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Background: Infertility, as an individual and social problem, affects couples’ quality of life and family functioning, job relationships, sexual skills, and marital satisfaction. Objectives: The present study aimed to investigate the relationship between infertility and the quality of life in fertile and infertile women. Methods: In this cross-sectional study with a convenience purposive sampling method, 220 eligible women (110 fertile and 110 infertile) admitted to Shiraz’s healthcare centers were selected. Data collection was conducted using a demographic information questionnaire and the World Health Organization Quality of Life questionnaire. Results: In this study, a total of 220 fertile and infertile women were studied. Our findings showed that the quality of life WHOQOL-BREF score was higher in the fertile group (72.21 ± 12.74) than in the infertile group (69.86 ± 12.58), although not significant. However, the physical area of the quality of life was significantly higher in the fertile group (17.55 ± 3.62) than in the infertile group (16.57 ± 3.55) (P = 0.04). There was no statistically significant difference between the groups concerning other quality of life areas (P > 0.05). Conclusions: The results showed that infertility could reduce the quality of life of infertile women in all areas, and this reduction was significant in the physical area. It appears that infertility diagnostic and therapeutic interventions can affect the quality of life of women in the physical area. Further research is recommended in this field.

Background: Jaundice can be observed in two-thirds of infants. Bilirubin prevents damage to the DNA from the oxidative stress of reactive oxygen species (ROS). Moreover, bilirubin has anti-inflammatory and anti-apoptotic roles in addition to antioxidant properties. Objectives: We decided to compare pro-oxidant-antioxidant balance (PAB) in physiologic and pathologic jaundice. Methods: This cross-sectional study evaluated 171 infants more than 35 weeks of gestational and > 2 days of postnatal age who were admitted to the Ghaem Hospital with jaundice from 2017 to 2019. Infants with bilirubin levels less or equal to 14 mg/dL on the jaundice meter were put in the physiologic jaundice group and infants with bilirubin higher than 15 mg/dL on the jaundice meter were entered into the study as the pathologic jaundice group. A questionnaire containing data regarding neonate’s characteristics and the mother’s medical history was filled out for each infant. Bilirubin levels, hematocrit, direct and or indirect Combs, reticulocytes, and PAB were evaluated in the case group. Results: The average age of the enrolled neonates was 7.3 ± 4.11 days and 52.4% of them were male. Between two groups of physiologic and pathologic jaundice, gestational age (P = 0.010), parity (P = 0.001) and PAB (P = 0.000) were significantly different. Overall, the amounts of the mentioned parameters in the pathologic jaundice group were less than the physiologic jaundice group. Conclusions: A pathological increase in bilirubin levels irrespective of its neurotoxic properties can change the pro-oxidant-antioxidant balance in favor of antioxidants. It seems that neurotoxic mechanism of bilirubin in pathological amounts differ with its antioxidant effects.

Background: VitaminDdeficiency is associated with prematurity, respiratory problems and infections. These are important causes of death in premature neonates. Objectives: The aim of this study was to compare the vitamin D level in the blood of preterm live neonates discharged with those neonates who did not survive. Methods: In a cross-sectional study, 335 premature infants (less than 34 weeks of gestation) were discharged and 48 infants died. We examined their umbilical cord blood for vitamin D. Results: Eighty-eight percent of our premature neonates had vitamin D deficiency. The mean of vitamin D in the survived neonates was 14.87±10.94 and in thosewhosuccumbed their prematurity it was 9.4±6.52 ng/mL (P< 0.01). There was a significant difference between the two groups in terms of the type of delivery, Apgar score of first and fifth minutes, duration of oxygen therapy and gestational age (P < 0.05). Conclusions: The results of this study showed that most premature neonates have a severe vitamin D deficiency, and this deficiency wasmorepronounced in the dead neonates than in those that survived, despite eliminated the role of gestational age. Measurement of cord blood vitamin D level may help predict the prognosis for premature neonates. © 2019, Kowsar Medical Publishing Company. All rights reserved.

Background: Resistance to ciprofloxacin as the most common antibiotic for the treatment of urinary tract infections (UTIs) is increasing. In this study, the role of gyrA and qnrA genes among ciprofloxacin resistant Escherichia coli (E. coli) isolates from UTIs was evaluated. Methods: During September to March 2014, urine samples were collected from patients with UTIs of Imam Khomaini hospital of Tehran. Bacterial identification was done based on standard tests. The antibiotic sensitivity test was performed based on the clinical and laboratory standards institute (CLSI) 2014 protocol and minimal inhibitory concentration (MIC) of ciprofloxacin was determined by E-test strips. DNA was extracted by the boiling method and assessment of gyrA (DNA gyrase (type II topoisomerase)) and qnrA genes was done by the polymerase chain reaction (PCR). Further sequencing was done for PCR confirmation and blasting. Results: All isolates were susceptible to carbapenems (100%) and 98.7% were susceptible to nitrofrontain. The highest resistance was towards piperacillin 85%, ampicillin 83.8%, sulfamethoxazole trimethoprim (SXT) 78.7%, ciprofloxacin 77.5%, and 75% tetracycline. Around 80% of the E. coli isolates were identified as multi drug resistant (MDR). All isolates with MIC of ≥ 4 μg/mL for ciprofloxacin were the candidates for DNA extraction, PCR, and sequencing. The gyrA and qnrA genes were detected in 100% and 39% of isolates, respectively. Mutations were found in the sequence analysis, yet the mean full change was related to change of serine to leucine at position 83 (S 83 L). Conclusions: Finally, contribution of both mutated chromosomal gyrA genes and plasmidic qnrA resistance genes in some of the high ciprofloxacin resistant bacterial strains was found in this study, besides the overuse of antibiotics, which can increase the emergence of resistant strains.

Introduction: Carbapenems are a broad-spectrum class of beta-lactam antibiotics, which are used in treatment of multi-drug resistant infections. Unfortunately, global emerging and spreading of carbapenemase, especially New Delhi metallo β lactamase 1 (blaNDM-1), is a concern in the treatment of multi drug-resistant agents. Here, we report the appearance of blaNDM-1producing Escherichia coli (E. coli) in Iran for the first time. Case Presentation: In this study, 2 blaNDM-1producing E. coli strains were isolated from 2 burn wounds of patients in the Motahari hospital, Tehran. The isolates were resistant to carbapenems (imipenem, meropenem and ertapenem) and other common antibiotics except nitrofurantoin. Combined Disk Test showed that the isolates could not produce blaAmpC and blaKPC carbapenemase, whereas they can produce metallo-β-lactamases (MBL). However, genetic detection using Polymerase Chain Reaction amplification with specific primers for blaKPC, blaIMP, blaVIM-1, blaVIM-1 – blaVIM-37, and blaNDM-1genes showed that only the blaNDM-1gene is amplified from the resistant isolates. Further sequencing of PCR products confirmed the presence of the blaNDM-1gene in these isolates. Conclusions: The emerging of blaNDM-1producing E. coli is a new threat for to the health system in Iran, due to the spreading of the blaNDM-1gene among pathogenic bacteria, which resulted in the emergence of multi drug resistant photogenes. Therefore, early identification of these isolates is mandatory.

Background: Health literacy can influence physical activity, mortality, self-care behaviors and health outcome for some conditions and diseases especially among the aged population. Objectives: This study aimed to assess health literacy in older adults and its related factors to encourage and inform interventions and the future research outline concerning this group of population in Iran. Methods: This cross-sectional study was conducted on 200 older adults in southeast Iran, during year 2015. The twenty health centers were selected randomly and 10 subjects were selected using multistage random sampling from a population from each health center. The Test of Functional Health Literacy in Adults Questionnaire was used for collecting the data. The data was analyzed using the Stata.12 software using Independent T test, Chi-square test and multiple linear regression. Results: The mean age of the subjects was 62.1 ± 3.9 years (ranging from 55 to 75 years old). The total mean score of health literacy was 64.4 ± 18.4 (range: 12 to 97). The mean score of health literacy amongst males and females was 61.5 ± 19.9 (range: 12 - 96) and 67.1 ± 16.6 (range: 22 - 97), respectively (P = 0.032). About 38.5% (n = 77), 29% (n = 58) and 32.5% (n = 65) of the subjects had inadequate, borderline and adequate HL level, respectively. Bivariate analysis and the results of linear regression analysis demonstrated that monthly income (β = 6.25, 95% CI: 5.03 - 17.27), educational level (β=6.61, 95% CI: 1.78-10.3) and husband’s educational level (β = 5.11, 95% CI: 3.2 - 11.21) were significantly associated with health literacy scores level of older adults. Conclusions: The results of this study showed that generally health literacy level is low among older adults in southeast Iran and needs special attention. The level of education was the most important determinant of health literacy. It seems that the best way to increase health literacy among older adults is health literacy training programs that should be implemented with respect to educational level, gender and income of the individuals.

Background: The first report of Pseudomonas aeruginosa (P. aeruginosa) carbapenem resistant strains, and especially the Metallo-Beta-Lactam (MBL) producers was from Japan, however, further reports were global. Objectives: The current study aimed to determine the frequency of vim and imp genes among P. aeruginosa MBL producer isolated from Children Medicinal Center during from 2011 to 2012. Materials and Methods: In the current descriptive study, 90 P. aeruginosa strains were collected from different clinical samples of children referring to Children’s Medical Center of Tehran, Iran. All the isolates were identified and confirmed by the standard tests. Their resistance against common antibiotics was determined by disk diffusion method based on Clinical and Laboratory Standards Institute (CLSI) 2010 protocol. The MBL producers were screened by Combined Disk Diffusion test (CDDT) and using imp-imp/Ethylen Ediamine Tetra Acetic Acid (EDTA), and increasing of 7 mm≤ the diameter of inhibiting zone. The frequency of vim and imp genes was determined by Polymerase Chain Reaction (PCR). Results: Based on standard tests including Triple Sugar Iron Agar and Oxidation- Fermentation (OF) media and disability of the bacteria for glucose fermentation, 90 P. aeruginosa strains were confirmed. Their resistance against the following antibiotics was evaluated by disk diffusion method: 36.6% to cefotaxim, cefpodoxim and ticarcillin 33.3%, meropenem and aztreonam 32.2%, amikacin 28.8%, ciprofloxacin and ceftriaxon 27.7%, ceftazidime 22.3% and imipenem 15.5%. By PCR the frequency of imp gene with its 328 base pair band was (3.3%). The vim gene was not detected among the tested strains. Conclusions: Despite of high resistance of P. aeruginosa, the resistance rate of P. aeruginosa strains isolated from children in the current study was not high. Then accurate prescription of antibiotics can decrease the speed of resistance creation.