فصلنامه کومش
سال هفدهم شماره 4 (پیاپی 60، تابستان 1395)

Hepatitis B causes liver inflammation in human and is one of the major health problems worldwide. Currently, about 2 billion people are estimated to be infected with Hepatitis B worldwide. Various studies have reported different immune responses to hepatitis B vaccine (HBV) in Iranian health staff, while there is not any estimate of overall responses. Therefore, the present study was conducted to determine the immune response to HBV among health staff in Iran using meta-analysis method.
This study was a systematic review of Iran databases related to the subject of immune response to HBV, including; Magiran, Iran medex, Iran Doc, SID, Med lib and international databases including Scopus, Pub med, Science Direct, and also Google Scholar search engine. Only those articles that have had inclusion criteria were included. To combine the results of different random effects of studies, the meta-analysis was used.
There were 1084 subjects included in 9 studies. The immune response to HBV in health staff was 86.7% (CI: 95%, 80.9-92.6) after 1.21 years of last vaccination. This rate was estimated to be 93.5% for males (CI: 95%, 89.3-97.6) and 90.7% for females (CI: 95%, 84.9-96.5). The minimum and maximum vaccine responsewere reported from Tehran (70.6%) and Yazd (99.2%), respectively.
The immunization to HBV in healthcare personnel was more than 80% after 1.21 years of last vaccination. Therefore, performing the complete course of hepatitis B vaccination for prevention of infection would be sufficient and booster dose would not be required

Sexual dysfunction is a common problem among substance abusers. This study investigates the effect of methadone maintenance therapy on men sexual function.
In this semi- experimental study, 30 men who received methadone were selected by convenient sampling method and monitored for 3 months. Glombock Rust Inventory state and demographic characteristics questionnaires were used for evaluation of patients. The assessment of patient’s sexual function was performed before and after methadone therapy.
The mean of global sexual function scores before methadone therapy was 6.1±2/2 and after 6.9±2/3 (P=0.1). Also the mean of subscales impotence, premature ejaculation, non-sensuality, avoidance and non-communication were not significant before and after methadone therapy. While, the mean of dissatisfaction and infrequency subscales showed significant differences before and after methadone (P=0.03, P=0.0001).In this study the relation between age and duration of substance abuse with sexual function was significant (P=0.0001, P=0.02) but the relation between other demographic variables with sexual dysfunction was not significant.
These findings showed that methadone has been increased sexual dysfunction in some parts of sexual function. Therefore, patients should be screened for sexual dysfunction at the onset of opioid replacement treatment and also they should be introduced for suitable treatment for prevention of the severity of disorders and improvement of quality of marital relationship

Regarding the role of probiotics in the balance of aerodigestive microorganism in the digestive system and the central role of bacteria colonization in the pathogenesis of ventilator associated pneumonia (VAP), the propose of this study was to investigate the effect of probiotics in prevention from ventilation associated pneumonia in ICU patients, who were undergoing mechanical ventilation with high risk for VAP.
Patients (n=60) hospitalized at ICU of Valiasr Hospital, Arak, Iran participated in a randomized, double-blind, placebo-controlled clinical trial. Patients were randomly divided into two groups (intervention and placebo). Intervention group received Lactobacillus rhamnosus Gagavage three times a day in addition to a routine care. Control group received placebo in addition to a routine care. Demographic and clinical data were recorded and clinical response to primary outcome (prevalence of VAP) and secondary (other clinical factors) was interpreted. Data were analyzed in SPSS 18, using student t-test and chi-square.
Twenty two patients (36.6%) were diagnosed with VAP, of which, 7 (23.3%), and 15 (50%) patients were in the probiotic and control groups, respectively. (p=0.03). The average of days spent in ICU (intervention: 14.2±4.7 vs control: 17.6±6.5, p=0.028), hospitalization (intervention: 24.1±5.6 vs control: 27.4±6.6, p=0.041), and number of patients with diarrhea caused by clostridium difficile (intervention: 1(23.3%) vs control: 6 (20%), p=0.04), were significantly lower in the probiotic group than the placebo group. The mean of intubation time till receiving VAP (intervention: 10.5±1.02 vs Control: 6.1±2.6, p=0.008) and full recovery (intervention: 25 (83.3%) vs control: 14(46.6), p=0.028) were significantly higher in the intervention than the control group.
These findings successfully presented that probiotics could effectively protect from VAP in a selected, high-risk ICU patients. As a result, the use of this therapy, in patients undergoing long-term intubation is recommended.

Streptococcus pneumoniaeis is the most frequent cause of bacterial meningitis, community-acquired bacterial pneumonia and acute otitis media (AOM). Eighty percent of children have at least once diagnosed by the three years of age. This study was conducted to determine the frequency of patients with Streptococcus pneumoniaein diagnosed with acute middle ear infections and antibiotic susceptibility patterns of this microorganism.
Middle ear discharge specimens were collected from 60 patients with acute otitis media during a period of 8 months, at Amir Alam Hospital (Tehran). Specimens were assessed for Streptococcus pneumonia by microscopic examination and culture. The antibiotic susceptibility test was performed by Kirby-Bauer disk diffusion method according to CLSI (clinical and laboratory standard institute) criteria. Antibiotics included tetracycline,erythromycin,vancomycin,chloramphenicol, amoxycilinclavulanate,Rifampine, ,ciprofloxacin, Cefixime,Trimethoprim䫩. Identification and confirmation of isolates were performed by PCR and culture.
Thirty three/ 60 and 27/60 of specimen were belong to men and women, respectively. Eight/ 60 tested specimens were confirmed as Streptococcus pneumonia. The sensitivity of isolated Streptococcus pneumoniae to different antibiotics was tested and the results were as following: tetracycline (56%), erythromycin (67%), vancomycin (22%), chloramphenicol (56%), and amoxycilin clavulanate (22%), Rifampine (44.4%), ciprofloxacin (56%), Cefixime (100%) Trimethoprim䫩 (77.8%).
Streptococcus pneumonia is the main cause for AOM. According to the emergence of resistant strains of Streptococcus pneumonia to conventional antibiotic therapy, especially beta-lactam antibiotics and erythromycin, continuous surveillance is needed to determine full picture of antibiotic susceptibility in patients with AOM.

Mothers of preterm neonates face with more stress and anxiety in comparison with mothers of neonates born at term. The aim of this study was to investigate the effect of 10 days tactile kinetic stimulations by mothers of preterm neonates on maternal state anxiety.
mothers and their preterm neonates (n=40) were purposefully selected from neonatal unit of Amiralmomenin hospital, Semnan, and randomly divided into two experimental and control groups. Mothers of experimental group were trained to conduct tactile kinetic stimulations on neonates, three times a day and each time for 20 minutes for 10 days, while the control group neonates received only usual care. Maternal anxiety was measured by Spielberger Inventory. Before and 10 days after intervention, questionnaire was completed by mothers and then the obtained data was compared together.
The results showed that the main effect of time and effect of interaction of time with intervention were significant (P≤0.001) and maternal anxiety of experimental group was significantly reduced at the end of intervention (P=0.029).
It can be concluded that tactile kinetic stimulation is an affordable and beneficial way to reduce anxiety in mothers of preterm neonates

Mindfulness is one of the important factors that predicts the attachment between mother and her fetus or neonate. It varies among different cultures and countries. Thereby, the aim of this study was to determine the relationship between Mindfulness and Maternal attachment to the fetus and neonate in prenatal and postpartum periods.
This longitudinal study was carried out with 347 primigravida women referred to Mashhad health care centres. The study performed with two stage sampling method (cluster-convenience) in 2014. Demographic/prenatal characteristics questioners including, mindfulness (39Q), fatal-maternal attachment (21Q) and maternal-neonatal attachment (22Q) were completed by the participants.
In the prenatal period, the mean (±SD) value for total Mindfulness and Maternal-fetal attachment were 112.8 (±12.8) and 59.89 (±8.6) and in the postpartum were 116.8(±13.4) and 71(±0.01), respectfully. Also there was a positive correlation between Maternal-fatal-Attachment in prenatal and postnatal period (P=0.40,r=0.102; P=0.16, r=0.129 respectively).
There was a correlation between Mindfulness and Maternal-fatal and neonate Attachment in the prenatal and postpartumperiods. Therefore, it is advisable that community health caregivers and midwives receive trainings regarding psychological problems during perinatal, which could be beneficial for early diagnosing and identifying such disorders

In spite of many studies conducted on the subject of pain and its effects on quality of life, there is not still any complete information about factors involving pain intensity and duration and how those can influent the patient’s life. The aim of the current study was determining the role of intensity and duration of pain on quality of life in patients with chronic pain.
This cross-sectional study was conducted with participation of the patients referring to the pain centers in Tehran's hospitals in 2012-2013. Patients (n=300) were selected by using multi-stage random sampling technique. For determining pain intensity, a 0–10 numeric rating scale was used and the patients were asked for the duration of pain. The questionnaire of quality of life,designed by the World Health Organization, was used to measure quality of life. Further, Pearson's correlation coefficient and regression tests were used to analyze the data by using SPSS version 19.
These findings showed that the pain intensity and duration has significant correlation with the quality of life and its different dimensions (P According to the results of this study, it could be suggested that pain intensity, particularly its corporal dimensions, have more significant role in predicting the patient's quality of life, whose suffering from chronic pain.

Burnout is a psychological phenomenon, which is defined as chronic fatigue and apathy in the work place. Among the factors that lead to an effective adaptation and can have an effective role in reducing burnout is resiliency. This study was aimed to predict the work place burnout according to resiliency, referring to the mediatory role of gender.
This study in terms of type of functional objective and data collection and communication between the variables component of the research is descriptive and correlational. In this study nurses (n=140) from two hospitals in Semnan (Iran) were randomly selected. Required Information was collected according to the Connor–Davidson Resiliency Scale and maslash burnout. For data analysis, Pearson correlation, multiple regression and independent t-test were used.
According to the results, the average burnout in women was more than men. Between Resiliency and gender with subscales of burnout a significant negative correlation was observed, gender and resiliency could predict 51% of burnout. Independent t-test showed significant differences in all variables between men and women.
Resiliency and gender are factors that can predict burnout. It is recommended that people with a greater capacity of resiliency to be hired in working places. Also in female nurses, considering the importance of indicator of job satisfaction and efforts to improve them, can be effective in reducing eork place burnout.

Occupational accidents are one of the most important causes of preventable disability and death in developing countries. Identifying the most probable risk factors in occupational injuries at a particular workplace can be considered as a basis for preventing or reducing the severity of these injuries. The aim of this study was to understand the factors that can affect occupational injuries in an industrial pipe factory.
This case-control study was performed by completion of the forms (these forms were designed Based on the literature review) and information from the workers records, who had a work-related accident during the years 2007- 2013. Control group were those who worked during this period in the same factory with no history of occupational accident. We used frequency tables for describing the types of accidents and logistic regression to analyse the data.
Out of 525 workers, 204 had occupational accident and 321 were considered as control group. The mean ± SD age of the case group was 29.7 ± 5.5 and that for the control group was 35 ± 6 years-old. This study showed that one of the main factors with the highest correlation with the risk of injury was lacking the home ownership. Youthfulness, smoking, marital status, level of education and lack of technical license were among the other factors that significantly (p Improving the socio-economic situations such as home ownerships can be very helpful in preventing injuries. Also a proper relevancy between the professional trainings and types of task assigned to the workers would be other effective solution in preventing work place injuries

Cervical ripening in labor is one of the most important objects in midwifery. Isosorbide dinitrate (ISDN) is one of the most important agents, which has been proposed for cervical ripening, but there are still controversies regarding its prescription. The present study aimed to assess the effects of vaginal and oral ISDN for preinduction cervical ripening.
In this non-blinded clinical trial, 99 nulliparous women with term or prolonged pregnancy were selected and were randomly divided into two groups by block randomization. The intervention groups included those received vaginal ISDN (n=50, 40 mg, daily) and oral ISDN (n=49, 20 mg, twice daily). Size of ripening was measured by bishop score before treatment and 24 hours after that.
24 hours after treatment, bishop score was significantly increased (P 0.05). Duration of induction to the second phase of delivery was compared in two groups. Although there was not any significant difference between the two groups in terms of shifting time from the active phase to delivery and duration of the second phase (P > 0.05), there was a meaningful difference between two groups in duration from induction to the active phase of delivery (P Prescribing vaginal ISDN for cervical ripening was more effective than oral medication, and it seems to be with minimum side effects.

Vitamin D deficiency plays an important role in unfavorable changes in the body composition of postmenopausal women and it seems that exercise training may affect serum vitamin D level. Hence the purpose of this study was to assess the effect of resistance training on serum vitamin D level and body composition in postmenopausal vitamin D deficient women.
Postmenopausal women with vitaminD deficiency (n=22) were selected using purposive sampling method and randomly assigned in two groups; experiment (N=12) and control groups (N=10). The experiment group performed 2 days per week for 8 weeks low intensity exercise (20-30% 1RM). The training program performed the progressive overload principle with 3,4 , 5 set and 20,25 , 30 1RM percentage in successive weeks. The amount of subject’s sun exposure and vitamin D diet intake was monitored. Serum vitamin D, PTH and calcium levels in fasting and body composition were measured before and after the training program.
after 8 weeks of resistance training, the results showed a significant increase in serum vitamin D (P=0.02) level in resistance in compare to control groups. However, the findings revealed no significant changes in body weight (P=0.36), body composition (P>0.05), serum level of PTH (P=0.42) and calcium (P=0.31) level in resistance in compare to control group.
vitamin D deficiency can significantly improve with exercise training and even without any changes in body composition, sun exposure and use of dietary supplements

Upper limb disorder is a common musculoskeletal deficiency in some occupational groups. In spite of its frequency in occupational groups, the study of prevalence and risk factors for upper limb disorder (ULD) in Iranian teachers is limited. The aims of this study were to assess the prevalence and risk factors for ULD and to investigate the association of individual and occupational characteristics with the prevalence of ULD in school teachers in Semnan.
This study was performed by a cross-sectional method. Regarding the inclusion and exclusion criteria, 586 teachers were randomly chosen from 22 primary and high schools in Semnan, Iran. Required data including personal and occupational characteristics, pain intensity, health status and the prevalence and risk factors of ULD were collected using different questionnaires.
The prevalence rates of ULD at the time of study, last month, last 6 months, annual, and lifetime were; 46.4%, 50.2%, 57.3%, 60%, and 62.6%, respectively. The prevalence of waist pain in teachers was more than shoulder and elbow pain. The prevalence of ULD was significantly associated with age, gender, and length of employment (P Prevalence of ULD in school teachers in Semnan was high. Factors such as age, gender, length of employment, and work-related activities developed significantly ULD in school teachers

Unsafe sexual behavior can lead to sexually transmitted diseases. Regarding the risks and negative consequences of unsafe sexual behaviors, the purpose of this study was to assess related factors with the intention of safe sexual behaviors based on the theory of planned behavior among male drug addicts covered by rehabilitation Centers.
This descriptive-analytical study was used in a study including 163 addicted men referring to Hamadan's rehabilitation centers chosen by simple sampling method. Data was collected using a questionnaire containing demographic information and the theory of planned behavior constructs. Data analysis was performed using SPSS-16 software by logistic regression.
Our findings in this study showed that 55.2% of participants had a history of Extramarital Relations and only 25.7% of them had used a condom during their last sexual intercourse. Results of logistic regression analysis on variables of constructs the theory of planned behavior showed subjective norms were the strongest predictors of behavioral intention for safe sexual behavior among participants (P=0.024).
Subjective norms can be used to predict the intention of safe sexual behavior and effectively in planning and intervention to prevent sexual risk behaviors among male drug abusers.

Epithelial ovarian carcinoma is considered to be the most lethal gynecological malignancy in women and accounts for more than 85% of ovarian carcinomas. The chemotherapeutical treatment of choice is cisplatin. However, long-term use of this drug mostly results in drug resistance phenomenon. Metabolomics, is a highly resourceful technique, which acts promising in monitoring of tumor growth. Proton nuclear magnetic resonance spectroscopy (1H-NMR) is a non-invasive and high reproducible technique used in metabolomics. In the present investigation, we tried to find biochemical pathways and their metabolic alterations in epithelial cells of ovarian carcinoma and study the mechanism involved in cisplatin drug resistance.
The cell lines A2780 and A2780CP were prepared. Methanol-chloroform-water extraction was performed.The hydrophilic layer were collected separately and cell1H-NMR spectroscopy were applied on a Bruker spectrometer operating at 400 MHz. After processing the data, outlier metabolites were identified and their biochemical pathways were worked out by Metaboanalyst and Human Metabolome Database.
In the present study, the main altered metabolites were; fucose, sorbitol, mannitol, mannose, rhamnose, glycerol, galactonite, alpha lactose, myo-inositol and melibiose. The biochemical pathway enrichment analysis showed that galactose, fructose and mannose metabolism was the most prominent altered pathways.
Our results disclose that cisplatin resistance results from alteration in carbohydrates metabolites and their pathways. However, further study is needed to confirm these findings

Toxocariasis is a zoonotic disease caused by the infection of human with second-stage larvae of Toxocaraspecies. The three main human syndromes are; visceral larva migrans (VLM), ocular larva migrans (OLM), and covert toxocariasis. The aim of this study was to determine the anti body titer against Toxocara in patients with uveitis.
A total of 161 uveitis patient’s blood &Serum were collected from patients referred to training hospitals Universities in Tehran. CBC was performed to determine the presence of hyper eosinophilia. Sera was examined by ELISA to determine Toxocaracanis antibody titer. The positive sera samples were confirmed by westernblot test.
One hundred and twenty four uveitis patients were male and 127 were female. Sera samples (n=10, %6/2) were positive for T.canis IgG, including 9 (%7/3) male samples and 1(%2/7) female sample. Nine of sera samples from 10 ELSA positive samples were confirmed for 24-35 KDa bands on nitrocellulose membrane that reconfirmed the Toxocaracanis infection and 1 sample was negative.
The mentioned results imply that the ocular toxocariasis exists in Iran and the children are more vulnerable to the disease. Therefore, its necessary to measure the antibody against Toxocaracanis in uveit patients by ELISA test and positive patients should be treated before implicating with irreversible signs and symptoms.

Phenylketonuria (PKU) is a relatively common metabolic disease in world .The high incidence of the disease in our country is due to consanguineous marriages. The prevalence of this disease in Iran is reported to be about 1: 4000 to1: 8,000 births per year. Mental retardation, physical disabilities, neurological disorders are the clinical symptoms of the disease. Early diagnosis is very important to prevent the disabling consequences of the disease. The purpose of this study was to use a multi-layer neural network perceptron (MLP) to build a model for early detection and treatment of phenylketonuria patients..
Urine samples were obtained from healthy and PKU children. nuclear magnetic resonance spectroscopy was performed in NMR 400 MHz Bruker with the help of NOESY Protocol. Then peak resonance of each metabolite was identified, and modeling was done with multi-layer neural network perceptron.
The Model build in this study was able to classify the data in two groups of patient and healthy individuals successfully, with more than 90% sensitivity and 0.2% error rate with high predictive power
Our results showed the high power capability of this technique to diagnose the Phenylketonuria with the help of NMR spectroscopy and artificial neural network

Staphylococcus epidermidis is considered to be an important opportunistic pathogen. S.epidermidis ability to cause infection is due to its biofilm formation ability. Several bacterial molecules act as S. epidermidis adhesion objects and play role in bacterial adhesion to protein or polymeric surfaces. This study aimed to determine the correlation of virulence factors and macroscopic biofilm formation in S. epidermidis clinical isolates.
A cross-sectional study was conducted including 59 S. epidermidis obtained from blood, urine, tracheal and wound samples in Tehran, Iran. S. epidermidis was identified by conventional bacteriological tests. Phenotypic biofilm formation assay was done by microtiter plate method. The virulence associated genes including icaA, IS256, aap, bhp and fbe were detected by specific PCR.
From 59 isolates 36 (61%) were able to produce macroscopic biofilm, of which 12(33.3%) were strong biofilm producers. Of the 36 biofilm producers, 32 (88.9%) were positive for icaA. The majority of the isolates carried fbe (91.7%), IS256 (77.8%), aap (72.2%), while bhp was presented only in (15.3%).
This study demonstrated that the presence of virulence factors is correlated with macroscopic biofilm production. The presence of these virulence factors enables S. epidermidis to produce biofilm, colonize and survive in patients. In the case of immune system compromising or hospitalized patients, infections can occur and would be more complicated than the antibiotic resistance cases

Activity restrictions can have potential impacts on the prevalence of mental disorders. However, in patients with lower limb traumas the problems and the physical disabilities are usually taken more into consideration than mental status, while they refer for further examinations. Therefore, this study is aimed to investigate the changes in the process of depression, anxiety and stress in men with lower limb traumas.
In a prospective study the patients with lower limb traumas, who have been hospitalized in Amir Al-Mo’menin and Kowsar hospitals in Semnan since June 2012 to August 2015, were selected randomly and studied. The data was collected by demographic and incident questionnaire and depression, anxiety and stress questionnaire. At first the patients were asked to complete the questionnaires based on their psychological experience of one month prior to the trauma. Then same questionnaires were completed by the patients one and three months after the trauma. The data was analyzed using Friedman and Wilcoxon tests.
The data of 157 patients was analyzed. The results showed that there was a significant difference in the severity of depression disorders, anxiety and stress in three stages of the study (P0.05).
The prevalence of depression, anxiety and stress is increased in people with lower limb traumas. Therefore it is recommended that the patients with lower limb traumas to be supported mentally, socially and economically.

Children’s initial lexicon vocabulary is one of the main dimensions of language development that is associated with the children utterance length mean. The aim of this study was to examine the most frequent expressive vocabulary of children 18 to 24 months in Sorani Kurdish language.
The present research was conducted longitudinally (for 3 months) with a group of 16 Kurd children in city of Bukan. Data collection tools included, weekly vocabulary form, vocabulary list and demographic questionnaire. Nonparametric Friedman and Mann-Whitney U Tests were employed for data analysis.
Among the 67 words which were mostly uttered by 18 month children the highest percentage of words (60%) were the real words, that 68% of them were nouns. The highest percentage of the nouns used were included the categories of important people in life (30%), categories of animals (22%) and food (15%). The results of the Mann-Whitney test (p-value >0.05) showed that the two sexes did not display a significant difference in terms of expressive vocabulary and the results of Friedman nonparametric test (p-value Children at their early years of life used the functional words (family, food) and words with easier pronunciation, which the percentage of expression of nouns was more than the verbs

In the recent years, brain simulation and mental imagination has been raised as a new and useful technique in rehabilitation of the neurological patients. One of the common problems of MS patients is fatigue and with regard to the overall impact of fatigue on quality of life, balance and sleep quality, there was a need to examine the impact of mental exercises to improve performance in these people. Therefore, the aim of this study was to evaluate the impact of the mental exercises in improving the sleep quality, fatigue, functional balance and walking in patient with MS.
Case In this study, the patient was a women with the secondary progressive multiple sclerosis experiencing the balance and gait disorders and pain. The new mental practice approach was employed for her treatment in 12 sessions, each for 30 minutes. The patient was assessed for walking, functional balance, fatigue and sleep quality before and after treatment. The comparison between evaluations before and after treatment showed recovery from fatigue 13%, gaining ability to walk 22% and the improvement in sleep quality was 18%. Functional balance also showed a significant difference in compare to before treatment.
The findings from this case report suggest that mental practice can be an effective method for improving sleep quality, fatigue, functional balance and walking in people with multiple sclerosis

Mastalgia is a common but concerning problem for most women referring to medical centers. Vitamins are one of the medical treatments which are used in the treatment of mastalgia. The aim of this study was to evaluate the effect of vitamin B6 on mastalgia.
In a randomized double blind clinical trial, patients with mastalgia, who referred to Amir-al-momenin and Kowsar Hospitals in Semnan, Iran, were divided in two study groups. Patients in the case group received vitamin B6 100mg BD for two months and patients in the control group took placebo in a similar route. The patients filled the daily breast pain charts and at the end of the trial, the mean pain score and the number of days with severe pain in the two groups were compared.
Patients (n=126) were evaluated. The mean pain score and the prevalence of severe pain decreased significantly in both groups. In the case group, the mean pain score and the prevalence of severe pain were decreased significantly from the beginning to the end of trial. In both groups, there was a significant reduction of breast pain in the first 5 days. This might be the effect of primary reassurance. No adverse effect of treatment was observed in any of the patients
Vitamin B6 is effective on mastalgia as a safe drug. In addition, primary reassurance has a significant effect on the reduction of the breast pain.

Negative consequences of infertility and its treatment involve women more than men. Psychological pressures of infertility negatively affect some in fertility treatment outcomes such as quality of life. In this study the rational relationship among anxiety, life satisfaction, quality of life and also the relationship between psychological factors and quality of life in infertile women was analyzed.
In this cross-sectional analytical study, 125 infertile women referring to Royan institute (Iran) were selected by convenience sampling. The participants were asked to complete the self-administered questionnaires of anxiety, life satisfaction and quality of life. SEM was used to assess the predictive relevance of the proposed model and partial least square (PLS) was used to estimate the model parameters.
The results of this study indicate that life satisfaction has direct and indirect effect on the quality of life of infertile individuals. Life satisfaction improves the quality of life and it also improves the quality of life through decreasing infertile people's anxiety. The Sobel test result shows that anxiety, as a mediator variable, influences the relationship between life satisfaction and quality of life.
Finally, the anxiety mediated indirect effect of life satisfaction on quality of life of infertile individuals is stronger than its direct effect.

Tuberculosis is an important health challenge with a worldwide increasing trend, especially in developing countries. Early diagnosis and advances in the effective treatment are two of the key elements in tuberculosis control program. The current study was designed to determine the delay in diagnosis and treatment of pulmonary tuberculosis patients regarding to clinical signs and risk factors.
This is a historical cohort study that conducted with inclusion of 113 tuberculosis patients from Markazi Province of Iran (Saveh and Zarandieh) between 2008 to 2014. Data was provided by a self-structured questionnaire and patient’s medical records. Data was analyzed by t-test and analysis of variances.
The mean age of patients was 57.7±92.1 years, with 52.2% being females. The mean of total delay was 129.9±171 days; including patient 52.7±92.1, health system 47±91.9 and treatment 2.1days. The mean in diagnosis and treatment delay did not show significant differences with gender, marital and nationality of patients. But patients with coughing more than two weeks had shown lower patient’s delay. In addition, patients who had previous contact with tuberculosis patients showed shorter diagnosis’ delay (p Long delay in early diagnosis and treatment is the result of defect finding the cases of tuberculosis within the health system, especially in urban communities. Therefore, increasing the level of health awareness about signs of disease and clinical symptoms would be effective in accelerating the references of suspected people to the health systems

The patients with polyps and ulcerative colitis diagnosis are more susceptible to colorectal cancer. So far, the diagnosis of colorectal diseases has been dependent on invasive procedures, such as sigmoidoscopy and colonoscopy. However, some recent research has been initiated for early diagnosis of colon cancer by using1H nuclear magnetic resonance (1H NMR) spectroscopy and chemometrics methods. In this study, spectrum results of patients and samples of normal subjects were compared.
Participants who referred for colonoscopy (n=40) filled a consent form.They had received liquid diets for last 72 hours. Blood samples were collected in heparinized tubes. Samples were collected from patients who were diagnosed with polyps and also normal subjects. The separated plasma samples were sent for 1HNMR spectroscopy using CPMG Spin-echo methods. The samples were analyzed using ProMetab software, with performance of Principle Component Analysis. The different metabolites were identified by their chemical shifts.
There were 1624 metabolites in each spectrum. Effective metabolites were detected using Human Metabolome Data Base and effective metabolic cycle were determined using metaboanalyst Data Base.
These findings indicated that the metabolism of amino acid tRNA synthase, histidine, cyanoamine and thiamine are the main differentiating metabolic cycles involved in the production of colorectal polyp.

Cryopreservation techniques are useful methods for long-term storage of cells and tissues of the reproductive system. The purpose of this study was to investigate the development and survival rate of vitrified preantral follicles compare with those of isolated preantral follicles from vitrified ovaries.
Preantral follicles of 14 to 16 days-old of NMRI mice ovaries were randomly divided into three groups. Group I: preantral follicles derived from fresh ovaries (control). Group II: preantral follicles derived from vitrified ovaries and group 3: vitrified preantral follicles. After thawing, preantral follicles were cultured in α- MEM medium containing 5% FBS, 100 mIU/ml hFSH, 1% ITS and 10 ng/ ml EGF. At the day 12 of culture, ovulation was induced by adding 1.5 IU/ml hCG. The preantral follicle diameter and the rates of survival, antrum formation and developmental stages of released oocytes were evaluated.
The results showed that the survival rate of vitrified preantral follicles was significantly higher than that of isolated preantral follicle from vitrified ovaries. The mean diameter of preantral follicles, the rates of antrum formation and MII stage oocytes in vitrified preantral follicles were significantly higher than those of isolated preantral follicles from vitrified ovaries.
Vitrified preantral follicles were more suitable to develop to mature oocytes in comparison with isolated preantral follicles from vitrified ovaries.

Ziziphora tenuior L. (Z. tenuior) has multiple biological activities such as spasmolytic, antidiarrheal, analgesic, antidepressant and sedative effects. In the present study, the effect of ethanolic extract of Z. tenuior on morphine withdrawal symptoms was investigated in the male mice.
In this study, 40 male mice weighing 20-30 g were used. The animals were divided into five groups of eight. The study groups included negative control or normal saline (10 ml/kg), positive control or clonidine (3.5 mg/kg), and different doses of Z. tenuior (50, 75, and 100 mg/kg). Dependency on morphine was induced by administration of different doses of morphine (50, 50, 75, and 50 mg/kg) in four days. On last day, after administration of single dose of morphine, naloxone (5 mg /kg) was injected and morphine withdrawal signs were observed and recorded within 30 min. All drugs and extracts were injected intraperitoneally with a single volume of 10 ml/kg.
Results showed that at all doses (50, 75 and 100 mg/kg) of Z. tenuior extract, significantly decreased the number of jumping (P Our results showed that ethanolic extract of Z. tenuior could alleviate morphine withdrawal signs. However, to determine the exact mechanism of action for Z. tenuior , the components have to be isolated and studied individually.

The aim of present study was to investigate the effects of eight weeks aerobic training on amyloid β42 (Aβ1-42), neprilysin and γ-secretase levels in the hippocampus of male rat Alzheimer's model by homocysteine injection.
For this purpose, 50 male Wistar rats (12 weeks old) were divided into five groups, including: Alzheimer’s control, Alzheimer's training, healthy control, healthy training and sham. To induce Alzheimers, homocysteine, with a concentration of 0.6M, was infused into the rat cerebroventriculum. To assess the memory impairment induced by homocysteine, the shuttle box test was used. Training groups, exercised using treadmill with 27m/min at 0◦ slope (75-80% VO2max, 60min/day, 5 days/week). Amyloid β42, neprilysin and γ- secretase levels were measured using rat ELISA kit.
The results showed that Aβ1-42 levels in the hippocampus of Alzheimer's control group was significantly higher than healthy control and healthy training group (P=0.001). The level of γ- secretase in Alzheimer's control group was significantly higher than healthy control, healthy training and sham groups (P=0.001). Likewise, levels of this factor in Alzheimer's training group were significantly lower than Alzheimer's control group (P=0.001). No significant differences were found between neprilysin levels in different groups (P=0.07). Mean level of Aβ1-42 showed a significant positive correlation with γ- secretase level (r = 0.54; P = 0.001).
Based on these results, it s likely that continuous physical training can markedly reduce Aβ level in the hippocampus through reducing the level of γ- secretase and would be warrant to be considered as a complementary therapy in Alzheimer's disease

Elastin-like polypeptide (ELP) s an artificial biopolymer and a pentapeptide with repeating motif of Val-Pro-Gly-Xaa-Gly (VPGXG). The structure is derived from extracellular cellular matrix (ECM) elastin. Protein-based polymers, which are composed of repeat units of natural or unnatural amino acids, have recently emerged as a promising new class of materials. The unique properties of ELPs such as being genetically encoded in a heterologous host (e.g., bacteria or eukaryotic cell), excitability under the influence of environmental factors, biocompatibility and biodegradability made them popular in a wide variety of biomedical applications.
In this study, 330bp GRGDS-ELP monomer gene (expressing21 pentapeptide) was oligomerized into the cloning vector pUC to produce 990bp trimer gene (expressing63 fusion pentapeptide).After confirming gene structure by sequencing, the gene sequence was subcloned into pET-MOD expression vector and transduced into the E.coli.
Recombinant protein expression was induced by IPTG and the accuracy of the recombinant protein was confirmed by SDS-PAGE and Western blotting.
With mentioned method, ELP was obtained for further studies

Probiotics are beneficial microorganisms that have been used in food production as well as health promotion over the centuries. Recombinant probiotics are used to express and transfer native or recombinant molecules to mucosal surface of digestive tract to promote efficiency in nutrition and health. Lactococcus lactis is a potential candidate for the production of useful biological proteins. Since there is not any vector nominated for this bacterium to show the extracellular protein secrition properties, therefore the aim of this study was to increase the efficiency of expression and secretion of recombinant proteins by adding transmission signal peptide usp45 to pBU003.
usp45 signal peptide has 81 nucleotides and previous studies indicated that it can also cause increase in the gene expression. In this study, after synthesising usp45 signal sequence, it was ligated into pBU003. Then the vector was transformed to Ecoli (MC1061). The recombinant plasmid named pFUM003 after “plasmid Ferdowsi University of Mashhad 003”.
Sequencing of recombinant plasmid containing usp45 showed that the plasmid had correct construction and the inserted sequence had exact match with the reference sequence (EU382094.1) reported in NCBI's GenBank.
The recombinant plasmid was named pFUM003. This recombinant plasmid structurally was correct and can be used to transmit into probiotics make them to benefit from extracellular protein production properties.

Gastric cancer is one of the most common and lethal malignancies in the world. All-trans retinoic acid (ATRA) has been widely used to treat cancers, most notably for the acute promyelocytic leukemia (APL) - as a differentiation inducer. Notch signaling plays important roles in cell proliferation and apoptosis. Aberrant activation of notch signaling pathway has been stated in different malignancies including gastric cancer. The aim of this study was to assess the possible effects of ATRA on cellular viability, cell cycle shift and apoptosis induction of gastric MKN-45 cell line. Moreover, alterations of notch1 and hes1 gene expression profiles after ATRA treatment have been considered.
Human gastric carcinoma cells (MKN-45) were treated with increasing concentrations of ATRA (2.5, 5, 10, 15, 20, 25 µM). The viability of cells was determined with 3-(4, 5-dimethlthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Caspase-Glo 3/7 assay kit was applied to measure the apoptosis. Flow-cytometry was employed to distinguish cells in different phases of cell cycle. Expression profiles for the notch1 and hes1 genes were evaluated by reverse transcriptase PCR (RT-PCR).
MTT assay showed that ATRA could diminish MKN-45 cell line viability rate; the most effective dose was 10 µM. Concentrations higher than 10 µM of ATRA had no significant effect on reducing cancerous cell viability. Furthermore, ATRA treatment significantly amplified caspase3/7activation. Flow-cytometry analyses showed significant accumulation of cells in G1 phase of cell cycle in ATRA treated group in compare to control. Following treatment with ATRA, showed a significant reduction in notch1and hes1 genes profile expression.
According to our findings, ATRA could exert its cytotoxic effects on gastric cancer MKN-45 cell line through reducing cellular viability and inducing apoptosis. Remaining at G1 phase of cell cycle and reducing notch1 and hes1 gene expressions suggest the antiproliferative activity of ATRA

Activated platelets in platelet concentrate, release membranous vesicles that called platelet microparticles and can be created spontaneously during the storage of platelets. Studies have shown that platelet microparticles can form aggregates with monocytes so we intended to survey the ability of these microvesicles to activate monocytes.
Platelet concentrate bags (PCs) were prepared from Iranian Blood Transfusion Organization in Tehran. Sampling of the bags and isolation of PMP was carried out during storage. Besides, the respiratory burst of monocytes was measured by flow cytometry technique before and after treatment with PMP using di-hydrorhodamine-123 (DHR-123).
Monocyte cells derived from human peripheral blood were activated after exposure to platelet microparticles and intracellular respiratory burst was significantly increased (P-value = 0.01). These findings suggest that PMPs have a dose-dependent effect on monocytes and they are more effective at the concentration of 500 micrograms per milliliter.
This study showed the potential of platelet microparticles in the stimulation and activation of human peripheral blood monocytes.