فهرست مطالب محمدحسن نمایی

Helicobacter pylori (HP) is the most common human pathogen. Due to differences in HP prevalence in different geographical areas, this study was conducted to investigate the seroprevalence of HP in patients with gastrointestinal disorders referring to Imam Reza Hospital in Birjand, Iran, in 2018. After blood sampling of 2,550 patients, the anti-HP antibody titer was measured by a commercial kit. The positive serum response of HP in this study was shown in 1,045 individuals (41%). The results of the present study showed that there was no significant relation between serum positive reaction and gender. In addition, the immunoglobulin G (IgG) antibody with 83% was the most abundant antibody in individuals with positive seropositive reaction. Epidemiological studies, especially serum IgG, can highly help with the detection of HP infection, particularly in individuals with clinical symptoms (P<0.05).

Extracts rich in phenolic compounds have an important role in antioxidant and antimicrobial effects, and pistachio green hull extract is rich in polyphenolic compounds.

The aim of this study was to evaluate the effect of green peel of Kalleqouchi and Fandoghi pistachio extract on performance, relative weight of carcass components, blood indices and intestinal microbial population of broiler chickens challenged with Staphylococcus aureus.

A total 168 one-day-old broiler chicks were randomly divided into six treatments, four replications and seven chicks. Experimental treatments included unchallenged groups (negative control) and chickens challenged with Staphylococcus aureus and fed 0, 200 and 400 mg / kg of aqueous extract of Kalleqouchi pistachio and 200 and 400 mg/ kg of pistachio Fandoghi green extract. All infected chicks were inoculated with oral solution containing 3 x 109 CFU of Staphylococcus aureus. Performance characteristics, immunity, blood indices and microbial population of the intestine were determined.

The aqueous extract of green pistachio inhibited the growth of Staphylococcus but the ethanolic extract inhibited the growth of lactobacilli. Growth performance of chicks was not affected by the experimental treatments except at day 24, when aqueous extract of 200 mg / kg led to higher body weight gain as compared to control (0.049). Kalleqouchi extract at 400 mg/kg level increased abdominal fat (P = 0.0005) and had no effect on relative weight of other carcass components. The 400 mg/kg Fandoghi green extract and 200 mg/kg kalleqouchi extract increased enzyme activity of alanine aminotransferase activity and decreased the concentration of blood total protein (P <0.01). The pistachios extracts at all levels increased total antibody titer compared to control (P <0.02). Pistachio extract reduced total bacterial population of jejunal area compared to negative control (P = 0.008).

Application of aqueous extract of pistachio extract improves immune response, decreases blood lipids and intestinal microbial population of broiler chickens challenged with Staphylococcus aureus.

Bioaerosols are airborne particles that contain bacteria, viruses and fungi. Human reaction to bioaerosols is very different. The aim of this study was performed to determine the density of bacterial particles cultivable in the air of inside and outside kindergartens in Birjand.

This descriptive-analytical cross-sectional study was performed. Birjand city was divided into 5 regions based on geographical location and 6 kindergartens were randomly selected. Sampling was done in the morning shift from 6 selected kindergartens.The culture medium used was triptic soy agar for bacteria. Sampling was performed at a flow rate of 28.3 L/Min in 35 minutes at a distance of 0.8 to 1 M above the ground in the center of each class. Statistical analysis was performed using SPSS (Version.16) software and Mann-Whitney and Kruskal-Wallis statistical tests and a significance level (P<0.05) was considered.

The results showed that the highest mean bacterial microbial load in February was (3.83±8.04) CFU/m3 and suspended particles in March (196.13±382.54) CFU/m3. There was no significant relationship between bacterial density with suspended particles and temperature (P>0.05). There was a significant relationship between bacterial density and total suspended particles (P<0.05). There was a significant relationship between the amount of suspended particles (PM1, PM2.5, PM10) with the environment inside and outside the kindergarten (P<0.05).

From the findings of this study, the concentration of bacterial contamination in terms of quantity and type of identified species and the amount of airborne particles can be identified to prevent adverse health effects.

Hand hygiene is the most effective, simplest, and least expensive way to prevent the spread of hospital infections. Hand hygiene needs an ingredient that shows effectiveness in reducing microbial load in a way; alcohol-based hand rubs have more effective fast and long-lasting disinfection than other antiseptics. The aim of this study was to prepare and optimization of an alcohol-based hand rub solution recommended by world health organization to reduce expenses in sanction situations and also enhance the satisfaction and tolerability of the product.

In order to investigate the effects of Aqueous extract of phenolic compounds in green hulls of two varieties Pistachios green hull Kaleghochi and Fandoghi on performance and carcass characteristics, blood biochemical parameters and immune response of broiler, a total of 220 male day old chicks (Ross 308) were allocated to 20 experimental units in a completely randomized design with five treatments, four replicates and 11 birds each. Treatments were 0, 200 and 400 mg/kg of water extract of Kaleghochi and 200 and 400 mg/kg of water extract of fandoghi. Body weight, feed intake and feed conversion ratio were measured at the end of each of three nutrition periods including starter (0-10 days), grower (11-24 days) and end (25-46 days). Two birds of each replicate were slaughtered and bleed to measure the blood biochemical parameters and immune system at 24 and 46 days. Results were indicated that the body weight gain and feed intake were higher in 400mg/kg Kaleghochi pistachio hulls extract as compared to control. The FCR were decreased when birds fed 400mg/kg Kaleghochi pistachio hulls extract. There were no significant differences among treatments for relative weight of carcass organs except for abdominal fat. The both pistachio hulls extract decreased the abdominal fat, cholesterol, triglyceride, and LDL (P<0.05). The enzyme activity of aspartate aminotransferase was decreased when birds fed both pistachio hulls extract. The pistachio hull extract improved the immune response against SRBC as compared to control. It is concluded that supplementation of Kaleghochi and/or Fandoghi pistachio hulls extract may improve the performance, immune response, decrease abdominal fat and blood lipid profile of broiler chickens.

Gastrointestinal disease is one of the most common infectious diseases in the world. One of the most important causes is Helicobacter pylori infection. Considering the importance of this bacterium and its different prevalence in different parts of the country, this study was conducted to determine the prevalence of Helicobacter pylori infection and its related factors in 9-15 year old asymptomatic children in Birjand city.
This descriptive cross-sectional study was conducted on 332 children aged 9 to 15 years old in Birjand, in 1395. Individuals who had inclusion criteria were selected by multi-stage sampling. The demographic profile including age, sex, duration of breastfeeding, number of households, and number of yoghurt consumption per week, were completed for children. Helicobacter pylori stool antigen test was used in feces to evaluate Helicobacter pylori infection. Data were analyzed using Chi-square and Fisher's exact test at a significant level of 0.05.
Of the 332 children studied, 59 (17.8%) children had Helicobacter pylori infection. Our results showed no significant relationship between sex and duration of lactation with Helicobacter pylori infection (p> 0.05). However, with increasing age and number of family members, Helicobacter pylori infection was significantly increased (p Due to the prevalence of Helicobacter pylori infection and less frequently in dairy consumers should be given the necessary training for families.

As one of the major causes of hospital and community acquired infections, Methicillin-resistant Staphylococcus aureus (MRSA) requires accurate and timely diagnosis. This study aimed to investigate the prevalence and antibiotic resistance patterns of MRSA in patients hospitalized in the Birjand-based Imam Reza hospital.
In this cross-sectional study, a total of 102 clinical Staphylococcus aureus isolates were evaluated. Staphylococcus aureus isolates were confirmed via conventional microbiological and PCR methods (coa gene). The antimicrobial resistance patterns of the isolates were determined using the Kirby-Bauer disk-diffusion based on CLSI guidelines. Resistance to methicillin in the isolates was confirmed by means of PCR method (mceA gene). Finally, the obtained data was analyzed using SPSS software (version 16).
In this study, 50.9% and 58.8% of Staphylococcus aureus isolates were reported as methicillin-resistant using the Kirby-Bauer disk-diffusion and PCR methods, respectively. The highest antibiotic resistance in MRSA strains was found to penicillin (96.6%), to erythromycin (45%), and to ciprofloxacin (36.6%). In present study, resistance to azithromycin, erythromycin, ciprofloxacin, gentamicin, minocycline, and rifampin in MRSA isolates was significantly greater than Methicillin-sensitive Staphylococcus aureus (P A significant percentage of MRSA isolates in the hospitalized patients was resistant to methicillin, which is confirmed even with a wider range in their genotype.

Free living amoebae (FLA) are amphizoic protozoa that are widely found in various environmental sources. They are known to cause serious infections in human and animal nervous systems.. The aim of the current study was to determine the presence of Acanthamoeba spp in surface water sources in Birjand city employing microscopic culture analysis based on morphology features of the amoebae. In this cross-sectional study, 50 samples of surface water sources in Birjand city. including. parks pools, public squares, waterfronts, and water stations were collected and. transferred to the laboratory and were passed through nitrocellulose filter paper. The remained elements in the filters were cultured on non-nutrient agar (NNA) with 100μl Escherichia coli suspension. After a few weeks of using morphological features,the amoeba grown were identified. Out of the total of 50 samples cultured on non-nutrient agar (NNA), 19 (38%) samples.were morphologically polluted with Acanthamoeba spp,. In 2 samples (4%) a colony of Vahlkampfiidae were observed. The results indicated that a significant percentage of surface water sources in Birjand city was contaminated with Acanthamoeba spp. It is necessary for physicians, therefore, to take into account the diseases caused by these infectious agents. Besides, local regional health professionals should take into consideration the potential role of surface stagnant water sources in transferring these infectious agents. Placing warning signs in areas contaminated with these infectious agents seems a useful measure.

The present study was done to study the effects of water Hypericum perforatum extract (WHPE) on performance، abdominal fat، carcass characteristics، and blood biochemical parameters of broilers with 160 day-old Ross 308. Broilers were randomly distributed among the16 experimental units of four treatments with four replications (10 birds in each replicate) for 42 days. The treatments were included 0، 150، 300 and 450 mg WHPE per kg diet from 0-42 days. Two birds from each pen were randomly selected، bleeding and slaughtered at 24 and 42 days of age. Results showed that the performance parameters were not affected by the WHPE with the exception of feed intake that was lower for the birds received 300 mg WHPE. The production index and carcass relative weight were not altered by the level of WHPE with the exception of the relative weight of liver، proventriculus and gizzard that greater at highest level of WHPE in 24 d. Birds received 300 and 450 mg WHPE had lower abdominal fat as compared to control (P<0. 05). Birds received 150 mg WHPE had higher concentration of HDL and lower glucose in 24 d. The enzyme activity of ALT and AST were higher when broilers received 300 mg WHPE in 24 d (P<0. 05) however، it did not changed at 42 d. It is concluded that the addition of WHPE to broiler diet could not significantly influence on performance parameters، although it may be reduce the abdominal fat and enhanced the liver enzyme activity.

Chronic otitis media with effusion is a common childhood infection. The present study aimed at determining the prevalence of bacterial causes of chronic otitis media with effusion and their drug resistance in patients with intact tympanic membranes. In this cross-sectional study of 100 patients with chronic otitis media with effusion who underwent myringotomy from October 2011 to September 2013 were selected through census and assessed. First of all، their middle ear secretions were collected and cultured in thioglycollate broth. Then، the isolated bacteria were identified and their drug sensitivity. was evaluated using standard disk diffusion method. Out of 87 samples with positive culture results the most common bacteria isolated were coagulase-negative staphylococci (39%) and streptococcus alpha، beta، and non-hemolytic (24%). A significant association between the type of bacteria isolated from the ear with acute otitis media discharge (P = 0. 003)، affected ears (P = 0. 049) and presence of allergy (P = 0. 029) was observed. Among the antibiotics tested، the highest sensitivity was that of levofloxacin (94. 7%)، clindamycin (84. 9%)، and ciprofloxacin (83. 3%); and the highest resistance belonged to oxacillin (77. 1%)، trimethoprim-sulfamethoxazole (59. 4%) and cefixime (58. 3%). Based to the obtained results، when the middle ear secretion culture is impossible، administration of the antibiotics clindamycin and ciprofloxacin to the patients is recommended.

The use of plant compounds to treat infections is an age-old practice in a large part of the world. Members of Rosacea family have long been used for food and medicinal purposes. The aim of this study is evaluation of antimicrobial effect of five different brands of rose water, water extract of Rosa damascene in comparison with rose oil. Five different brands of rose water, water extract of rosa damascene and rose oil were tested for antibacterial activity against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, Esherichia coli ATCC 25922, Pseudomonas aeruginosa and Candida albicans by broth micro dilution assay. Rosewater with five concentrations of 1%, 10%, 25%, 50%, 75% and 100% in the culture media and water extract of rosa damascene with six concentrations of 0.2, 2, 5, 10, 15 and 20 mg/ml and Rose oil with five concentrations of 0.1, 1, 2.5, 5 and 10 μl/ml were studied. All bacterial turbidities were examined visually. Each test was repeated three times. In this study, the use of any concentration of rose water failed to inhibit the growth of microorganisms, completely. However, we found that there is a significant difference between rising of rose water concentration and decreasing the microorganism growth. The minimum inhibitory concentration (MIC) values of water extract of Rosa damascene were 8 mg/ml in Staphylococcus aureus, 6 mg/ml in Enterococcus faecalis and Esherichia coli, 4 mg/ml in Candida albicans. The MIC values of rose oil were 10 µg/ml in Staphylococcus aureus and Esherichia coli, 5 µg/ml in Enterococcus faecalis, 1 µg/ml in Candida albicans. We also found no inhibitory effect of Rose extract and Rose oil on Pseudomonas aeruginosa. This study showed rose water, water extract of rosa damascene and rose oil have anti-microbial effects. However, clinical use of this material requires more and larger studies.

In 2003، a vaccination campaign was conducted to immunize the individuals aged 5 -25 years old against rubella infection. The present study aimed at investigating the extent of immunity to rubella in premarital women five years after the campaign. This descriptive study was conducted on 298 premarital women who had been vaccinated during the national rubella vaccination campaign (2003).، The anti rubella antibody (IgG) titer of the women referred to provincial health office in Birjand was evaluated through simple randomized sampling، using ELISA method. The antibody titer above 10 IU/ml was accounted protective. Mean age of the participants was 21. 7 ±4 years ranging from 14 to 30 years. Most of them (68. 7%) were living in urban areas. The majority of them (51. 2%) were school fellows or university students Only one participant''s antibody titer against rubella virus was less than 10 IU/ml. According to this study، mean antibody titer was 99. 77±58. 8 ranging from 5. 2 to 333. 5. Regarding the immunity of 99. 7% of the subjects، the risk of «congenital rubella syndrome» in our society seems to be low. However، low titers of antibodies in a small percent of the cases prompts the worry that there will likely be a reduction in immunity in the following years. Thus، it is recommended that the present study should be repeated in the following 3 or 4 years.

Taking patient's history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patient's history. This study aims to assess determinants of taking patient's history from the viewpoint of the students of Birjand Medical School.

This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test) were applied on the data.

The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58); and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57)had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005).

Although the students held a positive attitude toward taking patient's history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.

Invasive diarrhea is a self-limited disease but its antibiotic treatment not only reduces the disease marking time، but also excretion of the microbes and، consequently، a decrease in the pathogenicity of the disease. The present study was conducted to compare patients'' resistance to ciprofloxacin and to azithromycin in non-amoebic acute dysenteric. In this clinical- trial study 84 patients suffering from non-amoebic dysentery were selected through successive sampling، and were randomly divided into two groups. One group was administered Ciprofloxacin 500mg every 12 hours، the other group Azitromycin 250mg daily (every 24 hours). Then patients examined after 48 hours to see the probable improvement of their previous clinical symptoms. Besides، their first day feces culture was assessed. The obtained data was fed into SPSS software (V: 1/3)، and then it was analysed using X2 statistical test at the significant level α=0. 05. for afebrility and decreased diarrhea. data analyzed in using test. Out of 84 patients، shigella was diagnosed in 41 (48. 8%)، 18 patients of whom (43. 9%) had been treated with azitromycin and 23 cases (56. 1%) had received ciprofloxacin. In 14 samples (16. 7%) other microbes had grown (e. g. Salmonella، Campylobacter jejuni، Escherichia Coli). Antibiogram of 55 patients showed that 32 (58. 2%) of them were sensitive to ciprofloxacin and 41 subjects (74. 5%) to azitromycin. On the third day of treatment the clinical response of the patients was assessed through their probable fever and diarrhea. It was found that 29 cases (93. 5%) in azitromycin group and 31 patients (88. 5%) in ciprofloxacin group were a febrile. Thus، no significant difference between the two groups was observed (P=0. 6). The present study proved that Azitromycin and Ciprofloxacin have the same efficacy in treating non-amoebic dysentery

CRP is the main acute phase protein in humans and plays a key role in host defense against infections. This protein is increased in many infections، inflammatory arthritis، autoimmune diseases، neoplastic diseases، pregnancy and elderly this study was done on 400 serum samples that CRP was checked with 3 different kits with slide agglutination method and with photometric method for each sample. Results were compared with quantitative results in photometric method. statistical results in evaluating 400 serum samples with Anisan، Kimia pajohan and Shim enzyme kits were like below: false negative results were detected in 21، 20 and 33 samples respectively. Sensitivities were 87. 6%، 86. 2% and 80. 5% respectively. Specificities were 84%، 74. 1% and 80% respectively. Positive predictive values were 80%، 65. 4% and 74. 7% respectively. Negative predictive values were 90. 2%، 90. 5% and 84. 9% respectively. Although Anisan kits have higher sensitivity، specificity and positive predictive values among these three Iranian kits with slide agglutination method، it is advised to use quantitative methods like ImmunoturbidImetry or photometry because of high frequency of false results in agglutination method.

The aim of this study was to evaluate bacterial contamination of keyboards of computers located in various wards of Vali-e Asr Teaching Hospital, Birjand, Iran. In this study, all computer keyboards in various wards of Vali-e Asr Hospital were sampled (n=24). Then, the samples were sent to Microbiology Research Laboratory at Birjand University of Medical Sciences and were cultured on Blood ager, Manitol Salt ager and Eosin Methylene Blue media. The isolated bacteria were identified based on their colonial morphology and biochemical characteristics. A total of 26 samples from 24 different computer keyboards of 16 different wards were obtained. Two keyboards of Infectious Diseases and Neurology wards were routinely disinfected at the end of every shift. All samples(100%) showed contamination to different bacteria. The keyboard of the computer located in Internal Medicine ward(women's division) was the most contaminated one. In total, 13 different bacterial spp. were isolated from keyboards of different computers. The species belonging to Enterobacteriaceae family(61.5%) were the most common contaminating bacteria followed by Bacillus spp(30.7%). Based on the results, all the sampled keyboards were contaminated by at least one bacterial spp. Therefore, it is necessary to pay more attention to the fact that computer keyboards in hospitals should regularly be disinfected.

Toxoplasma gondii is an intracellular protozoan that causes severe infections in humans and animals. This study investigated the prevalence of toxoplasmosis infection in women in pre marriage stage in Birjand. This cross-sectional study was done in 2008. By randomized-simple sampling, we evaluated the anti Toxoplasma antibody (total antibody) titer in 300 women in pre marriage stage referred to provincial health office in Birjand. Total antibody against Toxoplasma gondii in serums of participants was measured, using ELISA method. Antibody titer above 20 IU/ml was considered positive. To investigate factors associated with infestation, a self-made questionnaire was used. Statistical analysis was performed using the spss software program, v. 11 and logistic regression test (α=0.05). The mean age of participants was 21.7 ±4 years with a minimum of 14 and maximum 30 years; and most of them (68.7%) were living in urban areas. Majority of participants were students (51.2%) and housewives were in the next rank (25.8%). 37of the total participants (12.33%) were seropositive. We found a significant relationship between consumption of soft-boiled egg and antibody titer against Toxoplasma gondii (P=0.035). No significant relationship between antibody titer against Toxoplasma and age, residence, occupation, history of consumption of non-industrial produced eggs as well as uncooked vegetables was found. As there is significant relationship between Toxoplasma infection and consumption of soft-boiled eggs, training the families in the prevention of toxoplasmosis infection is recommended.

Salmonella is one of the common bacterial pathogens between man and birds throughout the world. Inconsistent Salmonella contamination following consumption of eggs, as one of the main contributors of the disease has also become an important public health issue. The aim of this study was to investigate prevalence of Salmonella contamination in locally-produced eggs in Birjand in 2006. In this cross-sectional study, raw non industrialized eggs in Birjand were evaluated for Salmonella contamination. A total of 500 samples were purchased from retail outlets throughout the city. Both the shells and contents of the eggs were cultured using the standard method. Biochemical tests, Salmonella serotyping and PCR were applied to specify and confirm of Salmonella isolates. The overall finding was that 3 samples (0.6%) were contaminated with Salmonella. In two out of 3 contaminated eggs, salmonella was found on shell only; both the shell and content of the other one were contaminated. Prevalence of Salmonella contamination among the barn and free range eggs in Birjand was 0.6%, which is equivalent to approximately 1 in every 165 eggs. This is in accordance with other surveys in Iran (Shiraz, Tehran and Mashhad). Based on the results, to prevent salmonellosis, proper cooking of the eggs is recommended.

Bloody diarrhea (dysentery) is one of the acute gastrointestinal diseases and Shigellosis is an important cause of it in our country. Variety of its causing agents (Shigella strains) and occurrence of drug resistance have made troubles in selecting of appropriate antibiotics for the treatment of shigellosis. The current study was aimed at identifying different strains of shigella and assessing their drug resistance in the urban and rural regions of Nehbandan. In this quasi experimental study 140 patients presented with acute bloody diarrhea referring to the rural and urban health centers and health houses of Nehbandan were studied. Their stool samples were cultured and underwent antibiogram tests after being carried to a Birjand medical diagnostic laboratory. Cultures were prepared according to WHO standard protocols on Eosin Methylen Blue (EMB) and Shigella - salmonella agar (SS) media. Drug susceptibility was done using disk diffusion method. The obtained data was analyzed by Chi-square and Fisher test, and P0.05 was considered as the significant level. 35 (25%) out of 140 patients were positive regarding shigellosis. The most frequent shigella serotypes were shigella Flexneri in 30 cases (85.7%), shigella Boydii in 4 cases (11.4%) and shigella Sonnei in 1 case (2.9%). All shigella strains were sensitive to Ciprofloxacin and Nalidixic acid, but 85.7% to Cefixime. Only 20% of shigella strains were sensitive to Co-trimoxazole.

Hemophilic patients are at risk of several blood born diseases such as viral hepatitis (A, B, C), HIV infection due to several transfusion events during their life. This study was performed to evaluate the prevalence of HCV infection and related viremia in hemophilic patients in our region. 80 out of 400 hemophilic patients, registered in Khorasan hemophilia Society were evaluated. The case studies were selected randomly. The second generation of ELISA kit was used for evaluating anti HCV in serum. The positive ELISA results were confirmed using Western Blot method. Viremia was evaluated using RT-PCR method in anti HCV positive patients. Our results showed that 44 (55%) out of 80 were anti HCV positive, 25(56%) of whom, had viremia. Our results showed a significant relation between HCV infection with kind of hemophilia (P=0.044) and it's severity (P=0.033). As the prevalence of HCV infection in our study group was high, screening of all hemophilic patients for HCV infection is recommended. Based on the results, the evaluation of viremia in HCV infected patients is advised too.