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reza khashei

  • Nima Davari, Reza Khashei *, Bahman Pourabbas, Vajiheh Sadat Nikbin, Farid Zand
    Objective (s)

    The worldwide emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a major therapeutic concern to medical institutions. To date, no study has determined the frequency and risk factors of inpatients with CRE fecal carriage in Southern Iran. We studied the features of carbapenemase-producing Enterobacteriaceae (CPE) collected from the central ICU of a university hospital.

    Materials and Methods

    Totally, 173 samples, including 124 stool samples from 46 ICU inpatients on admission and different follow-ups, 9 ICU staff, and 40 environmental samples were included. CRE was identified using microbiological methods. Antimicrobial susceptibility was investigated by using the disk diffusion method and E-test. Carbapenemase producers were detected using the mCIM method. Seven carbapenemase genes were characterized. The genetic relationship among 20 CPE was elucidated by PFGE. 

    Results

    The overall fecal carriage rate was 28.2%, while CRE acquisition was 6.1%. CRE were classified as Klebsiella pneumoniae (71.4%), Escherichia coli (23.8%), and Enterobacter aerogenes (4.8%). From 21 CRE, 20 (95.2%) produced carbapenemases, of which 10, 15, 10, 25, 5, and 65% were blaKPC, blaSME, blaIMP, blaVIM, blaNDM and blaOXA-48-positive, respectively. Out of 20 CPE, 14 different PFGE patterns were observed, categorized into six clusters, suggestive of non-clonal spread. No difference between the examined risk factors with CRE carriage was shown. 

    Conclusion

    The data indicate a high CRE fecal carriage rate among inpatients. Our findings implicate the widespread of OXA-48 carbapenemase together with heterogeneity among CRE with great concern for dissemination and therapeutic threat. Early diagnosis and monitoring of CRE among inpatients are urgent.

    Keywords: Antibiotic resistance, Carbapenemase, Enterobacteriaceae, Fecal carrier, PFGE
  • Melika Moradi, Reza Khashei*, Yalda Malekzadegan, Jamal Sarvari
    Backgrounds

    The global spread of carbapenemase-producing Enterobacteriaceae represents a public health concern. This study aimed to investigate the prevalence of carbapenem resistance and the presence of some oxacillinase types and class 1-3 integrons among Enterobacter clinical isolates from an Iranian inpatient population.

    Materials & Methods

    Ninety Enterobacter isolates from hospitalized patients were diagnosed by microbiological methods. Antibiogram pattern was also determined. The presence of class 1-3 integrons and four types of oxacillinase genes was assessed using PCR.

    Findings

    Among 90 Enterobacter isolates, the most common species was E. aerogenes, (45.6%), followed by E. cloacae (30%). The highest resistance rate was against ampicillin (96.7%). Multi-drug resistance (MDR) was substantial (93%). Carbapenemase-producers were detected in 96% of carbapenem-resistant isolates by mCIM test. The frequency of evaluated genes was as follows: intI1 = 50 (55.6%), intI2 =12 (13.3%), blaoxa-1 =6 (6.7%), blaoxa-2 =5 (5.6%), blaoxa-10 =18 (20%), and blaoxa-48 =18 (20%).

    Conclusion

    Determinants of class 1 integron along with OXA-10 and OXA-48 like carbapememases are responsible for relatively considerable carbapenem resistance among isolates. This is the first report about the presence of OXA-10 and OXA-48-producing Enterobacter spp. in Iran, indicating that the prevalence of oxacillinases in the country might be on the rise.

    Keywords: Enterobacter, Carbapenemase, Oxacillinase, Integron, Iran
  • Reza Khashei *, Fatemeh Edalati Sarvestani, Yalda Malekzadegan, Mohammad Motamedifar
    Objective(s)
    Prompt detection of extended-spectrum β-lactamases (ESBL) and carbapenemase-producing enterobacteriaceae is crucial for infection prevention and control strategies. The present study aimed to characterize the ESBL and carbapenemase genes among Enterobacter isolates from an Iranian inpatient population.
    Materials and Methods
    A total of 96 Enterobacter isolates obtained from inpatients between June 2016 and March 2017, were identified by the conventional microbiological methods and diagnostic kits. Antimicrobial susceptibility pattern was performed using the disk diffusion method. The ESBL and carbapenemase genes were screened using polymerase chain reaction (PCR).
    Results
    All clinical isolates of Enterobacter were classified as E. gergoviae (52, 54.2%), E. aerogenes (34, 35.4%), E. cloacae (7, 7.3%), Cronobacter (E). sakazakii (3, 3.1%). The highest and lowest antimicrobial resistance rates were observed against ampicillin (93.8%) and imipenem (21.9%). High prevalence of multi-drug resistance (MDR=96.9%) was substantial. Of the 96 Enterobacter isolates, 35 (36.5%) and 28 (29.2%) were phenotypically ESBL-positive and non-susceptible carbapenem, respectively. Overall, the frequency of evaluated genes was as follows: blaCTX-M =25 (26%), blaTEM =30 (31.3%), blaSHV =12 (12.5%), blaIMP =3 (3.1%), blaVIM =0 (0%), blaNDM =8 (8.3%), and blaKPC =0 (0%).
    Conclusion
    In this study, we report for the first time the presence of E. gergoviae harboring blaNDM from an Iranian population. Regarding the increase of MDR Enterobacter spp. in our region, strict hygiene rules will be needed to control the quick spread of ESBL and carbapenemase-producing Enterobacter isolates in healthcare facilities of developing countries.
    Keywords: Antimicrobial resistance β, lactamase blaNDM, 1 Carbapenems Enterobacter
  • رضا خاشعی*
    مقوله سلامت تاثیر انکارناپذیری در توسعه جوامع دارد. همین امر وظیفه سیاست گذاران حوزه سلامت را پیچیده تر می کند. امروزه با توجه به کنترل بیماری های واگیر و افزایش طول عمر افراد، بیماری هایی شایع شده اند که کاملا به تغذیه انسان ارتباط دارند. اغلب جامعه شناسان امروزی بر این باورند که سبک زندگی افراد می تواند آنان را سالم نگه دارد یا بیمار کند. در این میان جهانی شدن نیز چالش های جدیدی در زمینه های مختلف پیش روی سیاست گذاران سلامت قرار داده است؛ چالش هایی که باعث ایجاد تغییراتی در الگوی مصرف مردم و سبک زندگی آنان به ویژه در حوزه سلامت شده است. از طرف دیگر، رسانه های جمعی نیز علاوه بر حضور گسترده در زندگی افراد، به عنوان منبع اصلی کسب اطلاعات مربوط به سلامتی، اثرات مهمی بر سلامت عمومی گذاشته اند.هدف این مقاله آن است که با روش مطالعه اسنادی و تحلیل ثانویه و با استفاده از یافته های پژوهش های قبلی در زمینه ی مورد بحث، به پرسش های زیر پاسخ دهد:
    میزان همسویی در دستگاه های متولی امر سلامت چگونه است؟
    آیا در این راستا از رسانه های جمعی برای فرهنگ سازی مقوله سلامت به درستی استفاده می شود؟
    آیا مردم به عنوان مصرف کنندگان پیام های سلامتی مطابق با سیاست های کلان سلامت زندگی می کنند؟

    یافته های این تحقیق نشان از فقدان هماهنگی و هم سویی کامل بین سیاست های بالادستی نظام سلامتی کشور ما با سیاست های رسانه های جمعی، همچنین ناهماهنگی در اجرای سیاست های داخلی وزارت بهداشت و درمان و نهایتا منطبق نبودن نیازهای مردم با سیاست های رسانه های جمعی دارد.
    کلید واژگان: ارتباطات سلامت, سلامت عمومی, سیاستگذاری سلامت
    Reza Khashei *
    Health of the community has always been one of the biggest and most important concerns of policy makers. This concern has a relatively great impact on the community’s development. This field is of great importance in all countries and makes the task of policy makers more complicated. At the present time, due to the control of contagious diseases and increased life span, there are diseases that are completely related to human nutrition. In the meantime, globalization has also brought new challenges to health policy makers, challenges that have brought about changes in patterns of people’s consumption and their lifestyle, especially in the health field. In this article, the research is conducted by studying library documents and secondary analysis together with findings of previous researches, in order to answer some questions such as: how is the degree of alignment in healthcare system? Has the mass media been used properly to culturalize health? And do people as health consumers live according to the health policies? The findings of the research indicate that there is a lack of coherence and perfect alignment between the high level policies of the health system of the country, likewise with the mass media policies. There is also some inconsistencies in the implementation of the domestic policies of the Ministry of Health and above all, the people’s needs does not meet with the policies of mass media.
    Keywords: Health Communications, public health, health policy, Integration in Health Policy
  • سید محمد مهدی زاده، رضا خاشعی
    تلاش های شتاب زده ای که در سده های اخیر برای گسترش ارتباطات بشری صورت گرفته، اثرات معکوسی بر سلامت همه انسان ها داشته و مسائل بهداشتی تازه ای را برای آنها به ارمغان آورده است. در این مقاله تلاش شده است تا با روش پژوهش ترکیبی، ابتدا محتوای پیام های سلامتی تولید شده در رسانه های جمعی منتخب: رادیو، تلویزیون، وب سایت سلامت نیوز و هفته نامه سلامت، استخراج و سپس، سبک های زندگی سلامت مردم شهر تهران به همراه میزان مصرف رسانه ای آنها، از طریق پیمایش با نمونه آماری 802 نفر از شهروندان 18 ساله و بالاتر، شناسایی شود تا در نهایت، مورد تجزیه وتحلیل قرار گیرد. نتایج به دست آمده حاکی از آن است که بین مصرف رسانه ای افراد و سبک زندگی سلامت محور آنها؛ همچنین بین سبک زندگی سلامت محور افراد و پایگاه اجتماعی و اقتصادی آنها، ارتباط معناداری وجود دارد. نتایج حاصل از بخش تحلیل محتوا نیز حاکی از آن است که در هر چهار رسانه یاد شده، میزان پرداختن به بعد جسمانی سلامت در رتبه اول قرار دارد و پس از آن، ابعاد «اجتماعی»، «روانی» و «معنوی» به ترتیب، بیشترین فراوانی و مدت زمان را به خود اختصاص داده اند.
    کلید واژگان: سبک زندگی سلامت محور, مصرف رسانه ای, پایگاه اجتماعی, اقتصادی, ارتباطات و سلامت, رفتارهای سلامت محور
    S.Mohammad Mahdizadeh, Reza Khashei
    Hasty endeavors to promote human communication in recent years have had repercussions on human health and brought new health issues to them. In the paper, we first tried to extract the content of health messages released in selected mass media: radio, television, Salamat News website, and Weekly Newspaper, and define the Healthy Lifestyles of people in Tehran. Data collected through survey from a sample of 802 people aged 18 and more, then it was analized. The results showed that there is a significant relationship between the media consumption of individuals and their health-oriented lifestyle; there is also a significant relationship between the health-oriented life style and social-economic position. Also, the results of content analysis showed that paying attention to the dimension of body health is on the high level of ranking in all four media, subcequently are social, psychological, and moral dimensions’ in terms of frequency and time being covered.
    Keywords: Health-Oriented Lifestyle, Media Consumption, Socioeconomic Position, Communication, Health, Health-Oriented Behaviors
  • Zahra Sedarat, Reza Khashei, Hedayatollah Shirzad, Nader Bagheri, Marzieh Sadeghiani, Heshmat Shahi, Behnam Zamanzad *
    Background
    Helicobacter pylori has been recognized as the most common pathogen of human gastroduodenal tract and it has been suggested that adhesins, including HopQ and SabA, are associated with the organism’s virulence.
    Objectives
    The current study aimed at determining the frequency of hopQI, hopQII, and sabA genes among H. pylori isolates from patients with gastroduodenal disorders in Shahrekord, Iran.
    Methods
    Gastric corpus samples were obtained from 150 symptomatic patients admitted to the endoscopy unit at gastroenterology clinic. After DNA extraction from all corpus samples, H. pylori molecular confirmation and genotyping was performed by the polymerase chain reaction (PCR), using specific primers for glmM, 16SrRNA and hopQ, sabA genes, respectively.
    Results
    The hopQI, hopQII, and sabA genes were found in 74 (49.3%), 59 (39.3%), and 43 (28.7%) cases, respectively. The hopQI gene was detected in 75% of patients with gastric cancer (GC), 42.4% with chronic gastritis (CG), and 57.4% with peptic ulcer disease (PUD). The hopQII among patients with GC, CG, and PUD was also detected in 50%, 38.8%, and 39.3%, respectively. Moreover, sabA was diagnosed in 50% of patients with GC, 29.4% with CG, and 26.2% with PUD.
    Conclusions
    No significant association was observed between hopQI, hopQII, and sabA genes with clinical outcomes.
    Keywords: Gastroduodenal Diseases, Helicobacter pylori, hopQ, sabA
  • Shahab Mahmoudvand, Khosrow Zamani, Akbar Safaei, Reza Khashei, Mohammad Motamedifar, Zohre Azizi, Jamal Sarvari*
    Background
    Worldwide, colorectal cancer is the fourth most common cause of cancer-related deaths. Infectious agents have long been associated with development of gastrointestinal malignancies including colorectal cancer. Therefore, the aim of this study was to detect Streptococcus gallolyticus subsp. gallolyticus and Helicobacter pylori in colorectal cancer tissue specimens in comparison with healthy tissue specimens.
    Methods
    A total of 210 tissue samples including 70 adenocarcinoma colorectal tissue, 70 adenomatous polyposis colorectal tissues, and 70 normal colorectal tissues were subjected to DNA extraction. The quality of the extracted DNA was confirmed by the amplification of a β-globin fragment using polymerase chain reaction (PCR). The presence of sod and glm genes were evaluated as Streptococcus gallolyticus and H. pylori presence markers by PCR method, respectively.
    Results
    Out of 210 subjects, 112 were male and the rest were female. The age of our patients ranged from 22 to 87 with an average of 54 years. None of the samples in two studied groups were positive for the sod and glm genes.
    Conclusions
    According to our results, S. gallolyticus subsp. gallolyticus and H. pylori might not be involved in colorectal cancer pathogenesis. More investigation on huge sample in different area might be clarified this results.
    Keywords: Colorectal Cancer, Helicobacter pylori, Streptococcus gallolyticus
  • Mehrdad Zalipour, Hadi Sedigh Ebrahim, Saraie, Jamal Sarvari, Reza Khashei *
    Background
    Biofilm formation capacity is recognized as an important virulence factor in staphylococci that makes the organisms more resistant to antibiotics and host defenses..
    Objectives
    This study aimed to determine the biofilm producing ability and presence of icaA/D genes in staphylococcal isolates obtained from different clinical specimens..
    Methods
    This cross-sectional study was performed on a total of 151 staphylococcal isolates (79 Staphylococcus aureus and 72 S. epidermidis) obtained from different clinical specimens from February to August 2013 in Shiraz, Southwest of Iran. Slime production ability was evaluated using the both phenotypic (by cultivation of staphylococcal isolates on Congo red agar (CRA)) and genotypic (detection of the presence of icaA/D genes by PCR) methods..
    Results
    Overall, of the 79 S. aureus isolates tested with CRA method, 64.7% of methicillin-resistant S. aureus (MRSA) isolates, and 46.7% of methicillin-sensitive S. aureus (MSSA) isolates were able to produce biofilm. The relative frequency of biofilm producing S. epidermidis isolates was 70.8% that was significantly higher than that of S. aureus isolates. The most common source of biofilm producing isolates in both S. aureus and S. epidermidis isolates was endotracheal tube (ETT) with 100% biofilm formation. Moreover, the presence of icaA/D genes was detected in 63.3% and 81.9% of S. aureus and S. epidermidis isolates, respectively..
    Conclusions
    The remarkable rates of biofilm production ability among clinically isolated staphylococci emphasize the necessity of more effective infections control policies to prevent biofilm formation on medical devices and hospital environmental surfaces..
    Keywords: MRSA, Biofilm, Antibiotic Resistance, Staphylococcus
  • محمدسعید ذکایی، ابوعلی ودادهیر، رضا خاشعی
    امروزه با توجه به کنترل بیماری های واگیردار و افزایش طول عمر جوامع بشری، بیماری هایی بوجود آمده اند که کاملا به تغذیه ی انسان ها ارتباط دارند. انواع سرطان، چاقی، دیابت، فشارخون از جمله بیماری هایی هستند که توجه کارشناسان را به مسئله تغذیه و سلامت دوچندان کرده است. کنترل بیماری های غیرواگیر تاحدود زیادی نشئت گرفته از سبک های زندگی غلطی است که منجر به انواع بیماری ها و مرگ و میر های زودرس شده اند. امروزه جامعه شناسان براین باورند که این سبک های زندگی افراد است که می تواند آنان را سالم نگه دارد یا به بیماری مبتلا کند. در این میان، غالب افراد بر این باورند که در زمینه سبک های زندگی، خودشان دست به انتخاب می زنند درحالی که تا حدود زیادی اینگونه نیست. در این پیمایش تلاش شده است تا پارامترهای تاثیرگذار (شامل: مصرف رسانه ای افراد، پایگاه اقتصادی – اجتماعی) بر روی سبک زندگی سلامت محور شهروندان مناطق 22 گانه شهر تهران مورد مطالعه قرار گیرد. نتایج به دست آمده از این پیمایش (با نمونه آماری 802 نفر از افراد 18 سال به بالا) حاکی از آن است که بین مصرف رسانه ای افراد و سبک زندگی سلامت محور و همچنین بین سبک زندگی سلامت محور افراد و پایگاه اجتماعی و اقتصادی آنها ارتباط معناداری وجود دارد. به عبارت دیگر، سبک های زندگی سالم تر بیشتر در بین افرادی که مصرف رسانه ای بالاتری دارند، مشاهده شده است.
    کلید واژگان: سبک زندگی سلامت محور, مصرف رسانه ای, پایگاه اجتماعی, اقتصادی, ارتباطات وسلامت, رفتارهای سلامت محور
    Mohammad Saeed Zokaei, Abouali Vedadhir, Reza Khashei
    Introduction and Problematic of Research: Nowadays, improvements in health are considered to be an achievement. It is something that people should work on that to promote their quality of life, and if they dont do so, they would risk being affected by chronic diseases and untimely death. Given the ability to control infectious diseases and human being increased life expectancy, in today's society certain illnesses have developed that have something to do with nutrition. All kinds of cancers, obesity, diabetes, high blood pressure are among diseases requiring the doubled attention of experts to nutrition and health-related issues. For the time being, controlling non-infectious diseases needs more serious and delicate treatments; these diseases stem much from improper lifestyles, leading to all kinds of illnesses and ultimately premature death. Nowadays, sociologists believe it is the lifestyle of individuals that provide an effective guarantee for their health otherwise there is a risk for development of an unhealthy society. Accordingly, most people unrealistically assume it is them who choose their own lifestyles; this is while the reality shows otherwise. The choices of most people take place within a limited structure, one that plays a key role in adjusting individual's choices (Mirzaei et al, 2010: 114). Meanwhile, globalization has brought about new challenges for health policymakers; these challenges prompt changes in people's consumption pattern and lifestyle, particularly in health-related areas. Furthermore, mass media have affected significantly the public health by their role in individual's lives and as the main source of health-related information (Nandy and Nandy, 1997: 238). In the present day, the relationship between mass media and health issue is a reciprocal one. On the one hand, health promotion is an important area of coverage for media, and on the other, health needs to be promoted by media due to its mission for awareness-making (Kia et al, 2012: 111). This is where the problematic of our research resides.
    Theoretical Framework: The theoretical framework for this study draws upon William Cockerham's Health Lifestyles Model. Cockerham believes that the type of experiences and the process of socialization, which itself is the product of different structural variables, provides capacities for life choices based on which individuals choose and assess their actions, giving them the ability to interpret their conditions, making choices and organize their behaviors in accordance with their mentalities (Cockerham, 2013: 138).
    However, other factors related to media consumption and the role and status of media in the process of people's sociability are added to this research, because Cockerham's model does not directly deal with media consumption and the level of using this component by individuals. Given the role and influence of media in people's everyday lives and their instructive role in all areas, particularly in health domain, it seems this aspect is a necessity which somehow completes Cokerham's model.
    Methodology
    It is worth noting that this study uses the capacities of survey methods. The present research, as a Ph.D. thesis in Social Communications in Allameh Tabatabaee University was carried out in Tehran, surveying a sample of 802 individuals (the age of 18 and above). In this survey, the researchers tried to study the key factors (including, people media consumption, social-economic status) affecting the health lifestyle of citizens in all 22 Municipal Districts of Tehran.
    Some of the objectives of this research include: identifying the manner and the extent to which Tehran citizens have access to health-related messages produced by media; recognizing the quantity and quality of behaviors and health lifestyles of the individuals; assessing the health lifestyle of Tehran citizens base on the amount of media consumption and social and economic class of the individuals.
    Finding and
    Discussion
    This paper which is written based on the research, tries to demonstrate the extent to which Tehran citizens have a healthy lifestyle; it also seeks to explain the factors affecting health lifestyle choices. It neednt to say that adopting a healthy lifestyle allows everyone to have some personal control on his own health condition as a preventive measure. The findings indicate that there is a significant relationship between individual's media consumption and their health lifestyle. There is also a significant relationship between health lifestyles and social and economic class of individuals. In other words, healthier lifestyles were observed among individuals with more media consumption. Other findings show that only 9% of the respondents had''healthy” lifestyles and 45% had a "somehow healthy" lifestyle. In terms of the Body Mass Indicator (BMI), around 40% of the individuals were obese. Men compared to women had a healthier lifestyle and behaviors; it was also found that people with healthy lifestyle are more persistent than other media active audience in pursuing media health-related programs. Furthermore, the finding indicated that lower social-economic class has to do with the lower media consumption.
    There was also a relationship between the respondent's social-economic status and the following variables: the amount of out-eating; the number of annual medical check-ups; the amount of medicines taken; self-treatment frequencies; observing traffic law. As the social-economic class went higher, the abovementioned variables ascended accordingly.
    Wholly, the findings indicate that those class which have higher media consumption and pursue health-related news more, have a healthier lifestyle. Also, men have a healthier lifestyle than women, which do not confirm the findings of Cockerham's global studies. Also women have a higher Body Mass Indicator (BMI) than men, which indicates women are more fat and obese than men.
    Given the mentioned findings, this paper suggests: for having a healthier society in future, one should focus on health through communications and putting the center of attention on women; to reach this goal and promote media consumption among people from all walks of life, health-focused synergic education in all mass media (radio, TV, the Internet and press) is needed.
    Keywords: Health Lifestyle, Media Consumption, Social, Economic Class, Communications, Heath, Health, centered Behaviors
  • رضا خاشعی*، محمدسعید ذکایی
    از آنجا که بشر امروزی غرق در رسانه های جمعی است، شایسته است با در نظر گرفتن تاثیرات قدرتمند رسانه ها، دریابیم که آیا فراگیری و تراکم پیام های سلامت محور رسانه ای، می تواند بسترساز انتخاب نوعی سبک زندگی سلامت محور برای آحاد جامعه باشد؟ بدیهی است در عصر حاضر اتخاذ سبک زندگی سلامت محور به مردم این امکان را می دهد تا به عنوان اقدامی پیشگیرانه، بر سلامت خود کنترل و مراقبت بیشتری داشته باشند. در این مقاله با استفاده از روش تحلیل محتوا، پیام های سلامت محور تولید شده در چهار رسانه (رادیو سلامت، تلویزیون، وب سایت سلامت نیوز و هفته نامه سلامت) به تفکیک چهار بعد سلامت (جسمانی، اجتماعی، روانی و معنوی) و با نگاهی تطبیقی بررسی و تحلیل شده اند. نتایج به دست آمده در بازه زمانی مورد بررسی (در سال 1392) حاکی از آن است که در هر چهار رسانه مذکور، میزان پرداختن به بعد جسمانی سلامت در رتبه نخست قرار دارد و پس از آن ابعاد «اجتماعی»، «روانی» و در نهایت بعد «معنوی» به ترتیب بیشترین فراوانی و مدت زمان را به خود اختصاص داده اند.
    کلید واژگان: سبک زندگی سلامت, سلامت جسمانی, سلامت روانی, سلامت اجتماعی
    Reza Khashei, Mohammad S. Zokaei*
    Since today’s man is immersed with mass media and given the powerful effect of media, it is necessary to find whether the ubiquity and density of media health-related messages could provide a ground for choosing a health-centered lifestyle or not? Needless to say, in the current era, adopting a health-centered lifestyle could give the people the option to take care of the health before-hand as a preventive measure. In this article, content analysis is used to analyze the health-centered messages produced Four Media (Health Radio, Television, Salamat-News Website, Health Weekly Magazine in terms of such health-related dimensions as physical, social, mental and spiritual. The findings indicate that in the selected period, (1392 Iranian calendar), in all the selected media outlets, the physical aspect is prioritized. Social aspect, mental aspect and finally spiritual aspect are orderly the other priorities.
    Keywords: Health Lifestyle, Physical Health, Mental Health, Social Health
  • Reza Khashei, Khosrow Zamani, Mohammad Kaveh, Mohammad Motamedifar, Hadi Sedigh Ebrahim, Saraie
    Background
    Staphylococcus aureus nasal carriage plays an important role in the epidemiology and pathogenesis of infections, and this status accounts for both community-acquired and nosocomial infections..
    Objectives
    This study was conducted to determine the frequency of the nasal carriage of S. aureus in healthy medical students..
    Patients and
    Methods
    This cross-sectional study was undertaken among medical students from August of 2012 until January of 2013. Nasal samples from both anterior nares were obtained from the subjects using sterile moistened swabs, and the isolates were identified as S. aureus by the standard microbiological tests. The antibiotic susceptibility profiles were determined by the disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines..
    Results
    Out of the 200 nasal swabs obtained, the overall nasal carriage of S. aureus was 24.5% (49/200). The prevalences of the methicillin-susceptible and resistant Staphylococcus aureus nasal carriage were 20% (40/200) and 4.5% (9/200), respectively, while the antibiotic susceptibility tests revealed that all 49 S. aureus isolates were sensitive to mupirocin..
    Conclusions
    Despite the higher frequency of S. aureus nasal carriage in the interns, compared to the first year students, the difference did not reach statistical significance. Therefore, attendance at medical centers cannot be considered a risk factor for increasing carriage..
    Keywords: Nasal Carriage, Antibiotic Resistance, Staphylococcus aureus
  • Maryam Nejabat, Reza Khashei, Abdollah Bazargani, Hadi Sedigh Ebrahim, Saraie, Mohammad Motamedifar
    The spread of methicillin-resistant Staphylococcus aureus (MRSA) is a major concern in medical centers. These isolates are considered in serious infections and nosocomial outbreaks worldwide. Mupirocin is one of the most important antibiotics used topically for the treatment of various staphylococcal and streptococcal skin infections. We aimed to use a combination of phenotypic and genotypic methods to evaluate the prevalence of mupirocin resistance among MRSA clinical isolates which had previously been collected during the period 2008-2009 in Shiraz, Iran.
    Methods
    This study was performed on a total of 167 clinical isolates of MRSA from Shiraz teaching hospitals. The isolates were identified as S. aureus using standard microbiologic procedures and confirmed as MRSA isolates by 30 μg cefoxitin discs and mecA gene detection. All isolates were investigated for the mupirocin resistance by mupirocin discs 5 µg and the presence of mupA gene by PCR.
    Results
    Antibacterial susceptibility tests against mupirocin disc 5 µg and PCR analysis for totally 167 MRSA clinical isolates showed no resistance to mupirocin.
    Conclusion
    In summary, fortunately regarding to absence of resistance to mupirocin among all the studied MRSA isolates, this resistance seems is not a threatening factor in studied hospitals. However, generalized our findings to whole hospitals wards and Shiraz general population afford larger sample size and periodic surveillance in further studies for detecting mupirocin resistance.
    Keywords: Staphylococcus aureus, MRSA, Mupirocin, Antibiotic resistance
  • Mohammad Motamedifar, Hadi Sedigh Ebrahim, Saraie, Davood Mansury, Reza Khashei, Zahra Hashemizadeh, Abdolhalim Rajabi
    Background
    Urinary tract infections (UTIs) are one of the most common bacterial diseases. The etiological agents and emergence of antimicrobial resistance UTIs vary according to time and geographical region..
    Objectives
    The present study aimed to determine the prevalence of etiological agents of UTIs and determine their antimicrobial susceptibility pattern to locally available antibiotics..Patients and
    Methods
    This descriptive cross-sectional study was conducted within six months on all patients with clinical symptoms of UTI who referred to Nemazee Teaching hospital, Shiraz, Iran. Clean catch midstream urine samples were collected and cultured on appropriate media in a short time as possible. Conventional bacteriological methods were followed for the isolation and identification of the bacteria. Antimicrobial susceptibility profiles were determined by locally available antibiotics by using disk diffusion method in accordance with CLSI recommendation..
    Results
    In this study, from overall 9991 specimens analyzed 848 (8.5%) culture had significant bacterial growth. Of the total positive cultures, 500 (59%) cases were female. Escherichia coli (50.6%) was the predominant gram-negative isolated pathogen followed by Klebsiella spp. and Enterobacter spp., respectively. Enterococcus isolates (11.2%) was the most isolated gram-positive cocci. Nitrofurantoin (80.9%), gentamycin (77.9%) and amikacin (65.3%) had the most in-vitro antibacterial effect on E. coli isolates as the predominant cause of UTIs..
    Conclusions
    The results of regional assessments, such as our study, provide not only useful information for prescription of more effective empirical therapy, but also good epidemiological background for comparison of our situation with other regions.
    Keywords: Urinary Tract Infections, Microbial Sensitivity Tests, Escherichia coli, Pediatrics, Age
  • Reza Khashei, Hadi Sedigh Ebrahim, Saraie, Mohammad Motamedifar, Mehrdad Zalipour, Jamal Sarvari
    Introduction
    Biofilm producing Staphylococcus aureus is known as one of the major causative agents of infections, failure of implanted devices and persistent infection among hospitalized patients. The aim of the present study was to determine the frequency of biofilm producing S. aureus isolates amongst the clinical specimens.
    Methods
    This cross-sectional study was conducted during 2012 to 2013 in two teaching hospitals in Shiraz, southwest of Iran. Totally, 345 S. aureus isolates from various clinical specimens were included. Biofilm producing isolates were phenotypically detected using Congo Red Agar (CRA) and genotypically by PCR assay for the icaA and icaD genes.
    Results
    Of the 345 S. aureus isolates, 42.3% were methicillin-resistant S. aureus (MRSA) and subsequently 57.7% were methicillin susceptible isolates. The results of CRA plates showed that 77 (52.7%) and 74 (37.2%) of MRSA and MSSA were biofilm producing isolates. The frequency of icaA/D genes among MRSA and MSSA isolates was 127 (87%) and 167 (83.9%), respectively.
    Conclusion
    Such a high rate of icaA/D harboring S. aureus among clinical isolates suggest the risk for establishing persistent infections in the hospital settings.
  • Detection of icaA/icaD Genes and Biofilm Formation among Clinical Isolates of Staphylococcus aureus from Shiraz, Iran
    Reza Khashei, Hadi Sedigh Ebrahim, Saraie, Mohammad Motamedifar, Mehrdad Zalipour, Jamal Sarvari
    Introduction
    Biofilm producing Staphylococcus aureus is known as one of the major causative agents of infections, failure of implanted devices and persistent infection among hospitalized patients. The aim of the present study was to determine the frequency of biofilm producing S. aureus isolates amongst the clinical specimens.
    Methods
    This cross-sectional study was conducted during 2012 to 2013 in two teaching hospitals in Shiraz, southwest of Iran. Totally, 345 S. aureus isolates from various clinical specimens were included. Biofilm producing isolates were phenotypically detected using Congo Red Agar (CRA) and genotypically by PCR assay for the icaA and icaD genes.
    Results
    Of the 345 S. aureus isolates, 42.3% were methicillin-resistant S. aureus (MRSA) and subsequently 57.7% were methicillin susceptible isolates. The results of CRA plates showed that 77 (52.7%) and 74 (37.2%) of MRSA and MSSA were biofilm producing isolates. The frequency of icaA/D genes among MRSA and MSSA isolates was 127 (87%) and 167 (83.9%), respectively.
    Conclusion
    Such a high rate of icaA/D harboring S. aureus among clinical isolates suggest the risk for establishing persistent infections in the hospital settings.
  • Arshid Yousefi-Avarvand, Reza Khashei, Hadi Sedigh Ebrahim-Saraie, Amir Emami, Kamiar Zomorodian, Mohammad Motamedifar
    Pseudomonas aeruginosa as an opportunistic pathogen produces several virulence factors. The most important of these factors are exotoxin A and type III secretion system (T3SS). The aim of this study was to determine the frequency of toxA, exoU and exoS genes among clinical isolates of P. aeruginosa. In this cross-sectional study from September 2011 to February 2012, 156 P. aeruginosa isolates were recovered from different clinical samples. Susceptibility testing against 10 antibiotics was performed on individual isolates by the disc diffusion method according to CLSI guidelines. Extracted DNA was subjected to PCR assay for determining the presence of toxA, exoU and exoS genes. Overall, the frequency of toxA, exoU and exoS genes were 90.4%, 66.7% and 65.4%, respectively. All of the abdominal and eye isolates were exoS+. The frequency of exoS+/exoU- and exoS-/exoU+ genotypes was estimated 19.2% and 16.2%, respectively. Indeed, genotypes exoS+/exoU+ and exoS-/exoU- were found with frequencies of 48.7% and 15.3%, respectively. The highest and lowest antibiotic resistance rate was seen against azteroenam (94.2%) and amikacin (44.9%), respectively. Fluoroqinolone-resistant isolates were isolated with frequency of 45.8%. Multi-drug resistant (MDR) isolates were detected in 62.8% of isolates. The resistance rate in exoU+ isolates was 86% compared to 66% in exoS+ isolates. The high frequencies of virulence genes detected in our clinical isolates with notable antibiotic resistance rates indicate the potential risk of these isolates in nosocomial infections.
    Keywords: Pseudomonas aeruginosa, exotoxin A, exoenzyme S, exoenzyme U
  • Kamiar Zomorodian*, Mohammad Javad Rahimi, Mohammad Taheri, Ali Ghanbari Asad, Soghra Khani, Iman Ahrari, Keyvan Pakshir, Reza Khashei
    Background
    Anabolic-androgenic steroids (AAS) abuse by the athletes has dramatically increased during the recent decades. These substances might increase the skin lipids and enhance the cutaneous microbial proliferation.
    Objectives
    The current study aimed to investigate the potential side effects of AAS on the bacterial microflora colonization of the bodybuilders` skin. Patients and
    Methods
    The skin samples of 94 male bodybuilders (71 AAS users، 23 non-AAS users) and 46 subjects of the control group، with similar gender and age، were cultured and incubated in both aerobic condition to isolate Staphylococcus aureus and anaerobic condition for Propionibacterium acnes. The isolated bacteria were identified by standard microbiological techniques.
    Results
    The skin lesions were more frequent in the body builders than the controls. Moreover، statistically significant differences were also observed in skin lesions among the AAS users and the non-AAS user athletes. The prevalence of S. aureus and P. acnes in the athletes was higher than that of the control group. In addition، there was a significant difference in distribution of P. acnes between the bodybuilders who used AAS and those who did not.
    Conclusions
    A higher number of bacterial flora was found in the bodybuilders particularly those using AAS in comparison to the controls، which might be due to the influence of these AAS on the skin microflora and transmission of the bacteria through the direct contact of the naked skin with the exercise instruments.
    Keywords: Athletes, cutaneous, Staphylococcus aureus, Drug Abusers
  • S Asghar Havaei, Parviz Mohajeri, Reza Khashei, Rasoul Salehi, Hamid Tavakoli
    Background

    It is believed that the Helicobacter pylori (H. pylori) vacA gene, as a major virulence determinant (One of the major virulence determinant, not major), may be a risk factor for the development of gastroduodenal diseases. The frequency of vacA genotypes varies in different human populations. This study evaluated the prevalence of vacA alleles/genotypes among dyspeptic patients in Isfahan.

    Materials and Methods

    One-hundred H. pylori-positive adult patients were examined in this study. After culture of gastric biopsies and DNA extraction from individual H. pylori isolates, the (all H. pylori strains harbor vacA alleles, please replace "presence" with "genotypes") of the vacA s and m alleles were determined using polymerase chain reaction (PCR).

    Results

    There were four vacA mosaicisms, including 28 for s1a/m1 (28%), 23 for s1b/m1 (23%), 26 for s1a/m2 (26%) and 23 for s1b/m2 (23%). The s2 allele was not found. The predominant vacA genotype in patients with non-ulcer dyspepsia and duodenal ulcer was s1a/m2, whereas in patients with adenocarcinoma was s1a/m1.

    Conclusion

    The results showed there was no significant correlation between different genotypes of the vacA and the clinical outcomes and appears to vacA genotypes were not useful determinants for gastrointestinal diseases in our area.

    Keywords: Adenocarsinoma, gastroduodenal diseases, Helicobacter pylori, Iran, Peptic ulcere, vacA gene
  • رضا خاشعی
    «انسان شناسی تصویری» اصطلاحی است ترکیبی که نمایندگی دو حوزه «فیلم» و «مردم نگاری» را به عهده دارد. هر یک از دو حوزه دارای روش ها و تکنیک های خاصی هستند که برای دیدن پدیده ها و پرداخت رویدادها از آن ها کمک می گیرند. بدیهی است تفاوت های نسبتا عمیقی بین این دو حوزه وجود دارد که ناشی از تفاوت های ماهوی و اختلاف روش بین آنهاست. اولی با متن نوشتاری سر و کار دارد و کار خود را با مبانی نظری آغاز و با تحلیل و گزارش نویسی خاتمه می دهد، درحالی که دیگری با «نوار سلولوئید» کار می کند و کار خود را با ایده آغاز و نهایتا با فیلم برداری و نمایش دستاوردها فیصله می دهد. این که چطور می توان از یک تفکر مردم شناختی مبتنی بر متن نوشتاری به یک تفکر مردم شناختی مبتنی بر نما و سکانس رسید؟ پرسشی است که در این مقاله مبنای بررسی قرار گرفته است. همچنین در این مقاله تلاش شده است تا ضمن مروری کوتاه بر دو حوزه مردم شناسی و فیلم مستند، نحوه شکل گیری انسان شناسی تصویری، بازنمایی حس در انسان شناسی تصویری و تمایزات برجسته در این حوزه به اختصار بیان شوند.
    کلید واژگان: فیلم اتنوگرافیک, مستند مردم شناسی, انسان شناسی تصویری, مردم شناسی بصری
    Reza Khashei
    “Visual anthropology” is a term representing two different areas, i. e. “Film” and “ethnography”. Both fields employ certain methodologies and techniques to study various phenomena and developments. Need not to say that there are relatively big differences between these two fields rising out of their intrinsic disparities and methodological variations. The former deals with written texts and starts with theoretical principles and ends with analysis and reports, while the latter works with “celluloid tape”, beginning with ideas and concluding with filming and achievements. The question “how one could reach a sequence- and shot-based anthropological thinking through a written-text-based anthropological thinking” is answered in the present study. Taking a quick look at these two different fields, the article, further explains visual anthropology formation process, representation of feelings in visual anthropology and the related outstanding distinctions.
    Keywords: Ethnographical Film, Anthropological Document, Visual Anthropology
  • Kamiar Zomorodian, Mohammad Jamal Saharkhiz, Mohammad Javad Rahimi, Samaneh Shariatifard, Keyvan Pakshir, Reza Khashei
    Objectives
    Over the past two decades, there has been a growing trend in using oral hygienic products from natural resources such as essential oils and plant extracts. Nepeta cataria L. is a member of the mint family (Labiatae) with several medicinal properties. The objective of this study was to determine the chemical composition and antimicrobial activities of essential oils (EOs) from N. cataria leaves against pathogens causing oral infections.
    Materials And Methods
    The chemical composition of EOs from N. cataria was analyzed by gas chromatography/mass spectrometry (GC/MS). The antimicrobial activity of the essential oil was evaluated by broth micro-dilution in 96 well plates as recommended by the Clinical and Laboratory Standards Institute (CLSI) methods. The plates were incubated at 30°C for 24-48 h (fungi) or at 37°C for 24 h (bacteria).
    Results
    The analysis of the EOs indicated that 4a-α, 7-α, 7a-β-nepetalactone (55-58%), and 4a-α, 7-β, 7a-α-nepetalactone (30-31.2%) were the major compounds of the EOs at all developmental stages. The tested EOs exhibited antimicrobial activities against the tested bacteria at concentrations of 0.125-4 µL/mL. Moreover, the oils entirely inhibited the growth of Candida species at a concentration less than 1 µL/mL.
    Conclusion
    Based on these results, the EO of N. cataria can possibly be used as an antimicrobial agent in the treatment and control of oral pathogens.
    Keywords: Nepeta Cataria, Volatile Oil, Anti, infective Agents, Mouth, Candida, Staphylococcus, Enterococcus, Streptococcus
  • Reza Khashei, Hasan Shojaei, Peyman Adibi, Ahmad Shavakhi, Mohammad Mehdi Aslani, Abass Daei Naser
    Objective
    Resistance to antimicrobial agents, particularly metronidazole and clarithromycin, is frequently observed in Helicobacter pylori and may be associated with treatment failure. This resistance rate varies according to the population studied. The aim of this study was to assess the pattern of antimicrobial resistance of H. pylori isolates from dyspeptic patients in Isfahan.
    Materials And Methods
    Antral gastric biopsies from 230 dyspeptic patients were cultured. Susceptibility testing to commonly used antibiotics performed on pure cultures of 80 H. pylori-positive isolates by Modified Disk Diffusion Method (MDDM). Genomic DNA extracted and subjected for study of entire genomic pattern using Random Amplified Polymorphic DNA- Polymerase Chain Reaction (RAPD-PCR).
    Results
    The overall rates of primary resistance were 30.0%, 8.75%, 6.25%, 3.75%, 3.75%, and 2.50% for metronidazole, ciprofloxacin, clarithromycin, azithromycin, tetracycline, and amoxicillin, respectively. Multiple antibiotic resistances were observed in 8 of 27 resistant isolates (29.6%) that mainly were double resistance with the prevalence of 6.25%. No association between antimicrobial resistance and either the gender, age or clinical presentation of the patients were detected. In RAPD-PCR, great diversity observed in 27 resistant strains isolated from different patients and this heterogeneity was not significantly different from susceptible strains.
    Conclusion
    Primary H. pylori resistance to metronidazole in our population was lower than the developing world and even other parts of Iran, to ciprofloxacin was considerable in comparison with results in most other countries. Moreover, antibiotic resistance had no effect on genomic pattern of H. pylori isolates. Finally, pretreatment H. pylori isolates susceptibility testing is highly recommended.
سامانه نویسندگان
  • رضا خاشعی
    رضا خاشعی
    پژوهشگر
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