1 school of paramedicine, golestan university of medical sciences 299 Drug- Resistance- Associated Mutations and HIV Sub-Type Determination in Drug-Naïve and HIV-Positive Patients under Treatment with Antiretroviral Drugs Naziri H b Tabarraei A c Ghaemi A d Davarpanah MA e Javid N f Moradi A g b MSc of Medical Virology, Department of Microbiology, School of Medicine, Golestan University of Medical Sciences c Assistant Professor of Medical Virology Department of Microbiology, School of Medicine, Infectious Diseases Research Centre d Assistant Professor of Medical Virology, Department of Microbiology, School of Medicine e Infectious disease specialist, Shiraz HIV and AIDS Research Center f MSc of Microbiology, Department of Microbiology, School of Medicine, Golestan University of Medical Sciences g Professor of Medical Virology, Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, 1 10 2013 7 3 1 8 26 06 2013 28 09 2013 Abstract Background and Objective: Resistance to antiretroviral agents is a significant concern in clinical management of HIV-infected individuals. Resistance is the result of mutations that develops in the viral protein targeted by antiretroviral agents. Material and Methods: In this cross-sectional study, the blood samples of 40 HIV-positive patients were collected. Twenty of them were drug-naïve and the rest were under treatment for at least one year by antiretroviral agents. Virus genome was extracted from patient's plasma with high-pure-viral-nucleic-acid kit. Then, by means of reverse-transcriptase and specific primers of protease genes were amplified and sequenced. Sequences of genes, drug- antiretroviral- resistant mutations and subtypes were determined using Stanford University’s HIV-drug-resistance databases. Results: Drug-naive patients show 15% resistance to nucleoside-reverse-transcriptase inhibitor (NRTI) and 20% resistance to non-nucleoside-reverse-transcriptase inhibitor (NNRTI). Anti-protease resistance is not observed in any patients. In under treatment patients, drug resistance to NNRTI (25%) is more than drug resistance to NRTI (20%) and the rate of drug resistance to protease inhibitor is 5%. Conclusion: Our findings show a high prevalence of drug-resistant mutations in Iranian-drug-naïve-HIV-infected patients. But in under treatment individuals, the rate of drug resistance is less than previous studies. Keywords: HIV Nucleoside Inhibitor Non-Nucleoside Inhibitor Protease Inhibitor
300 Comparison of Molecular (PCR) and Pap Smear Methods in Diagnosis of Human Papiloma Virus (HPV) in Women with Genital Warts Bashi zadeh Fakhar H h Faraji R i Ghane M j Jafarpour M k Ashoorizadeh B l h MSc of Microbiology, Young Researchers Club, Islamic Azad University i Associated Professor of Gynecology, Department of Gynecology j Assistant Professor of Microbiology, Department of Microbiology, Islamic Azad University k Assistant Professor of Microbiology, Department of Microbiology, Islamic Azad University l Resident of Surgery, Department of Surgery 1 10 2013 7 3 9 15 26 06 2013 28 09 2013 Abstract Background and Objective: Much research has shown that Human Papiloma Virus (HPV) plays an important role in cervix cancer and it is the cause of 99% of cervix cancer worldwide. Lots of research has been done to find a proper method for HPV diagnosis and screening in patients with genital warts. This study aimed at comparing PCR method with Pap smear test in HPV screening. Material and Methods: Considering the presence of DNA of HPV, 45 vaginal and cervix swap samples of women with genital warts were tested by means of specific PCR and Pap smear from September 2010 to April 2011. Results: Out of 45 vaginal and cervix swap samples of women suffering genital warts, 37 samples (82.2%) are positive. Of 45 Pap smear samples, 13 (29%) are neoplasia and 32 (71%) normal. Conclusion: The difference between the results of PCR and Pap smear is due to low specification and sensitivity of Pap smear. Thus it is recommended using diagnostic PCR method in addition to Pap smear in order to promote the quality of screening in individuals with genital warts. Keywords: Human Papiloma Virus (HPV) Genital Warts Molecular (PCR) Pap Smear 301 Diagnostic Value of Fructosamine and Glycosylated Hemoglobin in Estimating Blood Glucose Level in Diabetic Patients with Thalassemia Major Kosaryan M m MR n Aliasgharian A o Mousavi M p Roshan P m Specialist of Children Disorder, Thalassemia Research Center, Mazandaran University of Medical Sciences n Medical Doctor of Laboratory, Thalassemia Research Center, Mazandaran University of Medical Sciences o BSc of Laboratory, Thalassemia Research Center, Mazandaran University of Medical Sciences p General Practitioner, Thalassemia Research Center, Mazandaran University of Medical Sciences MSc of Immunology, Thalassemia Research Center, Mazandaran University of Medical Sciences 1 10 2013 7 3 16 23 26 06 2013 29 09 2013 Abstract Background and Objective: Diabetes mellitus is one of complications that thalassemia major patients face with. Hence, blood glucose monitoring is of vital importance to these patients. Because of high level of fetal hemoglobin in these patients, the measurement of hemoglobin A1c is not reliable and should be displaced by fructosamine test. Material and Methods: The current descriptive study was carried out on 33 beta-thalassemia major patients afflicted with diabetes mellitus (21 female and 12 male cases). Blood glucose level, fructosamine, hemoglobin A1c, serum ferritin and fetal hemoglobin were measured. Results: Blood glucose levels are 204±103 mg/dL and 221±101 mg/dL (p=0.63) fetal hemoglobin levels are 9%±7% and 13%±9% (p=0.22) serum ferritin levels are 1744±1534 ng/mL and 3253±1773 ng/mL (p=0.96) in female and male patients, respectively. The level of fructosamine (42±124 mmol/L) and glycosylated hemoglobin (8.9%±1.8%) are correlated significantly (r=0.69, p<0.01). Both Hemoglobin A1c (r=0.75, p<0.01) and fructosamine (r=0.54, p<0/01) show a significant correlation with blood glucose level. Conclusion: In diabetic thalassemia major patients with frequent blood transfusion, the level of fructosamine and glycosylated hemoglobin are related significantly, therefore they can be used alternatively. Keywords: Thalassemia major Fructosamine Hemoglobin A1c Diabetes Mellitus 329 The Comparison of Serum Vitamin D Level in Patients with Iron Deficiency Anemia and Minor Thalassemia Royani s Alijanpor s Shirbaghaei z Khorasaninejad R Roshandel GH Ayatollahi AA Joshaghani HR BSc of Nursing and MSc of Strategic Management, Medical Laboratory Kavosh MSc student of Genetics, Golestan University of Medical Sciences Msc Student of Immunology, Tehran University of Medical Sciences Student of Medicine, School of Medicine, Golestan University of Medical Sciences PhD Student of Epidemiology, Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences Medical Doctor of Laboratory, Laboratory Sciences Research Center, Golestan University of Medical Sciences Associated Professor of Biochemistry, Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences 1 10 2013 7 3 24 30 18 08 2013 29 09 2013 Abstract Background and Objective: Of the most common hypochromic microcytic anemia are iron deficiency anemia and minor thalassemia, which are common in Iran and their differential diagnosis is extremely important. The level of 25-hydroxy vitamin D is the indication of vitamin D blood status. The aim of this study was to compare serum levels of vitamin D in people with minor thalassemia and iron deficiency anemia with healthy subjects in order to investigate the relationship between vitamin D deficiency and iron absorption. Material and Methods: In this case-control study, 24 patients with minor thalassemia, 20 patients with iron deficiency anemia and 24 healthy individuals participated. Groups were matched for age and sex. Testing of Vitamin D level by ELISA, ferritin by quantitative luminescence method and HbA2 by column chromatography was carried out. Results: The number of individuals with low level of vitamin D in iron deficiency group is 15 (75%), in minor thalassemia group is 8 (33/3%) and in the control group 11 (45.8%). Conclusion: In this study, the highest percentage of vitamin D deficiency is observed in cases with iron deficiency anemia. Because of association between vitamin D and anemia, iron and vitamin D supplementation is recommended to enrich the diet. Keywords: Anemia Minor Thalassemia Iron Deficiency Anemia Vitamin D 302 Frequency of Dermatophytosis in Wrestling and Bodybuilding Halls in Challous, 2010 Forghani F Nasrollahi Omran A Kouchaki M Mirzaie A MSc of Microbiology, Young Researchers Club, Islamic Azad University Assistant Professor of Medical Mycology, Faculty of Medicine, Islamic Azad University MSc of Microbiology, Biology Department, Faculty of Biology Sciences, Islamic Azad University MSc of Microbiology, Biology Department, Faculty of Biology Sciences 1 10 2013 7 3 31 37 26 06 2013 29 09 2013 Abstract Background and Objective: One of the most common diseases of keratin tissues is dermatophytosis caused by dermatophyte fungi. Because of being contagious, it has a high prevalence rate in wrestling and body building gyms. This study was designed to evaluate the process of this disease and improve the hygiene of halls. Material and Methods: The Samples (N= 540) were obtained from athletes and gyms, and a questionnaire was used to gather information. To identify various specious of dermatophyte, the routine diagnostic procedures, culture media, and supplementary tests were performed. Results: Of samples taken from athletes, 59 wrestlers and 11 body builders suffer from dermatophytosis. Trichophytontonsurans (%28.81) and Epidermophytonfloccosum (%36.36) are the main isolates in wrestlers and body builders. Also the rate of epidermophytonfloccosum (%37.5) is the highest in the samples taken from gym mats and halls. Conclusion: Because of high prevalence of dermatophytosis, pay attention to increase of hygiene and training courses for coaches and athletes are crucially important. Keywords: Dermatophytosis Wrestling and Body Building Halls Challous 303 Analysis of Anti-Enterococcal Activity of Three Honey Samples in Golestan Province Shariati A Pordeli HR Tajari ME Yazarloo E Kaghazloo S Ebrahimi N MSc of Microbiology, Young Researchers Club, Islamic Azad University PhD of Mycology, Department of Lab-Medical Sciences, Islamic Azad University MSc Student of Microbiology, Islamic Azad University MSc of Microbiology, Young Researchers Club, Islamic Azad University BSc of Microbiology, Islamic Azad University BSc of Microbiology, Islamic Azad University 1 10 2013 7 3 38 45 26 06 2013 29 09 2013 Abstract Background and Objective: Understanding the resistance patterns of bacteria and their sensitivity and attempting to find new compounds with broad effective spectrum would be significant in controlling infection. This study aimed at evaluating antibacterial potential of three honey samples produced in Golestan province, Iran, against Enterococcus faecalis strains. Material and Methods: After the isolation and identification of bacterial strains, their antibiotic resistance was determined using Kirby-Bauer method. Then, seven isolates of Enterococcus faecalis with multidrug-resistance were selected and antibacterial activities of honey samples assessed by disk-diffusion, well-diffusion and minimum inhibitory concentration test (MIC). Results: The highest diameter of inhibition zone in disk-diffusion and well diffusion methods is 20 mm and 26 mm, respectively. Also the MIC is measured 62.5 mg.ml for all samples. Conclusion: In prohibiting microbial growth, all three samples were successful and they could prevent growing bacterial infection in spite of remarkable resistance of Entrococcus. Hence, further research should be conducted to assess the effects of honey samples against other bacteria. Keywords: Multidrug-Resistance Enterococcus spp Honey Golestan Province 304 Anti-Endomysial and Anti-Tissue Transglutaminase Serological Test Compared with Small Bowel Biopsy in the Diagnosis of Celiac Disease Shadman M Abedian Kenari S Alizadeh A Kaveh M Hosseini V 1 10 2013 7 3 46 53 26 06 2013 29 09 2013 Abstract Background and Objective: Celiac is an autoimmune disease that is characterized by an immune-system-related damage in the intestinal tissue after consumption of gluten. There is not any general agreement for gold standard. The Purpose of this study was the evaluation of specificity and sensitivity of anti-endomysial (EMA) and anti-tissue transglutaminase (TTG) serological test compared to small-bowel biopsy. Material and Methods: In the cross sectional study, we took blood specimen from 1825 patients with gastrointestinal disease. All the samples were tested by TTG and EMA kits using ELISA. The patients were studied in two groups. First, the individuals whom their serologic test was positive but their tissue condition was normal and second, those with positive serologic test with pathologic tissue results that show they have celiac disorder. Results: The mean of EMA and TTG shows that the level of antibodies in group 2 is significantly higher than that of the first group (P ≤0.001). There is positive correlation between modified marsh criteria of small-bowel biopsy and the two tests. The Sensitivity of EMA and TTG tests for celiac diagnosis is 92%. The specificity of EMA, TTG tests are 100% and 98.5%, respectively. Conclusion: EMA-IgA serology with cut-off point of more than 66 together with TTG-IgA serology with cut-off point of above 30 can be helpful to distinguish a wide range of patients who need small-bowel biopsy. Keywords: Celiac Anti-tissue Transglutaminase (TTG) Anti-endomysial (EMA) 336 The Prevalence of Intestinal Worms and Amebiasis in Gorgan(2005-2011) Koohsar F Amini A Ayatollahi AA Niknejad F Abbasi Nejat Z MSc of Parasitology, Laboratory Sciences Research Center, Department of Laboratory Sciences, School of Paramedical MSc of Microbiology, Department of Laboratory Sciences, School of Paramedical 1 10 2013 7 3 54 60 09 09 2013 14 10 2013 Abstract Background and Objective: In many countries, especially in developing countries, diarrheal diseases is one of the most important causes of mortality. In these countries, due to availability transfer conditions of parasitic infections, (pathogenic and non-pathogenic parasite), have a high prevalence. This study aimed was determining the prevalence of Parasites causing diarrhea in Gorgan . Material and Methods: This cross-sectional study was performed on 1086 Patients with acute diarrhea. The test was performing by the wetmount and formalin-ether concentration method according to WHO protocol. Results: From 1086 patients in study, 197 (18.1%) were infected by intestinal parasites, that 141 (13%) were infected with Protozoan and 79 (7.27%) were infected with intestinal worms. The prevalence of wet mount method was, Entamoebahistolytica in 69 (6.4%), Giardia lamblia in 27 (2.5%), Entamoeba coli in 15 (1.4%), Chilomastixmesnili in 8 (0.7%), and with formalin-ether method was Hymenolepis nana in 26 (2.4%), Trichostrongylus in 16 (1.5%), Enterobiusvermicularis in 10 (0.9%). Conclusion: The high prevalence of Entamoeba histolytica, is indicating protozoan importance as a cause of acute diarrhea. Keywords: Intestinal Parasites Diarrhea Wetmount Formalin Ether Gorgan 305 Seroepidemiology of Toxoplasmosis among Pregnant Women Referring to the Reference Laboratory of Zahedan, Iran (2011) Ebrahimzadeh A Mohammadi S Davoodi T Salimi Khorashad AR Jamshidi A Assistant Professor of Medical Parasitology, Department of Parasitology and Mycology MSc of Medical Parasitology, Department of Parasitology and Mycology 1 10 2013 7 3 61 68 30 06 2013 29 09 2013 Abstract Background and Objective: Toxoplasmosis is one of the most prevalent parasitic infections worldwide. Contamination of pregnant women with toxoplasmosis may cause fetal death, preterm delivery and congenital toxoplasmosis. Due to importance of congenital Toxoplasmosis and the need of further study, this research was accomplished in Zahedan. Material and Methods: The serum samples (N= 221) were collected from pregnant women referring to reference laboratory of Zahedan in 2011. The IgG and IgM antibody levels against toxoplasmosis were investigated using ELISA method. Results: Out of all samples, 30.8% are IgG positive and 1.4% are both IgG and IgM positive. There is no significant difference between positive and negative groups using Chi-square tests. Conclusion: The main part of pregnant women in Zahedan (69.2%) is serologically negative against toxoplasmosis therefore, hygiene education to eliminate risk factors especially during pregnancy period seems to be imperative. Keywords: ELISA Antibody Pregnancy Toxoplasma Zahedan 306 A Comparison of Direct Technique and Formalin-Ether Method in Determining Parasitic Infection among Health-Card Applicants in Shahroud City Amiri M Nazemi S Raei M Chaman R Norouzi P Assistant Professor of Health Service Management 1 10 2013 7 3 69 74 30 06 2013 29 09 2013 Abstract Background and Objective: Parasitic infection is one of the major health problems in the world. This study aimed at comparing the accuracy of two methods of direct examination and Formalin-Ether to detect the presence of parasitic infection among health-card applicants in Shahroud city, 2011. Material and Methods: This cross-sectional study was conducted on 801 patients seeking health-card. From each patient, three consecutive stool samples were taken and investigated, using direct examination and formalin-ether method. Results: The use of formalin-ether method in recognizing the parasitic infection specially giardia lamblia and entamobea coli is more than the direct method. Conclusion: The formalin-ether method is a more sensitive method than the direct method. But in circumstances that is urgency to respond or aims to see the shape of trophozoite, the use of direct method is recommended. Keywords: Parasitic Infections Health Card Direct Method Formalin-Ether 307 Microbial Contamination of Staff’s Hand while Going out of Hospital Naderinasab M Tayyebi Meibodi N Nahidi Y Bakhshizadeh A 1 10 2013 7 3 75 79 30 06 2013 29 09 2013 Abstract Background and Objective: Cross-transmission of microorganisms by the hands of health care workers is considered as a main transmission route of nosocomial infections. The aim of this study was to investigate the microbial contamination of health-care worker’s hands while going out of hospital. Material and Methods: Wearing the sterile glove with liquid culture, we obtained 100 Samples from the staff’s hands of three departments (clerical department, emergency ward and central laboratory) of Emam Reza hospital. After that, the samples were cultured. Results: Of all personnel, 40% have the habit of washing their hands. Of these, 95 percent wash their hands with water and soap, and 5 percent with alcohol rubs. Of 100 cultured samples, 90 have microorganisms including non-pathogen gram-positive bacillus (29%), coagulase-positive staphylococcus (39%), coagulase-negative staphylococcus (47%), Enterococci (3%), micrococcus (25%) and candida (3%). Contamination in those who had not washed their hands is 62.6% and in those who washed is 37.7% (P=0.04). Conclusion: Hands of health-care workers become progressively contaminated by the potential pathogens during daily activities. To reduce the rate of contamination, it is helpful if we ask staff to wash their hands while going out of hospital. Keywords: Microbial Flora Hospital’s Staff Hand Washing 308 Bacterial Agents Isolated from Wards’ Environment and Staff’s Hands in Yahyanejad Hospital, Babol Sadighian F Abedian Z Saane-ei A Mirkarimi Z 1 10 2013 7 3 80 84 30 06 2013 29 09 2013 Abstract Background and Objective: Nowadays, nosocomial infection is one of the greatest problems in hospitals. Normal flora of staff’s hands and the bacterial agents on the surface of medical equipment can become progressively colonized with potential pathogens during patient care. This study was carried out to determine the bacterial agents existed on staff’s hands and in the wards of hospital to step in to control nosocomial infection. Material and Methods: In this descriptive study, during 17 months (22.mar.2010- 30.aug.2011), 403 samples, using sterile swab , were randomly obtained from the staff’s hands and medical equipment of emergency departments , ICU, male operation room and female surgical unit . The samples were cultured on Blood agar (BA) and Eosin methylene blue (EMB). Then, identification of isolated bacteria was done with diagnostic tests. Results: Of 430 samples, 530 bacteria were isolated from staff’s hands (N= 291) and medical equipment (N= 234). The most common bacterium from personnel’s hands (144 49.5%) and medical equipment (24 10%) is Staphylococcus aureus. Also, three isolates of pseudomonas aeruginosa from staff’s hands of male surgical ward and medical equipment of ICU, and two isolates of Acinetobacter.spp from ICU’s medical equipment were identified. Conclusion: With regard to the findings, it seems that applying the appropriate disinfectant agents by using standard procedures is necessary. Keywords: Medical Equipment Staff’s Hand Nosocomial Infection Staphylococcus Aureus