pattern of resistance of this bacterium in medical centers, especially in hospitals. Inappropriate use of antibiotics has led to the increasing spread of resistant bacteria. Enterococci are now considered not only for their role in nosocomial infections but also for their increasing reistance. The parts of the body that are most infected with this bacterium are the urinary tract and blood. Enterococcal infections are very common in patients with vascular and urinary catheters, and in patients who have been hospitalized for a long time and have taken broad-spectrum antibiotics.  The aim of this research was study of phenotypic resistance pattern of E. faecalis isolated from blood and urine samples of patients admitted to Rasoul Akram General Teaching Hospital.

This case series study was performed from February 2019 to January 2020 at Rasoul Akram Hospital in Tehran. The origin of the isolated E. faecalis was urine and blood which were isolated from patients with urinary tract infection and bloodstream infection from the hospital. The grown bacteria were evaluated by catalase test, then gram-positive catalase negative cocci were examined by L-pyrrolidonyl-beta-naphthylamide (PYR) hydrolysis (BY), bi-scolin, salt tolerance tests of 6.5%. Then biochemical tests were performed to detect E. faecalis, which included motion test, 0.04% tellurium reduction and pigment production test. E. faecalis isolates were isolated after biochemical tests. Antibiogram test was performed using disc diffusion method and E-test to measure the resistance of these isolates. Antibiogram test by disk diffusion method using discs (gentamicin 10 mg), (erythromycin 15 mg), (ampicillin sulbactam 10 + 10 mg), (ampicillin 10 mg), (penicillin 10 mg), (ticoplanin 30 mg), (Rifampin 50 mg), (30 mg linezolide) from HiMedia India. The bacterial suspension was prepared from fresh culture of E. faecalis with half McFarland turbidity and cultured on Müller-Hinton agar medium. Antibiotic discs were then placed on Müller-Hinton agar medium. Vancomycin E-Test: Some bacterial colonies were removed from fresh culture by ounce and dissolved in sterile physiological saline and concentrated to half McFarland concentration. After the bacterial suspension was completely absorbed into the medium, a strip containing the vancomycin concentration gradient was placed on Müllerhinton agar medium using a pair of sterile forceps and the culture medium was kept in a 37 ° C oven for 24 hours. By examining the plates, the number in front of the intersection of the non-growth halo with the E-Test strip was considered as a small amount of the minimum concentration of growth inhibitor.

From 53 isolated E. faecalis, 46 samples (86.8%) were isolated from the urine and 7 samples (13.2%) were isolated from the blood. The source of isolation of E. faecalis was blood and urine samples from nephrology, surgical ICU, neurosurgery, transplantation, inpatient emergency, MICU, general surgery, ICU, orthopedics, internal medicine and neurological ICU wards.  The most sensitive antibiotics for these isolates were Linezolid (52), 98.1%, Vancomycin (47), 88.7%, respectively and the most resistant antibiotics to these isolates were Gentamicin antibiotic (43), 81.1%, and rifampin (34), 64.2%.

Annual nosocomial infections kill many patients around the world. Excessive use of antibiotics in medicine and agriculture has led to the development of multidrug-resistant bacteria, which are now recognized as one of the leading causes of nosocomial infections. In addition to high patient mortality, imposing high economic costs on patients and hospitals and medical centers is another consequence of microbial resistance. Enterococci are one of the most important causes of nosocomial infections, especially in intensive care units. These bacteria can be easily transmitted from one patient to another in a hospital through medical staff. In patients, the most common sites of enterococcal infection are the urinary tract, blood, and ulcers.In a study conducted by Ghasemi et al., on multidrug resistance of E. faecalis in two hospitals of Kashan, no resistance to linezolid antibiotic was observed in these isolates. In another study conducted by Najafi et al., on enterococcal antibiotic resistance in Hamadan teaching hospitals, no resistance to linezolid antibiotics was observed. Loza et al., in Spain showed that 100% of isolated enterococcal isolates were sensitive to linezolid, vancomycin and ampicillin. In this study, the most sensitive antibiotic against E. faecalis isolates was Linezolid, which is consistent with the studies mentioned above. In a study by Al-Harthi et al., on the pattern of antibiotic resistance of E. faecalis from 2003 to 2006, resistance to gentamicin was 89.6%. In this study, E. faecalis isolates had the highest resistance (81.1%) to the antibiotic gentamicin, which could be a warning to the physicians in prescribing this drug. in a study by Ghasemi et al., in Kashsn resistance to penicillin antibiotic was29.2%.  In another study conducted by Yousefi et al., on antibiotic resistance of enterococci in Ghaem Hospital of Mashhad, resistance to penicillin antibiotic was 54.5% . In the present study, resistance to penicillin antibiotics in enterococci was 54.7%. In another study conducted by Hosseinizadeh et al,. on the pattern of enterococcal resistance in Arak teaching hospitals, resistance to vancomycin antibiotic by MIC method was 14.66% . In another study conducted in India in 2013 by Suddhanshu et al., out of a total of 150 samples collected from different wards of the hospital, only 5 isolates were E. faecalis resistant to vancomycin. A study conducted by Arbabi et al., in 2015 in Rasool Akram and Milad hospitals in Tehran, out of 149 isolated Enterococcus specimens, 60% of the specimens were E. faecalis isolates. The highest resistance (77.1%) based on disk diffusion test against gentamicin antibiotic and the lowest resistance (28%) based on MIC test against vancomycin antibiotic was observed. In this study, the resistance of E. faecalis to the antibiotic vancomycin, which was performed by Etest method, was reported to be 11.3%, which is less than the study of Nikoei et al., Hosseinizadeh et al., and Arbabi et al.

The resistance of E. faecalis to antibiotics is increasing. Therefore, periodic monitoring of the resistance pattern of this bacterium can help effectively treatment of patients and reduce treatment costs. E. faecalis and Enterococcus faecium are inherently resistant to certain antibiotics, including cephalosporins, aminoglycosides, clindamycin, and fusidic acid.