مجله دانشگاه علوم پزشکی اردبیل
پیاپی 60 (تابستان 1395)

Fluoroquinolones have important role in treatment of P. aeruginosa infections. The main mechanism of fluoroquinolones resistance in P. aeruginosa is mutations in the quinolone-resistance-determining region (QRDR) of gyrA and parC genes. The aim of this study was to investigate the role of these mutations in ciprofloxacin resistance in different clinical isolates of P. aeruginosa.
A total of 75 clinical P. aeruginosa isolates were collected from different university-affiliated hospitals in Tabriz. Minimum inhibitory concentrations (MICs) of ciprofloxacin were evaluated by Etest assay. DNA sequences of the QRDR of gyrA and parC were determined by dideoxy chain termination method.
From 75 isolates, 77.33% were resistant to ciprofloxacin. No amino acid changes were detected in gyrA or parC genes of the ciprofloxacin susceptible isolates. Thr-83→Ile substitution in gyrA was observed in all ciprofloxacin resistant isolates. About 90% of them had Ser-87→Leu substitution in parC. Geometric mean MICs of ciprofloxacin were different for various clinical isolates of P. aeruginosa which had the same situation in type and location of gyrA and parC mutations. Moreover, the geometric mean MIC in isolates from urine was significantly (p Mutations in gyrA and parC genes are the major mechanisms for ciprofloxacin resistance in clinical isolates of P. aeruginosa. Moreover, the role of different effective factors in fluoroquinolone resistance can be different in various clinical isolates of P. aeruginosa.

Obesity is associated with metabolic abnormalities such as insulin resistance. Weight loss is always recommended for meaningful reduction in these abnormalities. Therefore, we examined the effects of balanced low calorie diet on weight loss, fasting insulin and insulin resistance in obese women attending the nutrition clinic.
In this clinical trial, forty five volunteer apparently healthy obese women (body mass index: 33.28 ± 2.90 kg/m2 and age: 28.40 ± 7.98 years) were recruited from the nutrition clinic in their first visit. The participants were received a balanced low calorie diet over 6 months after anthropometry measurement and blood sampling for determination of fasting insulin and insulin resistance level. Balanced low calorie diet was an individualized diet with an energy deficit of 500 calories of daily energy intake that was calculated from 3-day food records for every person. At 6 months after intervention, continuous and dichotomous variables were assessed using paired t-test and McNemar test, respectively.
The mean recommended energy intake was 2241.78 ± 219.02(kcal). After 6 months, there were significant reductions in body weight (p=0.003), body mass index (p=0.005), waist and hip circumferences (p In obese women attending the nutrition clinic, the balanced low calorie diet resulted in weight loss and improvement in fasting insulin. These positive changes can help to decrease the risk factor profile in obese individuals.

Spinal dural arteriovenous fistula (SDAVF) is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal.
Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment.
SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.

One of the most proven trajectories for analyzing the drug consumption patterns in the community is to assess the prescriptions. Using the antibiotics for prevention and treatment of infectious diseases not only leads to the loss of pathogens but also causes various complications, the most important of which is the drug resistance. The aim of current study was investigating the different antibiotics prescript by general practitioners (GPs) for outpatients in Ardabil city.
This study is designed based on the cross-sectional method. The number of 2,000 copies (according to Morgan) from total of 526000 copies sent to Ardabil health insurance during the 4 seasons of 2013 were randomly evaluated. The collected data were analyzed by descriptive statistics, ANOVA and T-Test using SPSS software. The P ≤0.05 was considered statistically significant.
In this study the average drug per prescription was 3.6 and 54.9% of the prescriptions included antibiotics so that the cefixime, azithromycin, Co-amoxiclave and penicillin 6.3.3 were the most frequently prescribed antibiotics, respectively. The highest prescriptions belonged to penicillins (39.4%) cephalosporins (27.7%) and macrolides (18.3%). The most expensive antibiotic was cefixime tablet (32% of the total cost). The most of the antibiotics were prescribed to be taken orally (tablets or capsules). The mean price of each prescription was 74539±71050 Rials. The highest rate of antibiotic prescription was related to the autumn and then winter and there was a significant relationship between the the number of antibiotics in different seasons of the year (p = 0.005).
The average drugs of each prescription are in accordance with local statistics, but much higher than the global figures. The frequency of antibiotics prescription was higher than the global, several Middle Eastern and even African countries’ indices but was lower than the average level of some regions in the country. The pattern of prescribing antibiotics among the Ardabil GPs shows the more drugs in number and expensive broad-spectrum. The average price of prescripts was higher than the national average. These findings suggest that prescription and using antibiotics is not desirable in Ardabil.

Pars Abad Moghan city, due to the mild weather and numerous Pastures for animals feeding, is a suitable place for breeding sheep and goat. Babesiosis is one of the most important parasitic infection in animals, especially ruminants. Babesia is a protozoa living inside the red blood cells and transmitted to the host by hard Tick especially Rhipicephalus, Hyalomma, Dermacentor and Haemaphysalis. The aim of this study was to consider Babesia infection in sheep of Pars Abad Moghan city.
In order to investigate the prevalence of babesia, 105 sheep in two different seasons of spring and summer were prepared and blood sample was taken and thin and thick smears were done. Thin blood smear was fixed with methanol and in order to determine the presence of the protozoan parasite, Giemsa with ratio of 1 to 14 in distilled water was used for staining.
The results showed that the number of 33 samples (31.42%) were infected with Babesia. Among these, 18 samples (17.14%) were infected with Babesia ovis, 9 (8.57%) with babesia motasi and 6 samples (5.71%) were infected simultaneously with both species of Babesia ovis and Babesia motasi.
The rate of infection to Babesia among the sheep in Pars Abad Moghan city is remarkable. Early diagnosis and early treatment can prevent spread of the disease in this area.

Prostate cancer is one of the main reasons of death between men. Although there are many methods for treatment of this cancer but most of the patients still are died of the postoperative recurrence and metastasis of disease. Over expression of HMGA2 gene was observed in many human malignancies such as colorectal cancer, thyroid, pancreatic carcinoma and lung cancers. The aim of this study was to investigate the effect of HMGA2 specific small interfering RNAs (siRNAs) on viability and apoptosis in PC3 prostate adenocarcinoma cell line.
siRNA transfection was performed with liposome approach. The cytotoxic effects of siRNA were determined using MTT assay on the PC3 cells and apoptosis was quantified using TUNEL assay.
Transfection with siRNA significantly suppressed the expression of HMGA2 gene in dose dependent manner after 48 hours resulting in spontaneous apoptosis. Moreover, siRNA transfection had effects on prostate cancer cells viability.
Our results suggest that the HMGA2 specific siRNA effectively decreases prostate cancer cells viability and induces apoptosis in this cell line. Therefore it can be considered as a potent adjuvant in prostate cancer therapy.

PCOS is one of the most prevalent endocrinology disorders and 5-15% of women in fertility age suffer from this disease. The leptin a 167 amin oacid peptide is secreted from adipose tissue in a pulsatile fashion. This hormone is essential in regulation of normal body weight and like the klotho hormone that is expressed most prominently in the distal convoluted tubules of kidneys and the choroid plexus of brain, has a role in pathogenesis of reproductive disorders. The secreted klotho has been identified as an anti-aging and anticancer hormone. Metformin is an anti-hyperglycemic drug with anorexic properties that could influence the function of ovaries.
In this case-control study, 45 patients with PCOS who referred to the infertility center of Jahad-e-Daneshgahi in the city of Ardabil from March 2013 through March 2014, were selected in accordance with the NIH criteria. Moreover, 45 healthy women were also selected as the control group. BMIs were calculated by division of weight by square of height and insulin resistance index was calculated by HOMA-IR model. Leptin and klotho serum levels were measured using ELISA kit. In the case group the measurements were repeated after a one-month course of therapy with metformin. Data analysis performed by SPSS software using dependent and independent t-tests.
PCOS patients showed significant improvements after receiving metformin for one month.
Patients’ weights showed some decline. Fasting plasma glucose levels and insulin resistance decreased significantly (p This study showed that metformin treatment can cause a rise in klotho and a decrease in leptin levels without considerable effects on the weights of women with PCOS. Probably, leptin exerts its physiological effects in low concentrations while klotho in contrast acts physiologically in higher concentrations.

Stroke is third leading cause of death and disability in the most of human communities. Several experimental studies have shown that combination therapy with drugs that act via different mechanisms can produce amplified protective effects. We examined the effects of combination therapy with candesartan and alpha tocopherol against cerebral ischemia.
Male Sprague-Dawley rats were divided into five groups (n=24): sham, control ischemic, candesartan treated (0.3 mg/kg), alpha tocopherol treated (30 mg/kg) and combined treated ischemic groups. Transient focal cerebral ischemia was induced by 90-min-long occlusion of the left middle cerebral artery followed by 24-h-long reperfusion. Neurological deficit score was evaluated at the end of the reperfusion period. Thereafter, the animals were randomly used for measurement of the infarct volumes and investigation of ischemic brain edema formation using a wet/dry method.
Induction of cerebral ischemia produced considerable brain infarction in conjunction with severely impaired motor functions and edema formation. Combined treatment with candesartan and alpha tocopherol significantly reduced the infarct volume and lowered the water content in the ischemic lesioned hemisphere. These effects on brain edema and oxidative stress biomarkers were significantly more than the monotherapy with candesartan.
The combination therapy with candesartan and alpha tocopherol can noticeably decrease ischemic brain injury and attenuate edema formation likely via increasing the antioxidant activity.

Estrogen reduction after the menopause is associated with visceral adipose tissue accumulation and insulin resistance. Serum omentin-1 level is also decreased by abdominal obesity and insulin resistance. This study investigated the effect of estrogen on visceral fat, omentin-1 and insulin resistance in ovariectomized (OVX) rats.
Thirty 13-week-old female Wistar rats weighing180±5 gr were randomly matched on their body weight and divided into OVX (n=20) and sham-operated (SHAM; n=10) groups. OVX rats were subdivided into estrogen replacement therapy (Ovxዋ; n=10), and control (Ovx뇫᪙ Oil; n=10) groups. The estrogen replacement therapy received 17b-estradiol (30µg/kg bw; in 0.2 ml sesame oil) three days a week, for eight weeks. Ovx㨩 received the same sesame oil subcutaneously as vehicle. All intra-abdominal fat depots were dissected out and weighed immediately. Omentin-1 concentration was measured by rat omentin ELISA kit and HOMA-IR was used to estimate the insulin resistance. Obtained data were analyzed by ANOVA and post hoc Tukey test.
Visceral fat was decreased by 12.84% in Ovxዋ compared to Ovx㨩 group; but it wasn ́t significant. Whereas, body weight was significantly decreased by 7.87 % in Ovxዋ compared to Ovx㨩; and it was significantly increased by 12.5% in Ovx㨩 compared to SHAM group. Omentin-1 level was significantly increased by 41% in Ovxዋ compared to Ovx㨩 group; whereas it was significantly decreased by 13.9% in Ovx㨩 compared to SHAM group. The levels of glucose, insulin and HOMA-IR were significantly decreased to 51.16%, 24.23% and 61.52%, respectively, in Ovxዋ group compared to the rats in Ovx㨩 group (p=0.0001).
8-week estrogen reduces body weight and improves insulin resistance probably via increase in omentin-1.

Type 2 diabetes is a metabolic disorder considered as one of the most common chronic diseases in many countries, including Iran. One of the reducing factors in insulin sensitivity is increased serum levels of inflammatory factors like hsCRP and TNF-α. On the other hand, in recent years, Cuminum Cyminum is known as one of the potent herbs in the treatment of diabetes type 2 in animal studies. The aim of this study was to evaluate the effect of two doses of 50 and 100 mg of Cuminum Cyminum extract on glycemic indices and indicators of inflammation in human subjects with type 2 diabetes mellitus.
This study is a double blind randomized clinical trial performed in Urmia city on 2015. Samples were selected based on inclusion criteria and randomly divided into 3 groups: two groups receiving Cuminum Cyminum extract of 50 and 100 mg per day and the control (placebo) group. Before and 8 weeks after intervention, fasting blood sugar, serum insulin and inflammatory profile of hsCRP and TNF-α were measured. Data were analyzed by SPSS and the effect of supplementation was studied.
The mean age of the all participants was 47.33±6.36. Results showed that the mean fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and serum insulin reduced significantly in the both groups receiving Cuminum extract of 50 and 100 mg(p This study indicates that short-term daily supplementation of Cuminum Cyminum extract at the doses of 50 or 100mg in patients with type 2 diabetes during 8 weeks may act to reduce the serum levels of insulin, blood glucose, glycosylated hemoglobin and hsCRP and TNF-α levels, and also may be fruitful for control of this disease.

Cyclophosphamide is one of the common drugs used for cancer treatment. Cyclophosphamide affects the placenta and it is teratogenic in pregnant women. The purpose of this study was to evaluate the protective effects of Mesna and Galbanum essential oil concurrent administration against cyclophosphamide toxicity in rat placenta tissue.
22 pregnant female rats were randomly divided into 3 groups: (1) control (normal saline, n=7 rats), (2) cyclophosphamide (15mg/kg, n=7 rats), (3) cyclophosphamide (15mg/kg), Mesna (100mg/kg) and Galbanum (200mg/kg, n=8 rats). Medications were administered intraperitoneally on the 13th day of pregnancy. Then, rats were sacrificed on the 20th day of pregnancy. The placenta was separated and fixed after macroscopic evaluation. 5 µm tissue sections were prepared, stained and studied by light microscopy.
Cyclophosphamide reduced the placental weight, thickness and the length of the small and large diameters. Histologically, it reduced the thickness of the labyrinth and basal layers, caused necrosis and congestion in these layers, reduced giant cells numbers and caused their nuclear shrinkage (p0.05) but histologically it could increase the labyrinth and basal layers thickness and also the giant cells numbers (p Mesna and Galbanum oil preserved the placenta of pregnant rat against toxic effects of cyclophosphamide probably by its antioxidant features and free radicals deletion.