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This study aimed to assess the efficacy of methanolic extract of Prosopis farcta (P. farcta) against protoscolices. In this study, the liver of sheep infected with hydatid cyst was collected from Birjand abattoir and after isolation of hydatid cyst protoscolices, to assess the protoscolicidal effect of P. farcta, concentrations of 250, 500, 1000 mg/ml Lit a liter of plant extract with a suspension of protoscolices and their mortality was calculated in 5 to 30 min. The metabolites in the P. farcta extract were characterized by gas chromatography-mass spectrometry (GC–MS). The average of the mortality protoscoleces was 100% after 5 min of incubation with the concentration of 1000 mg/ml of P. farcta extract. The mean of the mortality of protoscoleces after 10 min of incubation with the concentration of 500 mg/ml of P. farcta extract was 100%. That is, P. farcta extract requires a longer length of time to display potent protoscolicidal effects. The results of this investigation revealed that P. farcta extract could have a significant scolicidal activity on hydatid cyst protoscoleces. However, further research that must be accomplished particularly in human and animal subjects is required to reach this conclusion.

Background Melittin is one of the most studied antimicrobial peptides, and several in vitro experiments have demonstrated its antibacterial efficacy. However, there is evidence showing melittin has non-promising effects such as cytotoxicity and hemolysis. Therefore, concerns about unwanted collateral toxicity of melittin lie ahead in the path toward its clinical development. With these considerations, the present study aimed to fill the gap between in vitro and in vivo studies. Methods In the first step, in vitro toxicity profile of melittin was assessed using cytotoxicity and hemolysis tests. Next, a maximum intraperitoneal (i.p.) sub-lethal dose was determined using BALB/c mice. Besides toxicity, antimicrobial efficacy of melittin against extensively drug-resistant (XDR) Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA), and KPC-producing Klebsiella pneumonia (KPC-KP) pathogens were tested using both in vitro and in vivo methods. Results Melittin showed extensive hemolysis (HD50 = 0.44 µg/mL), and cytotoxicity (IC50 = 6.45 µg/mL) activities with i.p. LD50 value of 4.98 mg/kg in BALB/c mice. In vitro antimicrobial evaluation showed melittin MIC range from 8 to 32 µg/mL for the studied pathogens. Treatment of infected mice with repeated sub-lethal doses of melittin (2.4 mg/kg) displayed no beneficial effect on their survival and peritoneal bacterial loads. Conclusions These results indicate that melittin at its safe dose could not exhibit antimicrobial activity, which hinders its application in clinical practice.

Introduction: Otomycosis, as a common superficial fungal infection, is the term to infection of external auditory canal. Despite numerous studies on diverse antifungal agents, there is no common consent on effective agent for treatment of otomycosis. Therefore, the purpose of this study is compared therapy of otomycosis using two therapeutic agents; clotrimazole and iodine tincture. Materials and Methods: This research is a clinical trial study included 160 patients who were presented otomycosis. All patients were randomly assigned into two therapeutic groups of clotrimazole and Iodine Tincture (80 cases in each group). The results of response to thrapy were evaluated on 4, 10, and 20 days. Statistical analyses were performed using Independent-Samples t-test, Chi-Square, and Fishers҆ Exact tests in SPSS software v.18, in 0.05 significant level. Results: Fungal species were isolated including Aspergillus (72.5%) and Candida albicans (22.5%). After 4thday of treatment, 7.5% of the tincture group and 11.2% of the clotrimazole group revealed a good response to treatment (P=0.30). A good response to treatment was observed in35.0 and 41.2% of the patients on 10th day of treatment (P=0.44); and in 67.5 and 62.5% of the patients on 20th day of treatment (P= 0.20). There was no significant relationship between the two therapeutic arms. Conclusion: In this study, both clotrimazole and tincture showed the identical therapeutic efficacy on otomycosis. Our findings suggested that tincture can be used as a supplementary antifungal option for treatment of otomycosis.

Background: Toxoplasma gondii is a protozoan of the Apicomplexa phylum with widespread distribution in animals and humans. Toxoplasma gondii is also an important cause of infectious diseases in women of reproductive age. Objectives: This cross-sectional study aimed to determine the prevalence of anti-T. gondii IgG antibody and its associated risk factors among women of reproductive age referring to Birjand Comprehensive Health Center, East of Iran. Methods: A total of 300 serum samples were collected from women who were referred to Birjand Comprehensive Health Center to be screened for anti-T. gondii IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Analytical and descriptive statistics were carried out using SPSS software version 20. Descriptive statistics were reported as a percentage and mean (SD). The chi-squared test was applied to assess the univariate association between independent variables and outcome. The significance level in the test was considered P < 0.05. Results: The results showed that 8.3% of the subjects with an average age of 27 years were IgG-positive. Contact with cats had a significant effect on positivity for IgG and disease frequency (P < 0.05). On the other hand, age and the place of residence (urban or rural) had no significant effect on disease frequency (P > 0.05). Urban or rural location in all age ranges had no significant effect on IgG positivity (P > 0.05). Conclusions: Considering the high percentage of T. gondii among negative people in the target population, it is necessary to inform women of the reproductive age about the importance of testing and health issues related to T. gondii.

Objective Cutaneous leishmaniasis caused by Leishmania major (L. major) is an endemic disease in Iran. The current reference drugs, including Glucantime, possess high toxicity in addition to some side-effects. Therefore, there is a growing interest in exploring biomedical plants. The goal of the present study was to evaluate the anti-leishmanial activity and cytotoxicity of hydroalcoholic extracts from Prosopis farcta (P. farcta) over promastigote and amastigote forms. Methods This study was performed at the Iran Birjand University of Medical Sciences, during the year 2019. In this study, the hydroalcoholic extracts of the stems, leaves (LE) and fruits (FE) of P. farcta were obtained. The anti-leishmanial activity was assessed against leptomonad promastigotes and intracellular amastigotes of L. major. The cytotoxicity of these extracts was determined in murine macrophages. Results The FE and LE of P. farcta demonstrated a significant leishmanicidal effect against L. major promastigotes with an IC50 of 0.9 mg/mL and 1.1 mg/mL, respectively. The FE showed the most anti-leishmanial activity and presented with the highest index of selectivity (SI=14.6) as an anti-leishmanial product. Infected macrophages treated using the FE showed a reduction in parasite burden by 97.3%. Conclusion The results of the present study demonstrated the leishmanicidal activity of P. farcta on both promastigotes and intracellular amastigotes. There is a need for performing comprehensive studies on relevant animal models and to access the effects of active components of P. farcta extract on the growth of L. major.

Cystic Echinococcosis (CE) is a medically important disease that is caused by the metacestodes of Echinococcus granulosus. Human hydatid is considered an endemic disease in specific regions of Iran. The goal of the present study was to determine the genetic diversity of E. granulosus from the paraffin-embedded human tissue samples which were collected from the endemic regions of Iran. Fifty-five formalin-fixed and paraffin-embedded hydatid cysts (FFPE) of humans, which had been removed surgically, were obtained from the South Khorasan and Sistan and Baluchistan provinces. These regions are related to the East and Southeast regions of Iran, respectively. The cox1 and nad1 genes from mitochondria were amplified from the extracted DNA and sequenced. The sequences were edited using the BioEdit software. Furthermore, phylogenetic and genetic diversity analyses were performed. Sequencing of the cox1 and nad1 genes from the 44 CE samples was done successfully. Genetic analysis revealed that 38 (86.3%) and 6 (13.6%) of the isolates were G1- and G6-genotypes, respectively. In general, eight and six haplotypes were identified by cox1 and nad1 genes analysis, respectively. For G1 strains, the haplotype diversity index was higher for the cox1 gene (0.6 ± 0.07) in comparison with the nad1 gene (0.4 ± 0.09). The findings of the present study showed that the sheep strain (G1) and the less important camel strain (G6) play the main roles in the transmission cycle of CE in the East and Southeast regions of Iran. Therefore, these results could be useful for managing the hydatid disease control programs in the studied and other similar areas.

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

Neonatal invasive infections caused by Escherichia coli K1 are still major health problems and effective preventive strategies at the maternal level can be a concern. The aim of this study was to determine the prevalence of rectovaginal colonization, related risk factors, virulence factors, and antibiotic resistance properties of E. coli K1 among pregnant women. In this cross-sectional study, vaginal and rectal swabs were collected from 400 pregnant women. The identification of E. coli isolates was performed by microbiological tests. A polymerase chain reaction (PCR) assay was used to identify the E. coli K1 strains. The antimicrobial susceptibility patterns were determined by the Kirby-Bauer disk diffusion. Two duplex PCR assays were developed separately to detect genes encoding virulence determinants (fimH, hlyF, ibeA, and iucC) in the E. coli strains. The vaginal and rectal maternal E. coli K1 colonization rates were 3.7% and 19.25%, respectively. There is no significant association between demographic-obstetric factors and vaginal E. coli colonization in pregnant women. The most effective antibiotics against E. coli K1 strains were imipenem, gentamycin, ciprofloxacin, and ceftazidime. In our study, the E. coli K1 strains were significantly more likely to possess the fimH (90.9% vs. 60.7%) and iucC (90.9% vs. 53.6%) than the E. coli non-K1 strains. This study demonstrates that E. coli K1 seems to be more virulent than non-K1 strains. Our findings highlight the importance of screening pregnant women for vaginal colonization by E. coli K1 and of the appropriate antibiotic prophylaxis for the prevention of early-onset E. coli neonatal infection and comorbidity.

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

Background and Objectives: Non-fermentative Gram-negative Bacilli (NFGNB) is known as a major cause of health- care-associated infections with high levels of antibiotic resistance. The aim of this study was to investigate the antibiotic resistance profiles and molecular characteristics of metallo-beta-lactamase (MBL)-producing NFGNB. Materials and Methods: In this cross-sectional study, the antibiotic resistance profile of 122 clinical NFGNB isolates was determined by the Kirby-Bauer disk diffusion and microdilution broth methods. Bacterial isolates were investigated for the detection of MBLs production using the combination disk diffusion Test (CDDT). The existence of bla , bla , and bla NDM genes in all carbapenem-resistant isolates was determined employing polymerase chain reaction (PCR) assays. Results: High resistance in Pseudomonas aeruginosa was reported to cefotaxime and minocycline, whereas Acinetobacter baumannii isolates were highly resistant to all antibiotics except colistin. Multidrug resistance (MDR)-NFGNB (66% vs. 12.5%, P=0.0004) and extensively drug resistant (XDR)-NFGNB (55.7% vs. 12.5%, P=0.001) isolates were significantly more common in hospitalized patients than in outpatients. The production of MBL was seen in 40% of P. aeruginosa and 93.3% of A. baumannii isolates. It was found that 33.3% and 46.7% of carbapenem-resistant P. aeruginosa isolates, and 13.3% and 28.9% of carbapenem-resistant A. baumannii isolates were harboring bla IMP-1 and bla VIM-1 genes, respectively. The incidence of MDR (98.2% vs. 28.3%, P

Antibiotic resistance is already widespread in the world, and it has become a great health problem. Therefore, comprehensive efforts are needed to minimize the resistance. The exploration of alternative therapies may offer a more targeted approach with less susceptibility to resistance. Even though antimicrobial peptides (AMPs) have been introduced as emerging antibiotic sources, they are not widely discussed in the literature. Since Neisseria infections show resistance to different types of antibiotics, the purpose of this review was to discuss the currently investigated AMPs with anti-Neisseria properties. In the present review, we provide an overview of 24 AMPs with in vitro anti-Neisseria properties.

Background Cytomegalovirus (CMV) has been known as the most common cause for congenital infections worldwide which can lead to death in fetus and neonates as well as neuropsychiatric deficits. The aim of this study was to determine the prevalence of congenital CMV infection in newly born neonates and to evaluate the medical outcomes. Materials and Methods In this cross-sectional study, 868 neonates were selected using unconditional random sampling in 2017. Neonatal saliva was given on the first or second day of birth using a Dacron swab and tested by PCR for the presence of CMV DNA. All infants with positive CMV infection went through further tests and examinations to evaluate the clinical outcomes. Results: 787 (90.67%) and 81 (9.33%) births were term and preterm respectively. The PCR test was positive results only in 14 term neonates (1.61%). Thus, the prevalence of CMV infection in term neonates (n=14, 1.61%) was higher than that of preterm infants (n=0), although there was no statistically significant difference (P>0.05). The most common abnormalities were neutropenia (50%, n=4) followed by anemia (37.5%, n=3). Conclusion The prevalence of CMV infection in this study (1.61%) was within the global range and there was no association between CMV infection and birth weight, infant gender, and as well ae neonatal type. The frequency of symptomatic neonates at birth in this study was higher than the average global range, but almost the same as in developing countries.

Neonatal invasive infections caused by

Background: Urinary Tract Infection (UTI) is the most common bacterial infection in the world. E. coli is the predominant Pathogen. This study evaluates the prevalence of ESBL in E. colis isolated from patients with urinary tract infections with phenotypic and genotypic methods.Methods: This descriptive-analytical study was done on 155 isolates of E. coli isolated from patients with urinary tract infection who had received the study consent. After accurate identification of E. coli strains. ESBL production for Escherichia coli isolates which are resistant to ceftriaxone or ceftazidime was evaluated by CDT method. TEM, SHV and CTX-M genes were identified by PCR.Results: The results showed that 30 strains from 155 strains of E. coli had ESBL. Strains of ESBL producer were more in males was lower in educated persons. 38.9% of ESBL producer had antibiotic use, 29.9% -producing Escherichia hospitalization and 31.6% uti history. The highest level of drug allergy in the ESBL was related to nitrofurantoin, and the highest resistance was related to cefazolin, co-trimoxazole. The CTX-M and the CTX-M15 gene were found in 92.7% and 57.1% of cases, respectively; also the SHV and TEM genes were not found in any of ESBL-producing Escherichia coli strains. Most therapeutic response in patients was related to cefexime, ciprofloxacin and nitrofurantoin 27.4%, 26% 21.9%, respectively.Conclusion: This study showed that the history of antibiotic use, hospitalization, uti related to increase of ESBL-producing in E. coli isolates., the CTMX-M gene is the most common gene in ESBL-producing E. coli strains.

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.

The emergence of Escherichia coli sequence type 131 (ST131) as a multidrug-resistant and virulent pathogen represents a major challenge to public health globally. Recently, the O25b/ST131 E. coli producing CTX-M-15 with high virulence potential has been reported worldwide, but has received little attention in Iran. This study is the first in Iran to specifically determine the spread of the O25b/ST131 clone producing CTX-M-15 among E. coli isolates belonging to the B2 phylogenetic group. ST131 clone in phylogenetic group B2 was detected based on PCR detection of ST131-specific single-nucleotide polymorphisms in mdh and gyrB. O25b/ST131 E. coli clone was confirmed utilizing O25b/ST131 clone allele-specific PCR for the pabB gene. All group B2 E. coli isolates were characterized based on antibiotic susceptibility, extended-spectrum β-lactamase (ESBL) enzymes, and virulence traits. Our results demonstrated that 38 out of the 154 B2 group isolates (24.7%) were identified as belonging to the ST131 clone. Furthermore, of these, 28 isolates (73.6%) were detected as O25b/ST131 clone. Antibiotic resistance of ST131 E. coli isolates to ciprofloxacin, gentamicin, cefotaxime, and aztreonam was significantly higher than non-ST131 isolates. Almost all of the O25b/ST131 isolates with the ability for ESBL production were reported as CTX-M-15 producing (95.5%). Our results showed that the most prevalent virulence trait in ST131 clone was ompT (94.7%). This study is the first to report the prevalence of the CTX-M-15-producing O25b/ST131 E. coli in Iran. Our findings reinforce the surveillance of dissemination of ST131 E. coli clone as a major drug-resistant pathogen and an important new public health threat.

Financial support from the Research Council of Alzahra Universityis gratefully acknowledged. It is our honor to thank technical advising of colleagues at Medicinal Plants and Drug Research Institute of Shahid Beheshti University, Tehran, IRAN. This publication represents a component of the PhD thesis of Nazanin Ataee at the faculty of Microbiological Science of Alzahra University, Tehran, IRAN.

The aim of this study was to find biocatalyst which uses thebaine and extract of different parts of Papaver bracteatum to synthesize morphine alkaloids. The thebaine-resistant strains were obtained from microbial flora of different parts of P.bracteatum. They were purified and treated utilizing different concentrations of thebaine. Those that can grow at a concentration of over 500 µg/ml were chosen for the biotransformation experiments. Biotransformation experiments were carried out utilizing selected cells in the medium containing thebaine and/or the extract of P.bracteatum; the products of such biotransformation were extracted and the profiles of metabolites were evaluated using HPTLC, and LC/ESI-MS methods. Thereafter, the effective isolate for thebaine transformation was characterized by physiological, biochemical and biomolecular methods. The results show that among 67 isolates, 12 strains were selected using the HPTLC screening as candidates that can transform thebaine into codeine and morphine. Among them, 5 strains were identified to transform plant extract, among which, using LC/ESI-MS, a candidate was selected and identified as Bacillus sp. FAR. It can be concluded from this study, that this microbial flora candidate can transform thebaine into important narcotic drugs and it will be a valuable step in biotechnology.

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.

Objectives The recent expansion of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is a worldwide problem. The purpose of this study was to investigate the molecular characteristics of ESBL-producing E. coli strains in Mashhad, located in the northeast of Iran. Methods A total of 455 clinical E. coli isolates were collected at three hospitals in Mashhad between April–September 2015. Antimicrobial susceptibility was determined by the Kirby–Bauer disk diffusion test. The combination disk test was performed for phenotypic detection of ESBLs. PCR was used to screen isolates for ESBL typing. Phylogenetic groups and sequence type 131 (ST131) were determined by multiplex PCR. Results The prevalence of ESBL-producing E. coli among the collected strains was 51.6% (235/455). Among the 235 ESBL-producing strains, 222 (94.5%) tested positive for CTX-M type, whilst 115 (48.9%), 92 (39.1%) and 21 (8.9%) were positive for TEM, OXA and SHV, respectively. Moreover, CTX-M-15 (94.1%; 209/222) was the most common ESBL among E. coli. Based on multiplex PCR, phylogenetic group B2 was predominant (169/235; 71.9%), followed by D (32/235; 13.6%), A (21/235; 8.9%) and B1 (13/235; 5.5%). ST131 was the predominant clonal group among the phylogenetic group B2 isolates (151/169; 89.3%). Conclusion The results revealed that an urgent investigation of the source and transmission pathways of the CTX-M-15-B2-ST131 E. coli clone is needed to mitigate this emergent public-health problem.

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

Leishmaniasis is one of the most important diseases transmitted by arthropod. This disease is present in 88 countries. Approximately 400 million people are at risk, and 12 million are involved. We aimed to examine the application of ethanolic extract of the root bark of Berberis vulgaris L. for treatment of mice infected with cutaneous leishmaniasis. At first, 40 BALB/c mice were infected to Leishmania major promastigotes and were divided in two groups A and B. Then, each of A and B groups were divided to two subgroups. Mice from subgroup A1 were treated with 10 % root bark alcoholic extract, and mice from subgroup A2 were treated with only alcohol (control). Mice from subgroup B1 were treated with 20 % root bark alcoholic extract, and mice from subgroup B2 were treated with only alcohol (control). The 90 % recovery was found in the mice treated with 20 % root bark extract, and 55 % recovery was found with 10 % root bark extract, but in the control group, 0 % recovery was found. The results of our study showed that the lotion of root bark extract has good suppression effects on parasites. Therefore, it might be a pro for developing new antileishmanial drugs.

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