Tehran University Medical Journal

Thymoglobulin is a purified polyclonal immunoglobulin that has been used widely over the last decades in the prevention and treatment of rejection following renal transplantation. This immunoglobulin works against human thymocytes. Since thymoglobulin does not contain the nephrotoxic properties therefore it can be used in induction therapy especially in patients with higher risk of graft rejection such as patients who receive graft from cadavers. Recent research showed also its beneficial role in cross-match-positive transplantation, a role that is mediated through conjunction with inhibitors of terminal complement activation. This immunoglobulin has also been used for treatment of rejection following renal transplantation. Thymoglobulin can have various effects on various Immune system cells including T cells, B cells and also plasma cells. Thymoglobulin also affects the Tcell surface antigens, natural killer-cell antigens, B cell antigens, plasma cell antigens, adhesion molecules and chemokine receptors. Diverse effects of thymoglobulin on the immune system includes: T cell depletion, induce apoptosis in B cell lineage and interference with dendritic cell functional properties. Thymoglobulin can cause acute complications, delayed complications as well as infectious complications. Acute reaction events includes: anaphylaxis, fever, chills, dyspnea, nausea, vomiting and diarrhea. Thymoglobulin also induces cytokine release syndrome manifested by high grade fevers and chills and treated by steroid therapy. Delayed reactions events usually present as serum sickness and infections. Infectious complications are more important and include cytomegalovirus (CMV) infection, sepsis, candidiasis, herpes simplex and urinary infections. Thymoglobulin can also induce cytokine release syndrome. It has been thought that thymoglobulin increases the risk of post-transplant lymphoproliferative disorder (PTLD), however, debate still exists whether such an association is present when lower dosing regimens are used. In this review, we aimed to present first a brief history of thymoglobulin development and its mechanism of action and then assess the most recent published data regarding the role of thymoglobulin in following issues: immunological tolerance, ischemia-reperfusion injury, delayed graft function, prevention and treatment of acute allograft rejection, live donor transplantation, graft and patient survival and posttrans-plant lymphoproliferative disorder. This review can help specialist in transplant domain to appropriately used thymoglobulin in transplant patients.

Background: Seladin-1 protein protects the neural cells against amyloid beta toxicity and its expression decreased in vulnerable regions of Alzheimer's disease (AD) brains. On the other hand, changes in serum levels of S100 have been considered as a marker of brain damage in neurodegenerative diseases. Furthermore, this study was carried out to determine the relation between the change profile of serum S100&beta protein levels and hippocampal Seladin-1 gene expression in a rat model of sporadic AD. Methods: In this experimental study that established in Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Science, from March 2011 to April 2013, 72 animals were randomly divided into control, 4, 7, 14, and 21days ICV-STZ/Saline administrated rats. Alzheimer's model was induced by intracerebroventricular (ICV) injections of streptozotocin (STZ) [3 mg/kg] on days 1 and 3. Serum levels of S100&beta and hippocampal Seladin-1 gene expression were evalu-ated in experimental groups. The initial and step-through latencies (STL) were deter-mined using passive avoidance test. Results: Serum levels of S100&beta were significantly different between the STZ-7 day and STZ-14 day groups in comparison with the control, saline and STZ-4 day groups. As well as, there was a significant difference between the STZ-7 day group in comparison with the STZ-14 day and STZ-21 day groups (P=0.0001). Hippocampal Seladin-1 gene expression in STZ-14 day and STZ-21 day groups significantly decreased as compared to the control, saline and STZ-4 day groups (P=0.0001). However, significant correla-tion was detected between serum S100&beta protein decrement and Seladin-1 down regula-tion (P=0.001). Also, the STL was significantly decreased in 21 days ICV-STZ adminis-trated rats as compared to the control or saline groups (P=0.001). Conclusion: Monitoring the changes of serum S100&beta protein levels by relationship with changes in hippocampal Seladin-1 gene expression can be a useful indicator of neu-ronal damage in patients with Alzheimer's disease.

Background: Bacterial pneumonia is one of the most common causes of morbidity and mortality, and accurate diagnosis and treatment of the pneumonia causative agent, especially in polybacterial cases, is difficult and much appreciated. The aim of this study was to determine the causative agents and antimicrobial susceptibility of polybacterial pneumonia in patients with lower respiratory tract infections.Methods: In this retrospective cross-sectional study, 167 cases with symptoms of lower respiratory tract infection (LRTI), admitted since March 2010 to March 2013 to Baqiyatallah Hospital, Tehran, were studied. Bronchoalveolar lavage (BAL) samples have been obtained from all these patients and have been investigated for the presence of bacterial causative agent, presence of polybacterial pattern of the infection, and the pattern of antimicrobial susceptibility testing by disc diffusion method. Also, the samples have been studied for the presence of Mycobacterium tuberculosis through culture of specific media, separately.Results: From 167 patients (62 women and 105 men), 90 cases were positive for the presence of bacterial pathogens while 77 cases were negative by culture. The incidence of bacterial pneumonia was not statistically different between men and women. Totally 117 bacterial isolates were obtained belonging to 15 different bacterial species. Mycobacterium tuberculosis (25%), Pseudomonas aeruginosa (15%) and Staphylococcus aureus (14%) were the most frequent pathogens identified. 72 percent of pneumonic cases were monobacterial infections and the others were polybacterial infections (23% two-bacterial, and 5% three-bacteria). The highest antibiotic resistance rate was seen for amoxicillin and the lowest one was seen for vancomycin.Conclusion: This study found that the prevalence of bacterial pneumonia increases with age, and also is caused by different etiologic agents. A high percentage of negative cases may be due to fastidious bacteria, viral agents, and previous antibiotic therapy. Due to high levels of resistance to antimicrobial agents, accurate diagnosis and susceptibility testing of pneumonic patients is essential.

Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men.

Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA).

Results: A total of 96 patients were enrolled in two groups of 48 men and women both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001) but the changes in sperm count were not significantly different between the groups (P= 0.495).

Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.

Background: One of the most important issues in medical sciences is wound healing and repair. Application of natural ingredients and herbs for treating ulcers has been in the history of human life. Nowadays, due to the lack of side effects of medicinal plants and a variety of effective compounds in plants, as well as numerous disadvantages of synthetic drugs there has been tendency to use medicinal plants in clinic. Aloe vera is an herbal drug used for treatment of dermal diseases. In this study we evaluated, effects of aloe vera on the wound healing through the microscopic techniques and cell counting.

Methods: In this experimental study, sixty Wistar rats weighing 200-250 g were placed under general anesthesia and sterile conditions. Then a square shape wound with 1.5´1.5 mm dimension was made on the back of the neck. Rats were randomly divided to control and experimental group’s. Each group was divided to three subgroups with 4, 7, and 14 study days. In 1st experimental group aloe vera was used twice on the wound surface and in 2nd experimental group was used once daily and the positive control group were applied phenytoin cream 1% from the zero days of surgery. The control group did not get any treatment on the wound surface. For histological studies, during the fourth, seventh and fourteenth day’s rats were sacrificed and samples were taken from the wound area and adjacent skin. After histological staining with hematoxylin and eosin (H&E) and Masson's trichrome stains, the cells were counted, wound surface and wound healing were investigated.

Results: The macroscopic and microscopic evaluation showed that wound healing increased because the fibroblast numbers in two experimental groups improved compared with control group. The percentage of wound healing on different days in the experimental and control groups were significant. Data were analyzed by using one-way ANOVA test and P< 0.05 was significant.

Conclusion: Present study showed that the twice application of topical aloe vera mucilage can result in rapid wound healing in rats.

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.

Background: Self-immolation is a common method for suicide among women in developing countries. Culture is considered as an influential factor for attempting suicide by selfimmolation. Better understanding of the influence of culture will be useful to develop specific prevention strategies. Therefore, the study aimed to explore how the culture can influence on
attempting suicide by self-immolation among women.
Methods: The study was performed by a qualitative approach using directed content analysis in Imam Khomeini Hospital, Kermanshah, Iran, 2011- 2013. Our participants were selected purposefully among patients who attempted suicide by self-immolation (n= 9), their relatives (n= 6), and treatment staff (n= 6). We used semi-structure interview
for data gathering. The interviews were tape recorded and transcribed. Then, transcribed interview was analyzed by constant comparison.
Results: The main extracted theme was self-immolation sub-culture. Two main categories and 6 sub- categories were also emerged that explored the effect of culture on attempting suicide by self-immolation. The main categories were cultural restriction, and cultural acceptation. Marriage- divorced related traditions, living in extended family, and cultural
conversations and cultural meanings of self-immolation were among extracted subcategories. The category of cultural restriction described the role of culture in the occurrence of family conflicts as a predictor of attempting suicide by self-immolation, and cultural acceptation, the second category, explained how self-immolation is accepted as a
method of choice of suicide in the understudied culture.
Conclusion: Our finding showed that subculture of self-immolation provides influential conditions for attempting suicide by self-immolation. According to the findings, cultural restriction may facilitate conditions to occurrence of attempting self-immolation, and cultural acceptance provides conditions to perdurability of self-immolation as a method of
suicide. Considering these conditions is recommended in designing prevention programs.

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.

Background: High-resolution manometer (HRM) of the esophagus has become the main diagnostic test in the evaluation of esophageal motility disorders. The development of high-resolution manometry catheters and software displays of manometry recordings in color-coded pressure plots have changed the diagnostic assessment of esophageal disease. The first step of the Chicago classification described abnormal esophagogastric junction deglutitive relaxation. The latest classification system, proposed by Pandolfino et al, includes contraction patterns and peristalsis integrity based on integrated relaxation pressure 4 (IRP4). It can be discriminating the achalasia from non-achalasia esophageal motility disorders. The aim of this study was to assessment of clinical findings in non-achalasia esophageal motility disorders based on the most recent Chicago classification.

Methods: We conducted a prospective cross-sectional study of 963 patients that had been referred to manometry department of Gastrointestinal and Liver Research Center, Firozgar Hospital, Tehran, Iran, from April, 2012 to April, 2015. They had upper GI disorder (Dysphasia, non-cardiac chest pain, regurgitation, heartburn, vomiting and asthma) and weight loss. Data were collected from clinical examinations as well as patient questionnaires. Manometry, water-perfused, was done for all patients. Manometry criteria of the patients who had integrated relaxation pressure 4 (IRP4) ≤ 15 mmHg were studied.

Results: Our finding showed that the non-achalasia esophageal motility disorders (58%) was more common than the achalasia (18.2%). Heartburn (68.5%), regurgitation (65.4%) and non-cardiac chest pain (60.6%) were the most common clinical symptoms. Although, vomiting (91.7%) and weight loss (63%) were the most common symptoms in referring patients but did not discriminate this disorders from each other’s. Borderline motor function (67.2%) was the most common, absent peristalsis (97%) and the hyper-contractile esophagus were rarest in the non- achalasia esophageal motility disorders.

Conclusion: However, achalasia is a treatable esophageal motility disorder but non-achalasia esophageal motility disorders were more common. Thus, manometrial study is an imperative tool for proper diagnosis and treatment of these patients, especially in gastro-esophageal reflux disease. Clinical finding could not accurately diagnosis between different types of non-achalasia esophageal motility disorders from each other’s.

Background: Anemia disease is the most common hematological disorder which most often occurs in women. Knowledge discovery from large volumes of data associated with records of the disease can improve medical services quality by data mining The goal of this study was to determining and evaluating the status of anemia using data mining algorithms.

Methods: In this applied study, laboratory and clinical data of the patients with anemia were studied in the population of women. The data have been gathered during a year in the laboratory of Imam Hossein and Shohada-ye Haft-e Tir Hospitals which contains 690 records and 15 laboratory and clinical features of anemia. To discover hidden relationships and structures using k-medoids algorithm the patients were clustered. The Silhouette index was used to determine clustering quality.

Results: The features of red blood cell (RBC), mean corpuscular hemoglobin (MCH), ferritin, gastrointestinal cancer (GI cancer), gastrointestinal surgery (GI surgery) and gastrointestinal infection (GI infection) by clustering have been determined as the most important patients’ features. These patients according to their features have been seg-mented to three clusters. First, the patients were clustered according to all features. The results showed that clustering with all features is not suitable because of weak structure of clustering. Then, each time the clustering was performed with different number of features. The silhouette index average is 80 percent that shows clustering quality. Therefore clustering is acceptable and has a strong structure.

Conclusion: The results showed that clustering with all features is not suitable because of weak structure. Then, each time the clustering was performed with different number of features. The first cluster contains mild iron deficiency anemia, the second cluster contains severe iron deficiency anemia patients and the third cluster contains patients with other anemia cause.

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.

Background: Human papilloma virus (HPV) is one of the most important factors in cervical cancer. Viral sequences are integrated into the host cell genome. In mild cases the virus causes skin damages, in severe cases it leads to cancer. Like many other cancers, telomerase gene expression was increased in cervical cancer. This enzyme is a reverse transcriptase that contains two common subunits: i) catalytic protein called human telomerase reverse transcriptase (hTERT) and, ii) RNA sequence called hTR. hTERT expression is hardly found in any somatic tissues. Detection of high telomerase activity in human cells, lead to tumor genesis. So hTERT can be used as a diagnostic tool in cancer detection.

Methods: This experimental study was carried out from May 2013 to April 2014 in Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences in Tehran, Iran. Caski and Hela cancer cell lines were used which contain HPV16 and HPV18 respectively. Cell lines were cultured and total RNA was extracted. Following normalization agent glyceraldehyde-3-phosphate dehydrogenase (GADPH), hTERT expression level was determining by real-time PCR method. For each sample, the expression level of hTERT and GAPDH were quantified as copy numbers (per reaction) using the standard curve. Finally, hTERT levels in Hela and Caski cell lines were compared quantitatively by t-test using GraphPad statistic software version 5 (San Diego, CA, USA).

Results: According to the charts real-time PCR, hTERT gene expression in Hela and Caski cancer cell lines is significantly different (t=0.0319).

Conclusion: All results confirm that hTERT expression levels in Hela and Caski cell lines are significantly different and the level of hTERT expression in the Caski cell line was slightly higher than that of Hela cell line. The significant difference between hTERT mRNA expression levels reported here could be used as a tumor marker for HPV16 and HPV18 in cervical cancer.

Background: Cervical cancer is the third most common gynecologic cancer in women worldwide. Cervical cancer has lower incidence and mortality rates than uterine corpus and ovarian cancer, as well as many other cancer sites. Unfortunately, in countries that do not have access to cervical cancer screening and prevention programs, cervical cancer remains the second most common type of cancer. Staging of the disease is made clinically. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) for diagnosing the invasion of cancer to organs and staging of cervical cancer and the relationship between clinical and pathological findings and the sensitivity and specificity of the assay in cervical cancer.

Methods: The study included records of 40 patients with cervical cancer that undergo surgery or Chemoradiation in Firoozgar University Hospital. In this study that made retrospectively, non-randomized, the MRI reports and clinical findings records and pathology results was discussed. The sensitivity and specificity of MRI for diagnosing the invasion to parameters, bladder, rectum, vagina, pelvic wall and it’s accuracy to determine tumor stage has been set.

Results: A total of 40 patients with pathology information of cervical cancer was retrospectively reviewed in the study. The patients were 28-83 years old by mean age of 49.3 Pathology of cervical cancer in 80% of cases was SCC, 15% adenocarcinoma and 5% melanoma. The sensitivity and specificity of MRI for diagnosing invasion of parameter was 76% and 88%. The sensitivity of MRI in the detection of bladder invasion was 100% and specificity of 100%. The sensitivity of MRI in the diagnosis of rectal invasion was 50% and specificity of 100%. The sensitivity of MRI in the diagnosis of pelvic wall invasion was 100% and specificity of 86%. Sensitivity in detecting invasion into the upper third of the vagina was 100%.

Conclusion: Overall, this study showed a good sensitivity and specificity for detecting invasion into the bladder, vagina, pelvic wall and parameters and good specificity for the diagnosis of rectal invasion and acceptable accuracy at 67.5% for detection of tumor stage by MRI show.

Background: Chorionic villus sampling refers to a procedure in which small samples of placenta are obtained for prenatal genetic diagnosis, generally in the first trimester of pregnancy in 11 weeks till 13 weeks+6 days. This procedure provides prenatal diagnosis in pregnancy. Amniocentesis is a technique for windrowing amniotic fluid from the uterine cavity using a needle via a trans abdominal approach. Amniocentesis and chorionic villus sampling are invasive prenatal procedure. Their complications are fetal loss vaginal bleeding, rupture of membrane chorioamnionitis and limb reduction. There are some probable predictors of fetal loss after chorionic villus sampling and amniocentesis including maternal age, gestational age, number of needle insertion, previous miscarriage, and placental location. The aim of this study was to compare procedure related complications of amniocentesis and chorionic villus sampling in a tertiary referral hospital in Iran.

Methods: This retrospective cohort study was done in pregnant women who were high risk in genetic screening tests. The pregnancy outcome of women who underwent amniocenthesis and chorionic villus sampling was assessed in Yas Women General Hospital (Mirza Kuchak Khan), Tehran, Iran, from 2001 to 2011. Group one, pregnant women who underwent amniocentesis, was compared with group two, pregnant women that underwent chorionic villus sampling. The statistical analyses were performed with SPSSv.20 using a significant level of α<0.05.

Results: There were no significant differences between the two groups in procedure related fetal loss before 24th weeks of pregnancy (1.1% in chorionic villus sampling group versus 0.6% in amniocentesis group, P=0.318). A significant relationship between the number of needle insertion in the chorionic villus sampling group and fetal loss before 24th weeks of pregnancy was seen P<0.028. There were no significant differences between the two groups in the occurrence of vaginal bleeding, rupture of membrane, pre-term birth, placenta location, low birth weight and very low birth weight. The risk of chorioamnionitis was higher in chorionic villus sampling group (P=0.019). No significant difference was observed between the liquid and bloody amniotic fluid and pregnancy complications.

Conclusion: There was no significant difference between the procedure related complications of amniocentesis and chorionic villus sampling.

Background: To assess patient' reaction towards bedside teaching in the nephrology ward of Imam Khomeini Hospital Complex (Tehran) and to identify the factors that may influence it.

Methods: A cross-sectional study was conducted in the nephrology ward of Imam Khomeini Hospital Complex from march to September, 2014. All inpatients present on the day of the study were interviewed using a structured questionnaire.

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.

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.

Background: HLA disease association was investigated in several autoimmune, cancer and infectious diseases. The outcome of tuberculosis (TB) infection may be influenced by host genetic factors like MMP-1, MCP-1, IL-10, IL-12, TNF-α, IFN-γ and human leukocyte antigen (HLA). Given the paucity of information with regard to the association between the human leukocyte antigens (HLA) and TB infection among Iranians, we aimed to identify HLA polymorphisms that might confer susceptibility or protect against TB.

Results: The results of this study showed a significant increase and positive association  with -DRB1*04:03 (OR=3.13, CI 95% (2.47-3.96), -DRB1*14:04 (OR=3.13, CI 95% (2.47-3.96), -DQB1*0201 (OR=2.67, CI 95% (1.18-6.04), -DQB1*0601 (OR=3.16, CI 95% (1.36-7.73) ,while the frequency of -DRB1*07 (OR=0.16, CI 95% (0.05-0.52) were lower in patients than control group and shows negative association.