Objective: To design a rapid test to detect the rifampin (RIF) and isoniazid (INH) resistant mutant based on polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) technique that analyzes the katG, rpoB genes.Methods:tuberculosis. To determine the susceptibility of isolates to anti TB drugs, the proportional method was used. Mutations presented within the amplified products of the katG, rpoB genes were evaluated by SSCP.Results:Using proportional method, 12 (11.6%) and 9 (8.7%) isolates were resistant respectively Biochemical test as well as IS6110 targeting PCR revealed 103 clinical samples were to INH and RIF and 9 (8.7%) isolates showed resistance to both drug (multi-drug resistant tuberculosis). Three (2.9%) multi-drug resistant tuberculosis and two INH resistant isolates were detected by the PCR-SSCP and sequencing. The sensitivity and specificity of PCR-SSCP for multi-drug resistant isolates were 33% and 100%, respectively.Conclusions:Complete agreement between SSCP and sequencing can indicate that resistance-associated mutations have occurred in other genes except our considered genes.

PURPOSE: Field of view and voxel resolution of cone beam computed tomography (CBCT) might affect the diagnostic capability. This study was performed to compare between the standard and HiRes zoom modes in the diagnosis of external root resorption (ERR) using CBCT. MATERIALS AND METHODS: Sixty three small cavities (0.25 mm depth and 0.5 mm diameter) were simulated on the buccal, lingual, and proximal surfaces at three different levels of 16 roots of teeth. After covering the root with nail varnish, the roots were inserted in the sockets and the model was placed in a water-containing lacuna. CBCT scans were taken in both standard and HiRes zoom modes using NewTom VG (QR srl Company, Verona, Italy). Then, an observer assessed the images to determine the presence or absence of the cavities. This process was repeated by increasing the size and depth of cavities to 0.5 mm depth and 1 mm diameter. Data were analyzed by McNemar test. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio in evaluation of the simulated cavities were calculated. RESULTS: There was a significant difference between the two imaging modes in diagnosing the shallow cavities (p=0.02).The sensitivity of the standard zoom in detecting the shallow cavities was lower than that of the HiRes zoom. The likelihood ratio of the HiRes zoom was higher in the diagnosis of both cavity types. CONCLUSION: This study suggested that a smaller voxel size in the HiRes zoom mode of CBCT is preferred for diagnosis of ERR.
Cone-Beam Computed Tomography ; Nails ; Paint ; Root Resorption ; Sensitivity and Specificity ; Tooth

PURPOSE: Antenatal hydronephrosis (AH) is found in 0.5%-1% of neonates. The aim of the study was to assess the urinary concentrations of 3 biomarkers, endothelin-1 (ET-1), monocyte chemotactic peptide-1 (MCP-1), and N-acetyl-glucosaminidase (NAG) in severely hydronephrotic neonates. MATERIALS AND METHODS: Neonates with a history of prenatal hydronephrosis were enrolled in the prospective study in 2 groups. Group 1 included neonates with severe forms of obstruction requiring surgical intervention and group 2 included neonates with milder forms of obstruction without any functional impairment. Fresh voided urinary levels of ET-1, MCP-1, and NAG were measured and their ratios to urinary Cr were calculated. RESULTS: Fourty-two neonates were enrolled into the 2 groups: group 1, 24 patients (21 male, 3 female); group 2, 18 neonates (16 male, 2 female). There were no statistically significant differences between urinary ET-1, NAG, MCP-1 values, and ET-1/Cr and NAG/Cr ratios in groups 1 and 2. The urinary MCP-1/Cr ratio was significantly higher in group 1 than in group 2. For comparison of groups 1 and 2, the cut-off values were measured as 0.5709 ng/mg (sensitivity, 75%; specificity, 67%; positive predictive value [PPV], 71%; negative predictive value [NPV], 71%), 0.927 ng/mg (sensitivity, 77%; specificity, 72%; PPV, 77%; NPV, 72%), and 1.1913 IU/mg (sensitivity, 62%; specificity, 67%; PPV, 68%; NPV, 60%) for ET-1/Cr, MCP-1/Cr, and NAG/Cr ratios, respectively. CONCLUSIONS: The urinary MCP-1/Cr ratio is significantly elevated in neonates with severe obstruction requiring surgical intervention. Based upon these results, urinary MCP-1/Cr may be useful in identification of severe obstructive hydronephrosis in neonates.
Acetylglucosaminidase/*urine ; Biological Markers/urine ; Chemokine CCL2/*urine ; Endothelin-1/*urine ; Female ; Humans ; Hydronephrosis/*congenital/etiology/surgery/ultrasonography ; Infant, Newborn ; Male ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Ureteral Obstruction/complications/*diagnosis/surgery

Adult ; Analgesics, Opioid ; adverse effects ; Humans ; Male ; Serotonin Syndrome ; chemically induced ; Tramadol ; adverse effects

OBJECTIVES: The aim of this study was to investigate the diagnostic value of a stress coping scale for predicting perceived psychological traumatic childbirth in mothers. METHODS: This cross-sectional study was performed on 400 new mothers (within 48 hours of childbirth). Psychological traumatic childbirth was evaluated using the 4 diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders. Coping was measured using Moss and Billings' Stress Coping Strategies Scale. RESULTS: The overall mean score of stress coping was 29 ± 14.2. There were 193 (43.8%) mothers that had experienced a psychological traumatic childbirth. A stress coping score ≤ 30, with a sensitivity of 90.16 (95% CI = 85.1–94.0), and a specificity of 87.44 (95% CI = 82.1–91.6), was determined as a predictor of psychological traumatic childbirth. So that among mothers with stress coping scores ≤ 30, 87% had experienced a psychological traumatic childbirth. CONCLUSION: Investigating the degree of coping with stress can be used as an accurate diagnostic tool for psychological traumatic childbirth. It is recommended that during pregnancy, problem-solving and stress management training programs be used as psychological interventions for mothers with low levels of stress control. This will ensure that they can better cope with traumatic childbirth and post-traumatic stress in the postpartum stage.
Cross-Sectional Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Mothers ; Parturition ; Postpartum Period ; Pregnancy ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic

The present study was done to scrutinize the possible relation between infective genes and antimicrobial resistance in Enterococcus faecalis and Enterococcus faecium. Considering the fact that the presence of recognized infective determinants among clinical isolates may promote the emergence of infections and persistence of Enterococci in hospital settings, which can lead to an increase in antimicrobial resistance. 175 E. faecalis and 67 E. faecium isolated from clinical specimens were used. The isolates were identified, and then antibiotic susceptibility testing was performed. The MIC of vancomycin and teicoplanin were determined by broth microdilution method. The presence of infective genes esp, hyl and asa₁ was scrutinized using PCR. Of the 280 enterococcal isolates, 175 (62.5%) isolates were identified as E. faecalis, 67 (24%) as E. faecium and 38 (13.5%) as Enterococcus spp. The results of the antibiotic susceptibility testing showed resistance rates of 5% and 73% to vancomycin and teicoplanin in E. faecalis and E. faecium isolates, respectively. The statistical analysis showed that the esp infective gene has significant associations with ciprofloxacin, erythromycin and tetracycline in E. faecium and with chloramphenicol in E. faecalis strains; the hyl with teicoplanin and vancomycin in E. faecium strains; and also asa₁ with vancomycin in E. faecium and with ampicillin and chloramphenicol in E. faecalis strains. Regarding the relationships between virulence genes and antibiotic resistance in strains of E. faecalis and E. faecium, detection of infective factors associated with invasive diseases has become a major issue of concern.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Ciprofloxacin ; Drug Resistance, Microbial ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Iran ; Methods ; Polymerase Chain Reaction ; Teicoplanin ; Tetracycline ; Vancomycin ; Virulence

Volatile constituents obtained by water distillation from the aerial parts and root of Onosma dichroanthum Boiss (Boraginaceae) native to the north of Iran were investigated by GC and GC/MS for the first time. Palmitic acid (39.61%) and decane (31.39%) were the major components in the root while decane (26.26%) and phytol (25.52%) were the predominant constituents in the aerial parts. Ketones, aldehydes, alkanes, fatty acids, oxygenated diterpenes and sesquiterpenes were characterized as the most phytochemicals in the aerial parts. Alkanes and fatty acids were identified as the main groups in the root volatile substances. There were two ketone derivatives, belong to apocarotenoids, in the aerial parts; β-ionone and hexahydrofarnesyl acetone.

Toxoplasma gondii is an important opportunistic agent especially in immunocompromised hosts and can cause significant morbidity and mortality. Hence, detection and monitoring of anti-Toxoplasma antibodies are of a great interest in HIV-infected patients. A study on the prevalence of toxoplasmosis and associated risk factors was carried out among HIV-infected patients in Jahrom, southern Iran. The prevalence of anti-Toxoplasma IgG antibodies was 21.1% in HIV-infected patients by ELISA. PCR was performed on all of the samples, and 1 of the blood samples was positively detected. Among the HIV patients, anti-Toxoplasma IgG antibodies were significantly higher in age group of 30–39 years old (P=0.05). The seroprevalence of toxoplasmosis in patients with CD4+<100 cells/μl was 33.3% that was significantly higher than the other groups (P=0.042) with or without IgG antibodies. The CD4+ count mean of seropositive patients was lower than that of seronegative patients. The seroprevalence of toxoplasmosis in patients with highly active antiretroviral therapy was significantly less than patients without therapy (P=0.02). In conclusion, this study showed low seroprevalence of latent toxoplasmosis among HIV-infected patients in the region and confirmed the need for intensifying prevention efforts among this high-risk population and also the risk of toxoplasmosis reactivation which could be important among this population.
Antibodies ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Enzyme-Linked Immunosorbent Assay ; HIV* ; Humans ; Immunocompromised Host ; Immunoglobulin G ; Iran* ; Mortality ; Polymerase Chain Reaction ; Prevalence ; Risk Factors ; Seroepidemiologic Studies* ; Toxoplasma* ; Toxoplasmosis

OBJECTIVES: Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures. METHODS: This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships. RESULTS: Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term. CONCLUSIONS: The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.
Air Pollution* ; Birth Rate ; Carbon Dioxide ; Developing Countries ; Environmental Pollution ; Fertility ; Health Expenditures* ; Humans ; Infant ; Infant Mortality ; Iran* ; Jurisprudence ; Public Health

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
Case-Control Studies ; Child ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Humans ; Incidence ; Iran ; Logistic Models ; Mortality ; Poisoning ; Risk Factors