kiarash ghazvini

 This in vitro study was conducted to assess the phototoxic effects of curcumin, nanocurcumin, and erythrosine on the viability of Streptococcus mutans (S. mutans) in suspension and biofilm forms.

 Various concentrations of curcumin (1.5 g/L, 3 g/L), nano-curcumin (3 g/L), and erythrosine (100 μM/L, 250 μM/L) were examined for their impact on planktonic and biofilm cultures of S. mutans, either individually or in conjunction with light irradiation (photodynamic therapy or PDT). A blue light-emitting diode (LED) with a central wavelength of 450 nm served as the light source. The results were compared to 0.12% chlorhexidine digluconate (CHX) as the positive control, and a solution containing neither a photosensitizer (PS) nor a light source as the negative control group. The dependent variable was the number of viable microorganisms per experiment (CFU/mL).

 Antimicrobial PDT caused a significant reduction in the viability of S. mutans in both planktonic and biofilm forms, compared to the negative control group (P<0.05). The highest cell killing was observed in PDT groups with curcumin 3 g/L or erythrosine 250 μmol/L, although the difference with PDT groups using curcumin 1.5 g/L or erythrosine 100 μmol/L was not significant (P>0.05). Antimicrobial treatments were more effective against planktonic S. mutans than the biofilm form.

 PDT with either curcumin 1.5 g/L or erythrosine 100 μmol/L may be suggested as an alternative to CHX to inactivate the bacteria in dental plaque or deep cavities. Nanocurcumin, at the selected concentration, exhibited lower efficacy in killing S. mutans compared to Curcumin or erythrosine.

Pichia pastoris is a methylotrophic yeast with remarkable characteristics such as lacking endotoxin, producing high amounts of recombinant protein, performing post-translational modifications, and so on. Influenza A virus, a member of the Orthomyxoviridae family, is the cause of avian influenza. Three avian influenza virus subtypes, H5, H7 and H9, are commercially and physiologically significant in the poultry industry. Some researchers considered influenza to be the next pandemic disease. Nowadays, researchers have paid attention to producing novel and effective recombinant vaccines, especially in the poultry industry. Due to the advantages of P. pastoris yeast, it can be used as an ideal expression system for producing subunit vaccines. Although several studies have been conducted in this field, there is no comprehensive review of using P. pastoris to produce recombinant influenza vaccines. This review explains the different strains, phenotypes, and advantages of this yeast and then the production of recombinant influenza vaccines using this expression system is discussed in detail.

The use of a combination of three-drug regimen has improved HIV-1 infected patients' life span and quality; however the emergence of drug-resistant strains remains a main problem. Reverse transcriptase inhibitors (RTIs) consist of a main part of highly active anti-retroviral therapy (HAART) regimen. The present study aimed to investigate resistant mutations to RTI drugs in both treatment naïve and under treatment HIV patients in Mashhad city, north-eastern Iran. RNA was extracted from sera of 22 treatment naïve and 22 under treatment patients. The mean age of under treated and treatment naive groups were 38.5±6.7 and 40.8±7.9 respectively. cDNA was synthesized and amplified with Nested PCR assay targeting specific sequences of RT gene. The PCR products were sent for sequencing. Bidirectional sequencing results were analysed using HIV drug resistance database supplied by Stanford University (HIV Drug Resistance Database, https://hivdb.stanford.edu). Among under treatment patients 10 out of 22 (45%) had at least one high-level resistance mutation which was higher than high level resistance mutation rate among treatment naive cases (P<0.01). Detected resistance mutations were as follows: K101E, K103N, K103E, V106M, V108I, E138A, V179T, Y181C, M184V, Y188L, Y188H, Y188F, G190A, L210W, T215F, T215Y, K219Q, and P225H. A high level of resistance mutations to RT inhibitors was observed that causes drug resistance especially against lamivudine (3TC). Such mutations should be considered as probable responsible for therapeutic failure. Serial surveillance studies of circulating drug resistance mutations are recommended.

Mycobacterium tuberculosis is still one of the most dangerous human pathogens. Identification of the relationships between different clinical strains has remained a high priority for epidemiology research.

In this study, we used MLSA (Multilocus sequence analysis) to generate a highly robust phylogeny of M. tuberculosis. MLSA, based on single nucleotide polymorphism (SNP) was performed on five genes fragments from the Rpsl (302 bp), MprA (559 bp), LipR (322 bp), KatG (488 bp) and Fgd1 (266 bp), in order to identify polymorphic nucleotide sites, and the discriminatory power of each locus for all genes was measured with Hunter‐Gaston Index (HGI).

In this study, a sequence type (ST) number was assigned to each unique allelic profile, and 9 sequence types were identified from 20 strains, these imply that there is a high diversity of strains in this area.

Our results showed that the presence of high genetic diversity among clinical isolates of M. tuberculosis in Northeast of Iran. There is no evidence for recent transmission. Keywords: Mycobacterium tuberculosis, Multi-locus sequence analysis; Molecular epidemiology; Tuberculosis; KatG; Rpsl1. IntroductionMycobacterium tuberculosis (M. tuberculosis), the causative agents of tuberculosis (TB), is one of the most successful human pathogens, infecting nearly one-third of the people all around the world, causing over 9 million new cases and 1.7 million deaths each year [1-2]. Identification of the relationships between different clinical strains of M. tuberculosis has great significance to the public health [3].

Dental caries is a preventable multifactorial disease, with Streptococcus mutans being suggested to be its primary pathogen. Our study aim was to compare the effects of three different low‑cost and easy‑to‑use regimens with that of the gold standard (chlorhexidine [CHX] mouthwash) on the count of salivary S. mutans in dental students over 30 days.

In this single‑blinded parallel randomized controlled clinical trial, a total of 120 dental students were included and randomly allocated into four intervention groups: (1) CHX mouthwash (control(, (2) probiotic yogurt, (3) casein phosphopeptide‑amorphous calcium phosphate chewing gum, and (4) xylitol chewing gum. Salivary S. mutans counts were evaluated at baseline, 15 days, and 30 days after initiation of the study and compared at different times and among different groups using the repeated measures analysis of variance design analysis and least significant difference test with SPSS software version 20. The level of significance was determined to be 0.05.

The microorganism count variable at baseline, first, and second follow‑ups was significantly different for all groups except the probiotic yogurt group (P = 0.340). S. mutans count was significantly different when comparing the first follow‑up and baseline values in the CHX and xylitol gum groups (P = 0.027, P = 0.037). When comparing the second follow‑up with baseline values, a significant difference was observed in the xylitol gum group (P = 0.003).

Xylitol chewing gum seems to be a viable alternative to the gold standard (CHX mouthwash) in reducing the salivary count of S. mutans.

BCG vaccine has no longer been appreciated to immunize against tuberculosis, worldwide, so novel appropriate adjuvants have been dedicated to improve immune responses. This study aimed to evaluate the immunomodulatory effects of ISCOMATRIX as an adjuvant to stimulate potent humoral and cellular immune responses of the PPE17 loaded alginate coated nanoparticles through subcutaneous and intranasal vaccination.  Size, polydispersity index, and morphology of the resulting colloidal particles were explored by dynamic light scattering (DLS). The cellular and/or humoral immune stimulation properties of ISCOMATRIX adjuvant were measured by measuring the level of IFNγ, IL-4, IL-17, and TGFβ in spleen cell cultures and IgG1 and IgG2a in serum and sIgA in nasal lavage of immunized mice, respectively.  The spherical cage-like particles of ISCOMATRIX adjuvant have optimal size of 59±6 nm appropriate for an immune adjuvant vaccine. ISCOMATRIX induced robust Th1 (IFN-γ) and IL-17 cytokine response also significant IgG2a and IgG1antibodies in both subcutaneous and intranasal routes and elicited mucosal sIgA response when administered intranasally. As a booster for BCG, ISCOMATRIX induced immune responses only in subcutaneous route.  These findings indicate that ISCOMATRIX is a promising adjuvant with the potential for increasing cellular and humoral immunity both after subcutaneous and intranasal administration.

Chlamydial infections could lead to ectopic pregnancy and infertility. Considering the high prevalence of infertility in Iran and little information about the role of urogenital bacterial infections in this disease, this study aimed to evaluate the prevalence and sequence types of Chlamydia trachomatis in the urogenital tract of infertile couples in North Khorasan.
Materials &

Cervical or urethral swabs collected from infertile patients referring to two private clinics and the infertility center of Bent Al-Hoda hospital in Bojnurd during 2017-2021 were tested for C. trachomatis. These specimens were evaluated using PCR for C. trachomatis orf8 gene. Multi-locus sequence typing (MLST) was performed on positive samples using PCR amplification of seven housekeeping genes (GlyA, leuS, lysS, mdhC, pdhA, pykF, and yhbG) following a previously described protocol.
Findings. Out of 268 samples tested, 44 (16.4%) samples were positive for C. trachomatis. Among which, 35 cases were obtained from women, and nine samples were from men. Of the 44 positive samples, 10 cases were not typable. Only two sequence types were detected among 34 typeable isolates: 25 (73.5%) isolates belonged to ST80, and nine (26.5%) samples belonged to ST4.
Conclusion. The high prevalence of ST4 and ST80 in most symptomatic infertile patients may be attributed to the higher pathogenicity of these types in the urogenital tract. However, our sample size was insufficient to draw such a conclusion.,  Further research on the prevention and treatment of Chlamydial infections could potentially help to reduce infertility in Iran.

Colon cancer is well-known as a life-threatening disease. Since the current treatment modalities for this type of cancer are powerful yet face some limitations, finding novel treatments is required to achieve better outcomes with fewer side effects. Here we investigated the therapeutic potential of Azurin-p28 alone or along with iRGD (Ac-CRGDKGPDC-amide) as a tumor-penetrating peptide and 5-fluorouracil (5-FU) for colon cancer.  Inhibitory effect of p28 with or without iRGD/5-FU was studied in CT26 and HT29, as well as the xenograft animal model of cancer. The effect of p28 alone or along with iRGD/5-FU on cell migration, apoptotic activity, and cell cycle of the cell lines was assessed. Level of the BAX and BCL2 genes, tumor suppressor genes [(p53 and collagen type-Iα1 (COL1A1), collagen type-Iα2 (COL1A2)] were assessed by quantitative RT-PCR. These findings show that using p28 with or without iRGD and 5-FU raised the level of p53 and BAX but decreased BCL2, compared with control and 5-FU groups in tissues of the tumor, which result in raising the apoptosis.  It seems that p28 may be used as a new therapeutic approach in colon cancer therapy that can enhance the anti-tumor effect of 5-FU.

Most Escherichia coli are not pathogenic. But some strains of E. Coli become pathogenic by acquiring and synthesizing diverse virulence genes. Iron, as an essential nutrient, has a proven role in the pathogenicity of E. coli. One of the most common strategies of microorganisms in the presence of free iron is the production of siderophores. Siderophores act as extracellular agents for the absorption of iron from minerals or organic compounds in the absence of iron. The Purpose of this study was to identify and evaluate the genes encoding iron absorption systems in Enteroaggregative Escherichia coli isolates isolated from diarrhea specimens.

In this study, three panels were designed. Panel 1: iroN, iutA, fecA, Panel 2: fyuA, sitA, irp2 and Panel 3: iucD. In panels 1 and 2, Triplex-PCR method and panel 3, single-PCR method were used and 44 EAEC isolates isolated from diarrhea samples were screened by these three panels.

The results showed that a total of 44 EAEC isolates had respectively the highest frequency of fecA 44(100%), fyuA 43(97.73%), irp2 43(97.73%), iutA 42(95.45%), iucD 34(77.27%), sitA 29(65.91%) and iroN 4(9.09%). and 7 gene profiles encoding different iron absorption systems were identified.

The results showed that EAEC isolates have the ability to produce synthesize a variety of siderophores and use the variety of profiles of different iron absorption systems to obtain the required iron.

Q fever is a generally neglected infection caused by Coxiella burnetii. Slaughterhouse workers exposed to livestock are among occupationally at-risk people.

This study was conducted to investigate the seroprevalence of anti-Coxiella burnetii (Q fever) IgG antibody among industrial slaughterhouse workers and factors affecting the risk of infection.

In this cross-sectional study serum samples were taken from 91 individuals working at the central industrial abattoir in Mashhad, Iran using a convenient sampling method. Sera were kept at -80°C until assayed for specific anti-Coxiella burnetii IgG antibodies (phase 1) using the commercial ELISA kit. The participants filled out a checklist addressing potential risk factors of acquiring the infection. SPSS 11.5 was used for data analysis considering a significance level of P < 0.05.

The participants’ mean age was 38.7 ± 8 years. Fifty-six percent of the studied individuals (51 out of 91) were found positive for anti-Coxiella burnetii antibodies. The most prevalent cases were sheep (29, 57%) and cow (18, 35%) butchers. The odds of Q fever infection increased among those with a history of accidental hand cuts of more than five times during the previous years (OR = 2.56, CI95% = 1.02 - 6.33, P-value = 0.04) and those dealing with sheep as the primary livestock (OR = 2.9, CI95% = 1.09 - 7.66, P = 0.02).

The high seropositivity rate of anti-Coxiella burnetii IgG reflects high exposure rate of workers to this potentially serious pathogen in slaughtherhouses; therefore, careful education, follow-up, and revision of decontamination policies and improved occupational care and environmental hygiene should be strictly implemented in slaughterhouses to reduce the risk.

The tonsils are part of the immune system and tonsillar infection is one of the most common causes of diseases, especially in children. Tonsillitis sometimes does not respond to empirical treatment and the presentation of recurrent tonsillitis eventually leads to tonsillectomy. The aim of this study was to determine and compare palatal tonsil culture by superficial and deep methods in frequent tonsillitis patients referred for tonsillectomy.

This cross-sectional study was performed on all patients aged > 3 years with chronic recurrent tonsillitis referred for tonsillectomy during 2019-2020. After obtaining the informed consent of the patient's legal guardian, the patient underwent sampling of the right palatine tonsil with a swab through the mouth before tonsillectomy. After tonsillectomy, a sampling of the surface and deep tissue of the tonsil was performed. Microbiological examination, antibiogram determination, and blood culture before and after tonsillectomy were performed.

A total of 80 patients were recruited in this study of which 50% were male. In 87.1% of patients, the report of staphylococcus (as the most common organism found) had poor consistency in both surface and deep culture methods. This rate reached 81.3% in comparison between deep tissue culture results and secretions (swab) and 72.7% in comparison between surface samples and secretions (swab) (P<0.001). There was the lowest amount of negative cultures in the comparison of 3 surface cultures, deep cultures and secretions (swap) in deep samples. The highest antibiotic susceptibilities against tonsillar organisms were observed in clindamycin, erythromycin, cefoxitin, gentamicin, and doxycycline.

Blood cultures before and after tonsillectomy were negative in all samples. Based on the results, it seems that no persistent infection enters the blood during tonsillectomy in otherwise healthy patients. It also seems that the use of deep culture is more beneficial compared to surface culture because it has a lower false negative rate.

Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain polymerase chain reaction (PCR) diagnostic technique for chronic granulomatosis dermatoses including CL in Mashhad, Iran.

This study enrolled 64 patients within 2009-2013 with chronic granulomatosis dermatitis referred to dermatology and pathology departments of Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. We gathered demographic data from archived folders. Histological light microscopic evaluation and parasitological tests were done on selected specimens. We used PCR diagnostic test on specimens. Statistical analysis was done by SPSS version 15.

Generally, 7 out of 64 specimens had Leishmania DNA and other samples had no Leishmania DNA. The mean age of patients was 46 ± 18.77 years; disease duration was 7 ± 6.73 months ranging from 1-24 months. Most of the lesions were located on face and upper limb. Totally, 5 out of 7 samples were Leishmania major and 2 out of 7 samples were L. tropica. Tuberculoid granuloma was present in L. tropica samples and 3 of L. major samples. Other light microscopic changes were as follow: 42 suppurative granuloma, and epidermal changes including atrophy, pseudoepitheliomatous hyperplasia, and parakeratosis with dermal changes including, plasma cell, involvement of papillary and reticular dermis, and distribution of granuloma to hypodermis.

Our results addressed PCR-based diagnosis of chronic cutaneous leishmaniasis, which is resulted from L. major and L. tropica.

Purpose of this study was to investigate of prevalence, phylogenetic groups and antibiotic resistance pattern EAEC isolated from diarrheic children in Mashhad city.

This cross-sectional study conducted for one year. In total, 450 diarrhea samples of children under 10 years of age were collected from children's specialized hospital in Mashhad. After isolation of Escherichia coli, EAEC isolates were identified by PCR molcular method. Phylogenetic groups of EAEC isolates were determined using the original and updated 2019 method. Antimicrobial susceptibility test was performed using disc diffusion methods(Kirby-Bauer method) against 12 antibiotics.

44(9.8%) EAEC isolates were identified from 422(93.8%) Escherichia coli isolates by PCR. Seven phylogroups including D(40.9%), unknown(27.3%), G(11.4%), B1(9.1%), F(4.5%), B2(4.5%) and A(2.3%) were detected among EAEC isolates.The highest diversity of antibiotic resistance patterns was related to Phylogroup D. EAEC isolates showed the highest resistance to amoxicillin and erythromycin 100%. Overall, 97.7% of EAEC isolates were with multiple drug resistance(MDR).

The present study showed a significant presence of EAEC strains. Considering the role of EAEC in chronic diarrhea and growth retardation syndrome in children, it is suggested that the identification of EAEC strains to be considered in diagnostic laboratories in cases of children’s diarrhea. on the other hand, due to the high prevalence of multiple resistances, antibiogram test is required to treat diarrhea in children.

Based on serological studies, the prevalence of Helicobacter pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer, and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are geographically different, local studies are highly required. Eighty isolates of Helicobacter pylori were obtained from patients referred to the endoscopy unit of Ghaem Hospital in Mashhad. Demographic features including age, gender, and symptoms were recorded before the sampling. The antibiotic susceptibility patterns of isolates were determined for the five common antibiotics used for the treatment of Helicobacter pylori infection. The agar dilution method was used to evaluate the antibiotic resistance patterns. The patterns of antibiotic resistance were determined, and 41.2%, 13.7%, 8.7%, 6.6%, and 6.6% of isolates were resistant to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone, respectively. Our study demonstrates that the overall rate of antibiotic resistance of Helicobacter pylori especially in the case of metronidazole has increased over time. The resistance rates are generally higher in the age range of 30-60 years and in females for the case of metronidazole. This reminds us of the need for a continuous monitoring program of antibiotic susceptibility patterns.

 Many nosocomial infections, which cause death and cost society, may be transmitted through healthcare workers’ contacts. Preventive health measures greatly reduce their prevalence.

 This study aimed to investigate the microbial contamination of healthcare workers’ hands in different wards of Sheikh Hospital. In addition, the alcohol-based hand sanitizers’ ability to reduce microbial load of nosocomial infections was evaluated.

 The present study was performed in spring 2019. Thirty-two nurses’ hand samples were obtained from different wards of the hospital, including emergency, ICU, surgery, peritoneal dialysis, nephrology, and hematology-oncology. Biochemical tests determined the isolates. Participants’ hands were cleaned using a standard procedure using soap and 70% isopropyl alcohol-based hand sanitizer.

 Different species, including coagulase-negative Staphylococcus (CoNS), Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus, Klebsiella oxytoca, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Burkholderia cepacia complex were isolated. Following hand hygiene procedure, the most effective decontamination for a wide variety of organisms was observed.

 Separation of dangerous pathogenic bacteria such as S. aureus, K. pneumoniae, and E. coli from healthcare workers may be a great warning sign for these infections in the hospital. Therefore, hand hygiene procedures may be considered an appropriate method to decrease nosocomial infections.

Non-tuberculous species of Mycobacterium are a large group of Mycobacterium and are widely distributed throughout the world. Increased isolation of non-tuberculous mycobacteria from patients with mycobacteria infections in Iranian laboratories was associated with erroneous and unnecessary drug treatment, so that in some cases isolated strains considered as drug resistant strains. According to studies conducted in Iran, Mycobacterium simiae was one of the most abundant non-tuberculous mycobacteria. The treatment regimen used includes Moxifloxacin, Clarithromycin along with third drugs Trimethoprim-Sulfamethoxazole and Streptomycin antibiotics. Due to the limited studies performed on Mycobacterium simiae, in this study, the resistance of Mycobacterium simiae to common antibiotics used in the treatment regimen was evaluated by using the REMA Plate method.

In the present study, the drug susceptibility of 10 clinical isolates of Mycobacterium simiae to Clarithromycin, Moxifloxacin, Co-trimoxazole and Streptomycin antibiotics was evaluated using the REMA Plate method.

Out of 10 samples, all samples were sensitive to streptomycin and clarithromycin antibiotics (100%) and resistance to Moxifloxacin and Co-trimoxazole were %10 and %60, respectively.

The results indicated that the most effective drugs for the treatment were Clarithromycin, Streptomycin and Moxifloxacin, which can be used as a proper regimen in the treatment of Mycobacterium simiae infection.

Because of the current limitations of therapeutic methods, the worldwide appearance and spreading of carbapenem-resistant (CR)-Klebsiella pneumoniae has made it a key concern in the healthcare system. K. pneumoniae, the most frequent Klebsiella species is the cause of human infections, classified as top three pathogens of global concern which was established in the2014 WHO Global Report on Surveillance of Antimicrobial Resistance.

Embase, PubMed/Medline, Scopus, Google Scholar, Web of Sciences, and Iranian databases were searched to retrieve the potentially relevant studies. In this review, we explored the prevalence of K. pneumoniae generating three universal carbapenemases (KPCs, NDMs, and OXA-48- like) by following keywords: "carbapenem resistance" and"blaKPC" and"Metallo lactamase-beta" and "blaNDM" and "blaOXA" and "Klebsiella pneumoniae" and Iran.

After exploiting predefined inclusion and exclusion criteria, 37 articles were collected that reported prevalence of carbapenem-resistant Klebsiella pneumoniae. At finally, 20 studies reported blaNDM , 17 studies reported blaKPC, 14 studies reported blaOXA-48 and blaVIM as gene cause resistance among Klebsiella pneumoniae strains. The described resistance to carbapenem varied across different studies, ranging from 4.4% to 100%.

Our findings demonstrated that the high prevalence of carbapenem-resistant Klebsiella pneumoniae expresses concern over most Iranian hospitals.

The aim of this study was to determine the serum levels of ST2 protein and interleukin-33 in patients affected to tuberculosis and compare them with the control group. In the present study, at first 30 patients affected to TB were randomly selected and 52 healthy individuals, who were matched with respect to their age and gender, included in the study as the control group. After that, the serum levels of sST2 and IL33 were measured by ELISA sandwich method using commercial Quantikine Human ELISA kit (R&D Systems). The data were finally analyzed by SPSS software. IL-33 levels in the TB group were higher than the healthy controls and a statistically significant difference was observed in the IL-33 levels between the two groups (P = 0.021). Moreover, IL-33R (ST2) was slightly increased in the TB patients compared to the healthy controls, although statistical analysis showed no significant difference between the two groups (P = 0.083). Regarding the high normal variation of sST2 and the limitations of the present study, it is recommended that future studies of sST2 be performed in with higher number of TB patients.

Game theory describes the interactions between two players and the pay-off from winning, losing, or compromising. In the present study, Mycobacterium tuberculosis (Mtb)–host interactions were used as an example for the application of game theory to describe and predict the different outcomes of Mtb-infection and introducing target molecules for use in protection or therapy. The gene expression for eight main markers (CCR1, CCR2, IDO, Tbet, TGFβ, iNOS, MMP3, MMP9) of host response and three Mtb virulence factors (Ag85B, CFP-10, ESAT-6) were assessed in broncho-alveolar lavage of TB+ and TB- patients. The players’ strategies in the “Nash equilibrium”, showed that Ag85B is the main virulence factor for Mtb in active phase, and also the most immunogenic factor, if the host can respond by high expression of T-bet and iNOS toward a Th1 response. In this situation, Mtb can express high levels of ESAT-6 and CFP10 and change the game to the latency, in which host responses by medium expression of T-bet and iNOS and medium level of TGF-β and IDO. Consistently, the IDO expression was 134-times higher in TB+s than the TB-s,and the T-bet expression,~200-times higher in the TB-s than the TB+s. Furthermore, Mtb-Ag85B had a strong positive association with CCR2, T-bet and iNOS, but had a negative correlation with IDO. Ag85B and maybe ESAT6 (without its suppressive C-terminal) should be considered for making subunit vaccines. And, preventing IDO formation in dendritic cells might be a novel target for immunotherapy of tuberculosis, to reduce the pressure of immune-suppression on Th1 responses.

In the present study, we evaluated the 4-year antimicrobial resistance trends of several nosocomial pathogens during 2018-2021 in a reffereal Mashhad hospital, Mashhad, Iran.
In this study, we reviewed the data of 70,234 clinical isolates were registred Infection Control Data of Ghaem Hospital, Mashhad, Iran. The antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion method according to clinical and laboratory standard institute (CLSI) instructions to evaluate trends of antimicrobial resistance over the times.
There were identified (A. baumannii: n = 19,374; K. pneumonia n = 17,206; E. coli n = 23,777; S. epidermidis: n = 9,877). We did not find any significant difference in changes of antimicrobial trends over the time except in minor cases . However, The pattern of antimicrobial drug resistance was gradually differed except E. coli.
our results suggested the overall antimicrobial resistance trends was remins the same level during 2018-2021. It seems that in accessibility and stop prescribing of antibiotics can lead to decreasing antibiotic resistance rate.

The odds ratio with 95%CIs was used to evaluated the synergistic effects between high salt intake and H. pylori infection among gastric cancer cases. Heterogeneity was assessed by I2 index and Cochrane Q-test; In addition, the presence of publication bias was measured using Begg’s p-value and Egger’s p-value test (18). There were 7 studies met our criteria. These studies were conducted during 2003-2019 in Korea, Japan, United states, China, and Portugal. We evaluated data of 8,068 cases. H. pylori infection was confirmed by ELISA and UBT in these eligible studies (Table 1). The frequency of gastric cancer in habitual high salt intakes with positive H. pylori infection was significantly greater than those preference salty food with negative H. pylori infection (Chi-square: 5.33; p-value: 0.02). Our results suggested that there is a positive association between high salt intake and risk of gastric cancer in H. pylori infected-individuals (OR: 1.47; 95%CI: 1.01-2.15; p-value: 0.04; I2: 83.6; Q-value: 36.6; Begg’s p-value: 0.13; Egger’s p-value: 0.25) (Fig. 1). Gastric cancer is one of the top cause of cancer-related death in the world (1). Unfortunately, gastric cancer has a poor-prognosis and untreated early gastric cancer lesions will progress to advanced gastric cancer during 4-5 years (2). Gastric cancer is a heterogeneous malignancy with multifactorial causes including socio-economic status, diet, environmental condition, genetic polymorphism as well as infectious agents particularly chronic infection by Helicobacter pylori (3). In 1994, the International Agency for Research on Cancer (IARC) announced that H. pylori is considered as class I carcinogens and etiologic cause of human gastric cancer (4). However, a high rate of H. pylori infection in areas with a low incidence of gastric cancer remains an enigma (5). It has been suggested that H. pylori infection alone cannot cause gastric cancer without synergistic effects of lifestyle, diet, etc (6-7). On the other hand, there is evidence that dietary salt has an association with gastric adenocarcinoma (8-9). Therefore, it may that H. pylori infection and high salt intakes have synergistic effects in the development of gastric cancer. the previous studies reveal that salt cause upregulation of H. pylori cagA gene during in vitro experiments (10). We performed a comprehensive literature search in several databases including PubMed, Scopus, Embase, and Google scholar using search terms consisting “Helicobacter pylori”, “Salt”, “Gastric cancer”, “Dietary” and “Salt intake” without limitation in time and language. The potential relevant documents were evaluated and the required data such as first author, publication year, country, total cases, the frequency of high salt intake among H. pylori-infected cases with gastric cancer or odds ratio corresponding 95% confidence intervals (95%CIs), and H. pylori diagnostic test were summarized in Table 1. The odds ratio with 95%CIs was used to evaluate the synergistic effects between high salt intake and H. pylori infection among gastric cancer cases. Heterogeneity was assessed by I2 index and Cochrane Q-test; In addition, the presence of publication bias was measured using Begg’s p-value and Egger’s p-value test (18). There were 7 case-control studies that met our criteria. These studies were conducted during 2003-2019 in Korea, Japan, United states, China, and Portugal. We evaluated data of 8,068 cases. H. pylori infection was confirmed by ELISA and UBT in these eligible studies (Table 1). The sodium concentration was assessed by history, urinary sodium, as well as Food frequency questionnaires (FFQs) in these studies.The frequency of gastric cancer in habitual high salt intakes with positive H. pylori infection was significantly greater than those who preference salty food with negative H. pylori infection (Chi-square: 5.33; p-value: 0.02). Our results suggested that there is a positive association between high salt intake and risk of gastric cancer in H. pylori infected-individuals (OR: 1.47; 95%CI: 1.01-2.15; p-value: 0.04; I2: 83.6; Q-value: 36.6; Begg’s p-value: 0.13; Egger’s p-value: 0.25) (Fig 1). Tsugane et al, 2004 were suggested that there is a significant relation between salt intake and the subsequent risk of gastric cancer in a Japanese population (19). In addition, Ge et al., 2012 provided a systematic review to show the association between Habitual dietary salt intake and risk of developing to gastric cancer using 11 retrospective single-center studies (20).

Tuberculosis is one of the most important communicable infections in the health system. Knowing the presence or absence of the disease in health workers who can remain latent [LTBI] helps the health system by early detection of TB infection and timely use Prevent chemoprophylaxis from occurring. For this reason, all prestigious universities in the world and most health care centers have developed programs to prevent these people from developing the disease, including various aspects of prevention including before and after contact. These programs are tuberculin skin test (TST) to check for the presence of occult tuberculosis as a standard method of diagnosis. Since various factors influence the results of the TST test, this test may not be the definitive answer for infection in the individual. Therefore, in another test called IGRA (Interferon γ Release Assay) or QFT test (QuantiFERON-TB Gold In tube), the level of interferon gamma secreted by lymphocytes stimulated with specific Mycobacterium tuberculosis antigens is measured. More specifically, latent TB can be examined. Therefore, in this review study, in addition to reviewing available tests for latent tuberculosis, the results of various studies conducted in the country to evaluate the latency of latent tuberculosis among health workers in different diagnostic and treatment centers are compared.

This study aimed to compare the knowledge, attitude, and practice of the technicians and their supervision of dental clinics in Mashhad.

In this study, the researchers examined 84 clinics and distributed the questionnaire among the technicians. The quality of the sterilization was evaluated by biological and chemical indicators and the results of the questionnaire. The biological and chemical indicators were placed inside the autoclave. The questionnaire investigated the incubation method, autoclave numbers, device performance monitoring method, indicator type, device temperature and pressure, and the number of times the device was turned on during the day, as well as the knowledge, attitude, and performance of the technicians. The collected data were analyzed in SPSS software (version 19).

Based on the findings, class B autoclaves were used in only 59% of the clinics. It was revealed that 7%, 26%, and 31% of the clinics applied biological testing, chemical testing, and physical methods to assess autoclave performance, respectively. The results of biological tests were positive in 20% of clinics, and 11.9% of chemical indicators did not show sufficient color change. It was also found out the knowledge, attitude, and performance scores were significantly higher in the dental technicians than those in the physician technicians.

According to the results of this study, it is recommended that the technicians of the dental department of public clinics be dentists as well. Public clinics should pay more attention to the quality of sterilization and infection control. The improvement of the technicians' knowledge will lead to better performance and consequently to an increase in the quality of sterilization and infection control.

The world is currently challenging with the COVID-19 pandemic due to the SARS-CoV-2, a new member of coronaviruses which emerged in late December 2019. The rapid transmission of the disease made it a global concern that has attracted worldwide attention. As there have been no promising treatments or specific vaccines yet, the most important key to control the pandemic is an early diagnosis. Accordingly, performing diagnostic tests accelerates case detection and prevents further transmissions. Current available tests such as quantitative real-time polymerase chain reaction have some limitations. Therefore, new strategies should be developed for accurate and rapid detection of COVID-19, a life-threatening disease. Biosensing is one of the novel approaches for the SARS-CoV-2 detection, having the potential for rapid and early diagnosis to control this pandemic. RNA, antigens, and antibodies are the main targets in COVID-19 biosensors. Although there have been limited reported studies of COVID-19 biosensing strategies, this review summarized the recent progress in this field.

The sterilization cycle is one of the most important parts of infection control. Accordingly, the present study was conducted to assess the quality of steam sterilization and compare the knowledge, attitude, and practice of clinical directors in dental clinics, based on the experimental work in one of the most important and famous dental departments and clinics in the Northeast of Iran.

This cross-sectional study was conducted from June to September 2017 in 84 dental outpatient clinics of Mashhad, Iran. The status of sterilization quality was evaluated using biological (BI) and chemical indicators (CI) and the results of a questionnaire. The participants include the technical manager and operator of the Autoclave, who were included in this study according to the inclusion criteria by stratified cluster sampling. Information on their knowledge, practices, and attitudes were evaluated. Also, BI and CI were used to evaluate the autoclave accuracy. The data were analyzed by Mann Whitney U, Wilcoxon signed-rank, and Fisher’s exact tests using SPSS (Version 19, SPSS Inc., Chicago, IL, USA).

In this study, the results of 69 (82.1%) biological test were negative. Based on the questionnaire results, 64 (76%) clinics used CI, and only 4 (5%) clinics used CI and BI to evaluate the sterilization quality. The mean scores of attitude (P = 0.001), knowledge (P = 0.001), and practice (P < 0.001) of the technical manager in dental clinics were significantly higher than those in outpatient clinics. Also, there was a significant association between the knowledge and practice of the clinics’ technical managers (P < 0.001).

According to the results, 93.3% of the clinics that had a positive biological test were outpatient clinics. Also, it was revealed that insufficient knowledge, attitude, and practice lead to imperfect sterilization. Also, the mean score of dentists was higher than that of general practitioners, therefore, in addition to suggesting training programs for managers, it is recommended that employ a dental practitioner as the technical manager of outpatient clinics. In order to control infection in clinics, it is recommended to monitor the sterilization process in clinics according to the instructions of the monitoring units.