مجله دانشگاه علوم پزشکی شهرکرد
سال شانزدهم شماره 6 (پیاپی 75، بهمن و اسفند 1393)

Acinetobacter baumannii is an important opportunistic pathogen and is responsible for a variety of nosocomial infections, including pneumonia, bacteremia, surgical wound infections, secondary meningitis, and urinary tract infections. The aim of this study was to investigate the antibiotic resistance of A. baumannii isolates in Shahrekord educational hospitals. This cross-sectional-descriptive study was performed on 100 A. baumannii isolated from sections surgery, emergency and intensive care wards in shahrekord educational hospitals (Hajar, Kashani and Emam Ali). After A. baumannii diagnosis and confirming, their susceptibility rate was determined to the following 12 antibiotics via the antibiogram method (disk diffusion) using bacteriological standard tests. The investigation of the antibiotic resistance of isolates revealed that the highest resistance was against ceftazidime (%94), cefotaxime (%93), cefepim (%91), gentamicin (%85), ciprofloxacin (%89), norfloxacin (%87), imipenem (%86), meropenem (%73), tobramycin (%67) and amikacinwhereas (%66) antibiotics, respectively. The highest susceptibility was observed for colistin (%76) and ampicillin-sulbactam (%70) respectively. Moreover, %93 of isolates had antibiotic multi resistance. In the present study, A. baumannii isolates in Shahrekord educational hospitals showed high resistance to different antibiotics. Therefore, it is necessary to implement some procedures for the prevention of bacterial spread.

Different varieties of Chinese Hamster Ovary (CHO) cells are being used frequently for producing most pharmaceutical products for many years. Permanent production in these host cells is a major challenge. The aim of this study was to integrate the vector permanently in the genome. In this study, the phiC31 site-specific recombination system was used for prolonged maintenance of the vector in the CHO cells. In this laboratory experimental study, a restriction enzyme cut site (PvuII) was selected as a cloning site in the pSVM vector using CLC software. Cutting with this enzyme led to create two blunt ends into the vector. Two specific primers were designed for isolation and amplification of attB region from pDrBB2 vector, using Oligo®5 software. Gel electrophoresis and PCR analysis were performed on the amplified fragment in order to confirmation of its structure. The attB region was successfully integrated in to pSVM vector and was shown by gel electrophoresis. Colony PCR technique has revealed the correct structure of the reconstructed vectors. In this study, the phiC31 integrate catalyzes recombination between pseudo-attP sites (in CHO chromosomes) and attB site. A new construct has been made in this project containing attB site. This construct has to be introduced into CHO cells accompanied with pCMV-int vector (co-transfection) containing integrase. This integrase facilitates the incorporation of the pSVM vector into the chromosome, in order to get a permanent existence of the new construct into the CHO cells.

Inappropriate physical development and failure to allocate urban facilities appropriately such as disproportionate distribution of health care centers has caused waste of material and human resources and urban problems for citizens. The purpose of this study was to identify the districts lacking satisfactory access to health services for the optimal distribution of health facilities based on health equity in all districts of Shahrekord. This was a descriptive-analytical study based on documentary research methods. After integrating the data of all 10 health care centers and stations across Shahrekord, by geographical information system with determination of the radius of performance and availability in 2011-2012, the spatial distribution of these centers after analysis using hierarchical analysis of the data, ranking of the districts was run. The data of health care centers and stations in Shahrekord showed that there is large difference among all health care centers and stations of Shahrekord in maximum to minimum covered area (4.4 times), population (2.3 times) and population density (2.6 times). Peripheral areas of the north, south and east had an inappropriate access compared with the center of the city and 70% of density of the health care centers and stations of Shahrekord lacked appropriate distribution. The results indicate that density of the health care centers and stations of Shahrekord lacked appropriate distribution and no appropriate distribution was seen. Irrational distribution and disproportionate zoning of health units lead to decrease in the level of access, which is followed by possibility of declined levels of indicators of health equity.

Dairy industries generate a large amount of wastewater that contains high concentrations of carbonaceous and nitrogenous organic materials. Discharge of these wastewaters as untreated into environment leads to serious contaminations. The aim of this study was to evaluate the effectiveness of pumice stone application with sequencing batch reactor to remove organic compounds in dairy wastewaters. In this experimental study which was conducted at bench scale, two processes of sequencing batch reactor, conventional and equipped with pumice stone, were used as treatment models. In commissioning phase of systems, the sludge of municipal wastewater treatment plant underwent acclimatization for 9 days. Then, each reactor was inoculated with 2.5 liters of the sludge. In operation step, the reactors were continuously monitored for 36 days and the efficiency of the system for the removal of chemical oxygen demand (COD), biochemical oxygen demand (BOD5), proportion of total solids (TS) and total Kjeldahl nitrogen (TKN) was measured. The mean removal efficiency of COD, BOD5, TS and TKN was respectively 61.8±9.4, 58.5±8.6, 64.9±2.5 and 46.5±22.5 for the reactor without batch and 67.5±9.4, 63.4±11.8, 66.7±3.2, 62.2±15.7 for the reactor equipped with batch. By these results, removal efficiency of COD and TKN by the batch-equipped system had a significant difference from removal efficiency of these parameters by the system without batch (p<0.05). This study demonstrated increased removal efficiency of COD, BOD5, TS and TKN in sequencing batch reactor when pumice stone is used as microbial growth batch in reactor. This model could be considered as a suitable choice for treatment of dairy wastewaters.

Out of different techniques for chromium (Cr) removal, biological treatment has a special status. This study was conducted to determine the efficacy of biological sludge on hexavalent Cr (VI) removal from aqueous solutions. In this experimental study, the required sludge was collected from municipal sewage refinery after aeration basin and introduced into the reactor and Cr and nutrients were added to it. The effect of dissolved oxygen (DO), Cr initial concentration, pH, temperature, glucose concentration, and contact time on chromium removal rate was evaluated. At each step, the samples withdrawn from the reactor were filtered and Cr (VI) level was measured using HACH Company instructions and spectrophotometry. The findings of this study showed that at 2 mg/L DO, 80 mg/L Cr initial concentration, 5000 mg/L sludge concentration, pH= 3, 30°C temperature, 250 mg/L introduced glucose concentration, and 24 h contact time, about 97.5 % of Cr (VI) was removed. As DO, pH, and the introduced glucose concentration decreased and the initial sludge concentration increased, temperature and contact time of Cr removal efficiency increased. The results of this study showed that use of the activated sludge of sewage refinery could be used for Cr removal with regards to environmental aspects.

In recent decades, the presence of high concentrations of nitrate in drinking water has become a serious concern, which causes some disorders in human health, especially children. Nitrate can be removed by physical-chemical and biological methods. In this study, removal rate of nitrate from aqueous solutions was investigated by date kernel ash. In this experimental study which was conducted in vitro, the effect of initial nitrate concentration (50, 100, and 150 mg/L), initial pH (3, 5, 7, and 9), time (15, 30, 60, 120, and 180 minutes), and weight of adsorbent (0.4, 0.6, and 0.8 g) was investigated. The nitrate concentration was measured using spectrophotometer at two wavelengths 220 and 275 nm. All tests and samples analysis was done per textbooks on standard methods of sewage. The adsorbent dose increase from 0.4 g to 0.8 g in 100 mL nitrate solution with concentrations of 50 and 100 mg/L caused increase in absorption efficiency respectively from 75% to 91% and from 53% to 65%. Increase in solution’s initial pH from 3 to 9 caused decrease in the absorption efficiency from 52% to 8%. The results obtained in this study obey Freundlich isotherm (R2=0.98) and nitrate absorption obeys the pseudo-second order kinetic model (R2=0.999). The palm kernel ash is a natural and inexpensive absorbent that can be used to remove environmental pollutants.

Cognitive deficits in anxiety disorders is one of the topics which has faced with increasing evidence in recent years. The purpose of this study was to compare autobiographical memory and metacognition in patients with obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD), and normal group. In this descriptive-analytical study, three 22-individual groups of the patients with OCD and SAD, and normal people were enrolled per convenient sampling. The testees underwent autobiographical memory interview (semantic childhood, semantic adulthood, childhood events, adulthood events, and recent events) and filled out metacognition questionnaire (positive beliefs about worry, uncontrollability and risk, cognitive confidence, need for thoughts control, and cognitive self-awareness). By the results, for memory, the OCD group showed weaker performance compared with normal participants (P<0.01). Also, for metacognition, the OCD group showed weaker performance in uncontrollability and risk, and cognitive confidence compared with normal participants and SAD patients (P<0.01). The OCD group showed weaker performance in autobiographical memory compared with SAD group and normal participants, which seems to be due to neuropsychological deficits in OCD and also cognitive beliefs have an important role in the symptoms of anxiety disorders. Clinically, identifying cognitive aspects of anxiety disorders will lead to emergence of a new insight into this disorder so that the available therapeutic approaches could be modified appropriate to its characteristics or new therapeutic approaches could be developed.

Helicobacter pylori is the first known carcinogenic bacterium and cause of several gastroduodenal disorders. Therefore, detection and treatment of H. pylori infection is very important. The aim of this study was to evaluate egg yolk enriched columbia agar for isolation of H. pylori from gastric biopsy specimens of patients suffering from gastroduodenal disorders referring to Imam Khomeini Hospital, Kermanshah and comparison with rapid urease test. The study was an analytic descriptive cross-sectional survey that was carried out on 192 patients referred to Imam Khomeini Hospital in Kermanshah in 2013. Two gastric antrum biopsies and two corpus biopsies were taken from each patient and H. pylori infection was detected using rapid urease test and culture on egg yolk enriched columbia agar supplemented with antibiotics. After culture gram staining method and biochemical tests were used to detect identification of H. pylori. Data were analyzed using kappa calculator and SPSS software to calculate sensitivity and specificity. The rates of diagnosis of H. pylori infection in 192 biopsy specimens taken from patients with gastroduodenal diseases by rapid urease test and culture were 51.10% and 45.31% respectively. The sensitivity, specificity, and positive and negative predictive values of the culture were 76.5%, 87.2%, 86.2, and 78.0% respectively. The results showed that the test accuracy (effectiveness) of the method was 81%. This study indicates that egg yolk enriched columbia agar is an appropriate medium with high sensitivity, specificity and efficiency for isolation of H. pylori that is a low-cost and available culture medium.

TMC1 gene mutations are one of the most common causes of autosomal recessive Non-syndromic hearing loss (ARNSHL) in different populations. In view of large size of the gene and the large number of identified mutations in TMC1, use of polymorphic markers is suggested for carrier detection and prenatal diagnosis. The aim of this study was to evaluate informativeness of D9S1837 CA repeat STR marker in five different ethnic of Iranian population. In this descriptive analytical study the locus of D9S1837 within TMC1 gene was genotyped by polymerase chain reaction (PCR), polyacrylamide gel electrophoresis (PAGE) and fluorescent capillary electrophoresis, respectively. Allelic frequency, heterozygosity rate and genotyping data from 165 unrelated healthy individuals were estimated by Gene Marker HID Human STR Identity software, Gene Pop program and Microsatellite Tools software. The result obtained through Gene Pop program indicated the presence of 11 alleles of D9S1837 marker in the Iranian population. The most frequent allele was computed for 239 bp with 36% frequency. Heterozygosity of all investigated ethnic groups was above 70%, but among all Arab and Azeri ethnic groups had the highest heterozygosity (84.8%). The data of PIC value demonstrated that the D9S1837 marker was found highly informative in the examined population. According to the results of this study, D9S1837 marker could be used as an informative tool for carrier detection and prenatal diagnosis of TMC1 based ARNSHL by linkage analysis in Iranian population.

Cardiovascular diseases are one of the causes of mortality. The aim of the present study was to investigate the effects of pomegranate juice consumption on blood pressure, inflammation factors, and vascular function. This before and after clinical trial study was conducted on 13 patients aged 39–67 years with blood pressure above 140/90 mmHg referring Hypertension Clinic of Isfahan Cardiovascular Research Center. All patients consumed fasting 150 mL Pomegranate juice. The level of inflammation factors including E-selectin, high-sensitivity C-reactive protein, intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), interleukin-6 (IL-6), Systolic blood pressure (SBP), diastolic blood pressure (DBP), and flow-mediated dilation (FMD) was measured at baseline and 4-6 hours after PJ consumption. The patients consumed 150 ml pomegranate juice. All 13 patients cooperated to the end of study. The short-term consumption of Pomegranate juice decreased significantly systolic and diastolic blood pressure from 125.38±11.80 to 116.15±7.94, and from 82.69±5.25 to 78.08±3.25, respectively (P<0.05). Inflammation factors (VCAM, ICAM, CRP, IL-6, and E-selectin), and FMD didn’t reveal significant changes. Short term consumption of fresh pomegranate juice could have hypotensive properties in patients suffering from high blood pressure. It seems Pomegranate juice could be effective on preventing and treating cardiovascular diseases.

Polycyclic Aromatic Hydrocarbons (PAHs) are a class of potentially hazardous chemicals of environmental and health concerns. This compounds exhibit toxic, carcinogenic and mutagenic properties and are listed by the United States Environmental Protection Agency (USEPA) as priority pollutants. The aim of this study was the comparison of aerobic and anerobic biodegradation of disesel contamination soils using municipal soil was to and vermicompost. This experimental study was accomplished in pilot scale with application of a copmpost pile consisting 1000:120 ratio gram soils to gram of petroleum. This mixture was then mixed in a ratio of 1:2 with compost and vermicompost fertilizer separately (two parts soil and one part compost and/or vermicompost). In this research, phenantheren (phc), a three benzene ring compound, was selected as a PAHs representative. Phenanthrene concentration was measured using HPLC after extraction from contaminated soils by ultrasonic method. The results showed that the effective degradation of phc occures during two first weeks, and then the removal rate was decreased gradually. The decomposition rate on phc in the aerobic compost and vermicompost reactors was 89.5±9.1 and 91.7±7.0, respectively. At the same time, 19.2±5.1 and 26.4±5.0 of phc was removed in the anaerobic compost and vermicompost reactors, respectively. According to the results, phc maximum removal rate of 91.7±7.0 was achived in the aerobic vermicompost reactor. This study can be concluded that, with application of bioremediation at the ambient temperature, the polycyclic aromatic hydrocarbons may be removed from oil contaminated soils.

The most important cause of low back pain is intervertebral disc. The most common symptom of this disease is pain, which causes decrease in living daily activities. Today, many non-pharmacologic methods of pain relief have been offered. This study has been done to study the effect of progressive muscle relaxation (PMR) on pain level and living daily activities in patients with intervertebral discs. In this randomized clinical trial, 56 patients with lumbar intervertebral discs were enrolled by convenient sampling and randomized to two groups of test (n=28) and control (n=28). The PMR program was trained to patients in test group within seven theoretical and practical sessions with emphasis on 14 muscle groups. The questionnaire of pain intensity scale and living daily activities was completed prior to, and one month and three months after intervention in two groups. All 56 patients cooperated to the end of study. PMR program caused decrease in mean pain intensity and increase in domains of living daily activities in test group after three months of intervention compared with prior to intervention (P<0.001). Also, statistical test of repeated measures ANOVA indicates a significant difference in three times of pain level measurement and total score and score of domains of living daily activities in test group (P<0.001). In control group, these differences were not significant (P>0.05). In view of the findings of this study, PMR program is considerably effective on reducing chronic low back pain and increasing living daily activities in patients with intervertebral disc. Applying this program is recommended for decreasing chronic low back pain and increasing living daily activities in patients with intervertebral disc.

Surgery is a stressful experience accompanied with degrees of pain. Prayer and recital (God remembrance) prior to surgery contributes significantly to reduce pain. The aim of this study was to investigate the effect of recommended recitals on the level of perceived pain in patients after surgery. In this clinical trial study, initially 108 patients as samples of study were randomly enrolled from the hospital into two groups, control (n=54) and experimental groups (n=54). Physiological indices were controlled in each group prior to any intervention. Then, in experimental group, the necessary training on repeating recommended recitals was run. Using Visual Analogue Scale (VAS), the pain severity perceived by the two groups was evaluated at 3, 12 and 24 hours after surgery. All 108 patients cooperated to the end of study. Chi-square test showed that there was no significant difference between the two groups in type of surgery, sex, and educational level (P>0.05). Chi-square test indicated that there was a statistically significant difference in pain severity at 3, 12, 24 hours (P<0.05). Recital and prayer lead to increase in pain threshold, promotion of compatibility level, and relief of pain in the patients. Moreover, it was not observed any complication; Therefore, it is recommended to provide the patients with necessary facilities to practice recitals and ritual worship prior to surgery.

Nowadays so many preventive drugs for migraine with different effects are used all around the world. One of the plants that are used traditionally in the treatment of migraine is Valeriana officinalis. The present study was aimed to evaluate the effect of valerian capsule (350 mg, three times daily) on frequency, duration and intensity of migraine attacks. The present study is a Randomized, single-blind clinical trial that is carried out on 84 female patients suffering from migraine headaches. The patients were randomly allocated to case (n=42) and control groups (n=42) and treated during three consecutive phases of 45 days. In the first phase, both groups received sodium valproate tablet, (200 mg, twice daily) and indomethacin capsule (25 mg, in attacks). In the second phase, valerian capsule (350 mg, three times daily) was added to other drugs of case group. Control group received placebo instead of valerian. Finally, in the third phase, both groups were treated the same as the first phase. And then the data obtained from the drug influence on pain intensity were analyzed based on Mann-Whitney and K2. All 84 patients cooperated to the end of study. The results indicated that valerian capsule significantly reduced the frequency, duration and intensity of migraine attacks in a way that the mean of migraine attacks reduced from 6.2±2.3 to 2.2±1.2, the duration reduced from 17.0± 9.2 to 5.7±3.7 hours and intensity from 8.7±1.2 to 3.0±1.3. According to the remarkable effect of valerian capsule on the prevention of igraine attacks, it seems that it can be a potential alternative to common migraine medications.

Mosquitoes constitute a large family in Diptera and because of their ability in the transmission of a wide range of pathogens are of great public health and medical importance. This study was carried out to refresh our current knowledge on the fauna and the distribution of indigenous mosquitoes in Chahar Mahal and Bakhtiari Province. This descriptive, cross-sectional study was carried out during the summers of 2011 and 2012 in the all districts of Chahar Mahal and Bakhtiari Province. Larval specimens were collected by the standard dipping method and identified with the aid of valid keys. Identification data plus the geographical information of the collection sites were entered in ArcGIS 10.0 software to draw the map of distribution for each mosquito species. In this investigation, 8335 larvae were collected from 92 larval habitats belonged to 18 mosquito species including Culiseta longiareolata Macquart, Cs. subochrea Edwards, Ochlerotattus caspius Pallas s.l., Culex theileri Theobald, Cx. territans Walker, Cx. hortensis Ficalbi, Cx. pipiens Linnaeus, Cx. perexiguus Theobald, Cx. mimeticus Noe, Cx. tritaeniorhyncus Giles, Cx. arbieeni Salem, Cx. laticinctus Edwards, Anopheles maculipennis Meigen s.l., An. superpictus Grassi, An. dthali Patton, An. marteri Senevet and Prunnelle, An. claviger (Meigen) and An. turkhudi Liston. Culex territans is reported here as a new record for Chahar Mahal and Bakhtiari Province. Culex theileri and An. superpictus showed the most abundance and the widest distribution in the province. This study indicates that a few potential mosquito vectors are quite diverse and well distributed in Chahar Mahal and Bakhtiari Province. Further studies are needed to draw a reasonable conclusion on the capacity of indigenous mosquito species to transmit pathogens in the province.

By using the ideas of the personnel working in laboratory, it is possible to create valuable changes in the process of teaching for the laboratory sciences students. The aim of this study was to investigate application of laboratory sciences in work place. This cross-sectional descriptive study was performed in 2010 by census method. A questionnaire including two parts was fulfilled. The first part included demographic information (sex, educational document, and way of employment) and the second part was a questionnaire about teaching programs of different basic and specialized courses including theory and practical. It was filled by 70 employees of the personnel working in governmental laboratories. Based on results, among the specialized courses, practical hematology and practical bacteriology had the maximum amount of application with 74.3% and 71.4%, respectively and practical pathology and theory of pathology had the minimum amount of application with 2.9%. The average of application of specialized courses by employees with Associate degree was significantly less than employees with Bachelor, and Master Science degree (P<0.05), but in other parameters was observed no significant difference. Among basic courses, practical general biochemistry and English had the maximum amount of application with 44.3% and 30% in work place, respectively, but histology, anatomy and practical physics had the minimum amount of application with 4.3%, 4.3% and 2.9%, respectively. The average of the amount of application of basic courses had no significant difference with observed parameters (P<0.05). Based on this study, basic courses had the minimum amount of application in work place. Therefore, revising curriculum these courses is necessary to make them more useful.

Hydatid cyst disease is one of the most important zoonosis which is due to inhabitance of Echinocucus granolosus larva. The disease is accompanied with a wide range of clinical symptoms that involve individual organs such as liver, brain, spleen, and other parts of body in cystic form. In few cases, eye is involved which named Orbital hydatid disease. Case report: The present case is a 11-year-old boy who referred to a clinic with painless and unpalpated proptosis. CT scan showed a retro- bulbar cyst. The patient was hospitalized and the cyst was removed by surgery. Pathologic evaluation confirmed orbital hydatid cyst. The result of therapy was satisfying and clinical signs were disappeared after management. Due to existence of hydatid cyst in Chaharmahal & Bakhtaran province, physicians should include orbital hydatid cyst in the differential diagnosis of unilateral proptosis.

Methodological quality of scientific, research articles is accounted as one of the most important subjects for researchers. This study aimed to offer statistical points to improve and promote the methodology of the articles on medical sciences to help authors and reviewers. This study is a systematic review. At first, in Pub Med database, keys terms of statistical reports, research methodology and results reporting were selected. Then, texts relevant to medical sciences were sought in authentic databases. Inclusion criteria to the study were the relationship among articles, the statement of statistically key points, having useful guidelines, and agreement of two of three investigators in team. More than 200 articles were retrieved. After examination, 32 articles had the inclusion criteria and were relevant. 30 important points had indicator role for improvement and promotion of methodological quality in articles on medical sciences. These points are: identification and description of population, sampling, study design, independent, dependent, and controlling variables, samples for subgroups and for whole study, summarizing data adjusted to their statistical distribution, stating statistical tests, reporting (prevalence and survival rate), distribution (probability, risk rate), risk (absolutely, relative risk, risk differences with confidence of 0.95%), analyzing observations in terms of sex and used software. The most important factors that they had a main role in Methodological quality of scientific, research articles were reported. Use of introduced key points and checklists in articles’ materials and methods section could improve and promote the quality of articles in medical sciences fields and prevents research errors.