Tehran University Medical Journal

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Background: Uterine leiomyoma is one of the most common benign smooth muscle tumors occurring in 20-40% of women worldwide in their reproductive years. Recent studies revealed that estrogen plays an important role in the pathogenesis of this disease. Since glutathione S-transferase (GST) gene family are involved in the biosynthesis of estrogen, the prior probability that variants at this locus are associated with uterine leiomyoma is likely to be above the null. Therefore, this study was carried out to examine whether GSTP1 polymorphism (Ile105Val) is associated with increased risk of uterine leiomyoma in Iranian population. Methods: In this case-control study, 50 women diagnosed with uterine leiomyoma and 50 healthy controls were recruited from subjects referred to the Pasteur Institute of Iran from November 2012 to September 2013. The genomic DNA was extracted from peripheral blood leucocytes using the standard phenol-chloroform method and subsequently the GSTP1 polymorphism was genotyped using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Logistic regression analysis was applied to estimate odds ratios and 95% confidence intervals after age adjustment using the SPSS statistical software package, version 18.0. Results: The results showed significant differences between case and control groups in terms of genotype frequency (P<0.0001). In addition, the results indicated that the presence of the valine allele significantly increased risk of uterine leiomyoma about three times more in individuals carrying the mutant allele compared to control group (Odds Ratio: 3.34 95%CI: 1.82-6.15 P<0.0001). Conclusion: To our knowledge, this is the first study performed in Iranian population assessing the association between GSTP1 Ile105Val polymorphism and risk of uterine leiomyoma. However, further extensive studies with a large number of samples from different populations and ethnicities are required to validate the results obtained in this study.

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Background: This study aims to evaluate the outcomes and late complications of open Roux-en-Y gastric bypass surgery in the treatment of morbid obesity. Methods: Over a 15 year-period between May 1997 and May 2012, we reviewed our experiments with 39 patients who underwent open gastric bypass for morbid obesity. The weight of the patient and surgical complications were recorded. Ideal weight, body mass index, weight loss and excess weight loss were calculated. Results: The follow up period ranged from 6 to 180 months with a mean of 100 months after operation. Average weight loss was 3.9 and 0.28 kg per month during the first and second years after operation weight loss was slower from the third year on-wards. Weight loss generally was stabilized between 12 and 18 months after operation. Only one patient (2.6%) had a weight loss failure criterion. Concomitant condition ex-isted in 14 patients (48.2%) of our series. These included hypertension in 3 cases (10.3%) that was resolved in 100%, diabetes mellitus in 4 (13.7%) that was resolved in 75%, cholelithiasis in 7 cases (24.1%) that was resolved by cholecystectomy during the operation. There was no early postoperative death. Early complications occurred in 2 patients (5.1%), including pulmonary embolism (2.6%) and gastrointestinal bleeding (2.6%). The late complications occurred in 7 patients (17.9%) involved 2 patients with anastomotic stricture at the gastrojejunostomy (5.1%), One patient with symptomatic cholelithiasis (2.6%), three patient with anemia (7.7%), and one patient had Wernicke ’s disease who died of this complication (2.6%). Conclusion: The results of the study showed that the open Roux-en-Y gastric bypass surgery is an effective procedure in the treatment of morbid obesity with minimal late complications.

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Background: Uterine myomas are benign tumors of the uterus and the most common solid pelvic tumors causing symptoms in approximately 25% of women in their reproductive years. However, its etiology and pathogenesis remain obscure there is increasing evidence that endometriosis is inherited as a complex genetic trait. Recent studies indicated the involvement of glutathione S-transferase M1 (GSTM1) gene in the pathogenesis of this disease and current investigations are devoted to the other members of phase II detoxification system genes such as glutathione S-transferase T1 (GSTT1). Therefore, current study was carried out to investigate the distribution of GSTM1 and GSTT1polymorphisms in Iranian population in order to estimate possible impact of null-alleles of each gene in development of this disease. Methods: In this study, 50 patients with endometriosis diagnosed by both pathology and laparoscopic findings according to the revised American Fertility Society classification of endometriosis were recruited from subjects referred to the Pasteur Institute of Iran between November 2012 to September 2013. Accordingly, controls (n=50) were subjects without any of aforementioned gynecologic conditions. The genomic DNA was extracted from peripheral blood leucocytes using the salting out method and GSTM1 and GSTT1 genotyping for gene deletions were carried out using Gap-polymerase chain re-action. Logistic regression analysis was applied to assess whether there was any significant risk increase between the case group with higher null genotypes compared to control group. The level of statistical significance was set at 0.05 and all analyses were conducted using the SPSS version 18.0 (SPSS Inc., Chicago, IL). Results: There was significant evidence that the distribution of the GSTM1 and GSTT1 genotypes differed between the patients and the controls with an allelic odds ratio (OR) of 3.56 (95%CI: 1.35-9.37, P=0.01) and 3.92 (95%CI: 1.4-10 P=0.009) respectively. Data analysis also revealed that individuals with both GSTM1 and GSTT1 null genotypes (-/-) had higher risk to develop the disease in comparison to the people with the both present (+/+) genotype (OR:19.23, P=0.007). Conclusion: The findings suggest that the GSTM1 and GSTT1 genetic polymorphisms are associated with the development of endometriosis in Iranian women which is in agreement with previous results obtained in other populations. However, the ethnic variations of polymorphisms should be evaluated in detail and differences should be incorporated into investigations of susceptibility variants for this disease.

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Background: Staphylococcus aureus is the most important cause of nosocomial infections acquired in the community. Protein A is a major component of Staphylococcus aureus cell wall. In analysis of the nucleotide sequence Protein A encoding spa, locus x consists of 24 base pairs which repeat with high polymorphism. In this study, the spa gene of Staphylococcus aureus isolated from clinical specimens were obtained from patients admitted to the hospital and healthy carriers. Methods: In a cross-sectional study, a total of 200 samples were collected. One hundred fifty samples were obtained from hospitalized patients and 50 samples obtained from staff nasal swabs in Hamadan University Hospitals from October 2013 to August 2014. Disk diffusion antibiotic susceptibility tests performed. The antibiotics studied were Vancomycin (30 µg), Cefoxitin (15 µg) Gentamicin (10 µg), Tetracycline (30 µg), Trimethoprim/sulfamethoxazole (25 µg), Ciprofloxacin (5 µg), Erythromycin (15 µg), Clindamycin (2 µg), Rifampin (5 µg). The tests performed according to the guidelines of clinical and laboratory standards institute (CLSI). It also detect the mecA gene of Methicillin-resistant Staphylococcus aureus strains (MRSA) and genes spa which encodes the protein A by polymerase chain reaction (PCR). The PCR products using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method with enzyme Rsa I (Afa I) were prepared. Results: This methicillin-resistant Staphylococcus aureus strain (MRSA) had the highest sensitivity and resistance to ciprofloxacin and clindamycin. Totally, 8 amplicon with different sizes for the spa gene were identified. A total of 9 patterns polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) were found. Some of these patterns between Staphylococcus aureus isolated from clinical specimens and nasal carriers were common. Conclusion: There is a similar pattern of spa gene among patients admitted to the hospital and staff, according to our findings. Analysis of the patterns can reduced transmission of infection in both hospital staff and patients. Also it can help the physicians for correct management of infections.

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Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants. Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant. Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27). Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.

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Background: One of the main reasons of hemorrhagic fevers is Ebola. The high rate of mortality and lack of definite treatment have been caused this infection to be a serious problem in the world. Ebola, especially in the early stages, when causes symptoms such as fever, anorexia and nausea, can be confused with malaria infection and conversely, severe malaria with Ebola. Plasmodium falciparum is an important cause of severe malaria that more than other types of plasmodium confused with Ebola. Case presentation: The patient is a 54-year-old man who had gone to Sudan about 8 months ago. The patient reported that fever, chills and headache had been started one week before traveling from Sudan to Iran and hematuria was added to his symptoms in third week of illness in Iran. He was referred to the emergency department with probable diagnosis of Ebola. Plasmodium falciparum gametocytes were revealed in his peripheral blood smear. Finally, he was treated with Coartem (artemether/lumefantrine) for malaria and after clinical improvement discharged to home with good condition. Conclusion: Ebola should be suspected in every patient with fever and a history of traveling to endemic areas. Considering the fact that in most areas where Ebola is endemic also malaria is common, lack of clinical suspicion to malaria causes that clinicians mistake malaria with Ebola. Necessary laboratory tests to rule out important differential diagnoses in patients with suspected Ebola virus contains: Peripheral blood smear for malarial parasite and blood culture and blood cell counts to investigate typhoid fever and other bacterial infections. Therefore, malaria should be considered as an important differential diagnosis in every patient suspected with Ebola.

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Background: Staphylococcus aureus is one the most common pathogens causing community-acquired infections and a major concern for public health, and the other hands antibiotic resistance is also of great concern for public health authorities also Staphylococcus aureus produce a lot of virulence factors such as variety of exoproteins included toxic shock syndrome and exfoliative toxin which causes colonization and different infections in their host. The aims of current study were to evaluate the prevalence of Toxic shock syndrome toxin 1 (TSST-1) and ETs genes in isolated S. aureus strains using polymerase chain reaction (PCR) assay. Methods: This cross-sectional study was performed on 100 methicillin-resistant staphylococcal aureus (MRSA) and 100 methicillin-sensitive staphylococcal aureus (MSSA) isolated from clinical specimens of inpatients, outpatients hospitals and nasal carriers in Hamadan University from October 2013 to August 2014. Identified species by biochemical methods were confirmed by the PCR method. Antibiotic resistance was performance by disk diffusion and the presence of TSST-1 and ETs genes was investigated using PCR. Results: Of the 100 isolates MRSA examined, the most frequent resistance was observed to ciprofloxacin (95%), followed by tetracycline (91%), erythromycin (92%), Gentamicin (90%), Rifampin (85%), trimethoprim-sulfamethoxazole (85%), clindamycin (80%) and cefoxitin (100%). Of the 100 isolates MSSA examined, the most frequent resistance was observed to erythromycin (68%), ciprofloxacin (66%), followed by tetracycline (52%), gentamicin (25%), clindamycin (46%), rifampin (45%), trimethoprim-sulfamethoxazole (66%) and cefoxitin (0%). Prevalence of TSST-1 and ETs genes were determined 13% (n=26) isolates, totally. Also the prevalence of TSST-1 was 11% (n=22) and ETs genes was 2% (n=4) isolates and none of the investigated isolates carried eta gene. Conclusion: The increasingly prevalence of MRSA and emerging its antibiotic resistance in clinical isolates can be considered a serious problem for public health. Detection of the high rate prevalence of TSST genes in current study is considered as a serious problem and existing and circle of these strains in according to colonization in community especially old people and immunocompromised patients is very serious.

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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.

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Background: Peripheral nerve injury is one of the most challenging of modern surgical problem. Recent advances in understanding the physiological and molecular pathways demonstrated the important role of growth factors in peripheral nerve regeneration. Platelet-rich plasma (PRP) is a biological product that has many growth factors. The aim of this study was to investigate the effect of PRP in the regeneration of sciatic nerve crush in the rat model.

Methods: In this experimental study that established in the animal lab of the Hazrat Fatemeh Hospital in Tehran from September to October 2013, Twenty-four healthy male Sprague-Dawley rats (200-250 g) were randomly divided into two groups. In all rats the sciatic nerve was cut and then carefully repaired by the tension free method under a light microscope. In group 1, after the repair, 0.05 µL of PRP was injected below the epineurium to the proximal and distal parts of the repaired area. In group 2 the same amount of normal saline was injected to the proximal and distal of the repaired area. After six weeks footprint analysis, neurophysiologic and histopathology evaluations were performed.

Results: Significant differences existed between the two groups footprint analysis (P= 0.001). Also the nerve conduction latency test was significantly shorter in PRP group. (1.0233 ms in PRP group and 1.7375 ms in control) (P< 0.001). The average amplitude in the first group and the second group was 7.6250 mv (control) 6.3667 mv that does not show a statistically significant difference (P= 0.093). Significant differences between the two groups in the number of axons of the proximal portion of the study was not seen (P= 0.29). The parameters included number of axons of the proximal and the distal part of axons, the diameter of the distal and proximal axons in the two groups were compared. In the two groups there was statistically significant difference between the above parameters. (P= 0.298).

Conclusion: It seems that PRP may have an important role in peripheral nerve regeneration and functional recovery after nerve laceration and repair. Further clinical evaluation recommended.

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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: Pain control after orthognathic surgeries due to severity of pain and limitations of opioids use in these patients are particular importance. The aim of this study was to evaluate the effect of oral gabapentin and intramuscular ketorolac in combination with intravenous acetaminophen for pain control after this surgery.

Methods: This study was a randomized clinical trial (RCT) on 75 patients (18-60 years old American Society of Anesthesiologists (ASA) physical status classification system, I, II) that undergo orthognathic surgery in Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran from June 2013 to August 2014. The patients were randomly divided in 3 groups. All of groups received 1 gr (intravenous acetaminophen) 30 minutes before the end of surgery. The control group (n= 25) received placebo. The second group (n= 25) received 30 mg ketorolac intramuscular after induction of anesthesia and the third group (n= 25) received 600 mg Gabapentin orally 30 minute before the induction of anesthesia. The pain severity score assessed by visual analogue scale (VAS), the level of sedation assessed by Ramsey scale, opioid requirement, nausea and vomiting was recorded in the post-anesthesia care unit (PACU) at 1, 3, 6, 12 and 24 hours after surgery. For rescue pain management intravenous morphine was administered.

Results: Seventy-five patients were enrolled in this study. Use of Ketorolac and gabapentin declines the pain intensity, level of agitation and morphine requirement in the recovery room and early hours in the ward (P= 0.011). The 24-hour opioid consumption, nausea and vomiting was significantly higher in control group compared with the both intervention groups (15±1.4 vs. 5±0.5 mg) (P< 0.05) retrospectively. Mean arterial pressure and heart rate changes was significantly lower in ketorolac and gabapentin groups compare to control group in recovery room (P< 0.05).

Conclusion: The result of this study suggest that ketorolac as well as gabapentin can decline the pain intensity and opioid requirement with less nausea and vomiting and good hemodynamic control after orthognathic surgery.

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Background: Coagulase-negative staphylococci (CoNS) were considered as contaminats previously, but, during the past decade considered as one of the most common photogenic bacteria in hospital. Resistance to beta-lactams especially methicillin in staphylococcus species is being worrying in hospitals. Rapid identification of mechanisms of resistance and confirmation of their resistance to methicillin is a basic principle for antibiotic treatment. The aim of this study was to determine antibiotic resistance, frequency of mecA gene, and determination of SCCmec types in CoNS isolates from teaching hospitals in Iran.

Methods: The descriptive cross-sectional study was carried out one hundred clinical samples isolated from patients with an average age of 7-69 years at teaching hospitals in Hamadan City, Iran, from September 2014 to February 2015. After confirmation of isolates by microbiological standard biochemical tests, antimicrobial susceptibility testing was performed by disk agar diffusion (DAD) method. After extraction of isolated genomicm, mecA gene was detected. Then, the types of SCCmec were performed by PCR.

Results: In this study, 387 clinical samples were collected which among 100 CoNS isolated, Staphylococcus epidermidis was the most prevalent species with frequency 55 (55%), followed by S. haemolyticus 40(40%) and S. saprophyticus 5(5%). The highest antibiotic susceptibility was to rifampin 96(96%) and the lowest resistance was detected for trimethoprim/sulfamethoxazole (TMP/SMX) 47(47%). None of the strains were resistant to vancomycin. Resistance to methicillin was detected in 50% of CoNS isolates. Typing of SCCmec was performed by The polymerase chain reaction (PCR). Frequency types of SCCmec was type III with frequency 13(13%), type V 11(11%), type II 6(6%), type IV 4 (4%), type I 3(3%) respectively. Thirteen isolated was not typable in this study.

Conclusion: The result of this study showed that a large percentage of coagulase-negative staphylococci are resistance to methicillin, and the prevalence of SCCmec type was type III, which encodes the largest number of resistance genes. This information could be use in epidemiological study for preventing of infectious control in hospital and health centers.

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Background: The genome of the bacteria has considerable diversity in terms of sequence of nucleotide bases and change over the time. With the advancement of bioinformatics science possibility of the vast comparison to living organisms has risen. During the last two decades many information about genome sequencing of pathogenic and non-pathogenic bacteria have been published. Using this information and to find connections between them and many phenotypic characteristics and behavior of bacteria could be used in many studies. In this study we compared some of the genetic, phenotypic and behavioral properties of archaebacteria and eubacteria. Methods: In this analytical study, genomic Information of 286 species of archaebacteria and 122 species of eubacteria were collected from the NCBI (National Center for Biotechnology Information) site which was conducted in April to June 2015. Mean of gene size, gene number, protein number and C+G content compared in the two groups of archaebacteria and eubacteria. Association of genomic characterization of bacteria with several other characteristics were analyzed using SPSS statistical software version 19 (Chicago, IL, USA). For this purpose, the Pearson correlation coefficient (Pearson), Student’s t-test and ANOVA test (One-way analysis of variance) was used. The P values less than 0.05 was considered as significant level. Results: There was significant association between means discrepancy in two group (P= 0.01). The genome size of eubacteria and archaebacteria have significant association with some of the characteristics of bacteria, such as the C+G content, the number of proteins, genes and habitats of the bacteria (P= 0.01). As well as there was significant association between genome size and features such as number of pseudogene, mobility and type of breathing in eubacteria (P= 0.01) but not in archaebacterial (P˃ 0.05).

Conclusion: Many characteristics of eubacteria and archaebacteria are significantly associated with genomic properties. Comparison genomics of bacteria will help in identification of evolutionary origins as well as differences between different categories of bacterial.

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Background: Since high plasma level for C-reactive protein (CRP) is a risk factor for cardiovascular disease, thereby decrease in the level of high- sensitivity C-reactive protein (hs-CRP) in acute coronary syndrome (ACS) patients through anti-inflammatory drugs can reduce mortality and the incidence of heart failure. Accordingly, this research aims to investigate the effect of hs-CRP on ACS patients before and after treatment with astatines.

Methods: This cross-sectional and cohort study was performed for the population of 90 patients with acute coronary syndrome (ACS) martyrs at the Mustafa Khomeini University Hospital in the Ilam city, Iran, From July to September, 2014. Blood samples were collected at admission and demographic and clinical symptoms, echocardiography and electrocardiography were recorded. At admission, the questionnaire including demographic information and medical history of patients was filled by the researchers and echocardiography and physical examination was carried out by cardiologist. The obtained data are further explored and analyzed via SPSS software, ver. 19 (Chicago, IL, USA).

Results: The sample under study was 52.2% and 48.8% men and women, respectively. Phi correlation coefficient of 73% and positive Cramer's V of 0.879 was observed between re-admission and arrhythmia admission for the group received 40 mg atorvastatin. It means that we have more re-admission when arrhythmia increases. Only 4% correlation coefficient and very low positive Cramer's V of 0.293 was seen for the group who receive 80 mg atorvastatin. It indicates that no significant correlation exists between eject fraction of admission and re-admission (P=0.18). The results showed that hs-CRP of the group that received 80 mg atorvastatin was 0.179 which is lower than 0.37 for the group who received 40 mg atorvastatin.

Conclusion: By increasing the astatine dose, the amount of hs-CRP and consequently the risk of subsequent cardiovascular events were reduced. Hence, high starting dose of atorvastatin at preliminary stages of hospitalizing can reduce re-admission and cardiovascular consequents.

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Background: Burns and its complications are regarded as a major problem in the society. Skin injuries resulted from ultraviolet radiation, radioactivity, electricity or chemicals as well as respiratory damage from smoke inhalation are considered burns. This study aimed to determine the epidemiology and outcome of burn patients admitted to Motahari Hospital, Tehran, Iran.

Methods: Two hundred patients with second-degree burns admitted to Motahari Referral Center of Burn in Tehran, Iran. They were studied during a period of 12 months from May 2012 to May 2013. During the first week of treatment swabs were collected from the burn wounds after cleaning the site with sterile normal saline. Samples were inoculated in blood agar and McConkey agar, then incubation at 37 C for 48 hours. Identification was carried out according to standard conventional biochemical tests. Treatment continued up to epithelial formation and wound healing. Results of microbial culture for each patient was recorded. Healing time of the burn wounds in patients was recorded in log books. Chi-square test and SPSS Software v.19 (IBM, NY, USA) were used for data analysis.

Results: Our findings indicate that the most causes of burns are hot liquids in 57% of cases and flammable liquid in 21% of cases. The most cases of burns were found to be in the range of 21 to 30 percent with 17.5% and 7% in male and female respectively. Gram-negative bacteria were dominated in 85.7% and among them pseudomonas spp. with 37.5% were the most common cause of infected burns, followed by Enterobacter, Escherichia coli, Staphylococcus aureus, Acinetobacter and Klebsiella spp.

Conclusion: The results of this study showed that the most cause of burns in both sex is hot liquid. Men were more expose to burn than women and this might be due to the fact that men are involved in more dangerous jobs than female. Pseudomonas aeruginosa was the most common organism encountered in burn infection.

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Background: Diabetes is associated with many pathological changes and one of the most important consequences of the diabetes is hepatic injury. The present study was performed to investigate the effect of eight weeks endurance training with consumption of cinnamon supplementation on plasma concentrations of liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in women with type II diabetes.

Methods: In this quasi-experimental study, 36 female volunteers with type II diabetes (age 52.72±2.64 years and body mass index 29.28±2.94 Kg/m2) were participated. The subjects were homogenized regarding their body mass index and then were divided randomly into four groups (each group=9 patients): Training, training-cinnamon, cinnamon, and Control. Endurance training was performed for eight weeks (three sessions per week) at the intensity of 60-75% of maximum heart rate for 40-60 minutes. The consumption of cinnamon supplementation was 1.5 gr per day. Plasma concentrations of ALT and AST were measured following 12 hours fasting, 48 hours before and after performing the experiment, by the enzymatic method. Data were analyzed by paired t-test and factorial ANOVA, using SPSS version 21 (Chicago, IL, USA) and at the significant level of P<0.05.

Results: The levels of ALT was reduced in three experimental groups, which only its reduction was significant after consumption of cinnamon P<0.05. Also, plasma concentrations of AST increased in training-cinnamon and decreased in training and cinnamon groups which none of them was not significant. All interventions had no effect on blood fasting glucose in all experimental groups P>0.05. There was no significant difference between groups in pre and posttests.

Conclusion: The results confirm that cinnamon supplementation may be effective in improving the plasma levels of ALT but the intensity and duration of an effective exercise training especially with consumption of cinnamon supplementation simultaneously need more study in diabetic patients.

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Background: In recent years the use of diced cartilage grafts in reconstructive surgery particulary rhinoplasty have been considered by most plastic surgeons. However, long-term resorption usually occurs. Stem cells are a powerful tool for reconstructive surgery to rebuild and maintain tissue with reduced complications. Since the adipose tissue-derived stem cells (ADSCs) can rebuild a wide variety of tissues such as skin, fat, bone and cartilage are used, this is a very good chance for cosmetic surgery. The aim of this study was to examine the effects of adipose-derived stem cells on the viability of diced cartilage grafts.

Methods: This interventional study was performed on May 2014 in animal laboratory of Hazrat Fatima Hospital on 10 New Zealand white male rabbits, weighing 2000-2500 grams, approximately 12 to 16 weeks of age. Stem cells was harvested from inguinal adipose tissue of each rabbits. After completely removing the skin and perichondrium, cartilage became divided into two equal pieces using a scalpel. Then place the ear amputation was restored by nylon 4 zero. After weighing cartilages, on either side of the center line on the back of each rabbits, left and right, subcutaneous pocket created equal weight and each piece of cartilage was placed in an envelope. Stem cells were injected in one side and the other side was control. The cartilage weights were recorded both before implantation and after explantation. Evaluation of living chondrocytes was conducted 12 weeks after implantation.

Results: The mean difference of cartilage weights was varied between two groups (intervention and control sides), So that the average was significantly higher in stem cell side than that in the control side (P= 0.021). The average number of live chondrocytes was significantly higher in the intervention side than the control side (P< 0.001).

Conclusion: Despite the unclear mechanism, these results suggest that adipose-derived stem cells can maintain the viability of diced cartilage. Because adipose-derived stem cells are autologous and easy to harvest, they can be use to improve the long-term outcomes of diced cartilage grafting.

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Background: Human brucellosis is a significant public health problem in many middle east countries including Iran. Brucella organisms, which are small aerobic, facultative intracellular coccobacilli, localize in the reproductive organs of host animals, causing abortions and sterility. They are shed in large numbers in the animal’s urine, milk, placental fluid, and other fluids. Dairy product from raw milk are a potential threat to public health in endemic developing countries. The gold standard for the diagnosis of brucellosis is isolation of Brucella species. However, isolation Brucella species is time consuming and needed to level 3 biocontainment facilities and highly skilled technical personnel to handle samples and live bacteria for eventual identification. Handling Brucella species increase risk of laboratory infection. Polymerase chain reaction (PCR) with high sensitivity and specifity overcomed to these disadvantages. The aim of this study was to detect Brucella species in milk from dairy cattle farms in Kerman province, Iran by PCR technique.

Methods: Forty and eight bulk tank milk (BTM) were collected from October 2015 to March 2016 from 48 dairy cattle farm including 4200 cows. DNA of milk samples extracted by lysis buffer and proteinase K method. All milk samples were examined by PCR to detect Brucella-specific DNA targeting IS 711. Positive samples must be showed 317 bp amplified, corresponding to the expected size of the IS 711 genome region in all Brucella species.

Results: Using IS711 primer were detected in 4 samples (8.3%) Brucella spp. from 48 BTM samples in this area.

Conclusion: The results indicate that brucellosis by Brucella species is endemic in the Kerman province dairy farms. Consumption of raw milk dairy products by individual farmers operating under poor hygienic conditions represents an high risk to public health. The need for implementing control measures and raising public awareness on zoonotic transmission of brucellosis are recommended. Vaccination of cattle is recommended for control of bovine brucellosis in enzootic areas with high prevalence rates.

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Background: Multidrug-resistant bacteria make many problems in clinical therapy, design and manufacture of synthetic drugs. Pseudomonas aeruginosa is one of the most important multidrug-resistance bacteria leads to variety infections in human especially in immunocompromised, patients with severe burns, and nosocomial infections. It Recent years, this organism makes a big challenge in clinical treatment of infections using a wide range of antibiotics. Medicinal herbs for thousands of years to prevent or treat infectious diseases were considered. Today, pharmacists have high interest of using medicinal herbs to prepare a new antimicrobial compounds. The goal of this study was to investigation the effect of aqueous and alcoholic extract of fresh garlic on the expression of genes encoding elastase and exotoxin A virulence factors, in P. aeruginosa PAO1 strain.

Methods: Present study was an experimental study and performed from 2015 to 2016 in Hamadan University of Medical Science, Iran. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of aqueous and alcoholic extract of garlic was determined. Then in order to investigation the gene expression of elastase and exotoxin A genes, quantitative real-time polymerase chain reaction (qPCR) method was performed at sub-MBC concentrations. Results: According to the results aqueous extracts of garlic had better impact in comparison with alcoholic alone. At concentration of 64 and 8 mg/ml of aqueous extract the expression of both elastase and exotoxin A genes were decreased. Although, the expression of elastase gene was most affected by garlic at different concentrations than exotoxin A.

Conclusion: The results suggested that the compositions of garlic extracts can inhibit the production of virulence factors in P. aeruginosa. So in order to treat infectious diseases in the near future, medicinal plants known as new antimicrobial drugs can be used alone or with antibiotic drugs against pathogenic bacteria.

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Background: Nowadays, stroke can be considered as the one of the major causes of disability and mortality worldwide. However, relationship between serum C-reactive protein (CRP) level with stroke early prognosis has not been well studied, especially in Iran. Therefore, the present study aimed to study the relationship between CRP level of serum in patients with acute stroke at first 24h of admission and stroke early prognosis. Methods: This prospective cross-sectional study was performed on 50 patients with acute stroke who were admitted at Emergency Ward of Shahid Rajaie Hospital, in Tonekabon City, Iran, between May 2013 to July 2014. In first step, valid clinical diagnosis was made based on CT scan and magnetic resonance imaging (MRI) of the patients. The ethical observations were considered for all patients. The serum level of CRP was measured by standard method, at first 24h of the admission. Clinical information and risk factors (age, gender, type of stroke, high blood pressure, diabetes mellitus) was detected for each patient. On discharge, early prognosis by modified Rankin Scale (mRS) (mRS< 3= good and mRS≥ 3= bad) was also recognized. In this study, statistical analysis was performed using SPSS software, and logistic regression method was used (P< 0.05). Results: The results of this study showed that 38% of the patients were 70-80 years old. Also, 52% of the patients were male and 48% were female. The serum CRP level of patients at the first 24h of admission increased in all studied patients. The mean of the serum CRP level was 12.82 that were higher than the normal range. The statistical analysis showed that there was no significant relationship between the serum CRP level and the stroke early prognosis. Conclusion: Although the serum CRP level was not recognized as an anticipator factor for stroke prognosis at this study, it is recommended to performance of more studies by case-study method on this setting.