Tehran University Medical Journal

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Background: Helicobacter pylori is a gram negative microaerophilic spiral bacilli, which causes duodenal and gastric ulceration. Also this organism cause distal gastric adenocarcinoma and primary gastric lymphoma. The most important Helicobacter pylorus virulence factor is cytotoxin associated gene A (cagA) Pathogenicity Island that cause secretion of antibody by stimulation of immune system. Measurement of the serum antibody can be used to diagnosis strain of Helicobacter pylorus that causes peptic ulcer disease (PUD). Serological discrimination between strain types would reduce the need to emergent endoscopic studies. The aim of this study was comparison of serum anti-CagA antibodies of patients with peptic ulcer disease and patients with Non-ulcer dyspepsia. Methods: This case-control study was carried out from october 2011 to october 2012, in 130 patients who complained of dyspepsia more than six months and referred to gastroenterology and endoscopic ward of Firoozgar Hospital, Iran University of Medical Sciences, Tehran. Serum sample obtained from all patients. Anti-CagA antibodies levels were measured in serum samples using ELISA technique. Patients with peptic ulcers as cases and patients without peptic ulcer in endoscopy study were considered as controls. Results: One hundred thirty patients were enrolled in the study and equally two groups (65 patients in case group and 65 patients in control group). Fifty nine subjects of case group (90.76%) and 37 subjects of control group (56.92%) had positive serum anti-CagA antibody (P= 0.003). Sixty one percent of anti-CagA antibodies positive patients and 17.6% of anti-CagA antibodies negative patients had peptic ulcer (P= 0.003). (Odds ratio= 7.4 95%CI: 2.8-19.7 P= 0.003). Conclusion: The detection of CagA antibodies as an additional and noninvasive test in association with determination of serum anti-CagA antibodies, could help better detection of risk factors of peptic ulcer disease. Also it can reduce the emergency endoscopy process. We can use this technique in patients with dyspepsia who had no warning signs or malignant disease and not taking a nonsteroidal anti-inflammatory drugs in primary care of clinical practices.

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Background: Diarrhea is the most common bacterial infections, and the main cause of death in the children. Worldwide, food and waterborne diseases are estimated to cause more than two million deaths per year. Foodborne diseases and resistance to antimicrobial agents are two problems worldwide and are increasing. However, standard surveillance systems do not routinely collect information on controls. The aim of this study was to analysis epidemiological data of foodborne outbreaks at the country level. Methods: This is a descriptive study, in total 305 fecal swab samples from 73 outbreaks during one year from April 2012 to March 2013 in different provinces of Iran, were collected and transferred to the microbiology laboratory of Public Health School of Tehran University of Medical Sciences to identify the cause’s diarrhea. The patterns of antibiotic-resistance were determined by using Kirby Bauer method. Results: In total 73 food borne outbreaks that were studied, the largest number 26 (35.6%) were found in Hamadan province with 103 samples (34.2%). Out of 73 outbreaks 40 (54.79%) of were related to foods, 6 (8.22%) to water, and 27 (36.98%) were unspecified (P< 0.0001). Fifty seven outbreaks (78.08%) in the city and 16 outbreaks (21.92%) occurred in rural areas (P< 0.0001). The most dominated Gram-negative isolated organisms were Shigella (6.9%) and Gram-positive bacteria Staphylococcus aureus (12.8%). The dominated age group was under five years (16.4%), and dominant gender group was men 186 (61.8%) (P< 0.0001). In total 69 (22.9%) were hospitalized and 11 deaths were reported. Most clinical symptoms of abdominal cramping (82%), nausea and vomiting (68.4%), bloody diarrhea (23.3%), and non-bloody diarrhea (76.7%). All the isolated gram-negative were sensitive to ciprofloxacin and resistant to clindamycin. The gram-positive were sensitive to cephalexin and resistant to penicillin. Conclusion: The knowledge of bacterial agent of foodborne diseases and determination of antimicrobial resistance pattern are helpful to reduce the rate of foodborne outbreaks, the cost of treatment. The prevention control of outbreaks is also very important.

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Background: Hematopoietic stem cell transplantation (HSCT) is a therapeutic approach in treatment of hematologic malignancies and incompatibility of bone marrow. Umbilical cord blood (UCB) known as an alternative for hematopoietic stem/ progenitor cells (HPSC) for in allogenic transplantation. The main hindrance in application of HPSC derived from umbilical cord blood is the low volume of collected samples. So, ex vivo expansion of HPSCs is the useful approach to overcome this restriction. Synthetic biomaterials such as nanofibers is used to produce synthetic niches. The aim of this study was the ex vivo expansion of hematopoietic stem cells on biocompatible nanofiber scaffolds. Methods: This study was done at Tarbiat Modares University from November 2012 to June 2013 and was a research study. Umbilical cord blood CD133+ hematopoietic stem cells were separated using MidiMacs (positive selection) system by means of monocolonal antibody (microbeads) CD133. Flow cytometry was used to assess the purity of cells. Cell culture was done on plate (2 Dimensional) and fibronectin conjougated polyether sulfone nanofiber scaffold (3 Dimensional). Colony assay test was used to asses the ability of colonization of cells. Results: Cell count analysis revealed the expansion of hematopoietic stem cells in cell culture plate (2D environment) and on nanofiber scaffold (3D environment) after 2 weeks. Expansion of cells in 2D environment was greater than 3D condition. Colony assay test revealed that the colonization ability of cells decreased after 2 weeks, but this decrease was lower in scaffold culture than plate culture. Conclusion: This study demonstrated that umbilical cord blood CD133+ hematopoietic stem cells can expand on fibronectin conjugated polyether sulfone scaffold and we can use this system for expanding of cells in vitro situation.

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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: Inguinal hernia is a common surgical problem which increases with aging especially in men. A common method for treatment is surgical repair using prosthesis, Lichtenstein technique. One frequent complication after inguinal herniorrhaphy is soft tissues seroma. There are several methods to prevent or to drain seroma. Some surgeons suggest the insertion of closed suction drainage system but others disagree. Methods: In this clinical trial study, 42 patients who are candidate for hernia repairing (Lichtenstein technique), referred to Amir Al-Momenin Hospital in Semnan, Iran, from 2011 to 2012, were randomly divided into two groups. So that, the list of eligible patients in the study, were numbered, and then using the patients' code, patients, who assigned an odd number in the registration list, were allocated to group 1, the remainder were placed in group two. The two first numbers in registration list (1 or 2), were randomly assigned to groups. Group 1 underwent hernia surgery without closed suction drainage and the second group underwent hernia surgery with closed suction drainage. The patients were evaluated for seroma, hematoma or wound infection after 24 hours, during days 4 to 7 and days 10 to 15 following surgery. Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00). Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.

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In situ hybridization (ISH) is a method that uses labeled complementary single strand DNA or RNA to localize specific DNA or RNA sequences in an intact cell or in a fixed tissue section. The main steps of ISH consist of: probe selection, tissue or sample preparation, pre-hybridization treatment, hybridization and washing, detection and control procedure. Probe selection is one of the important aspects of successful hybridization. ISH sensitivity and specificity can be influenced by: probe construct, efficiency of labeling, percentage of GC, probe length and signal detection systems. Different methods such as nick translation, random priming, end tailing and T4 DNA polymerase replacement are used for probe generation. Both radioactive and non-radioactive labels can be used in order to probe labeling. Nucleic acid maintenance in samples, prevention of morphological changes of samples and probe penetration into tissue section are the main aims of sample preparation step. Then, a small amount of solution containing probe, is added on slides containing tissue sections for hybridization process, then slides are incubated overnight. Next day, washes are carried out to remove the probes which are not bound to target DNA or RNA. Finally, in order to be sure that the observed labeling is specific to the target sequence, using several control procedures is very important. Various techniques based on ISH consist of: Fluorescence in situ hybridization (FISH), chromogenic in situ hybridization (CISH), genomic in situ hybridization (GISH), comparative genomic hybridization (CGH), spectral karyotyping (SKY) and multiplex fluorescence in situ hybridization (MFISH). One of the most common techniques of ISH is fluorescence in situ hybridization. FISH can be used to: 1) detect small deletions and duplications that are not visible using microscope analysis, 2) detect how many chromosomes of a certain type are present in each cell and 3) confirm rearrangements that are suspected after microscope analysis. In this technique different fluorescent labels are attached to the probes. In this review article ISH, its different types, their application, advantages and disadvantages have been considered.

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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: Medullary thyroid cancer (MTC), includes 5-10% of all the thyroid cancers. RET proto-oncogene mutations have been found in association with MTC development. Therefore, identification of the mutations in RET can allow early diagnosis of the families who are at the risk of the disease. The goal of this study was to investigate existence and association between mutations in exon 19 of the RET proto-oncogene in an Iranian population medullary thyroid cancer patients and their family members. Methods: This study was run in the research laboratory of Research Institute for Endocrine Research Center Shahid Beheshti University of Medical Sciences from May, 2013 to May, 2014. In this study, 110 patients with confirmed medullary thyroid carcinoma were selected and examined. At first, the genomic DNA content of the peripheral white blood cells (WBC) of the samples were extracted using a saturated salting out and proteinase K standard method. Exon 19 of the RET proto-oncogene using polymerase chain reaction (PCR) method was amplified. Then the desired PCR products formation was confirmed by electrophoresis technique for true amplification, and finally the amplified samples were used for direct sequenced for finding and assessing any possible mutations Results: In this study, two nucleotide changes at position rs2075912 (Y: T/C) and position rs2075913 (W: T/A) exon 19 RET proto-oncogene were found in the patients with medullary thyroid cancer. The frequency of both nucleotide changes were higher in men than women with medullary thyroid cancer. The frequency of the rs2075912 and rs2075913 were 11.2 and 6.3% higher in men than women. But in statistical analysis, there was no association between age, sex and the founded two mutations. Conclusion: In addition to mutations in other exons of proto-RET, mutations in exon 19 can also be used for early detection and confirmation of medullary thyroid carcinomas.

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Background: Human papilloma virus is a DNA virus from the papillomavirus family that is most prevalent in human cervical cancers and many studies showed the E6 and E7 proteins are present in the majority of cervical cancer cases. Development of universal HPV peptide-based vaccine with more serotypes coverage has considerable value. The aim of the study was to design a multi-epitope universal vaccine for major HPV based on E6 and E7 proteins and optimization the expression of polytopic construct contains E6 and E7 genes from different genotypes of human papilloma virus as a candid vaccine.

Methods: In this experimental study that was carried out in Pasteur Institute of Iran, Virology Department from October 2013 to November 2014. In order to design the polytypic construct, we predicted the most probable immunogenic epitopes of E6 and E7 from common high risk HPV16, 18, 31, 45 along with high prevalent type 6 and 11 using bioinformatics methods. The synthetic pET28a expression vector harboring E6 and E7 protein was transformed into Escherichia coli hosts and its expression was analyzed by SDS-PAGE and western blotting. Finally, in order to expression optimization of recombinant protein, cell density, induction time, growth temperature, IPTG (Isopropyl &beta-D-1-thiogalactopyranoside) concentration and cultures media were studied.

Results: In the present study the recombinant fusion protein was expressed successfully and the highest expression of target protein was achieved in super broth medium containing 0.1% glucose and 0.2% L-arabinose. In Super broth medium, the optimum condition for recombinant protein expression was occurred at OD600 of 0.8, 0.1mM IPTG, one hour’s incubation time at 37 °C and BL21 (A1) host.

Conclusion: The results of this study show that the optimum expression of E6 and E7 proteins from different genotypes of human papilloma virus can be performed. Moreover, by purification of recombinant protein and evaluation of its immunogenicity in mice, it can be used as a vaccine candidate against the human papilloma virus.

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Background: This study investigated compatibility between post chemoradiation magnetic resonance images and histologic findings after operation and chemoradiation in patients with locally advanced rectal cancer.

Methods: In this prospective study, 63 patients referred to Cancer Institute of Emam Khomeini Hospital, Tehran, Iran, from October 2011 to October 2013 with locally advanced rectal cancer receiving neoadjuvant chemoradiation (50.4 Gy external beam radiation with concomitant capecitabine 825 mg/m2 PO twice a day with or without 60 mg/m2 oxaliplatin weekly). Patients had an MRI before chemoradiation and MRI assessment were used to identify Tumor (T) and lymph node (N) staging by an experienced radiologist. Patients were recommended to repeat MRI after surgery but it was not obligatory. Findings of post chemoradiation MRI and histopathologic reports were compared. Downstaging was defined as at least one stage decrease in T or N in histopathologic report comparing to their first MRI, on condition of no sign of disease progression.

Results: 32 patients (50.79%) had T downstaging and 36 of them (57.14%) showed N downstaging: none had disease progression. In this study MRI had an accuracy of 55.5% for rectal tumor (T) restaging after chemoradiation comparing to pathology. MRI sensitivity for T restaging was 33.3% to 83.3%.  There was a higher possibility to have errors in restaging of T1-2 stages. Specificity of MRI for T restaging was higher than its sensitivity, 66.6%. In this study lymph node involvement (N) was determined according to morphology and size. MRI has an accuracy of 42.8% for detecting lymph node involvement. Its sensitivity and specificity for N restaging were 50% and 66.6% respectively. All patients had MRI before chemoradiation, although 21 of them repeated MRI after chemoradiation since it was not mandatory. 19 of these 21 patients underwent surgery.

Conclusion: Although MRI is a suitable imaging for staging locally advanced rectal cancer its use for restaging after chemoradiation is under question. According to this study, MRI accuracy rates for both T and N restaging were below the rates of previous studies.

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Background: Polycystic ovary syndrome (PCOS) is a common complex condition. Evidences from studies on women with PCOS and rat PCO model suggest that the sympathetic regulatory drive to the ovary may be unbalanced (hyperactivity). Findings that support the involvement of sympathetic nervous system in the pathophysiology of PCOS are that the catecholaminergic nerve fibers in the polycystic ovaries of women with PCOS are denser than in normal ovaries. The purpose of this study was reduction of this hyperactivity.

Methods: This study was clinical trial and was performed in Reproductive Health Research Center, Tehran University of Medical Sciences, Iran, during January 2013 to 2015. A total of 61 women between aged 20-40 years and BMI under 28 kg/m2, who were previously diagnosed with PCOS were assessed. The diagnosis of PCOS was made according to joint criteria of the European Society of Human Reproduction and Embryology and the American Society of Reproductive Medicine (ESHRE/ASRM). The study objectives were explained to the patients before they entered the study, and an informed consent was obtained from all. They were divided into three groups as follows: (i) two study group (n=39) and (ii) control group (n=22). For evaluating effects of alpha-2 inhibitors (Clonidine and Yohimbine) by Eliza, the following variables were evaluated before and after drug therapy: serum cortisol adrenaline (A) noradrenalin (NA) beta-endorphin (&beta-End) insulin as well as sex hormones including FSH, LH and Estradiol.

Results: Our results showed that, Clonidine as central anti-adrenergic drug causes 61% of all pregnancies in the study group. This is high percentage of the pregnancy rate compared with yohimbine (P< 0.001). Yohimbine (Indol alkaloid) as alpha-2 adenoceptor antagonist increases follicular development in this disease. This follicle growth is higher than clonidine (P< 0.01).

Conclusion: Our findings showed that increasing the pregnancy rate and follicular development represent the strategic role of sympathetic nervous system (SNS) in polycystic ovary syndrome and) SNS may thus offer a novel biological and pharmacological target in treatment of PCOS.

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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.

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Viruses are important causes of acute and chronic diseases in humans. Newer viruses are still being discovered. Apart from frequently causing infections in the general community, many types of viruses are significant nosocomial pathogens that with emerging viruses has become a real issue in medical field. There are specific treatments, vaccine and physical barrier to fight some of these infections. Health care-associated viral infections are an important source of patient’s morbidity and mortality. The method of sterilization or disinfection depends on the intended use of the medical devices (comprising critical, semicritical and noncritical items) and failure to perform proper sterilization or disinfection of these items may leads to introduction of viruses, resulting in infection. Disinfection is an essential way in reducing or disruption of transmission of viruses by environmental surfaces, instruments and hands which achieves by chemical disinfectants and antiseptics, respectively. This review discusses about chemical agents with virocids properties (e.g. alcohols, chlorine compounds, formaldehyde, phenolic compounds, glutaraldehyde, ortho-phthaldehyde, hydrogen peroxide, peracetic acid, iodophor, ammonium compounds quaternary, bigunides and so on.), mechanisms of action and their applications in health care-associated viral infection control. As well as, we described an overview for hierarchy of viruses in challenge with disinfantans, effective agents on viral inactivation, i.e.targect viruses, viral stability or survival duration time in enviromental surfaces and hands. We explained disinfection of surfaces, challenges in emerging viral pathogens inactivation, viral resistance to chemical disinfectants and antiseptics. Because, there are laboratory studies and clinical evidences for some viruses which viral resistance to biocide or failure to perform proper disinfection can lead to infection outbreaks. Also, we described virucidal properties of antiseptics and introduced selected antiseptics with extensive virucidal action, because hands play an important role in the spread of many viral diseases, and regular proper hands hygiene is essential to decontaminate hands and can interrupt the spread of viruses. Here, we compared the currently available laboratory methods, standard methods from many countries and kinds of viruses in these methods for evaluation of virocide activity. Finally, it’s good to know: any disinfectant is not virocide unless it confirms by laboratory methods.

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Background: Laparoscopic cholecystectomy is a minimally invasive procedure whereby the gallbladder is removed using laparoscopic techniques. Monopolar electerosurgical energy is the method of dissection of gallbladder from liver bed. Ultrasonic energy causes less thermal damage and suggests an alternative to monopolar elevterocautery. Leptin is a tissue factor and C-reactive protein (CRP) is an acute phase protein that builds up in surgical damages. In laparoscopy, pneumoperitoneum and thermal damage cause this increase. In this study, after completion of surgery with both methods, plasma leptin and CPR were measured. Next, the complications and benefits of the two methods were compared.

Methods: This single blind randomized clinical trial was conducted on 78 patients who were candidate for laparoscopic cholecystectomy in surgery clinic of Razi Teaching Hospital in Ahvaz Jundishapur University of Medical Sciences from March 2013 to March 2015. Patients were divided randomly into two groups of ultrasonic and electerocautery. Then, leptin’s level and CRP’s level were measured at completion of surgery, 30 minutes after completion, 6 and 24 hours after completion of surgery in the two groups.

Results: This study shows that the average rate of leptin at completion of surgery, 30 minutes after completion, 6 and 24 hours after completion of surgery in ultrasonic group had less increase than electerocautery group and the difference was statistically significant (P= 0.0001). The average rate of CRP at completion of surgery, 30 minutes after completion, 6 and 24 hours after completion of surgery in ultrasonic group had less increase than electerocautery group and the difference was statistically significant (P= 0.0001).

Conclusion: The level of leptin and CRP shows that surgery with ultrasonic method will provoke the immune system less than electerocautery method.

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Background: Lots of vitamin D functions are mediated by its steroid family receptor (VDR). Vitamin D role in infertility is reported by significant fertility reduction in many male laboratory animals with vitamin D deficiency. The reason for reduced fertility in male VDR-null mouse model has been reported to be reduced sperm count and sperm motility. Vitamin D has effects on sperm motility, sperm-ovum coupling, and acrosome reaction stimulation. As VDR is expressed in human male reproductive system, the aim of the current study was to investigate the role of rs2228570 polymorphism of VDR gene in male infertility.

Methods: Investigation was done as a case-control study on infertile azoospermic or oligospermic men referring to Avicenna Research Institute from March 2014 to April 2015. Rs2228570 single nucleotide polymorphism (SNP) located in exon 1 of VDR gene was chosen according to its role on protein function. Blood sampling was done on cases and control groups and after DNA extraction the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) reaction was designed and performed on 100 normal cases, 100 azoospermic and 100 oigospermic control samples. Distribution of quantitative age variable was done using Student’s t-test and qualitative variables (genotype and allelic frequencies) was done using SPSS, ver. 22 (Chicago, IL, USA).

Results: Chi-square test didn’t show significant difference between two case groups and controls (Azoosperm and control P=0.5 and oligosperm and control P=0.09). Comparing CC genotype frequency with TT and CT genotypes (azoosperm and control P=0.48 OR=0.77, oligosperm and control, P=0.17 OR=0.77) and in comparing between TT genotype with CT and CC genotypes (azoosperm and control P=0.49 OR=3.03, oligosperm and control P=0.19 OR=7.21) the difference between these groups was not significant and didn’t increase the probability of disease and didn’t show protective role against it.

Conclusion: According to the findings, the association between rs2228570 polymorphism of vitamin D receptor gene and infertility was not significant and investigation of other polymorphisms might show a relationship with male infertility.

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Background: Thyroid cancer is the most common endocrine malignancy. Accounting for approximately 1-2% of all cancers. Thyroid cancers have been divided into four main types: papillary, follicular, medullary and anaplastic. The active form of vitamin D (1,25- (OH) 2-vitamin D3) by binding to its receptor, using genomic and non-genomic mechanisms inhibits the proliferative effect of TSH on thyroid cells. Therefore, vitamin D may have a role in regulating of thyroid gland cell proliferation. Many studies have shown anti-cancer effects of vitamin D in cancers. Polymorphisms of Vitamin D receptor can influence the prevalence to various cancers. In the present study, serum level of vitamin D and FokI, BsmI and Tru9I polymorphism of vitamin D receptor was investigated.

Methods: This case-control study was performed in the summer of 2015 in Endocrinology and Metabolism Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Forty medullary thyroid cancer patients and 40 healthy controls were investigated. Genomic DNA of subjects was extracted with saturated salt/proteinase K and polymorphisms of vitamin D receptor gene investigated by polymerase chain reaction-sequencing. Serum level of vitamin D evaluated by ELISA technique. The results were analyzed by SPSS, ver. 20 (Chicago, IL, USA) and GraphPad Prism, ver. 5 (GraphPad, Inc., CA, USA) softwares.

Results: Genotypic and allelic abundance of FokI and BsmI polymorphisms between test and control groups have not shown significant different. In Tru9I polymorphism, Tt genotype abundance in test group were 45 percent and in control group were 17.5 percent and t allelic abundance in test group were 25 percent and in control group were 8.7 percent which this different were significant. Average serum level of vitamin D in test group was 23.32 ng/ml and in control group was 18.95 ng/ml which was statistically significant.

Conclusion: Unexpectedly, serum levels of vitamin D in test group were higher than control group. Tru9I polymorphism is significantly correlated to medullary thyroid carcinoma prevalence.

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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: Multiple sclerosis (MS) is a chronic inflammatory disorder of the CNS characterized by destruction of the myelin sheath, gliosis and progressive neurological dysfunction. The regulatory T (Treg) cells play a major role in the control of the autoimmunity and inflammation. The forkhead box p3 (FOXP3) is a central molecule in the function of Treg cells that play an important role in the immunoregulation. The aim of this study was to investigation single nucleotide polymorphism (SNP), rs2232365, in FOXP3 gene in patients with multiple sclerosis.

Methods: In a case-control study, peripheral blood samples were collected from 90 patients with MS (46 men and 94 women with different patterns of disease) from January 2014 to April 2015 in the Afzalipoor Hospital, Kerman (a city located in the southeast of Iran). In a total, 90 healthy subjects were also enrolled into the investigation as a control group. The healthy subjects were recruited among blood donations of the Kerman Transfusion Organization and interviewed regarding CNS disease, and none of them had any history of CNS diseases or other relevant disorders. The SNP rs2232365 in FOXP3 gene was assessed by single specific primer-polymerase chain reaction (SSP-PCR) method. Finally, statistical analysis was performed using SPSS version 22 (Chicago, IL, USA).

Results: In both patients and healthy control groups, there was significant difference among subjects with GG, AG, and AA genotypes at rs2232365 in FOXP3 gene. The frequencies of AA and AG genotypes at rs2232365 in the FOXP3 gene were significantly higher in MS group as compared with healthy subjects (P<0.002). Moreover, the frequency of GG genotype was significantly lower in the MS group in comparison with healthy control subjects (P<0.002). The frequency of A allele was significantly higher whereas the frequency of G allele was significantly lower in MS patients as compared with healthy subjects (P<0.001).

Conclusion: The results of the present study suggest that SNP rs2232365 may influence the susceptibility to multiple sclerosis. Therefore, SNP rs3761548 may directly or indirectly alter the level of the FOXP3 protein expression in Treg cells.

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Background: Polycystic ovary syndrome (PCOS) is a common complex condition in women associated with reproductive and metabolic systems and also psychological disorders. There is considerable evidence to suggest that the sympathetic nervous system is involved in PCO and metabolic syndromes. Noradrenalin (NA), corticotrophin releasing hormone (CRH) and nerve growth factor (NGF) are the strong stimulants for two axes: hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-ovarian (HPO) axes which are regulators for the female reproductive system. Following previous studies on sympathetic nervous system over activity in PCOS, the main purpose of this study is to evaluate the role of CRH and NGF as two important findings from the perspective of the psycho-emotional.

Methods: This case-control study was conducted in Reproductive Health Research Center of Imam Khomeini Hospital, Tehran, Iran in the September of 2011. 170 women participated in this study. The diagnosis of PCOS was made according to the joint criteria of the European Society of Human Reproduction and Embryology and the American Society of Reproductive Medicine (ESHRE/ASRM). All women have 20-40 years of age and body mass index (BMI) of less than 28. Demographic questionnaire was used in this study and blood sample was obtained from all participants before 8AM. All analysis was done in SPSS software, version 19 (IBM SPSS, Armonk, NY, USA). P-value less than 0.05 considered as significant level.

Results: Serum levels of CRH and NGF in patients with polycystic ovary was significantly lower than the control group (P< 0.001). This reduction can disrupt two neural axes: the sympathetic nervous system (SAS) and hypothalamus-pituitary-adrenal (HPA). These axes have a fundamental role in psycho-emotional reactions in women with PCOS. Moreover, using demographic questionnaire quantitative and qualitative characteristics of the population studied, the results of which are reported in the regression model.

Conclusion: The results of this study confirmed previous studies. This reduction in serum levels of CRH and NGF shows the hyperactivity of sympathetic nervous system in polycystic ovary syndrome can be one of the causes of mental disorders in women with PCOS.

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Background: The purpose of the current study was to investigate the effect of a high- intensity running (12 weeks) with bee pollen on gastrocnemius muscle ABCA1 and apoA1 mRNA expression in male rats.

Methods: In the present semi-experimental study, 24 white male Wistar rats aged 8 weeks with an average weight of 90±20 were prepared from the Pasteur Institute of Amol, Iran. The rats were kept in a room with dimensions of 6×5 meters under controlled conditions of light (12 hours light, 12 hours darkness, light began at 6 am, and the darkness began 6 pm), temperature (22±3 ºC) and moisture content (about 45%) from November to the end of February 2013. After a week of familiarity with laboratory space and manipulation by human, the rats were divided with simple random sampling into four groups matched by weight: saline-control, bee pollen-control, saline-training and bee pollen-training. Rats were sacrificed 48 h after the last training session. Data were analyzed statistically using two-way ANOVA and a significance level of 0.05.

Results: The results of the present study showed that intense endurance training decreased non-significantly in the gastrocnemius muscle. In addition, the bee pollen caused a significant increase in ABCA1 gene expression in the gastrocnemius muscle of male rats (P< 0.0001). while apoA1 not expressed in the gastrocnemius muscle.

Conclusion: The results of this study showed that high-intensity running reduces ABCA1 gene expression is severe. In addition, consumption of bee pollen can increase ABCA1 gene expression in the gastrocnemius muscle. According to the results of the present research, the bee pollen intake is more effective than intense endurance training on ABCA1 gene expression in gastrocnemius muscle of male rats and plays an important role in reverse cholesterol transport.