مجله دانشگاه علوم پزشکی اراک
سال پانزدهم شماره 1 (پیاپی 60، فروردین و اردیبهشت 1391)

TEM, PER, and VEB are extended-spectrum betalactamase (ESBL) enzymes that are capable of hydrolyzing penicillins, cephalosporins, and aztreonam. The aim of this study was to determine the prevalence of ESBL producing E.coli and molecular evaluation of TEM, PER, and VEB β-lactamases among E.coli strains. A total of 200 clinical strains of E.coli were isolated from clinical specimens and their antibiotic susceptibility was determined by disk diffusion method. ESBL production was determined using the combined disk method with CAZ and CTX with clavulanic acid and alone. Minimum concentration inhibition (MIC) for CAZ and CTX with clavulanic acid and alone was determined by agar dilution method. Finally, PCR with specific primers was used for determining the presence of blaTEM, blaPER, and blaVEB genes. Combined disk method confirmed 94 strains (47%) to be ESBL producing E.coli. Of the 94 ESBL producing strains, 36 samples had MIC=16, 44 samples had MIC between 32-256, and 10 samples had MIC≥512 for ceftazidime, whereas 8 samples had MIC=16, 68 samples had MIC between 32-256, and 21 samples had MIC≥512 for cefotaxime. The frequency of TEM was 44%; however, blaPER and blaVEB genes were not detected by PCR among ESBL producing isolates.The results indicated that the high percentage of ESBL producing E.coli is 47% and PCR method showed a high frequency of TEM enzyme, but PER and VEB betalactamase were not found among them.

Green tea due to its antioxidant properties can prevent some types of chromosomal damage. In this study, the effects of green tea on repressing chromosomal aberrations induced by cell phone waves in bone marrow polychromatic erythrocytes of male Balb/C mice were investigated. In this experimental study, 40 adult male Balb/C mice were randomly divided into five groups: control (natural conditions), sham exposed (no exposure to cell phone waves in vitro), experimental group 1 (exposure to cell phone waves), and experimental group 2 (intraperitoneal injection of 100 mg/kg dose of green tea extract for 5 days and exposure to cell phone waves), and experimental group 3 (intraperitoneal injection of 200 mg/kg dose of green tea extract for 5 days and exposure to cell phone waves). Micronucleus test was run in all groups. Data were analyzed by ANOVA and Tukey tests using SPSS software (p<0.05). The mean number of micronucleus in polychromatic erythrocytes of the sham group (3.47± 0.253) compared with control group (3.43 ± 0.605) did not show a significant difference (p> 0.05), whereas the mean micronucleus frequency in the experimental group 1 (5.64±0.308) increased significantly. However, the mean micronucleus frequency in experimental group 2 (0.92 ± 0.129) and experimental group 3 (0.55 ± 0.046) compared with the control and sham exposed groups decreased significantly (p = 0.001). Cell phones microwaves (940 MHz) induce chromosomal aberrations in bone marrow polychromatic erythrocytes of male Balb/C mice, but green tea has inhibitory effects and reduces chromosomal damage.

Low immunogenicity of hepatitis B vaccine is an important problem in patients with chronic renal failure (CRF). A possible solution is intradermal versus conventional intramuscular delivery of vaccine in this population. The goal of this study was to compare the efficacy of these routes of vaccination in Bu-alicina Dialysis Center, Qazvin, Iran. This randomized clinical trial was done on 29 CRF non-responders randomly allocated to two groups. Fifteen patients received 40 μg of euvax B vaccine intradermally and 14 patients received 160 μg of this vaccine intramuscularly. Anti-HBs antibody titre was measured after 1, 6, and 12 months. Seroprotection was defined as anti-HBs antibody titre above 10 lU/L. Data were analyzed using SPSS software version 16. Difference of seroprotection rate between two groups was not statistically significant after1and 6 months; however, after 12 months, seroprotection rate was 93.3% in the interadermal group versus 50% in the intramuscular group (p<0.05). Considering the high cost of vaccination, intradermal vaccination may be a reasonable choice in CRF patients.

Candida albicans is the fourth common cause of chronic fungal infections that cause both mucosal and deep tissue infections. Nowadays, mortality and morbidity due to C. albicans infections via medical devices, such as catheter and implants, are increasing. Therefore, finding new methods of combating such infectious agents seems necessary. In this study antifungal effects of titanium dioxide nanoparticles and photocatalyst TiO2 nanoparticles on C. albicans biofilms were investigated. In this experimental study, TiO2 nanoparticles were synthesized and exposed to UV ray with 370 nm wavelength. Biofilms of C. albicans were developed on flat-bottomed 96-well microtiter plates, and antifungal effects of TiO2 and photocatalyst TiO2 nanoparticles were evaluated. Data were analyzed by t-test using SPSS software. MIC50 of photocatalyst TiO2 nanoparticles was 1.9 µg/ml and its MIC90 was 2.74 µg/ml while MFC was determined to be 3.37 µg/ml. Biofilms inhibitory concentration of TiO2 nanoparticles, photocatalyst TiO2 nanoparticles, and fluconazole for susceptible strains were 5.14, 4.54, and 4 µg/ml, respectively. These values for the fluconazole resistant strains were 5.35, 4.88, and 8 µg/ml, respectively Photocatalyst TiO2 nanoparticles showed a suitable antifungal property against C. albicans biofilms compared with fluconazole. Thus it can be a new strategy in prevention of fungal biofilms, especially those formed on the surface of medical devices.

Enterotoxigenic Escherichia coli bacterium is the most important bacterial agent causing diarrhea. Specific virulence factors, such as enterotoxins and colonization factors, distinguish ETEC from other classes of diarrheagenic E.coli. In this study, heat-labile toxin was purified which could be utilized for anti-toxin assay in GM1 gangelioside receptor-ELISA based method and for identification of ETEC producing toxin.

In this experimental study, bacterial strain producing heat-labile toxin was first cultivated for production and purification of toxin. Then supernatant soluble proteins were precipitated with ammonium sulfate and purified using biochemical methods. Finally, purified protein was dialyzed against Tris 0.02 mM pH 8 and analyzed on gel electrophoresis. GM1 gangelioside receptor-ELISA based method was used for detection and assessment of the purified toxin. Through this method, the effect of anti-recombinant heat-labile toxin B subunit neutralization on heat-labile toxin was investigated.

Toxin purification was revealed by the presence of 12 and 28 KD protein bands. This study demonstrated that anti-recombinant heat-labile toxin B subunit antibody can detect the purified toxin and can inhibit its binding to GM1 receptor up to 80%.

Purification of heat-labile toxin and gangelioside receptor-ELISA assay can be used for accurate detection and epidemiological study of clinical isolates.

Olive oil as a mjor source of fat in diet, besides having a high level of unsaturated fatty acid contains biological components, such as the antioxidant phenolic compounds that can prevent the destructive effect of free radicals and their resulting mutation on cellular structures. The main goal of this study was to investigate the antioxidant and anticancer effects of olive oil through Salmonella typhimurium and microsome. In this study, 16 Iranian olive oil samples and one Spanish sample were used. The determination test of anti-mutagenic potential was based on the method proposed by Ames et al. using mutant strain of Salmonella typhimurium TA100 and a well-known carcinogenic material (sodium azide) which by adding microsome of rat liver (S9), its anticancer effect was examined. Positive and negative controls which respectively contained sodium azide and distilled water were studied. Each test was simultaneously done three times and the percentage of inhibition was determined according to (1-T/M) × 100. The inhibitory percentage in its highest level in darkness was equal to 63.64% based on the variety of olive oil and in light was equal to 60.70%. The findings of this study show that the antioxidant and anticancer properties of olive oil decrease with exposure to light.

Physiological studies suggest that sleep deprivation may influence bodyweight through affecting appetite (decreasing leptin and increasing ghrelin). The aim of this study was to evaluate the effects of 12 weeks of aerobic training on obesity indices, serum levels of ghrelin and leptin, and sleep quality in overweight and obese men. In this quasi-experimental study, 22 overweight and obese men with low sleep quality were randomly assigned to aerobic training (n=12) and control (n=10) groups. Aerobic training was performed (50-60 min/day, 3 day/week) for 12 weeks. Serum ghrelin and leptin and obesity and sleep quality indices were measured before and after the intervention. Changes in dependent variables resulting from the training intervention were assessed by dependant t-test using SPSS software. After aerobic training, weight (p<0.03), body mass index (p<0.04), visceral fat (p<0.04), total abdominal fat (p<0.03), and sleep quality (p<0.001) significantly improved. However, ghrelin and leptin serum levels did not change in response to aerobic training (p<0.05) during the same period. Short-term aerobic training improved obesity indices and sleep quality in obese/overweight men, yet this improvement was not accompanied by changes in ghrelin and leptin serum levels.

It has been indicated that there is a relationship between vitamin B12 status and cognitive functioning. Measurement of serum vitamin B12 is routinely performed in patients with memory loss during initial diagnosis. Noticing the role of cholinergic system and vitamin B12 on memory, the aim of this experimental study was to examine the effect of the interactions between vitamin B12 and nicotine on memory retention in passive avoidance learning in adult male rats. The present study was an experimental one. Drugs, including vitamin B12 (0.01, 0.02, 0.03, 0.05, 0.1, and 1 µg/rat) and nicotine (0.1, 0.5, and 1 µg/rat) were administrated after training session intracerebroventriculary (i.c.v.). The drugs were used (i.c.v.) in a volume of 1µl/rat immediately after the training session. The level of memory retention was evaluated by passive avoidance learning. Twenty-four hours after training, a retention test was performed to determine long-term memory. Statistical analysis was carried out using one-way ANOVA test. The results showed that the administration of vitamin B12 and nicotine significantly increased memory retention in rats. Nicotine significantly increased the response to vitamin B12 in memory retention process. Vitamin B12 through interaction with cholinergic system acts in memory retention process.

Because of high mortality and morbidity of severe acute pancreatitis (AP) and its increasing incidence in recent years, early detection of severity of AP is very important. Since interleukin (IL) rapidly responds to body temperature changes, this study was done to examine the relationship between blood levels of interleukin 15 and 17 and severity of acute pancreatitis. In this cross-sectional study, 52 patients with AP were studied. For all patients, paraclinical information, Ranson criteria, and APACHE-II were completed. Serum interleukin 15 and 17 levels were measured by ELISA method. Then the relationship between them and AP severity was determined based on Ranson criteria and APACHE-II. In this study, 36.5% of the patients were male and 63.5% were female and the mean age was 61.06 years. The serum level of IL-17 was negatively correlated with the severity of AP based on Ranson criteria (p=0.021, r= -0.319). ROC curve showed significant values for blood level of IL-15 and CRP in AP diagnosis. Sensitivities were 92.3% and 78.8% and specificities were 40% and 48%, respectively. Based on Ranson criteria, the role of serum level of IL-17 as an unknown factor was seen significant in determining the severity of AP. However, the diagnostic value of serum IL-15 should also be verified with further studies.

Nowadays, one of the basic problems of tuberculosis treatment is drug resistance. This study was done to determine the drug resistance of mycobacterium strains isolated from patients with pulmonary tuberculosis to anti-tuberculosis drugs and determine the affecting factors.

In a cross-sectional study, all patients with tuberculosis who were covered by Markazi Province Health Center (917 persons) during 2005 to 2010 were included in this study. For all patients with resistant pulmonary tuberculosis, culture and antibiogram by standard method (proportional) were done. Effective factors in drug resistance were identified by logistic regression model using SPSS software.

Overall, the rate of resistance in patients with smear-positive was 7.3% and the rate of MDR-TB was equivalent to 4.3%, and 0.5% of smear positive patients were resistant to all five drugs. The most resistant strains were isoniazid (68.8%), rifampin (62.5%), pyrazinamide (25%), ethambutol (21.9%), and streptomycin (21.9%), respectively. The highest rate of resistance was in the 15-45 years age group. The incidence of resistance was significantly associated with sex, grade of smear positivity, relapse of TB, and HIV infection.

The study of drug resistant mycobacterium strains over six years showed a growing trend. Therefore, close attention to prevent the production and dissemination of resistant strains is very essential.

A lot of research has been done on the post-traumatic stress, but few studies have investigated the effect of chronic stress disorders on physical and psychological health. This study investigated the combined interactive effects of chronic stress disorders and mental disorders on somatoform disorders reporting among employees at Isfahan Steel Company. In this correlational study, 189 employees in Isfahan Steel Company wwere selected according to the stratified random sampling method and completed demographic characteristics, chronic stress disorders of Cohen, Karmark, and Mermelstein, and mental disorders and somatoform disorders of Barling, Loughlin, and Kelloway questionnaires in 2011. Data were analyzed using Pearson correlation coefficient and hierarchical regression. Results showed significant internal correlations among chronic stress disorders, mental disorders, and somatoform disorders (p<0.01). In addition, by controlling for demographic variables, the results of hierarchical regression analysis showed the interactive effect of chronic stress disorders and mental disorders on reporting somatoform disorders to be significant (p<0.05). This study showed that chronic stress disorders have a positive relationship with reporting somatoform disorders both in experiencing and not experiencing psychological disorders; however, this relationship was stronger when employees in addition to chronic stress disorders experienced psychological disorders.

Infantile colic is a behavioral syndrome characterized by severe crying without a specific cause in healthy under three-month-old infants. The aim of this study was to compare the effectiveness of infant massage and rocking on the duration and frequency of crying time in colicky infants.

This randomized clinical trial involved 100 infants 1-2 weeks of age with colic who referred to Amir Kabir Hospital, Arak, Iran, in 2010. The infants were randomly assigned to massage group (n=50) and rocking group (n=50). In the massage group, mothers were recommended to massage their child three times a day for 7 days. In the rocking group, mothers were recommended to rock their child during crying every day for 7 days. In both groups, mothers recorded infant crying durations during one week in a checklist. Data were analyzed by SPSS software.

The mean difference of total crying times and durations were 8.34 and 4.12 during the first day and 4.26 time/day and 1.32 hour/day during the last day in the massage group, whereas in the rocking group, these values were 7.50 and 2.42 in the first day and 6.94 and 2.14 hour/day in the last day, respectively. The means of crying times and durations in the massage group were more than those of the rocking group (p<0.001).

Infant massage can reduce the duration of crying in colicky infants and it can enhance the relationship between mother and child and their relaxation.

Male involvement in maternal health is one of the policies promoted by international reproductive health bodies. To better understand male involvement issues in maternal health, this study was done to explore midwives’ experiences toward the promotion of male involvement in maternal health and barriers to such programs. In this qualitative study, sampling was conducted by means of focus group discussions (FGDs) and in-depth interviews through a semi-constructed questionnaire. The experiences of all midwives at health centers were surveyed through 2 group interviews and the views of 8 midwives employed in Maternity Hospital of Sabzevar, Iran, were considered as well. Content analysis was applied to data analysis. Results of this study can be divided into three categories: Arguments in favor of, obstacles to, and outcomes of male involvement in maternal health. Based on midwives’ experiences, the provision of couple-friendly health services would enhance the quality of care, better understanding of health information provided to pregnant women and easier acceptance of tasks like taking a sonogram. Midwives indicated some obstacles like manpower and work space deficiency and cultural barriers like husbands and midwives uneasiness while communicating and giving information. Disagreements between partners and higher likelihood of partner interventions in affairs were found to be possible negative outcomes of such programs. Midwives’ attitudes towards male involvement in maternal health were positive and indicate that the introduction of such programs would be accepted. However, attention should be paid to midwives’ concerns and cultural obstacles and they should be trained for such programs.

Vasomotor disorders are one of the most painful menopausal complications that negatively affect the quality of life in menopausal women. This study investigated the effects of omega3 fatty acid on vasomotor disorders in menopausal women. This randomized, double-blind, placebo-controlled clinical trial study was done on 83 menopausal women aged 45-60 years that had met the inclusion criteria. The participants were randomly assigned to omega3 or placebo groups. Fish oil capsules (containing 300 mg of omega3) or placebo capsules were prescribed to the participants one capsule a day for 8 weeks. Of the 83 patients enrolled, 68 completed the study (omega3 supplement, n=34; placebo; n=34). Data collection was done through demographic questionnaire, daily self report, and food frequency questionnaire (FFQ). Data were analyzed by t-test, Chi square, Fiedman, and Mann-Whitney tests using SPSS software version 18. After 8 weeks of intervention, there was a significant difference in HF frequency (p=0.003) and nightsweats frequency (p=0.001) between the two groups. There was no significant difference in HF intensity between the two groups (p=0.2) but reduction of nightsweats intensity was significant between the two groups (p=0.003). Omega3 affected the reduction of HF frequency and nightsweats frequency and intensity but it did not have a significant effect on the severity of HF.