Tehran University Medical Journal

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Background: Drug Utilization Evaluation (DUE) studies are performed to define, determine, and finally improve the quality of drug usage. These types of studies are especially valuable for drugs with a narrow therapeutic index or specific indication, or for expensive medications. In Iran, vancomycin is only available by prescription for methicillin-resistant staphylococcal and enterococcal infections. It is obvious that extensive and irrational use of this drug can increase bacterial resistance to this antibiotic. The goal of this study was to assess vancomycin utilization.
Methods: In a descriptive cross-sectional study performed during the fall and winter of 2004, this vancomycin DUE was done in the Infectious Disease Department of Imam Khomeini Hospital in Tehran. All of the patients receiving vancomycin were enrolled in this study. The Centers for Disease Control (CDC) and American Society of Hospital Pharmacists (ASHP) protocols have been used to perform this study.
Results: Of the 565 inpatients at this hospital, 39 subjects (7%) received vancomycin. Vancomycin utilization among these patients was compatible with CDC and ASHP protocols in only 28% and 35% of the patients, respectively.
Conculusion: Vancomycin is predominantly administered empirically, rather than being based on the antibiogram. This may be due to the routine protocol of the ward or the physician doubting the reliability of the antibiogram.

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Background: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis.

Methods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study). Using a questionnaire developed by COPCORD group (Asia & Oceania), we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations.

Results: Age (OR 1.096 CI95%: 1.091-1.1 P: 0.00) and sex (OR 2.85 CI95%: 2.49-3.28 P: 0.00) showed significant association with knee osteoarthritis. Overweight (OR 1.81 CI95%: 1.28-2.55 P: 0.00) and obesity (OR 3.3 CI95%: 2.34-4.66 P: 0.00) both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44 P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR 0.54 CI95%: 0.38-0.78 P: 0.00).

Conclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

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Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community.
Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden’s/ Bouchard’s nodes, CMC1’s squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis.
Results: Symptomatic hand osteoarthritis was present in 2.8%(CI 2.3-3.4) (52.6% female, mean age 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement.
Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Dendritic Cell (DC) is an important antigen-presenting cell that present tumor antigen to CD8⁺ and CD4⁺ T- Lymphocytes and induce specific anti-tumor immunity. In order to induce effective anti-tumor response, an option is increasing the efficiency of antigen presentation of dendritic cells and T cell activation capacity. The aim of the present study was to investigate the effect of dendritic cell maturation with protein components of toxoplasma gondii on cytotoxic T lymphocyte activity and their infiltration in to the tumor.
Methods: For DC generation, bone marrow cells were cultured in the presence of GM-CSF and IL-4 for five days. After that, LPS, protein components and whole extract of toxoplasma gondii were added to the culture media and incubated for another two days for DC maturation. To generate tumor, mices were injected subcutaneously with WEHI-164 cell line. For immunotherapy 10⁶ DCs matured with different compounds were injected around the tumor site. Infiltration of CD8⁺ T cells were determined by flow cytometry and cytotoxic activity was measured by LDH detection kit.
Results: Immunotherapy with DCs treated with protein components of toxoplasma gondii led to a significant increase in the activity of cytotoxic T cells and infiltration of CD8⁺ T cells in to the tumor. Immunotherapy using protein components of toxoplasma gondii significantly improved the survival of the mice compared with other groups (p<0.0001).
Conclusion: Protein components of toxoplasma are able to increase DC capability in induction of CTL-mediated anti-tumor response and increase infiltration of these cells in to the tumor.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Infantile colic has been defined as episodes of excessive and persistent crying without known medical cause. Kangaroo mother care is a new method for baby care with several advantages. A universally available and biologically sound method of care for all newborns, with three components: skin-to-skin contact, exclusive breastfeeding, support to the mother-infant dyad. This study designed for evaluating Kangaroo mother care on infantile colic. 

Methods: This study was a randomized controlled trial. From 1th may 2008 to 1 may 2009 a total of 70 children, aged 3-12 weeks with persistent colic symptoms were studied. The children were referred to Sheikh clinic, Mashhad, Iran, because of excessive crying. Normal mother-infant pairs were recruited at 3 to 12 weeks of age after obtaining baseline for two days. Subjects divided randomly to kangaroo care or conventional care group and mothers in both groups filled diary for seven days.

Results: In the beginning of the study, the infants in kangaroo care group had 3.5 hr/d crying and after the intervention, it decreased to 1.7 hr/d, the difference were significant (p<0.05). But there were no difference in feeding duration between two groups (p=0.2). Awake and content (normal behavior) behaviors were significantly increased in the kangaroo care group (p=0.001). Sleep duration was significantly increased in the kangaroo care group (p=0.02).

Conclusions: Kangaroo care may be used as a simple and safe method for treatment of infantile colic.

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Background: Exogenous natural and synthetic surfactants is a rescue treatment for respiratory distress syndrome (RDS). The goals of the study were to compare the clinical response and side-effects of two frequently used surfactants, poractant alfa (Curosurf) and beractant (Survanta), for the treatment of respiratory distress syndrome in preterm infants.

Methods: This clinical trial study was performed during a two-year period in the Neonatal Intensive Care Unit of Ghaem Hospital in Mashhad, Iran. Sample size calculated by a 95% confidence and power of 80, included 104 premature neonates, 74 in survanta and 30 in curosurf groups. The level of statistical significance was considered to be < 0.05.

Results: There were no statistically significant differences between the infants treated by survanta or cursurf groups regarding their mean gestational age (30.58 Vs. 29.00 weeks) and birth weight (1388 Vs. 1330 g), (p=0.3) There were also no significant differences between the two groups regarding incidences of broncho- pulmonary dysplasia (BPD) (40.5% Vs. 40%), intraventricular hemorrhage (IVH) grades III/IV (13.5% Vs. 13.3%), pneumothorax (both 20%), patent ductus arteriosus (PDA) (28/3% Vs. 20%) or death (28% Vs. 26.6%) on the 28th day postpartum.

Conclusion: This study showed that survanta and curosurf had similar therapeutic effects in the treatment of neonatal respiratory distress syndrome.

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Background: Nowadays, dendritic cells (DC) are used for tumor immunotherapy as they can induce immune responses against tumor cells. In this research, we comprehensively studied the maturation stimulus addition, PHA-activated T-cell (PHA- TCM) conditioned medium, autologous monocyte-conditioned medium (MCM) and TNF-α for their ability to promote uniformly mature dendritic cells that elicit T-cell responses. Methods: Plastic adherent monocytes were cultured with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for five days and two days with monocyte-conditioned medium (MCM), tumor necrotizing factor-α (TNF-α) without TCM (PHA-activated T-cell conditioned medium). Phenotypic and functional analyses were carried out using anti-CD14, anti-CD80, anti-CD86, anti-CD83 monoclonal antibodies. Phagocytic activity, mixed lymphocyte reaction (MLR) and cytokine production were also evaluated. Results: The generated dendritic cells had high expression of surface molecules i.e. CD80, CD83, CD86 and HLA-DR. Moreover, the cells had low phagocytic and high T- lymphocyte stimulating activities. Measurement of the produced cytokines showed the generation of type-1 dendritic cells (DC1) in the study. Conclusion: The findings indicated that more efficient maturation of dendritic cells could be achieved by the use of PHA-activated T-lymphocyte conditioned medium in the culture medium. The aforesaid supernatant can be used as a maturation factor for the production of efficient dendritic cells with the ability to be used for tumor immunotherapy. This conditioned medium can provide new strategies and evolve into more advance tools for the generation of dendritic cells in vitro for tumor immunotherapy.

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Background: The innate and adaptive immune responses are dependent on the migration of leukocytes across endothelial cells. Dendritic cells (DCs) play an important role in the initiation of cellular immune responses during their migration from tissues into the lymph nodes where they interact with endothelial cells of lymphatic vessels. We investigated the effects of surface-adherent and non-activated endothelial cells on phenotypic and functional characteristics of dendritic cells. Methods: Immature dendritic cells were generated from the isolation of peripheral blood mononuclear cells and their subsequent culture in DC-RPMI 1640 medium containing 10% FCS, interleukin-4 and granulocyte-macrophage colony-stimulating factor (GM-CSF) for five days. On day five, a maturation factor (composed of monocyte-conditioned medium, tumor necrosis factor-α (TNF-α) and poly I:C) was added to the RPMI medium where immature DCs were co-cultured with endothelial cell monolayer for 24 h. The maturation of harvested DCs on day seven was evaluated via flow cytometry, a beta-counter and an ELISA kit. Results: This study showed that the endothelial cells interact with dendritic cells generated from peripheral blood monocytes via cell-to-cell interaction. This interaction inhibits the maturation of DCs via decrease in the expression of CD83, CD86, CD80, HLA-DR and up-regulation of CD14. The interaction also inhibits the stimulation of T-lymphocytes resulting in a decrease in their proliferation. Conclusion: According to the findings of this study, it could be concluded that the endothelial cells can act as a potent regulator for DCs differentiation and function at the encounter made between them during the migration of DCs from tissues to lymph nodes.

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Background: It is demonstrated that morphine and tramadol affects seizure but the mode of action of these drugs on seizure has not been compared yet with increasing of age. The aim of this study was to compare the impact of exposure to these drugs on Pentylenetetrazol-induced seizure in immature rat.
Methods: Male neonate rats were randomly chosen and divided into three groups namely Saline (n=21), Morphine (n=12) and Tramadol (n=13). On postnatal days 8-14, Saline group received normal saline and two other groups received morphine and tramadol with additive doses, respectively. On postnatal days 22-28, the saline treated rats divided into three subgroups and received saline (n=8), morphine (n=8) or tramadol (n=5). Morphine treated rats received saline or morphine (each n=6), and tramadol treated rats received saline (n=7) or tramadol (n=6). At postnatal day 29, they were evaluated for PTZ-induced seizure.
Results: Number of tonic-clonic seizure was increased in all groups compared with control and tramadol+saline groups (P<0.05). Duration of tonic-clonic seizure was decreased in tramadol+saline group compared with other tramadol groups (P<0.05). Latency of tonic-clonic seizurewas decreased in tramadol+saline group compared with control rats (P<0.05), But it was increased in saline+tramadol group compared with other groups except to saline group (P<0.05). Latency of myoclonic contractions in saline+morphine and saline+tramadol groups was lower than in control rats (P<0.05).
Conclusion: Similar age-related changes may occur inchronic exposure to morphine and tramadol in the neonatal period which leads to an increase in severity of seizures in rats on postnatal days 22-28. The effect of morphine and tramadol does not show any significant difference.

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Background: Primary culture takes place following the cell isolation from tissues. Isolation and culture of melanocytes based on their roll in the protection of body against hazardous sun rays, production of skin, cornea and hair color is really important. This study was done to set isolation, culture and proliferation of melanocytes from children foreskin and adult eyelashes, and also comparison of two types of melanocyte culture medium.
Methods: Human foreskin and eyelash samples were used for melanocyte isolation and culture. After isolation of epidermis from dermis, epidermis cell suspensions were prepared by enzymatic digestion. The isolated cells were cultured in two melanocyte selective culture media. Immunocytochemistary and reverse transcription-polymerase chain reaction (RT-PCR) assays were used for confirmation of isolated and cultured melanocytes.
Results: Our results indicated that isolated melanocyte cultured in the selective medium without phorbol esters is better than the melanocytes cultured in selective medium cont-aining phorbol esters not only morphologically but also physiologically and from the aspect of cell adhesion. In addition, the results showed that isolated melanocyte from adult eyelashes are more dendritic than melanocytes isolated from children foreskin. Conversely, our results indicated that the number of cell passages in melanocyte isolat-ed from foreskin is more than melanocytes isolated from adult eyelashes.
Conclusion: Melanocytes cultured in selective medium containing convenient growth factors in absence of phorbol esters show more native physiological and adhesive properties. In addition, melanocyte isolated from younger tissues such as foreskin have better proliferative and sub-culturing properties so we suggest isolation and culture of younger tissues.

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Background: Various surgical procedures were described for the correction of the external genitalia in male-to-female transsexualism. In all these methods complications such as vaginal stenosis, unpleasant appearance of external genitalia and lack of consent are seen. This paper describes a method of surgery for repair of these complications and success rate of this surgery.
Methods: Reconstructive surgery was performed by one surgeon in 16 patients from 2009 to 2011 in Imam Reza Hospital of Mashhad. Mean age 25.75 years of age from 21 to 31 years. Due to the condition of each patient appropriate reconstructive surgery was performed. These surgeries include: clitoroplasty, inverted U flap, labioplasty, urethroplasty, removal of excess skin and increasing depth of vagina. After the surgery, the patients admitted for complete bed rest up to 5 days. They received postoperative prophylaxis medication for anti-thromboembolic events.
Results: Only 3 complications were seen in all 16 patients. One hematoma of surgery site, one infection of surgery site and a blood transfusion. Eleven patients had history of vaginoplasty using small intestine and 10 patients with penile and perineal skin. From 3 to 24 months follow up after discharge were done, no patient had a major complication in long-term follow up and were generally satisfied with their sexual intercourse.
Conclusion: This study has some limitations. Follow-up of the patients was performed for about one year that longer follow-up for these patients is favorable. Also, evaluation of patients' satisfaction from their intercourse was not performed as systematically with using an standard questionnaire and by a person who is blind to the study. Using this method of restoring external genitalia in the hands of expert surgeon, aesthetic and functional result would be expected very well.

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Background: Rabies is an acute encephalitis that causes more than 60,000 deaths worldwide. The only way to save individuals bitten by a rabies-infected animal is the timely use of effective vaccines. Treatment with new generation vaccines is expensive. Therefore, there is a global movement towards the production of less expensive vaccines which retain and improve upon the quality and effectiveness of the vaccine. Production and evaluation of non-classical vaccines is one of the approaches taken in this regard. In this study, we describe a new eukaryotic expression system to express the nucleoprotein N gene of rabies virus which, if suitable, may be evaluated for anti-rabies vaccine production. Methods: The complete sequence of the N gene of rabies virus PV subtype was amplified by real-time polymerase chain reaction and cloned into the pCDNA3.1(+) vector. The cloned gene was excised from the vector by restriction enzyme digestion and sequenced. Due to mutations detected in the N gene, the gene coding sequence was purchased as a recombinant pGH/N vector. Vector pGH/N was amplified and following enzymatic digestion, the excised N gene was once again cloned into vector pCDNA3.1(+). Successful cloning was confirmed using restriction digests and quick check. The recombinant vector pCDNA3.1(+)/N was transformed into cultured BSR cells and protein N expression was analyzed using fluorescent antibody test (FAT). Results: Electrophoresis confirmed amplification of the nucleoprotein N gene and subsequent restriction enzyme digestion showed that the N gene had been successfully cloned into the recombinant pCDNA3.1(+)/N vector. However, DNA sequencing revealed the presence of mutations within the N gene. Restriction digest of the commercial pGH/N vector showed that the N gene had been excised from the vector. Successful cloning of the N gene into the pCDNA3.1(+) expression vector was confirmed using restriction digests and quick check. Protein expression in BSR cells was assayed by immunostaining with anti-ribonucleocapsid FITC-conjugated antibody and visually confirmed by fluorescence microscopy. Conclusion: This study showed that the protein N of rabies virus subtype PV can be expressed in a eukaryotic expression system using the pCDNA3.1(+) expression vector.

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Mesenchymal Stem Cells (MSCs) are well known as the regulator of the immune system. These multipotent non-hematopoietic progenitor cells have been originally isolated from bone marrow, and later on found in several other tissues, such as skeletal muscle, umbilical cord blood, adipose and fetal liver tissues. Immunomodulatory effects of MSCs on a variety of immune cells such as T and B lymphocytes, Natural Killer cells (NK), neutrophils, macrophages and dendritic cells, has made a good candidate of them for the treatment of inflammatory disorders, particularly autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. In addition, several studies have indicated mechanisms by which MSCs could reduce immune cell proliferation and activation leading to immune tolerance induction. Since T lymphocytes are considered as the most important immune cells, effect of MSCs on the activity of these cells has a very special significance to direct immune response. Under various conditions, T-lymphocytes have different phenotype and performance and can be differentiated into particular subtype such as regulatory T cells. Both in vitro and in vivo studies have indicated that MSCs modulate innate and adaptive immune system by promoting generation of CD4+CD25+ T regulatory cells which have important role in immune tolerance induction and autoimmune disease prevention. MSCs are able to block pro-inflammatory and increase anti-inflammatory cytokines secretion. So such unique immunomodulatory features make MSCs ideal candidates for clinical application as immunosuppressants which can be considered for autoimmune diseases treatment. Therefore, in this short-review, we attempt to focus mainly on the existing information about MSCs in association with immunomodulatory function of them on the immune system. In addition, the possible mechanisms and the performance impact of MSCs in autoimmune diseases improvement are discussed here. However, increasing knowledge of how MSCs will influence on the immune system suppression, leading us to better use of these cells as a promising tool in the treatment of autoimmune diseases.

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Background: Mycoplasma contamination in cell cultures is considered as a major economic, research and production problem. In this study, mycoplasma-infected Vero cell lines were treated by various dilutions of ciprofloxacin and enrofloxacin in a timely manner. Removal of mycoplasma contamination from infected cell cultures was evaluated and demonstrated by polymerase chain reaction (PCR) method. Methods: This study was done from October 2013 to May 2014, in Human Rabies Vaccine Laboratory, Pasteur Institute Production and Research Complex, Tehran, Iran. Different dilutions of ciprofloxacin and enrofloxacin were used in sequential passages for treatment of infected Vero cell line. Based on lowest passages of the cell line, antibiotic treatment with ciprofloxacin and enrofloxacin was done. Amelioration of the infection and removal of mycoplasma contamination was confirmed in each step by PCR method. The technique for order of preference by similarity to ideal solution, TOPSIS method, was used to suggest the most efficient concentration of ciprofloxacin and enrofloxacin. Results: Proposed concentration of ciprofloxacin is 20 μg/ml, and in the second order is 200 μg/ml. For enrofloxacin the best proposed concentrations are 30, 300 and 3 μg/ml respectively. Ciprofloxacin and enrofloxacin and ability of them for removal of mycoplasma and also the time of treatment were verified by evaluation of the recurrence of infection through consecutive subcultures of the treated cell line. Conclusion: Our results showed that 20 μg/ml of ciprofloxacin was the dilution of choice for mycoplasma elimination followed by 200 μg/ml of ciprofloxacin. Concentrations of 3, 30 and 300 of enrofloxacin, respectively, are appropriate for mycoplasma removal. More detailed works would be needed to verify the authenticity of the proposed simple and affordable way of mycoplasma elimination.

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Background: Bloodstream infections (BSI) have a high incidence and high mortality in the worldwide. The mortality rate is variable between 20-70%. Therefore, early and timely detection of BSI agent in clinical laboratories is necessary. The aim of this study was to determine an efficient diagnostic tool to septicemia in accompany of blood culture method by Real-time PCR (using panbacterial 23S rRNA gene).

Methods: This cross-sectional study was conducted in two analytical and clinical stages in Hamadan University of Medical Sciences, Iran, from October 2014 to June 2015. In analytical stage, sensitivity (by serial dilution from 104 to 1 CFU/ml) and specificity of the primer were evaluated with the Staphylococcus aureus (as Gram positive indicator bacteria) and Escherichia coli (as Gram-negative indicator bacteria), human genome (from Hella cell culture), Candida albicans yeast and Aspergillus fumigatus fungus. In clinical stage, 121 blood samples were collected from patients suspected to sepsis in intensive care unit (ICU) from Hamadan University Hospitals. Finally, the results of Real-time PCR and blood culture methods were compared.

Results: The Real-time PCR showed a sensitivity ranging from 2 to 10 target copies per reaction to the whole blood for Escherichia coli and Staphylococcus aureus respectively. The specificity of this method was evaluated and no false positive amplification was identified. 57.85% (70 cases) of the samples were positive by Real-time PCR and 13.22% (16 cases) of the samples were positive by blood culture. However, none of the cases that were positive by blood culture were negative in Real-time PCR. As well as, 44.62% (54 cases) of cases were positive by Real-time PCR but blood culture showed no bacteria in the samples, and 42.15% (51 cases) were negative by both methods. Correlation or agreement of Kappa was 0.20, that indicating poor agreement between the two methods.

Conclusion: Real-time PCR is more sensitive than blood culture and also, because of high sensitivity of this primer by Real-time PCR, we can use it for screening blood samples from suspected patients of sepsis.

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Background: Nano scale dendrimers are macromolecules synthetic which frequently used in medical and health field. Because traditional antibiotics inevitably induce bacterial resistance, which is responsible for many treatment failures, there is an urgent need to develop novel antibiotic drugs. This study was aimed to examine Synthesis and the antibacterial effect of NanoPolyamidoamine-G7 (NPAMAM-G7) dendrimer on Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus.

Methods: In this experimental study that has been conducted in June 2015 in the Laboratory of Microbiology, Iran University of Medical Science, NPAMAM-G7 dendrimers was synthesized by Tomalia’s divergent growth approach. The antibacterial effects of NPAMAM-G7 dendrimer were studied by disc diffusion and micro-dilution method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against gram-positive and gram-negative bacteria were determined according to Clinical and Laboratory Standards Institute (CLSI) guideline. Standard discs were prepared using different concentrations of dendrimer on Mueller-Hinton agar plates.

Results: Zone of inhibition in concentration 25 μg/ml of NPAMAM-G7 dendrimers for Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus were 26, 38, 36, 22 and 25 mm, respectively. Regarding the zone of inhibition in gram negative bacteria with gram positive ones was P= 0.16 and was not significant difference. The MIC for Salmonella Typhi was 0.025, for Proteus Mirabilis, Bacillus Subtilis, Staphylococcus Aureus and Escherichia Coli was 0.25 μg/ml. The MBC for Salmonella Typhi was 25μg/ml, for Proteus Mirabilis and Bacillus Subtilis was 50 μg/ml and for Escherichia Coli and Staphylococcus Aureus was 100 μg/ml. The least of sensitivity against NPAMAM-G7 related to Escherichia Coli and Staphylococcus Aureus and the most of sensitivity related to Salmonella Typhi.

Conclusion: The NPAMAM-G7 dendrimer with end amine groups exhibited a positive impact on the removal of standard strains, gram-positive and gram-negative bacteria. Therefore, it is possible to use these nanodendrimers as antibacterial in the future.

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Background: Poly(amidoamine) (PAMAM) dendrimer derivatives have been investigated for their biological applications, especially for delivery of drugs, including antimicrobial drugs to eukaryotic cells, but their effects on bacterial cells are largely unexplored. Nanotechnology and its application is one of the rapidly developing sciences. As demand of fresh drinking water is increasing, nanotechnology can contribute noticeable development and improvement to water treatment process. This study was aimed to examine synthesis and the antibacterial effect of Nanopolyamidoamine-G7 (NPAMAM-G7) dendrimer on Escherichia Coli (E. Coli), Klebsiella Oxytoca (K. Oxytoca), Pseudomonas Aeruginosa (P. Aeruginosa), Proteus Mirabilis (P. Mirabilis) and Staphylococcus Aureus (S. Aureus) from aqueous solution.
Methods: In this experimental study that has been conducted in August to December 2015 in the laboratory of microbiology of Iran University of Medical Sciences, initially dilution of 103 CFU/ml were prepared from each strain of bacteria. Then different concentrations of dendrimer (0.025, 0.25, 2.5 and 25 µg/ml) in the laboratory temperature (23-25 °C) was added to water. In order to determine the efficiency of dendrimers in removal of bacteria, samples were taken at different times (0, 10, 20, 30, 40, 50 and 60 min) and were cultured on nutrient agar medium. Samples were incubated for 24 hours at 37 °C and then number of colonies were counted.
Results: Antibacterial properties of dendrimers in aqueous solution by increasing the dendrimer concentration and contact time is directly related. At a concentration of 25 μg/ml at 60 minutes all bacteria except S. Aureus, and at 30 minutes, E. Coli and K. Oxytoca bacteria for 100% excluded. The concentration of 2.5 μg/ml at 60 minutes of bacteria, E. Coli, K. Oxytoca and P. Mirabilis are 100% excluded. All concentrations of dendrimers at different times were reduced bacteria in the PAMAM- G7 dendrimer effect on gram-negative bacteria, gram-positive bacteria was better.
Conclusion: The NPAMAM-G7 dendrimer with end amine groups exhibited a positive impact on the removal of standard strains, gram-positive and gram-negative bacteria. Therefore, it is possible to use these nanodendrimers as antibacterial in the future.

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Background: Electrolysis is an electrochemical method for the treatment of water. recently water disinfection by electrochemical methods has been increasingly carried out. The aim of this applied research was to investigate the removal of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria from drinking water by using electrolysis method with Al-Fe electrodes parallel with the monopole mode.

Methods: An experimental study was conducted in the laboratory of microbiology, Iran University of Medical Science in May 2017. In this study, the contaminated water samples were prepared through adding 10³, 10⁴ and 10⁵ E. coli and S. aureus bacteria per 1 milliliters (mL) of drinking water. Independent variables Included: different concentrations of E.coli and S. aureus bacteria (10³, 10⁴ and 10⁵ CFU/ml), reaction time (5, 10, 15, 20 and 25 min), initial pH (7, 8 and 9), electrode gap (1, 2 and 3 cm), current density (0.83, 1.67 and 3.3 mA/cm²) to determine the optimum conditions were investigated. One-way ANOVA was used to analyze the results.

Results: The results show that in the optimum conditions with increasing the pH from 7 to 9 removal efficiency of bacterial strains of E. coli and S. aureus were decreased significantly from 98 to 73% and 99.1 to 76%, respectively. In initial concentration of 104 CFU/ml, optimum conditions were obtained for current density, reaction time and electrodes gap, 1.67 mA/cm2, 20 min and 2 cm, respectively. With increasing current density and reaction time in both strains of bacteria, were decreased significantly. The electrodes gap do not have much impact on the efficiency of the process. The amount of electrical energy consumed in optimal conditions was calculated 0.5128 kilowatt-hour (kWh/h). Statistical analysis shows that exist significant relationship (P<0.01) between initial concentrations of bacterial strains and efficiency of the process. Conclusion: According to the results, E. coli and S. aureus, removal efficiency were obtained more than 98%, therefore electrolysis process can be used in the removal of pathogenic bacteria from drinking water.

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Background: Anode heel effect refers to reduction of radiation intensity in the anode side of X-ray tube. This variation in radiation intensity across the anode-cathode of X-ray tube can be benefited for decrease radiation exposure in some radiological examinations. The aim of this study was to evaluate the effect of anode heel orientation on the radiation dose received by the testes in male patients undergoing pelvic radiography.

Methods: This is a cross-sectional study, conducted at one of the teaching hospitals of Ahvaz, Jundishapur University of Medical Science Ahvaz, Iran, from September 2015 to March 2016. In order to measure the profile of radiation intensity variation, 13 paired sets of high radiosensitive cylindrical lithium fluoride thermo-luminescent dosimeters (TLD) aligned on the cathode-anode central axis upon the table and then irradiated using routine exposure parameters. The anode of X-ray tube was positioned toward the feet for 40 patients and toward the head for 39 patients undergoing pelvic radiography. For measure the entrance skin dose (ESD), 8 TLD chips were located on the central point of the radiation field and 5 TLDs were located on the testes position to measure the dose received.

Results: Radiation intensity profile showed that radiation intensity decrease from the cathode to the anode side. Discrepancy of radiation intensity on central axis of cathode-anode was calculated about 35%. The radiation dose received by the testes was 26.74% lower for patients the anode directed toward the feet, compared to the patients in which the anode directed toward the head (FTC: 1.260±0.296 mGy, FTA: 0.923±0.167 mGy, P<0.05). There was no meaningful difference for the measured ESD of pelvis between two groups of patients (FTC: 1.256±0.315 mGy, FTA: 1.195±0.205 mGy, P=0.788). Conclusion: In pelvic radiography, positioning of testes directed to the anode of X-ray tube can decrease the receive dose.