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Abstract Background and Objective: The vast clinical testing process often is performed to diagnose the origin of the fever. The aim of this study was to investigate the rate of abnormal paraclinical findings of the neonates with fever. Material and methods: This cross-sectional study was carried out on 109 randomly selected febrile neonates admitted to Amir-Kabir Hospital, 2010. Blood, Cerebro Spinal Fluid (CSF) and Urine samples were sent to laboratory and the results were analyzed by Chi-Square test, using SPSS software. Results: Blood culture of 19 cases (17.43 %) is positive. None of the CSF samples are gram positive and also show the sign of Meningitis. Conclusion: With regard to the high rate of positive blood culture, it seems that the use of blood culture in febrile neonates is important for diagnosis. Keywords: Fever Neonate Paraclinical Test

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Abstract Background and Objective: Cross-transmission of microorganisms by the hands of health care workers is considered as a main transmission route of nosocomial infections. The aim of this study was to investigate the microbial contamination of health-care worker’s hands while going out of hospital. Material and Methods: Wearing the sterile glove with liquid culture, we obtained 100 Samples from the staff’s hands of three departments (clerical department, emergency ward and central laboratory) of Emam Reza hospital. After that, the samples were cultured. Results: Of all personnel, 40% have the habit of washing their hands. Of these, 95 percent wash their hands with water and soap, and 5 percent with alcohol rubs. Of 100 cultured samples, 90 have microorganisms including non-pathogen gram-positive bacillus (29%), coagulase-positive staphylococcus (39%), coagulase-negative staphylococcus (47%), Enterococci (3%), micrococcus (25%) and candida (3%). Contamination in those who had not washed their hands is 62.6% and in those who washed is 37.7% (P=0.04). Conclusion: Hands of health-care workers become progressively contaminated by the potential pathogens during daily activities. To reduce the rate of contamination, it is helpful if we ask staff to wash their hands while going out of hospital. Keywords: Microbial Flora Hospital’s Staff Hand Washing

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Abstract Background and Objective: Nowadays, nosocomial infection is one of the greatest problems in hospitals. Normal flora of staff’s hands and the bacterial agents on the surface of medical equipment can become progressively colonized with potential pathogens during patient care. This study was carried out to determine the bacterial agents existed on staff’s hands and in the wards of hospital to step in to control nosocomial infection. Material and Methods: In this descriptive study, during 17 months (22.mar.2010- 30.aug.2011), 403 samples, using sterile swab , were randomly obtained from the staff’s hands and medical equipment of emergency departments , ICU, male operation room and female surgical unit . The samples were cultured on Blood agar (BA) and Eosin methylene blue (EMB). Then, identification of isolated bacteria was done with diagnostic tests. Results: Of 430 samples, 530 bacteria were isolated from staff’s hands (N= 291) and medical equipment (N= 234). The most common bacterium from personnel’s hands (144 49.5%) and medical equipment (24 10%) is Staphylococcus aureus. Also, three isolates of pseudomonas aeruginosa from staff’s hands of male surgical ward and medical equipment of ICU, and two isolates of Acinetobacter.spp from ICU’s medical equipment were identified. Conclusion: With regard to the findings, it seems that applying the appropriate disinfectant agents by using standard procedures is necessary. Keywords: Medical Equipment Staff’s Hand Nosocomial Infection Staphylococcus Aureus

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Abstract Background and Objective: Iron deficiency anemia is one of the most common nutritional problems in the world. This research aimed at determining the prevalence of iron deficiency anemia in one of the most endangered age group in Baft, Iran. Material and Method: this cross-sectional study was conducted on 325 high school students selected via simple random sampling (165boysand 160girls). The participants with MCV≤ 80µm or MCH ≤ 27 Pg who had simultaneously TIBC ≤ 15 % or Ferritin ≤ 1 5 ng/ml were considered as an iron deficiency anemia. Results: considering MCV and MCH, the prevalence of iron deficiency anemia in girls (14.37%) and boys (2.42%) was significantly different (P <0.05). Conclusion: The prevalence of anemia in high school students of Baft is significantly high in comparison with other studies. To increase students' intellectual and physical performance, Screening and treatment of iron deficiency are recommended. Keywords: Anemia Iron Deficiency Baft Students

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Abstract Background and Objective: The patients with Post-Infectious Irritable bowel syndrome (PI-IBS), a subtype of irritable bowel syndrome, suffer from bacterial gastroenteritis. Since campylobacter Jejuni (CJ) is one of the most common agents in this syndrome, we aimed to evaluate the prevalence of Campylobacter Jejuni in patients with Irritable Bowel Disease. Material and Methods: This case - control study was conducted on 160 patients divided into 2 equal groups of healthy and unhealthy. The presence of Anti- CJ antibody (IgG and IgA) was evaluated by ELISA and the comparison was performed by chi-square test. Results: The mean age of case (31.51) and control (31.84) was not statistically different (P = 0.87). Titer of Anti- Campylobacter Jejuni antibody IgG was positive in 25% of patients and 18.8% of the healthy ones (p=0.02). IgA Seropositivity in patients was 7.5% but no one in control group was positive (p =0.01) Conclusion: Seroprevalence of Cj in patients with IBS was higher significantly than that of control group. Thus, Cj can be known as one of the causes of Post-infection in patients with IBS in our region and it should be paid more attention in diagnostic assessment of these patients. Keyword: Irritable Bowel Syndrome Campylobacter Jejuni Antibody

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Abstract Background and Objective: The excessive use of broad-spectrum antibiotics will lead to drug resistance of microorganism and specially nosocomial organisms. Because of high incidence of antibiotic resistance in hospitals, we aimed to study antibiotic resistance to gram negative bacteria. Material and Methods: This cross-sectional study was conducted on the data of biological samples (2006-2008), with positive culture result. Using antibiogram, microbial resistance to isolated microorganism was determined, and after culturing the samples, bacteria were identified by using differential media and antiserum. Then, antibiotic resistance was performed by disk diffusion. Results: The most common gram-negative microorganism obtained from all cultures was Ecoli with the lowest drug resistance to Nitrofurantoin. Conclusion: Based on the results, antimicrobial resistance pattern is not the same in different places and furthermore it is ever changing. Therefore, further research is needed to be done to have an accurate pattern of antibiotic resistance to provide effective treatment regimens. Key words: Antibiotic Resistance Disk Diffusion Gram Negative Bacteria Gorgan

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Abstract Background and Objective: Breast cancer is the most common cancer in women. Telomerase enzyme is one of the major factors causing the development and proliferation of immortal cells such as cancer cell. The aim of this study was to evaluate telomerase activity in breast tissues of breast cancer patients and healthy people. Material and Methods: In this descriptive study, the samples from 32 patients with malignant tumors and from 24 with benign tumors or healthy individuals were obtained .To assess the relative activity of telomerase in the samples, TRAP assay (PCR-ELISA) was used. Results: The frequency of telomerase activity was 93.75% in patients and 8% in healthy people. Conclusion: The results indicate that the relative activity of telomerase in tumor tissues measured by TRAP assay could be a suitable biomarker for identifying the breast cancer tissue. Keywords: TRAP Assay breast cancer telomerase

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Abstract Background and Objective: Transmission of pathogens by cosmetics is one of the major health complications. Direct contact with contaminated non-standard cosmetics can have irreparable side effects for the consumers. Thus, the evaluation of microbial contamination in cosmetic products is important. The aim of this study was to assess the microbiological contamination of one of frequently used cream. Material and Methods: In the present study, 135 samples of a special moisturizing cream were randomly selected from pharmacies in Tehran. The microbial contamination assessment, sampling and culturing method were based on the protocol (No.3978) of Iranian Institute of Standard and Industrial Research. Results: sixty-two (46%) out of 135 samples were contaminated. The highest and lowest contaminations observed were Pseudomonas aeruginosa and Bacillus, respectively. Conclusion: Due to the high contamination rate of cosmetic creams, we recommend extremely monitoring and controlling these products by health centers. Keywords: Cosmetics, Microbial Contamination, Pseudomonas Aeruginosa

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Abstract Background and Objective: Ice cream is a suitable environment for microbial growth due to its chemical structure, ingredients, and its increased supply and demand. In the absence of hygienic considerations, it can cause poisoning. This study aimed to determine bacterial contamination in traditional ice cream produced in Arak city in 2011. Material and Methods: The samples (n= 30) were randomly obtained from different parts of Arak in, 2011. The Samples were shipped in cold conditions and total count of microorganisms test was performed according to Iranian national standards. Results: In 16.66%, the microbial contamination was below the limit of microbial load (5×104), and in 83.3% the contamination was more than allowed level. Conclusion: This study highlights the dire situation for bacterial contamination of traditional ice cream in Arak city. Keywords: Arak, Ice Cream, Microbial Contamination

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Abstract Background and Objective: Bacterial colonization in upper respiratory airways is one of the major risk factors for the development of the ventilator–associated pneumonia (VAP), which is the most common and serious hospital-acquired infection in intensive care unit (ICU). The aim of this study was to determine the frequency of oropharyngeal microorganisms of patients with tracheal tube hospitalized in ICU. Material and Methods: Of 39 patients hospitalized in ICU of panje Azar Hospital, the oropharyngeal cultures were taken after admission. The samples were evaluated for growth of Staphylococcus aureus, Pneumococcus, Enterococcus, Pseudomonas, and E-coli. Results: The mean age of the patients (21 men, 18 women) was 43.64±15.01. The culture was positive in 28.2% and the most common isolate was Pseudomonas aeruginosa (10.3%). Conclusion: Pseudomonas, which is the main pathogen for ventilator- associated pneumonia, may be a potential threat for the patients hospitalized in intensive care units. Keywords: Microbial Colonization, Endotracheal Tube, Intensive Care Unit, Ventilator Associated Pneumonia

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Abstract Background and Objective: Burkholderia cepacia complex (BCC) is a plant pathogen that is an important mortality factor in immune-compromised and hospitalized patients. We aimed to Isolate and Characterize the Burkholderia Cepacia Strains from Hospitalized Patients in the Hospitals of West Guilan Province. Material and Methods: This study was conducted on 90 saliva and blood samples obtained from patients with blood infection, pneumonia, asthma, patients connected to the monitoring and ventilator systems, and immune-compromised patients in different sections of hospitals such as the pediatrics, internal section, ICU and CCU. Primary screening was performed by cultivating the samples on Burkholderia cepacia selective agar (BCSA) Sensitivity to antibiotics was tested by Kirby-Bauer and Muller-Hinton Agar (MHA) and the separated isolations were recognized by strengthening the gene rec A. Results: Of 90 isolated samples, only one strain suspected B. cepacia was isolated from 24-year old women with asthma. This strain was resistant to bacitracin, pipracillin and ciprofloxacin antibiotics. Conclusion: The incidence of B. cepacia is rare in western part of Guilan province, which is congruent with the results of overall incidence in Iran.

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Abstract Background and Objective: Trichomonas vaginalis is a pathogenic agent known worldwide and affects about 180 million annually. We aimed to investigate the prevalence of Trichomonas vaginalis in diabetic patients referred to diabetic research center. Material and Methods: In this descriptive-analytic study, 215 women referring to the Diabetic Center in Kermanshah Province were investigated for Trichomonas vaginalis. After collecting the data by a questionnaire, the samples were obtained from posterior fornix by sterile swabs and sent for assessing by direct microscopy and Dorset medium. Results: Totally, 1.3 percent of the women were confirmed to be infected with T. vaginalis. Conclusion: The range of blood sugar cannot remarkably affect the prevalence of T. vaginalis. Given the limitations of this study and low prevalence compared to similar studies, we recommend further comprehensive research for better understanding. Keywords: Trichomonas Vaginalis, Diabet, Prevalence

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Abstract Background and Objective: Diarrheal diseases may occur in all age groups, worldwide. Escherichia coli (E. coli O157: H7) is one of the most important bacterial agents causing this disease. The purpose of this study was to assess the prevalence of diarrhea in patients with acute diarrhea caused by this bacterium. Material and Methods: In this study, 214 stool samples were collected from acute diarrheic patients in hospitals and clinical laboratories of Malayer city, Iran. The samples were cultured in rich, differentiation, specific and selective medium. To detect E. coli O157: H7, rapid detection method and antisera were used . Results: In 12.15% of the samples, lactose fermentation was observed and E. coli was afirmed. The results of lactose positive samples showed that 6.54% were negative-β- Glucuronidases and were confirmed as E. coli O157. Finally, by using O157: H7 antisera, 1.87% of 14 samples that were negative- β-Glucuronidases were asserted as E. coli O157. Conclusion: based on the results, the prevalence of E. coli O157: H7 is higher in children and elders than the others. Food and water play a significant role in transferring E. coli. Keywords: Prevalence, E. coli O157: H7, Gastroenteritis, Patients

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Background and objectives: Soil contamination with Toxocara spp. eggs is the main source of human toxocariasis. The aim of this study was to determine rate of soil contamination with Toxocara spp. eggs in Yazd, central Iran.
Methods: During September 2014 to February 2015, a total of 220 soil samples were collected from public parks, primary schools, green areas, kindergartens, suburban areas, streets, residential complexes, backyards and a bus terminal in the city of Yazd, Yazd Province. Soil samples were investigated for the presences of Toxocara eggs by flotation technique using sucrose solution (1.2 g/cm³) and using light microscopy. Data analysis was carried out by SPSS (version 23) software package.
Results: A total of 220 soil samples from nine different places were examined. Of these samples, 51 (23.2%) were contaminated with Toxocara spp. eggs. The contamination rate was 26.3% in public parks, 19.2% in primary schools, 28.6% in green areas, 22.2% in kindergartens, 24% in suburban areas, 8.3% in streets, 18.8% in residential complexes, 19% in backyards and 28.6% in the bus terminal. There was no significant difference in the soil contamination rate with Toxocara spp. eggs between different sampling places (χ² = 3.096, d.f = 8 and P= 0.92) and sampling areas (χ²= 2.289, d.f = 2 and P= 0.318).
Conclusion: The high rate of soil contamination with Toxocara spp. eggs in Yazd emphasize on the need for preventive measures, such as improving sanitation, providing public health education and controlling stray dogs and cats near children play areas.

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Background: Klinefelter syndrome (KS) also known as 47, XXY is one of the most prevalent chromosomal abnormalities among men. Infertility is one of the most primary features of this condition. However, there are some other associated features such as thin and tall appearance, absent, delayed or incomplete puberty, small and firm testicles, small penis and gynecomastia.
Case description: We herein report a patient with mosaic KS whose karyotype consisted of 47, XXY/46, XY. The case’s wife had two miscarriages, followed by a healthy girl with a normal karyotype who was born taller than the average at the age of two.
Conclusion: Mosaic KS dramatically increases the chance of having healthy offspring with normal genetic patterns without performing artificial insemination methods compared to those with complete KS.

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Background and objectives:  Intraoperative blood transfusion is a common medical intervention worldwide. Although mostly lifesaving when indicated, inappropriate administration of intraoperative can be potentially life-threatening. The aim of this study was to analyze the most common surgery/invasive procedures requiring intraoperative transfusion and to determine indications for intraoperative transfusion as well as the outcome of the patients after intraoperative transfusion.
Methods: A retrospective review of the electronic database of medical records was done for surgical patients who received intraoperative transfusion from June 2019 to December 2019. Preoperative hemoglobin values, associated comorbidities, and physiological triggers including hypotension and tachycardia were recorded. Descriptive statistics were used to summarize the data.
Results: A total of 36 patients (age range: 9-80 years) were studied. Orthopedic surgeries (53%) were the most common surgeries that required intraoperative transfusion. Preoperative anemia (hemoglobin <10 g/dl) was the predominant reason for intraoperative transfusion. Type 2 diabetes mellitus (36.3%) was the most frequent comorbidity among the cases of intraoperative transfusion. Half the cases received two units of packed red blood cell (pRBC), while 39% of the cases received one unit of pRBC. The remaining 11.1% received more than two units of pRBC. Furthermore, 77.7% of the patients were discharged to home within a week, while 16.6% of the patients were discharged after a prolonged hospital stay (> one week). The remaining 5.5% died in the hospital within a week of the procedure/surgery.
Conclusion: Transfusion practices vary among physicians, hospitals, and countries. The findings highlight that the hospital might be the most important determinant of the number of administered transfusions, with some adopting programs to reduce transfusions for elective surgery.

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Background and objectives: Semen cryopreservation is widely used in assisted reproduction techniques, and reliable semen analysis is essential to define the clinical practice. However, many parameters used for semen evaluation have high variability among technicians. Here, we describe a method of validating semen analysis prior to cryopreservation, comparing each operator’s results with an expert, and also analyzing inter-operator variability. As a second endpoint, we compare this method by analyzing semen parameters before and after cryopreservation.
Methods: Four professional trainees studied and practiced semen analysis according to the World Health Organization guidelines for one month, under supervision of an expert in the field. Next, microscopic results (sperm concentration, motility, vitality, and morphology) obtained by each team member were compared with the findings obtained by the expert.. Finally, analyzes of inter-operators were evaluated for the same parameters.
Results: The findings obtained by the operators and the expert did not differ significantly. Furthermore, in the inter-operator analysis, the morphology parameter differed significantly in the fresh semen sample, which was not observed in the post-thaw sample.
Conclusion: Our results indicated that the laboratory staff training for semen analysis was effective, ensuring the assessment of individual performance and uniformity among operators in sperm count parameters, producing consistent results.

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Background: Cutaneous leishmaniasis (CL) is a prevalent infectious zoonotic disease between humans and animals. Golestan Province is one of the important centers of CL in Iran. The current method for detecting Leishmania parasites in patients is Giemsa-stained direct smear from skin ulcers; however, PCR is a strongly recommended method for epidemiological studies. This study aimed to investigate Leishmania species in negative ulcer smears from patients suspected of having CL referred to Aq Qala Health Center using the multiplex nested PCR method.
Methods: This study was performed on 72 negative ulcer smears from patients suspected of having CL referred to Aq Qala Health Center, Golestan Province, northeastern Iran, from August 2019 to April 2020, using the multiplex nested PCR method to detect Leishmania major and Leishmania tropica species.
Results: Out of 72 samples, 4 (5.55%) samples were positive by multiplex nested PCR. Moreover, all positive samples are related to Leishmania major species.
Conclusion: The multiplex nested PCR method is strongly recommended for detecting Leishmania species in negative ulcer smears from patients suspected of having CL.