mohammad aghazadeh
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امروزه عمده درآمد شهرداری های ایران را منابع ناپایداری همچون عوارض و جرایم ساختمانی تشکیل داده است و چنین رویکردی آن ها را به سمت بحران مالی، چالش در مدیریت شهری و درنهایت به نارضایتی شهروندان سوق داده است؛ لذا در شهرهای توسعه یافته ی دنیا جهت پایدارسازی و درآمدزایی اقتصاد شهرداری ها، از ظرفیت گردشگری به عنوان یکی از محرک های اصلی و تاثیرگذار در واکاوی اقتصاد شهری استفاده می کنند؛ بنابراین هدف اصلی این پژوهش، ارایه ی مدل جامع از درآمدزایی پایدار شهرداری ها مبتنی بر گردشگری است و روش تحقیق با استفاده از رویکرد تفسیری و روش نظام مند فراترکیب بوده و جامعه ی آماری بر اساس یافته های مطالعات کیفی سایر محققین در حیطه ی درآمد پایدار شهرداری ها مبتنی بر گردشگری در بازه ی زمانی سال 1370-1398 شمسی است. روش نمونه گیری به صورت سیستماتیک، 26 مقاله را از بین 315 مقاله بر اساس عنوان، چکیده، تحلیل محتوای مقاله ها با ابعاد و مولفه های مرتبط با قابلیت نوآوری مبتنی بر درآمد پایدار شهرداری ها از صنعت گردشگری انتخاب نموده است و داده ها بر اساس استراتژی تحلیل محتوی با استفاده از نرم افزار Maxqda کدگذاری و بر اساس شاخص «دو کدگذار» جهت ارزیابی پایایی و کنترل کیفی یافته ها با 92/. توافق عالی بین دو ارزیاب منتج گردید. یافته های تحقیق حاضر نشان می دهد که از 131 کد اولیه، 15 کد دارای مفاهیم و با 6 مقوله ی اصلی و تاثیرگذار به عنوان منابع بالقوه در ایجاد درآمد پایدار شهرداری ها مبتنی بر گردشگری همچون برگزاری جشنواره ها، مراسمات ویژه و ایجاد ارتباطات، برنامه ریزی اوقات فراغت، توسعه ی زیرساخت های حمل ونقل شهری، استفاده از ظرفیت پنهان جاذبه ی گردشگری شهری، احداث فضاها و محیط های گردشگری، تقویت نقش های چندگانه گردشگری می توانند به عنوان راهبرد در نظر گرفته شوند و درنهایت، حاصل پژوهش صورت گرفته، ارایه ی مدل مفهومی کاربردی برای پایدارسازی درآمد شهرداری ها مبتنی بر گردشگری است.
کلید واژگان: گردشگری، اقتصاد شهری، ظرفیت های پنهان شهری، درآمدزایی پایدار، شهرداری ها، فراترکیبToday, the major source of income for Iranian municipalities is the unstable resources such as construction fines and charges and Such an approach has led them to the financial crisis, the challenge of urban management and ultimately to citizens' dissatisfaction. So, in the developed cities of the world, tourism is used as one of the main and influential drivers in analyzing the urban economy in order to sustain and monetize the economy of municipalities. Therefore, the main purpose of this research is to present a comprehensive model of municipalities' sustainable income generation based on tourism. For the research method, interpretive and systematic meta-synthesis approach has been used and the statistical population is based on the findings of qualitative studies of other researchers in the field of sustainable income of the municipalityS based on tourism in the period of 1370-1388 solar years and systematic sampling method has selected 26 articles from 315 articles, based on the title, abstract, content analysis of articles with dimensions and components related to the capability of innovation based on sustainable income of municipalities from the tourism industry. Data were coded using Maxqda software based on content analysis strategy and based on the "double coding" index to evaluate the reliability and quality control of the findings, with 0.92 excellent agreement was reached between the two evaluators. The findings of the present study show that 131 initial codes, 15 codes with concepts and with 6 main categories and effective in creating sustainable income of municipalities based on tourism are effective in holding festivals, special ceremonies and communication, leisure planning, development of urban transportation infrastructure, Using the hidden capacity of urban tourism attractions, constructing tourist spaces and environments, reinforcement the multiple roles of tourism and tourism They can be considered as a strategy, finally, the result of the research is the presentation of a practical concept model for stabilizing the income of municipalities based on tourism.
Keywords: Tourism, urban economy, Urban hidden capacities, Sustainable Income Generation, Municipalities, Meta-synthesis -
BackgroundThis study aimed at evaluating the effect of the extract and essential oil of Zataria multiflora on reducing phenotypes and genotypes of biofilm formation in clinical isolates of Staphylococcus epidermidis.MethodsThe ability to produce biofilm was evaluated by microtiter plate (MtP) for phenotype and through the presence of icaADB and aap by PCR for genotype among the 153 clinical isolates of Staphylococcus epidermidis. The impact of ethanol extract and essential oil of Zataria multiflora were measured on biofilm formation in phenotypic evaluation based on MtP and on the expression of ica operon and aap by real time-PCR.ResultsThe results showed that 71.2% of isolates were able to produce biofilms. The PCR results showed that 52.2% and 88.9% of the isolates had icaABD and aap, respectively. In addition, the relative mRNA expression of icaA, icaD, and aap genes were significantly reduced compared to the negative control after treating the Staphylococcus epidermidis RP62A with subMIC concentration of essential oil and extract (P < 0.001).ConclusionsGiven the significant inhibitory effect of the extract and essential oil of Zataria multiflora on biofilm formation, it seems that these substances are good options for studies related to controlling biofilm formation in Staphylococcus epidermidisKeywords: Biofilm, Staphylococcus epidermidis, Zataria multiflora
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International Journal of Tourism? Culture and Spirituality, Volume:3 Issue: 1, Summer 2018, PP 26 -56As one of the richest intellectual domains of mankind, Islamic culture has played a prominent role in the formation of diverse dimensions of Islamic community. In this regard, the rich Islamic art, which is intermixed with the elegance of Islamic architecture, is regarded as one of the aspects of Towhid (belief in the oneness of God) and divine worldview. Since the mankind is not a single-dimensional creature, and is innately inclined to beauty and innovation, architects have sought to create an original work imbued with spiritual meanings and themes within a material realm through reliance on their experience, thoughts, individual creativity as well as an aesthetic spirit on one hand, and the manifestation of spirituality and other notions on the other. The contemporary human, by setting out on journey on the earth, has made an attempt to seek knowledge and awareness, and Islamic architecture is considered as an epiphany of human nature as well as a manifestation of contemplation and existence in the depth of human spirit, which is believed to be one of the most significant elements of tourism. The present research is aimed at exploring the conceptual symbols in Islamic architecture originating from Islamic worldview, as the rich Islamic principles have inspired Muslim architects, whose thoughts and environment have been influenced by Islamic worldview. The present article has been written adopting a descriptive-analytical method. The results indicate that architectural elements in Iran have not been created without taking Islamic ideology and concepts into account, but rather all the elements applied are endowed with spirituality and divine symbols.Keywords: art, Islamic architecture, Spirituality, Symbol, Tourism
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Genotyping and Phylogenetic Analysis of Group B Streptococcus by Multiple Locus Variable Number Tandem Repeat Analysis in Iran
Farzaneh Khodaei, Behrooz Sadeghi Kalani, Naser Alizadeh, Alka Hassani, Mohammad Najafi, Enayatollah Kalantar, Abbas Amini, Mohammad AghazadehBackgroundGroup B streptococcus (GBS), also known as Streptococcus agalactiae, is well known as a causative agent for neonatal invasive diseases; it is also a major pathogen in adults. Analytic epidemiology is required to monitor the clinical isolates of GBS. However, there is insufficient information on the genetic background of GBS in Iran, and this information is needed to guide and develop a GBS vaccine.Materials and MethodsIn total, 90 well-characterized GBS isolates were collected from April 2014 to August 2015. In this study, molecular typing was used to disclose a relationship between the multiple-locus variable number tandem repeat analysis (MLVA) types, serotyping, and pilus islands. The isolates were characterized by the types of capsular polysaccharides and pilus islands and were examined by MLVA to study the epidemiological relationship of isolates.ResultsThe results indicate that there is a significant relationship between the distribution of serotypes and pilus island genes; GBS isolates were differentiated into 12 types by capsular polysaccharides and pilus islands analysis. The discriminatory power of an MLVA analysis was high based on the five most variable numbers of tandem repeat loci and 44 MLVA types that were identified.ConclusionsThis study has provided useful insights into the genetic heterogeneity of GBS isolates in Tehran and Alborz, Iran. The extensive distribution of pilus islands in various serotypes and MLVA types throughout the GBS population refers to the advancement of the pilus-based GBS vaccines.Keywords: Antimicrobial Susceptibility_Capsular Antigen_Group B Streptococcus_MLVA Typing_Pilus Island -
BackgroundGastroenteritis is known as the leading cause of morbidity and mortality in children worldwide. Diarrhea is the second leading cause of infant death in the developing countries. Identification of gastroenteritis-causing pathogens helps to control fecal-oral transmission and prevents further outbreaks.ObjectivesThe current study aimed at evaluating the prevalence of bacterial, viral, and parasitic pathogens associated with childrens diarrhea in Ardebil, Iran.MethodsA total of 400 stool specimens were collected from children within the age range of 2 months to 12 years from December 2015 to June 2016 in Bu-Ali hospital in Ardebil, Iran. The samples were tested for bacterial, viral, and parasitic agents.ResultsThe results showed that parasites had the largest proportion of pathogens in the collected samples, followed by bacteria and viruses. The most commonly detected pathogens were: rotavirus, Escherichia coli, and Entamoeba histolytica, respectively. Protozoan parasites showed higher prevalence compared with helminthic infections.ConclusionsRotavirus, E. coli and E. histolytica were the most prevalent agents of diarrhea in childrens aged 2 month to 12 years in this study. Although detection of few micro organisms were considered in our study, the results indicate importance of hygiene improvement in this area. More specified molecular epidemiology studies with evaluating the most common etiologies will be helpful for a better understanding of the frequency of common infections and their transmission in this area.Keywords: Gastroenteritis, Acute Diarrhea, Pediatric, Children Diarrhea, Infectious Diarrhea
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زمینه
ظهور مقاومت های آنتی بیوتیکی به آنتی بیوتیک های خانواده بتالاکتام در میان باسیل های گرم منفی، کاربرد این آنتی بیوتیک ها را محدود ساخته است. این مطالعه به منظور تعیین میزان فراوانی بتالاکتامازهای وسیع الطیف (ESBLs)و وجود خانواده ژنی CTX-M3 (شامل زیر خانواده های CTX-M22و15و3) در باکتری های اشریشیا کلی و کلبسیلا پنومونیه ایزوله شده از نمونه های بالینی مختلف انجام شد.
روش کار71 ایزوله اشرشیا کلی و 63 کلبسیلاپنومونیه از نمونه های بالینی مختلف که به بخش میکروب شناسی بیمارستان سینای ، تبریز، ایران فرستاده شده بود انجام گرفت. باکتری ها با روش های فنوتیپی مرسوم تعیین هویت شدند. تست حساسیت آنتی بیوتیکی با روش دیسک دیفیوژن بر روی محیط مولر هینتون آگار تعیین شد. اشرشیاکلی و کلبسیلا پنومونیه های تولید کننده ی ESBLs ابتدا به روش دیسک ترکیبی و سپس حضور خانواده ژنیCTX-M3 با استفاده از روش PCR مورد بررسی قرار گرفت.
یافته هادر این مطالعه از میان اشرشیا کلی41 (74/57%) ایزوله و در کلبسیلاهای مورد مطالعه 45 (42/71%) ایزوله تولید کننده ی ESBLs بودند. از بین اشرشیاهای ESBLs مثبت 30 (17/73%) ایزوله و از بین کلبسیلاهای ESBLs مثبت 26 (57.77%) ایزوله، دارای ژن CTX-M3 بودند. در بین آنتی بیوتیک هایی که جهت شناسایی ESBLs بودن استفاده شد، بیشترین مقاومت در اشرشیا کلی به سسفپوداکسیم (92%) و در کلبسیلا به سفپودوکسیم (90%) و آزترئونام (90%) مشاهده شد.
نتیجه گیریاین مطالعه شیوع بالا از سویه های اشرشیا کلی و کلبسیلا نمونیه مولد ESBLs را در بیمارستان ما نشان داد. این مشکل اهمیت طراحی نظارت بیشتر کنترل شده بر مقاومت های آنتی بیوتیکی و لزوم انجام مطالعات اپیدمیولوژیک گسترده برای شناسایی باسیل های گرم منفی مولد ESBLs را روشن می سازد.
کلید واژگان: اشرشیا کلی، کلبسیلا نمونیه، بتالاکتامازهای وسیع الطیف، CTX، M3BackgroundEmerging resistance to beta-lactam antibiotics among gram negative bacteria limits their usage. This study was done to determine the frequency of ESBLs producers and presence of CTX-M3 family gene (including CTX-M 3, 15, 22 subfamily) in Escherichia coli and Klebsiella pneumoniae isolated from different clinical specimens in Sina Hospital, Tabriz
Methods71 isolates of E. coli and 63 K. pneumoniae were isolated from different clinical specimens sent to Division of Microbiology, Sina Hospital, Tabriz, Iran. Bacteria were identified by conventional phenotypic methods. ESBL production in E. coli and K. pneumoniae was first detected with combined disc method using Mueller-Hinton agar and later presence of CTX-M3 family gene was detected by PCR technique.
ResultsIn this study, 41 (57.74%) E.coli and 45 (71.42%) K. pneumoniae isolates were observed as ESBL producers. Among them, 30 (73.17%) E. coli and 26 (57.77%) K.pneumoniae were found carrying CTX-M3 gene. Among various antibiotics used for ESBL detection, highest resistance towards cefpodoxime (92%) was observed in E.coli, while in K.pneumoniae 90% isolates show resistance towards cefpodoxime and azterornam.
ConclusionOur study revealed that there is a high frequency of ESBLs producing isolates of E. coli and K. pneumoniae in our hospital set up. The problem elucidates the importance of designing more controlled surveillance of antibiotic resistance and need for large-scale epidemiologic studies to identify outcomes of the ESBL-production in gram negative bacilli.
Keywords: E.coli, Klebsiella pneumoniae, Extended Spectrum beta- lactamase, CTX-3 -
BackgroundMembrane vesicles are non-viable structures released by pathogenic bacteria. They contain numerous antigenic materials from the bacterial outer membrane, making them attractive targets for use as vaccine antigens. The membrane vesicles are related to the virulence because of their capacity to concentrate immunomodulatory molecules and toxins..ObjectiveIn the present study, we examined the membrane vesicles of Mycobacterium tuberculosis as adjuvant and vaccine candidate..MethodsMycobacterium tuberculosis standard strain CRBIP7.11 was cultured at 37°C in Loewenstein Johnson (LJ) media for 3-4 weeks. To confirm the species, standard microbiological and biochemical tests were performed. After preparation of membrane vesicles, the amount of protein in membrane vesicles was measured by SDS-PAGE and Nanodrop. To analyze the integrity and morphology of extracellular vesicles, transmission electron microscopy was used. The lipopolysaccharide was determined using the Limulus Amebocyte Lysate (LAL) kit..ResultsThe total mass of vesicular fraction was 4.8 mg. SDS-PAGE showed protein bands in the approximate regions of 35, 40, 70, and 90 kDa. The amount of membrane vesicles total protein was 1.26 and 1.29 mg/mL. Transmission electron microscopy analysis of pellets revealed that the extracted vesicles are 50-200 nm in size. Also, LaL test showed negative results (values were less than 300 IU)..ConclusionsThe results of the present study give important evidence that actively released mycobacterial vesicles are delivery instruments for immunologically active molecules involved in mycobacterial virulence..Keywords: Adjuvant, Vaccine, Membrane Vesicle, Mycobacterium tuberculosis
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BackgroundDespite the implementation of the national control program, tuberculosis is one of the greatest health problems in Iran. The prevalence of different strains in specific ethnic populations suggests that Mycobacterium tuberculosis transmission has been limited and restricted to close contact..ObjectivesIn the present review, we describe the epidemiology of tuberculosis in Iran..MethodsIn this review article, databases including Scopus, PubMed, and Google scholar were used to search for the epidemiology of tuberculosis in Iran..ResultsSince 1996, tuberculosis incidence has been decreased as the national tuberculosis control program was established in Iran. However, due to the emergence of drug-resistant strains, recurrence of the disease, and association of tuberculosis with HIV pandemic, tuberculosis is becoming a health problem in Iran like many other parts of the world. Moreover, several other factors such as poverty, homelessness, inadequate access to health services, and lack of infrastructure in public health play an important role in worsening the situation. The distribution of the disease is not similar in all parts of Iran and it is higher in the western and eastern parts than the central areas..ConclusionsReview of the studies revealed that levels of multidrug-resistant tuberculosis among new tuberculosis patients are increasing in Iran and the vaccination system needs to be reformed. Because of the increasing number of patients coming from neighboring countries with multidrug-resistant tuberculosis, this area needs more stewardship and control in order to prevent the outbreak of multidrug-resistant tuberculosis. Finally, by improving the healthcare system, it is trusted that a more noteworthy number of these patients will be cured in Iran..Keywords: Epidemiology, Surveillance, Multidrug resistance, Mycobacterium tuberculosis
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BackgroundPseudomonas aeruginosa is main bacterial pathogen accountable for nosocomial infections. Furthermore, it could potentially become resistant to β-lactams, aminoglycosides and fluoroquinolones antibiotics..ObjectivesThe purpose of this study was to determine the antibiotic susceptibility pattern and genotyping of P. aeruginosa in hospitals of Tabriz (Iran) and investigate the prevalence of OXA producer isolates..MethodsOverall, 151 non-replicated isolates of P. aeruginosa were collected from October 2013 until September 2014. Antibiotic susceptibility pattern was determined by disk diffusion (Kirby Bauer) method, according to the clinical laboratory standards institute (CLSI) guideline. Genes encoding OXA (Ambler class D) β-lactamase were detected by PCR for all isolates. Polymerase chain reaction with Enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) primers was used to establish the clonal relationship between the different isolates..ResultsThe frequencies of resistance to antibiotics were as follows: gentamicin: 68%, ceftazidime: 67%, piperacillin: 66%, cefepime: 64%, ciprofloxacin: 62%, tobramycin: 61%, amikacin: 60%, imipenem: 52%, gatifloxacin: 28%, polymyxin B: 2 % and colistin: 2%. The OXA group I genes was identified in 82 (56%), the OXA group II gene in 26 (18%), OXA group III in 14 (9%), OXA-1 in 22 (15%) and OXA-4 in 3 (2%) isolates. The ERIC-PCR indicated high genetic diversity among P. aeruginosa isolates..ConclusionsThe high prevalence of OXA β-lactamase and high genetic diversity of P. aeruginosa indicated that the resistance of P. aeruginosa might be expanding in our studied hospitals..Keywords: Antibiotic, Pseudomonas aeruginosa, Genotyping, Beta, Lactamase OXA, Polymerase Chain Reaction
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PurposeTo compare dry eye signs and symptoms between patients with preoperative low and normal Schirmer test after Photorefractive keratectomy (PRK).MethodsIn this prospective, nonrandomized, comparative case series, 76 eyes of 76 patients were preoperatively categorized into two groups according to selected criteria for characterization of tear film status: the low Schirmer test value (STV) group and the normal STV group. For the tear function assessment, we performed a Schirmer test with and without anesthesia, tear break-up time (TBUT) test, and measurement dry eye symptoms using the Farsi translation of Ocular Surface Disease Index (OSDI) questionnaire pre- and 3 months post-operation.ResultsPostoperatively, the Schirmer and TBUT values were significantly lower in both groups than preoperatively (all pConclusionThese results demonstrated that tear function deteriorates after PRK. Therefore, patients with low preoperative Schirmer test values should be thoroughly assessed for dry eye before proceeding with refractive surgery to eliminate postoperative complication.Keywords: Schirmer test, Photorefractive keratectomy, Tear function
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مقدمهاین مطالعه، به منظور مقایسه ی لایه ی اشک در بیماران مایوپ با خشکی چشم متوسط و طبیعی قبل و بعد از عمل جراحی PRK انجام شد.روش هامطالعه به روش هم گروهی (Cohort) به صورت آینده نگر و با روش نمونه گیری غیر احتمالی به روش آسان انجام گرفت. افراد کاندیدای جراحی Photorefractive keratectomy (PRK)، پس از آزمایش شیرمر 1 (Schirmer''s test I) (بدون بی حسی) به دو گروه طبیعی و دچار خشکی متوسط چشم تقسیم شدند. معیارهای ورود شامل افراد مایوپ خفیف تا متوسط بین 5/5-2 دیوپتر، بدون آستیگماتیسم و یا دارای آستیگماتیسم کمتر از 2 بود که معیارهای جراحی رفراکتیو را داشتند. معیارهای خروج، شامل وجود کنتراندیکاسیون با عمل رفراکتیو قرنیه، مصرف داروهای چشمی، وجود خشکی چشم و عوامل تشدید کننده مثل استعمال سیگار و کار بیش از 3 ساعت در روز با کامپیوتر و عمل جراحی مجدد ریفراکتیو بودند. پس از انجام معاینات کامل برای بیماران قبل از عمل، 3 ماه بعد از عمل معاینات مجدد انجام گرفت و نتایج بررسی شد.یافته هادر مجموع، 78 چشم (از 78 مرد و زن) با میانگین سنی 35-20 سال بررسی شدند. بیماران به دو گروه 42 چشم طبیعی و 36 چشم دچار خشکی متوسط، تقسیم شدند. دو گروه از نظر سن، جنس، میانگین معدل کروی و ضخامت قرنیه، تفاوت معنی داری با هم نداشتند. میانگین آزمایش شیرمر 1 در گروه طبیعی قبل از عمل
14/6 ± 64/28 و در گروه خشکی متوسط چشم 87/1 ± 36/8 بود و نتایج 3 ماه بعد از عمل در گروه طبیعی 12/9 ± 64/24 و در گروه خشکی 44/2 ± 17/6 بود.نتیجه گیریطی عمل ریفراکتیو قرنیه در هر دو گروه طبیعی و دچار خشکی چشم متوسط، مقدار اشک تا 3 ماه بعد از عمل کاهش می یابد، اما احتمال ایجاد خشکی چشم در گروه خشکی چشم متوسط، بیشتر است.کلید واژگان: خشکی چشم متوسط، جراحی Photorefractive keratectomy، کیفیت لایه ی اشکBackgroundThis study aimed to compare tear film in myopic patients with moderate and normal dry eye before and after photorefractive keratectomy (PRK) surgery.MethodsThis was a prospective cohort study which used non-probability convenience sampling method. After running Schirmer's test I (without anesthesia), the patients undergoing PRK surgery were divided into two groups of normal and moderate dry eye. Inclusion criteria for mild to moderate myopic patients was between 2 to 5.5 diopters, without astigmatism or with astigmatism less than 2D which had refractive surgery criteria. Exclusion criteria included refractive surgery contraindications, taking ocular drugs, having dry eye and intensifying factors like smoking, working on computer more than 3 hours a day and repeated refractive surgery. A complete examination of patients was performed before the surgery and 3 months after the surgery, re-examination was performed and the results were evaluated.
Findings: A total of 78 eyes (of 78 male and female subjects) with a mean age of 20-35 were evaluated. The patients were divided into two groups of 42 normal eyes and 36 moderate dry eyes. The two groups had no significant difference in terms of age, gender, spherical mean and corneal thickness. Schirmer 1 test average before the surgery was 28.64 ± 6.14 in the normal group and 8.36 ± 1.87 in the dry eye group. Three months after the surgery, the result was 24.64 ± 9.12 in the normal group and 6.17 ± 2.44 in the dry eye group.ConclusionIn corneal refractive surgery on both control group and moderate dry eye group, tears were reduced by 3 months after the surgery, but the risk of developing dry eye was higher in the moderate dry eye group.Keywords: Moderate dry eye, Photorefractive keratectomy (PRK) surgery, The quality of tear film -
BackgroundCandidiasis is one of the most prevalent and important opportunistic fungal infections of the oral cavity caused by Candida yeast species like Candida albicans, C. glabrata, and C. krusei. In addition, several bacteria can cause oral infections. The inhibition of microbial biofilm is the best way to prevent oral infections.ObjectivesThe aim of the present study is to evaluate the antifungal, antimicrobial, and anti-biofilm properties of ginger (Zingiber officinale) extract against Candida species and some bacterial pathogens and the extracts effects on biofilm formation.Materials And MethodsGinger ethanolic extract as a potential mouthwash was used to evaluate its effect against fungi and bacteria using the microdilution method, and biofilm was evaluated using the crystal violet staining method and dead/alive staining. MTT assay was used to evaluate the possible cytotoxicity effects of the extract.ResultsThe minimum inhibitory concentrations (MICs) of ginger extract for evaluated strains were 40, 40, 20, 20, 20, 20, 10, and 5 mg/mL for Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Bacillus cereus, Acinetobacter baumannii, C. albicans, and C. krusei, respectively. Ginger extract successfully inhibited biofilm formation by A. baumannii, B. cereus, C. krusei, and C. albicans. MTT assay revealed no significant reduction in cell viability after 24 hours. The minimum inhibitory biofilm concentrations (MIBCs) of ginger extract for fungi strains (C. krusei and C. albicans) were greater than those of fluconazole and nystatin (P = 0.000)..ConclusionsThe findings of the present study indicate that ginger extract has good antifungal and antibiofilm formation by fungi against C. albicans and C. Krusei. Concentrations between 0.625 mg/mL and 5 mg/mL had the highest antibiofilm and antifungal effects. Perhaps, the use of herbal extracts such as ginger represents a new era for antimicrobial therapy after developing antibiotic resistance in microbes.Keywords: Biofilms, Antifungal, Antimicrobial, Candida albicans, C. krusei, Zingiber officinale
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Background And ObjectivesThe prevalence of multidrug resistant Pseudomonas aeruginosa is the main reason of new drugs resurgence such as colistin. The main objectives of this study were to determine the antibiotic resistance pattern and the rate of colistin resistance along with its correlation with overexpression of MexAB-OprM and MexXY-OprM efflux pumps among P. aeruginosa isolates.Materials And MethodsHundred clinical isolates were collected from 100 patients during 6 months in 2014. Susceptibility to the eight antibiotics was investigated using Kirby-Bauer and agar dilution methods. The Quantitative Real-time PCR was used to determine the expression levels of efflux genes.ResultsResistance rates to various antibiotics were as follows: ticarcillin (73%), ciprofloxacin (65%), aztreonam (60%), ceftazidime (55%), gentamicin (55%), imipenem (49%), piperacillin/tazobactam (34%) and colistin (2%). In disk diffusion method, only two isolates were non susceptible to colistin, however in agar dilution method the two isolates were confirmed as resistant and two others were intermediate resistant. Sixty eight (68%) isolates were multi-drug resistant and 10 isolates were susceptible to all tested antibiotics. Both colistin resistant isolates showed overexpression of both efflux pumps, but two intermediate resistant isolates exhibited reduction of efflux genes expression.ConclusionsEmergence of colistin resistance is increasing in P. aeruginosa indicating great challenge in the treatment of infections caused by MDR strains of this organism in Iran. ParRS may promote either induced or constitutive resistance to colistin through the activation of distinct mechanisms such as MDR efflux pumps, and LPS modification.Keywords: Pseudomonas aeruginosa, Multi drug resistant, Colistin, MexAB, OprM, MexXY, OprM
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The emergence and spread of carbapenemase-producing bacteria, that hydolyze most β-lactams, including carbapenems, are a major concern of public health system worldwide, particularly in the Middle East area. Since the plasmids harboring resis- tance genes could be spread across other bacterial populations, detection of carbapenemase-producing organisms has become more problematic. These organisms produce different types of enzymes including the most prevalent types including KPC, VIM, IMP, NDM, and OXA-48. Carbapenemase producers are mostly identified among Escherichia coli, Klebsiella pneu- moniae, Pseudomonas aeruginosa and Acinetobacter baumannii. This study reviewed almost all papers, which conducted in the Middle East. In order to decrease the spread of resistance, the regional cooperation has been emphasized by the Middle East countries. The highest resistance, which is mediated by KPC has been observed in Afghanistan, Saudi Arabia and Jordan followed by NDM in Pakistan and OXA in Turkey and Pakistan. It is important to mention that the spread of these types have been reported sporadically in the other countries of this area. This review described the widespread carbapenemases in the Middle East area, which have been identified in an alarming rate.Keywords: Carbapenemase, KPC, NDM, OXA, Acinetobacter baumannii, Enterobacteriaceae, Pseudomonas aeruginosa, Middle East countries
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SCCmec Typing of Methicillin-Resistant Staphylococcus aureus: An Eight Year ExperienceBackground
Methicillin resistant Staphylococcus aureus strains (MRSA) are important pathogens that cause serious diseases in humans. Throughout the recent years, the spread of these strains has increased in medical environments and society, and has become a serious challenge in health systems. Therefore, it is vital to investigate the various MRSA types to identify the origins of the infections and to control the spread of these infections in hospitals..
ObjectivesThe current study aimed to evaluate the different SCCmec types in MRSA isolates from hospitals of Tabriz, by staphylococcal cassette chromosome mec (SCCmec) typing..
Materials And MethodsThe present descriptive and retrospective study was performed on 151 selected S. aureus isolates obtained from clinical specimens who were referred to Tabriz university of medical sciences educational-health care centers from April 2005 to September 2012. MRSA isolates were identified by agar disk diffusion and mecA PCR assays. Ultimately, they were typified according to the genetic diversity of the chromosome cassette of SCCmec and ccr regions..
ResultsOf the 151 isolates, 53 were recognized as MRSA. All of these 53 samples were sensitive to teicoplanin and vancomycin. Antibiotic resistance patterns were as follows: azithromycin 56.6%, ciprofloxacin 28.3%, imipenem 11.3%, meropenem 9.4%, ofloxacin 13.2%, ceftriaxone 66%, cotrimoxazole 49.1%, gentamicin 52.8%, linezolid 11.3%, penicillin 90.6%, and rifampicin 5.7%. The majority of MRSA isolates belonged to SCCmec III (69.8%) followed by SCCmec IVc (7.5%), SCCmec IVa (3.8%), and SCCmec I (1.9%). Other types of SCCmec were not observed in the present study. Moreover, from the 53 MRSA samples, 9 were recognized as non-typable. However, staphylococcal cassette chromosome recombinase (ccr) genetic complex analysis revealed that among the 53 studied samples, 4 isolates had ccr type 1 pattern, and 11 and 32 isolates had ccr type 2 and ccr type 3 pattern, respectively. Furthermore, 6 isolates were considered as non-typable with ccr -typing..
ConclusionsAs about 70% of methicillin-resistant isolates belonged to SCCmec III, the present study can conclude that, over an 8-year period, only one dominant and stable clone of MRSA strain was found in Tabriz hospitals. This finding could be a result of incorrect medical orientations, inadequate infection controlling policies, and insufficient preventive approaches..
Keywords: MRSA, SCCmec Typing, ccr Typing, Multiplex, PCR -
PurposeTo determine the agreement between intraocular pressure (IOP) measurements using an automated non‑contact tonometer (NCT), Goldmann applanation tonometer (GAT), and the ocular response analyzer (ORA) in subjects with primary congenital glaucoma (PCG).MethodsTwenty‑nine eyes of 17 PCG patients underwent IOP measurements using NCT, GAT and ORA. Variables obtained by the ORA were corneal‑compensated IOP (IOPcc), Goldmann‑correlated IOP (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF). A difference more than 1.5 mmHg for IOP was considered as clinically relevant.ResultsMean age of the patients was 12 years. Mean IOP (±standard deviation, SD) was 15.3 ± 2.8 mmHg (GAT), 15.5 ± 6.0 (NCT), 19.2 ± 7.0 (IOPg), and 21.1 ± 7.9 (IOPcc); (P = 0.001). Except for NCT vs. GAT (P = 1.0), the average IOP difference between each pair of measurements was clinically relevant. The 95% limits of agreements were − 10.2 to 10.3 mmHg (NCT vs. GAT), −7. to 15.3 (IOPg vs. GAT), and − 8.1 to 19.0 (IOPcc vs. GAT). The differences in IOP measurements increased significantly with higher average IOP values (r = 0.715, P = 0.001, for NCT vs. GAT; r = 0.802, P < 0.00, for IOPg vs. GAT; and r = 0.806, P < 0.001, for IOPcc vs. GAT). CH showed a significant association with differences in IOP measurements only for IOPcc vs. GAT (r = 0.830, P < 0.001).ConclusionMean IOP obtained by NCT was not significantly different from that of GAT, but ORA measured IOPs were significantly higher than both other devices.Keywords: Goldmann Applanation Tonometer, Intraocular Pressure, Noncontact Tonometer, Ocular Response Analyzer, Primary Congenital Glaucoma
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مقدمه و اهدافپیرچشمی از دست دادن وابسته به سن تطابق عدسی است که منجر به عدم توانایی فوکوس در فواصل نزدیک می شود. اینتراکور یک روش درمانی جدید است که می تواند جایگزینی برای عینک نزدیک باشد. با توجه به گرایش مردم به عدم استفاده از عینک بررسی کارایی و نتایج این روش درمانی اهمیت زیادی دارد. هدف این پژوهش ارزیابی حدت بینایی و عیب انکساری بعد از عمل اینتراکور در افراد پیرچشم بود.مواد و روش هادر این مطالعه که به روش مشاهده ای تحلیلی هم گروهی انجام شد، حدت بینایی و عیب انکساری 22 چشم (چشم راست: 11 و چشم چپ: 11 مورد) از 15 فرد که تحت عمل اینتراکور قرار گرفتند ارزیابی شد. داده های مورد مطالعه، قبل و 12 ماه بعد از عمل مورد آنالیز قرار گرفتند. این افراد تا قبل از این عمل، جراحی چشمی دیگری انجام نداده و آب مروارید و نامنظمی های قرنیه نداشتند. نتایج این مطالعه با استفاده از نرم افزار SPSS-19، آزمون T-test زوجی و Wilcoxon مورد تجزیه و تحلیل قرار گرفت.یافته هامتوسط سن این افراد 4±1/ 50 سال بود (بازه 5/ 44-66 سال). میانگین حدت بینایی تک چشمی اصلاح نشده دور از 20/ 0±74/ 0 دسیمال به 16/ 0±85/ 0 دسیمال افزایش یافت (01/ 0 >P) و حدت بینایی دوچشمی اصلاح نشده دور از 16/ 0±85 /0 دسیمال به 09/ 0±92/ 0 دسیمال افزایش یافت. (05/ 0 >P) حدت بینایی تک چشمی نزدیک با اصلاح دور از 07 /0±27/ 0 دسیمال دوازده ماه بعد از عمل به 15/ 0±39/ 0 دسیمال افزایش یافت (01/ 0 >P) و حدت بینایی دوچشمی نزدیک با اصلاح دور از 07/ 0±30/ 0 دسیمال به 21/ 0±50/ 0 دسیمال افزایش یافت، حدت بینایی اصلاح نشده دوچشمی نزدیک از 05/ 0±23/ 0 دسیمال به 24/ 0±68/ 0 دسیمال افزایش یافت. (001/ 0 >P) همچنین میانگین تغییرات عیب انکساری اسفریکال تک چشمی و حدت بینایی تک چشمی و دوچشمی اصلاح شده نزدیک کاهش معنی دار آماری داشته است. (001/ 0 >P)نتیجه گیریبهبود قابل ملاحظه ای در حدت بینایی دور و نزدیک افراد بعد از عمل اینتراکور ایجاد شد، این بهبود در حدت بینائی نزدیک چشمگیرتر بود.
کلید واژگان: پیرچشمی، حدت بینایی، عیب انکساری، اینتراکورBackground And AimPresbyopia is an age-related loss of lens accommodation that results in an inability to focus at near distances. Intracor is a new surgical treatment for presbyopic patients which claim to be a replacement for near spectacle. Due to great desire among patients for not using spectacles, evaluation of efficiency and results of this surgical treatment has a great significance. The purpose of this study was determining visual acuity and refraction after Intracor surgery in presbyopic patients.Materials And MethodIn an observational cohort study, 22 eyes (left eye: 11, right eye: 11) of 15 presbyopic patients underwent intracore surgery were enrolled. Refractive error and visual acuity were evaluated before and 12 months after surgery. Patients with history of previous ocular surgery, corneal irregularity or incident of cataract were excluded. Statistical analyzes was performed by SPSS-19 software. Paired T-test and Wilcoxon signed ranked test was used.ResultsMean age of patients was 50.1 ± 4 years (range 44.5 to 66 years). Average monocular uncorrected distance visual acuity increased from 0.74 ± 0.20 decimal at base line to 0.85 ± 0.16 decimal at the last visit (P< 0.01). Average binocular uncorrected distance visual acuity increased from 0.85 ± 0.16 decimal at base line to 0.92 ± 0.09 decimal at the last visit (P < 0.05). Average monocular and binocular near visual acuity with distance correction increased from 0.27 ± 0.07 and 0.30 ± 0.07 decimal at base line to 0.39 ± 0.15 and 0.50 ± 0.21decimal at the last visit respectively (P < 0.01). Average near visual acuity without distance correction increased from 0.23 ± 0.05 decimal at base line to 0.68 ± 0.24 decimal at the last visit (P< 0.001). Average of monocular spherical refraction and monocular and binocular corrected near visual acuity had a statistically significant decrease (P<0.001).ConclusionThere was a statistically significant improvement in both distance and near visual acuity after Intracor surgery. Improvement in near visual acuity was more significant.Keywords: Presbyopia, visual acuity, refractive error, Intracor -
Journal of Dental Research, Dental Clinics, Dental Prospects, Volume:8 Issue: 2, Spring 2014, PP 77 -83Background and aims. Various materials and methods have been introduced for obturating cleaned and shaped root canal systems. This in vitro study aimed to evaluate the sealing ability of single-cone obturation technique with mineral tri-oxide aggregate and calcium-enriched mixture based on bacterial leakage approach. Materials and methods. Sixty-four single-canal teeth were prepared and randomly divided into 5 groups, consisting of three experimental groups (n=16) and two control groups (n=8). In group 1, root canal obturation was performed using gutta-percha with 0.02 taper and AH26 sealer by lateral compaction technique. In groups 2 and 3, single Protaper gutta-percha cone was used for obturation with MTA and CEM cement, respectively. A bacterial leakage apparatus was utilized for leakage assessment for 60 days. Leakage comparison between the experimental groups was performed by one-way ANOVA using SPSS 16 statistical software. Results. The mean bacterial leakage intervals in groups 1, 2 and 3 were 33.68±9.39, 40.68±11.03 and 39.56±9.03 days, respectively. One-way ANOVA indicated no significant differences in bacterial leakage between the three experimental groups (P=0.109). Conclusion. Single-cone obturation with well-fitted gutta-percha and MTA and CEM cement is an appropriate alternative for traditional lateral compaction technique.
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مقدمه و اهدافبا توجه به اینکه میزان بستن چشم سالم در درمان آمبلیوپی، بین اپتومتریست ها و چشم پزشکان مختلف، متفاوت است. این مطالعه جهت مقایسه دو روش بستن پاره وقت (2 تا 5 ساعت در روز) و تمام وقت(بیش از 6 ساعت در روز) جهت یافتن حداقل زمان موثر در درمان تنبلی چشم غیر استرابیسمی انجام گرفت.مواد و روش هااین مطالعه از نوع کارآزمایی بالینی بود و جامعه مورد بررسی، کودکان شرکت کننده در طرح سنجش پیشگیری از آمبلیوپی اداره بهزیستی شهرستان تبریز در سال 91 بودند. کودکان آمبلیوپ شرکت کننده در این مطالعه، بصورت بلوکهای جایگشتی تصادفی در دو گروه بستن چشم سالم بطور تمام وقت و پاره وقت قرار گرفتند. معاینات دوره ای بصورت ماهانه انجام شد و به مدت 6 ماه بطول انجامید. نتایج کلیه تست ها به کمک نرم افزار SPSS18 و آزمونهای t مستقل، t زوجی، رگرسیون چندگانه و دقیق فیشر مورد توصیف و تحلیل قرار گرفتند.یافته هااز کل 4565 کودکی که مورد ارزیابی قرار گرفتند، 125 کودک با مشکل آمبلیوپی شناسایی گردید و از این تعداد 80 نفر (بین 3 تا 7 سال)که دارای شرایط ورود به مطالعه بودند انتخاب شدند و در دو گروه بستن پاره وقت (2 ساعت در روز) و تمام وقت (6 ساعت در روز) قرار گرفتند. 40 نفر در گروه بستن پاره وقت و 40 نفر در گروه تمام وقت قرار گرفتند. اختلاف نمرات حدت بینایی قبل و بعد از درمان با 293/0=p نشان داد که دو گروه از این نظر اختلاف معنی دار آماری ندارند.نتیجه گیریبا توجه به یافته های آماری نسبت میزان بهبودی این دو روش مشابه بوده و اختلاف معنی داری مشاهده نشد. لذا می توان نتیجه گرفت که برای جلوگیری از عوارض نامطلوب بستن چشم سالم، روش صحیح درمان آمبلیوپی غیر استرابیسمی با شدت متوسط، احتمالا روش پاره وقت می باشد.
کلید واژگان: تنبلی چشم، بستن تمام وقت، بستن پاره وقت، آمبلیوپی غیر استرابیسمیBackground And AimConsidering appropriate different ways and views between optometrists and ophtalmologists about time of patching the safe eye, it was nessary to performe an investigation about this subject. The main purpose of this investigation was to compare two methods of part time and full time patching to find the least effective time in treatment of nonstrabismic and moderate amblyopia.Materials And MethodsThe present study was based on clinical experiments and the tests were done by Autorefractometer, Retinoscope, Ophtalmoscope and Broken wheel. There were 4565 children in screening test. About 80 amblyopic children aged between 3-7 years old were selected from 125 cases with the problem of amblyopia. Periodical exams were done monthly. Independent T, dependent T, regresion, and Fisher’s Exact Tests were for statistical analyses (SPSS 18).ResultsEighty amblyope children were classified in 2 groups of closing safe eye in full time or part time patching. The difference of visual acuity was measured before and after treatment. There was not any statistical difference between 2 groups (p=0.293).ConclusionConsidering statistical results, the extent of improvement was equal between these 2 groups and there was not any meaningful difference between them. So, it would be concluded that in order to prevent unwanted side effects of closing the safe eye, an appropriate method for treatment of unstrabismic amblyopia may be the part time patching.Keywords: Amblyopia, Full time patching, Part time patching, nonstrabismic, moderate amblyopia -
BackgroundMuch of the vision loss from age-related eye disease can be prevented. The purpose of this study is to determine the prevalence of preventable causes of low vision.Materials And MethodsIn this study, files of 204 patients were evaluated. Low vision was defined as best-corrected visual acuity in the better eye between 20/70 to 20/200. Diagnosis of anterior and posterior segment disease was based on the eye examination that performed with Topcon slit-lamp biomicroscope and direct and indirect ophthalmoscope examination.ResultsThe prevalence of preventable causes of low was respectively: diabetic retinopathy, in 33 patients (16.18%), glaucoma in 6 patients (2.94%), and amblyopia in 2 patients (1%).ConclusionThe majority of cases have treatable and/or preventable causes; reduction of low vision or blindness can be achieved by appropriate screening strategies.Keywords: Diabetic retinopathy, Age related macular degeneration, Glaucoma, Preventable cause of low vision
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IntroductionMost current root-end filling materials do not provide a perfect seal. Thus, a microscopic space is likely to exist in the interface between walls of the root-end cavity and filling material, which allows microorganisms and their products to penetrate. In addition to good sealing ability and biocompatibility, root-end filling materials should ideally have some antimicrobial activity. Therefore, this in vitro study aimed to evaluate the antimicrobial properties of Angelus white mineral trioxide aggregate (MTA) and the mixture of MTA with silver nanoparticles (1% weight; MTA/SN).Materials And MethodsAntimicrobial properties of MTA and MTA/SN were tested by agar diffusion technique against Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans. The microbial inhibition zones around the materials were measured by a caliper with 0.1-mm accuracy. Student’s t-test was used for comparison between the two groups in normal data distribution and Man-Whitney U test for non-normal distribution.ResultsStudent’s t-test revealed that for E. faecalis, C. albicans, and P. aeruginosa, microbial inhibition zone of MTA/SN was significantly greater than that of MTA (P=0.000). Mann-Whitney U test indicated no significant difference between the effect of MTA and MTA/SN on S. aureus (P>0.05).ConclusionBased on the results of this study, adding silver nanoparticles to MTA improved its antimicrobial efficacy.Keywords: Antibacterial Agents, Antifungal Agents, Mineral Trioxide Aggregate, Nanoparticles, Silver
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Journal of Dental Research, Dental Clinics, Dental Prospects, Volume:7 Issue: 2, Spring 2013, PP 102 -104Background And AimsEnterococci are Gram-positive cocci that often occur in pairs (diplococci) or short chains. Beside developing high level of antibiotic resistance, these bacteria can cause wide range of disease in human, thus to help provide an effective treatment for infections caused by this genus, this study was conceived to provide information on Enterococcus faecalis Antibiotic resistance to widely used antibiotics in hospitalized patients.Materials And MethodsDisk diffusion agar and Broth dilution methods were used to perform Antibiogram test on isolated Enterococcus faecalis. Culture medium used for Disk diffusion agar test was Muller Hinton agar, and for Broth dilution methods, Muller Hinton broth culture medium was utilized. In disk diffusion agar method, different commercial antibiotics disks produced by Pharmaceutical companies were used. Microsoft Excel software was used to perform statistical analysis.ResultsBased on antibiograms of 105 cases, a high resistance to Synercid, Nalidixic acid, Oxacillin and Teofilin was detected whereas the lowest resistance observed in Nitrofurantoin, Vancomycin, Linezolid and Teicoplanin antibiotics.ConclusionAccording to the results, Teicoplanin, Vancomycin, Linezolid and Nitrofurantoin are recommended against E. faecalis species.
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PurposeUrinary tract infection (UTI) is the most common nosocomial infection among hospitalized patients. Meanwhile, most frequent infections involving enterococci affect the urinary tract. The aims of this study were to investigate the susceptibility pattern of isolated enterococci from UTI and the prevalence of virulence genes.MethodsThe study used enterococci isolated from urinary tract infections obtained from 3 university teaching hospitals in Northwest Iran. The antimicrobial susceptibility of the strains was determined using the disc diffusion method. Multiplex PCR was performed for the detection of genus- species specific targets, and potential virulence genes.ResultsOf 188 enterococcal isolates, 138 (73.4%) and 50 (26.6%) were Enterococcus faecalis and E. faecium, respectively. Antibiotic susceptibility testing showed high resistance to amikacin (86.2%), rifampicin (86.2%) and erythromycin (73.9%), irrespective of species. In total, 68.1% were positive for gelE, and 57.4%, 53.2%, 56.4%, and 52.1% of isolates were positive for cpd, asa1, ace, and esp, respectively.ConclusionThe study revealed that most of UTI isolates were multidrug resistance against the antibiotics tested and antibiotic resistance was more common among E. faecium isolates than E. faecalis. A significant correlation was found between UTI and the presence of gelE among E. faecalis strains (p < 0.001).Keywords: Enterococcus faecalis, Enterococcus faecium, Urinary tract infection, Virulence genes
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