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Background and Aim: Bioaerosols are airborne particles that contain bacteria, viruses and fungi. Human reaction to bioaerosols is very different. The aim of this study was performed to determine the density of bacterial particles cultivable in the air of inside and outside kindergartens in Birjand. Materials and Methods: This descriptive-analytical cross-sectional study was performed. Birjand city was divided into 5 regions based on geographical location and 6 kindergartens were randomly selected. Sampling was done in the morning shift from 6 selected kindergartens.The culture medium used was triptic soy agar for bacteria. Sampling was performed at a flow rate of 28.3 L/Min in 35 minutes at a distance of 0.8 to 1 M above the ground in the center of each class. Statistical analysis was performed using SPSS (Version.16) software and Mann-Whitney and Kruskal-Wallis statistical tests and a significance level (P0.05). There was a significant relationship between bacterial density and total suspended particles (P

Background: Blood-borne viruses (BBVs) are one of the most important public health concerns. South Khorasan has a long border with Afghanistan and concern has risen there about blood-borne oncogenic viral infections. The aim of the present study was to evaluate the prevalence and associated risk factors of human T-lymphotropic virus 1 (HTLV-1) and co-infections of BBVs in Birjand, Iran’s eastern border. Methods: In this cross-sectional study, 3441 subjects were tested for sero-prevalence of HTLV-1 by ELISA. The data on demographic features, HTLV-1-related risk factors and other characteristics of the population were analyzed by Pearson chi-square and logistic regression tests. Finally, the co-infection of BBVs was evaluated in the study. Results: The prevalence of HTLV-1 was 0.3% (95% CI: 0.12–0.48). Notably, the sero-prevalence of HIV, hepatitis B virus (HBV), hepatitis D virus (HDV), and hepatitis C virus (HCV) in our previous studies was reported at 0%, 0.2%, 1.2% and 1.6%, respectively. The results indicated that the occurrence of HTLV-1 infection was associated only with the history of hospitalization (odds ratio [OR]: 0.27, 95% CI: 0.07–0.97, with P = 0.04). The co-infection of HBV with HCV was the most common (2.35%), while a co-infection rate of 1.17% was found for both HBV/HTLV-1 and HBV/HDV. Conclusion: Although a higher prevalence of the viruses was expected, it was close to the overall Iranian population. With respect to close relationship with an HTLV-1 endemic area (Mashhad and Neyshabour), the prevalence is very low; however, more attention is needed. Our findings reinforce the importance of increasing knowledge about BBV-related health risk behaviors to prevent the emergence of new cases, especially in low-risk populations.

Hand hygiene is the most effective, simplest, and least expensive way to prevent the spread of hospital infections. Hand hygiene needs an ingredient that shows effectiveness in reducing microbial load in a way; alcohol-based hand rubs have more effective, fast and long-lasting disinfection than other antiseptics. The aim of this study was to prepare and optimization of an alcohol-based hand rub solution recommended by World Health Organization (WHO) to reduce expenses in sanction situations and also enhance the satisfaction and tolerability of the product. Key Words: Alcohol-Based Hand Rub; Disinfection; Optimization; Production; World Health Organization

Introduction: Otomycosis is a common diseases that can be associated with many complications including involvement of the inner ear and mortality in rare cases. Management of otomycosis can be challenging, and requires a close follow-up. Treatment options for otomycosis include local debridement, local and systemic antifungal agents and utilization of topical antiseptics. Objective: This study was designed to compare the recovery rate of otomycosis using two therapeutic methods; topical betadine (Povidone-iodine) and clotrimazole. Methods: In this single-blind clinical trial, 204 patients with otomycosis were selected using a non-probability convenient sampling method and were randomly assigned to two treatment groups of topical betadine and clotrimazole (102 patients in each group). Response to treatment was assessed at 4, 10 and 20 days after treatment. Data were analyzed using the independent t-test, Chi-Square and Fisher exact test in SPSS v.18 software, at a significance level of p

Objective:To assess the frequency of bacterial agents in chronic suppurative otitis media and the antibiotic susceptibility patterns of isolates among patients.Methods:A total of 185 patients clinically diagnosed with chronic suppurative otitis media were interviewed and middle-ear effusion samples were collected using sterile swabs. All bacterial isolates were identified by conventional microbiological methods. Antibiotic susceptibility patterns of the isolates were determined by Kirby–Bauer disc diffusion.Results:Staphylococci spp. (64.9 per cent) were the most prevalent bacteria isolated, followed by Klebsiella spp. (12.9 per cent) and Pseudomonas aeruginosa (10.3 per cent). The most effective antibiotic for treatment of bacterial chronic suppurative otitis media was ciprofloxacin. Statistical analysis showed no significant difference in bacterial infestations among chronic suppurative otitis media patients and the antimicrobial susceptibility patterns of the bacterial isolates based on gender and age (p > 0.05).Conclusion:Our findings highlight the importance of a continuous and periodic evaluation of the bacteriological profile and antibiotic susceptibility patterns in chronic suppurative otitis media patients for efficacious treatment of the infection.

Background: We evaluated the sequential changes of interleukin (IL)-10 and IL-13 serum levels with tuberculosis (TB)-related radiographic changes during pulmonary TB (PTB) treatment. Materials and Methods: In this cross-sectional study during two consecutive years, forty cases with PTB were recorded, and finally, 24 cases were completed the study. Serum levels of IL-10 and IL-13 were measured on admission time, and 6 months later. Furthermore, chest radiography was performed on admission and 6 months later in the treatment course. Results: Radiography at the baseline indicated pulmonary infiltration in all patients (n = 24). Fifteen (62.5%) cases had abnormal and 9 (37.5%) cases had normal radiography at the end of 6 months treatment course. IL-10 and IL-13 upregulated during the treatment time course, and their relationship with radiographic changes shifted from negative (r = −0.14 and P = 0.71) on admission to positive (r = 0.80 and P < 0.001) at the end of 6 months treatment course in normal radiography group. IL-10 level at the start of the treatment was 121.90 ± 88.81 in patients with normal and 82.68 ± 41.50 in patients with abnormal radiography (P = 0.31). Conclusion: Sequential increase in IL-10 and IL-13 during PTB treatment course may have a role in clearing the TB-related radiographic infiltration and preventing scar formation.

Background The occult hepatitis B virus infection (OBI) is a health concern among high-risk groups and immunosuppressed individuals. There is still a paucity of data regarding the occult hepatitis B virus infection among hemophilic patients. With this in mind, we aimed to evaluate the molecular prevalence of OBI among clients with hemophilia. Methods Totally, 87 hemophilic patients were selected to be studied. To detect OBI, nested polymerase chain reaction test was used to amplify HBV-S, X, and Core regions. Viral load was determined using an in-house real-time PCR assay. Finally, sequence of S gene was used for genotyping and analysis of mutations. Results The mean age of patients was 28.4 ± 5.3 years old, with 90.7% of whom were men. HBV-DNA was detected in eight subjects (9.3%). The rate of OBI was much higher in anti-HBs seronegative subjects than that in other patients (P = 0.019). All OBI cases had HBV genotype D, subgenotype D1. In addition, five out of eight cases (62.5%) showed detectable viral loads (a mean viral load of 4.5 × 10 2 copies/mL). sR73H, sI110L, sP120A, sP127T, sQ129H, sG130R, and sC137S were shown to be the most determinant escape mutation and OBI-relevant mutants. Conclusion The rate of OBI among the studied population of hemophilia seems to be remarkable. Therefore, screening for OBI must be a routine practice in patients with hemophilia and also patients undergoing immunosuppressive treatments. Amino acid substitutions were observed in the major hydrophilic region. However further investigations are needed for analysis of exact function.

Background: Infection with Hepatitis B virus (HBV) is still a leading cause of cirrhosis and hepatocellular carcinoma around the world. Objectives: Having recently received reports of high HBV prevalence in the South Khorasan Province in the Esfandiar village, we aimed to evaluate the prevalence of HBV in this region in comparison to neighboring villages, with associations to risk factors. Methods: This was a cross sectional study that included the Esfandiar village and neighboring villages, Marghoub, and Zenowghan. All of the Esfandiar and certain neighboring villages were summoned and blood sampling was performed along with the completion of a questionnaire. Positivity for HBsAg, anti-HBc along with the seromarkers of HCV and HDV were assayed using ELISA method. Statistical analysis was performed using the SPSS software with chi-square tests, logistic regression, and risk-estimation analysis. Results: From total 1.245 participants, 856, 172, and 217 cases were from the Esfandiar, Marghoub, and Zenowghan villages, respectively. The prevalence of anti-HBc in the Esfandiar, Marghoub, and Zenowghan were 48.7%, 20.3%, and 7.8%, respectively (P-value: 0.001). The figures for HBsAg were 17.8 %, 1.7 %, and 0.5 %, respectively (P-value: 0.001). HBV was more prevalent among those with a history of experimental dentistry, traditional phlebotomy, war veterans, endoscopy, and familial history of HBV. In Esfandiar, prevalence of HBsAg among below and above 22 years- old (beginig of natoinal HB vaccination) were 2.3% and 22.4%, respectively (P-value < 0.001). Conclusions: There was a very high prevalence of HBV in this small endemic region. The result showed the impressive effect of neonatal vaccination on reducing the incidence of hepatitis B, by 89.7%. Thus, the high prevalence requires an urgent consideration of organizing health programs and certain sociocultural behaviors.

Background and Aim: Neonatal infections are significantly correlated with maternal rectovaginal colonization with group B streptococcus during pregnancy. Therefore, screening programs are needed for identifying and treating group B streptococcus colonization among pregnant women. The present study was conducted to assess the prevalence of group B streptococcus rectovaginal colonization and antimicrobial susceptibility pattern among pregnant women. Methods: This descriptive-analytical study was conducted from June 2013 to June 2014 in 500 pregnant women admitted to the maternity unit of Valiasr hospital, Birjand, Iran. Rectovaginal samples were transported in Todd Hewitt broth to a university laboratory. The samples were cultured in blood agar medium and colonial growths in the medium were tested for chemical characteristics of group B streptococcus. Antimicrobial susceptibility was tested via the agar disc diffusion method using Mueller-Hinton culture medium containing 5% - 10% sheep blood. The data were analyzed using SPSS software (v. 18.0) by running the Chi-square and Fisher exact tests at a significance level of less than 0.05. Results: The study findings revealed that the prevalence of group B streptococcus rectovaginal colonization was 5.2% (26 cases). The highest antimicrobial susceptibility of group B streptococcus was observed to ampicillin (92.2%), trimethoprim-sulfamethoxazole (88.5%), and penicillin G (88.5%), in sequence. Group B streptococcus rectovaginal colonization had significant relationships with age, number of parities, educational status, intrauterine contraceptive device use, history of drug abuse, history of vaginal or urinary tract infections, history of intrauterine fetal death, and history of neonatal death. Conclusions: The prevalence of group B streptococcus rectovaginal colonization among pregnant women is 5.2%. Given the risks of infections for both women and their neonates, antibiotic therapy is needed to prevent and manage group B streptococcus colonization among pregnant women, particularly during delivery.

Background It is estimated that about 5% of hepatitis B surface antigen (HBsAg) carriers are infected with hepatitis D virus (HDV) worldwide. Moreover, dual infection with hepatitis B virus (HBV) / HDV causes more severe diseases and leads to a higher risk of mortality.Objectives This study was performed to determine the prevalence of HDV infection and identify HDV-associated factors among HBsAg-positive patients in Birjand, South Khorasan province, Iran.Methods This descriptive, cross sectional study was conducted on 5235 participants in line with a previous study on the seroprevalence of HBV in South of Khorasan. HDV was assessed through evaluating the blood serum of diagnosed HBsAg-positive patients (85 cases) by ELISA test. For statistical analysis, descriptive statistics were calculated, using SPSS version 22.Results In this study, the mean age of HBsAg-positive patients was 45.1 ± 12.9 years (minimum, 22 years; maximum, 70 years). In total, 1 out of 85 cases was positive for HDV virus. The prevalence of HDV infection among HBsAg-positive patients was 1.2% (95% CI, - 1.2 to 3.5).Conclusions The low prevalence of HDV infection in South of Khorasan was remarkable, considering the great area of this province, use of a comprehensive and inclusive sampling strategy, and mutual borders with Afghanistan.

Background: There are 350 million carriers of hepatitis B virus (HBV) around the world. HBV can be associated with type II diabetes mellitus. The aim of this study was to evaluate the prevalence and risk factors for type II diabetes mellitus among patients with HBV. Methods: This community-based, cross sectional, descriptive, correlational study recruited participants above 13 years, who resided in Esfandiar rural area, Tabas, Iran. A blood sample was collected from each participant for serological and biochemical tests. A researcher-made questionnaire was used to collect data on the participants’ demographic characteristics, HBV risk factors, and diabetes mellitus risk factors. Independent sample t test, Chi square test, and Fisher’s exact test were applied in SPSS v. 22.0 at a significance level of 0.05). Conclusions: This study suggests that HBV can be a risk factor for type II diabetes mellitus. Therefore, continuous monitoring for diabetes mellitus is essential for patients with HBV infection, particularly those above 50 years, those with a body mass index above 25 kg/m2, and those with a positive family history of type II diabetes mellitus.

Background: Infection by certain types of human papilloma virus (HPV) is known as a causal and essential factor for cervical cancer, the second most common malignancy in women around the world. Objectives: The aim of this study was to determine the frequency and types of HPV among women with normal and abnormal cytology in Southern Khorasan, eastern Iran. Methods: This was a cross-sectional study with 253 randomized Pap smear samples from women who were referred to gynecologist clinics. Human papillomavirus-DNA testing (a nested PCR with primers MY09/ MY11 and GP5 +/ GP6 +) was performed on Pap smear samples. The first round PCR product was subjected for sequencing to determine the HPV types. Phylogenic analysis with Mega 6 was carried out to determine the relationship between HPV types. Results: The mean age of patients were 34.47 ± 5.38 years; 85.77% with normal cytology, and the rest were with an abnormality; atypical cells of undetermined significance (ASCUS) and Low-grade squamous intraepithelial lesions (LISL). Human papilloma virus-DNA was detected in 18.57% of population (15.66% of normal and 36.11% of abnormal group) with the most prevalent HPV types 6 and 11. The HPV type 84 was identified in a case. Conclusions: The result of this study revealed a partially high prevalence of HPV in women with normal cytology which are high risk for transmission in population. It is suggested that HPV testing should be carried out along with Pap test in screening programs to enhance early detection of neoplasia and intended infections.

Background and objective: This study was performed to evaluate the prevalence of Hepatitis C virus (HCV) infection as well as HBV, HDV, HTLV I/II, and HIV infection in hemodialysis patients in our district. Methods: The subjects of this study involved 41 hemodialysis patients admitted to hemodialysis ward, Vali- Asr hospital. HBV, HDV, HIV, and HTLV1/2 infections were evaluated by enzyme-linked immunosorbent assay (ELISA) technique. Serum anti- HCV anti-body was measured using the 3rd generation of ELISA kit. HCV Viremia was evaluated in all patients using RT-PCR technique. Results: HCV infection was not observed in none of patients by ELISA technique; however RT-PCR technique demonstrated HCV viremia in one (2.43%) patient. HBsAg was detected in 4(9.75%) patients, and one (2.43%) was Anti HTLV 1/2 positive; none of patients were HDV or HIV positive. Conclusion: HCV infection is less common than HBV infection in our patients. ELISA technique can not demonstrate all hemodialysis patients with HCV infection, For this reason it is requirement to evaluate this group of patients for HCV infection using RT-PC technique. DOI: http://dx.doi.org/10.3329/bjms.v13i1.13903 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 36-39

Background: Infection with the hepatitis B virus (HBV) is an important global health problem. Knowledge of the geographic dis- tribution pattern of HBV infection can help to control the spread of the disease. Objectives: To determine the prevalence of HBV infections and risk factors for the disease for the first time in Birjand, Southeastern Iran. Methods: This was an analytical cross-sectional study conducted in 2013 - 2014 of 5235 HBV cases in Birjand, South Khorasan Iran. Subjects aged 15 - 70 y were selected using the cluster sampling method. Blood samples were taken and tested at a reference labora- tory for the hepatitis B core antibody (anti-HBc). Seropositive specimens were tested for the hepatitis B surface antigen (HBsAg). Results: The mean age ( SD) was 39.07 ( 14.04) y, and 786 (15%) subjects were anti-HBc positive. The prevalence of HBsAg was 1.6% (n = 85). The prevalence of anti-HBc seropositivity was significantly higher in subjects with a lower level of education (P = 0.09), older subjects (P = 0.001), intravenous (IV) drug users (P

Background Human parvovirus B19 (B19V) is one of the smallest DNA viruses and shows great resistance to most disinfectants. Therefore, it is one of the common contaminant pathogens present in blood and plasma products. Parvovirus 4 (PARV4) is a newly identified parvovirus, which is also prevalent in parenteral transmission. In this study, we aimed to evaluate the prevalence of B19V and PARV4 DNA among patients with hemophilia in Birjand County in eastern Iran. Methods This was a cross-sectional epidemiological study comprising nearly all people with hemophilia in this region. Whole blood samples were taken after patient registration and sent for plasma isolation. After nucleic acid extraction, B19V was detected with real-time polymerase chain reaction, PARV4 DNA was then detected using sensitive semi-nested PCR. Results In total, there were 86 patients with hemophilia, with mean age 28.5±1.5 years. Of these, 90.7% were men and 9.3% women; 84.9% had hemophilia A and 7.0% had hemophilia B. We found 11 patients (12.8%) were positive for B19V DNA and 8 were positive (9.3%) for PARV4 DNA. The prevalence of B19V was higher in middle-aged groups rather than younger people, whereas PARV4 infection was more common in younger patients (P