JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2017 | Volume:26 | Issue:145|Papers Count:50

Background and purpose: Congenital Myasthenic Syndrome (CMS) is a rare genetic disease with autosomal recessive inheritance pattern which is caused by mutations in the COLQ gene. Molecular diagnosis of the disease using direct mutation analysis is expensive and time consuming. Alternatively, linkage analysis using Single Nucleotide Polymorphic markers (SNP) provides a suitable method in carrier detection and prenatal diagnosis of the disease in families with an affected individual. The aim of this study was to investigate the informative situation of rs6442530 marker in COLQ gene.Materials and methods: In this experimental study, using bioinformatics investigations, rs6442530 marker located in intron 1 of COLQ gene was selected for genotyping studies. For this purpose, 152 healthy individuals from Isfahan population were genotyped using ARMS PCR technique. Then the allelic frequencies, the Hardy-Weinberg equilibrium and heterozygosity of the marker were estimated using the Genepop software. Finally the amount of Polymorphism Information Content (PIC) was computed by PIC Calculator software for the marker.Results: The results indicated 43.4% Minor Allele Frequency (MAF), 48.684211% heterozygosity rate and 0.3706 PIC for rs6442530 marker in Isfahan population. Hardy Weinberg Equilibrium showed the presence of equilibrium for rs6442530 in this population.Conclusion: Together, according to the results (MAF>0.2 and PIC close to 0.375) rs6442530 marker could be suggested as an appropriate marker for molecular diagnosis of CMS in Isfahan population.

Background and purpose: Chronic lymphocytic leukemia (CLL) is characterized by clonal proliferation and accumulation of long-lived B lymphocytes within the peripheral blood, bone marrow, and secondary lymphoid organs. In this study, immunophenotypic characteristics of leukemic cells and their association with disease prognosis were investigated in CLL patients.Materials and methods: A case-control study was carried out in 25 CLL patients and 15 healthy individuals. Complete blood count was performed for all subjects. CLL patients were classified into different clinical stages based on the Rai staging system. For immunophenotypic characterization of leukemic cells, peripheral blood mononuclear cells (PBMCs) were isolated from CLL patients and stained using specific monoclonal antibodies. They were then analyzed by flow cytometry.Results: The CD5, CD19, CD20, and CD23 were expressed significantly more in advanced clinical stages of CLL compared to those in primary stages (P=0.03, 0.01, 0.02, and 0.02, respectively). The mean fluorescence intensity (MFI) of CD38 in advanced progressive stages of CLL patients was higher than that of primary non-progressive stages (P=0.02).Conclusion: Our results indicated significant immunophenotypic profile and higher CD38 expression in CLL patients with advanced clinical stages. These immunophenotypic characteristics are useful biomarkers for the disease monitoring and therapy.

Background and purpose: Endothelial growth factor type b with anti-angiogenic activity and inhibition of tumor growth are considered as new anticancer drugs. The aim of this research was to study the expression of vegf111b in HEK293 human cells.Materials and methods: In this experimental study, HEK293 cells were transfected by pBUD.VEGF111b vector containing the VEGF111B gene through lipofectamine method. The mRNA of transfected cells and control cells were extracted and cDNA was built over it. Then, the expression levels of vegf111b were measured using Real time- PCR.Results: Transfection of HEK293 cells was successfully done and 48 hours after transfection of HEK293 cells, ct of the vegf111b expression in transfected cells was 23.17 and ct of the GAPDH control gene expression in these cells was 21.11. In the control (untransfected) cells the ct of GAPDH was 21.09 and there was no expression of vegf111b in these cells.Conclusion: Expression of Vegf111b recombinant protein in HEK293 cells is the first step for further research on this protein. Current study has provided the possibility of using this product for future research on angiogenesis and cancer treatments.

Background and purpose: Incidence of breast cancer is increasing day by day. Scientists are interested in the effects of inhibition of breast cancer cell on treatment of this cancer. The aim of this study was to determine IC50 of doxorubicin in 24 hours on cell lines MCF-7 and MDA-MB-231 and the expression of heat shock protein HSP90a as a factor in the cell before and after 24 hours exposure to doxorubicin in both breast cancer cell lines.Materials and methods: A descriptive interventional study was done in two cell lines MCF-7 and MDA-MB-231' after 24 hours exposure to doxorubicin. Sensitivity of cells to doxorubicin was determined using MTT Assay in excel software. HSP90a heat shock protein expression were qualitatively compared in both cell lines before and after exposure to doxorubicin using immunofluorescent techniques (Immunocytochemistry).Results: MTT Assay showed that IC50 value in MDA-MB-231 and MCF7 cells after 24 hours exposure to doxorubicin (the dose that kills 50% of cells) were 14.521 and 16.3315mM, respectively. Immunocytochemistry revealed that HSP90a protein expression in both cell lines after exposure to doxorubicin decreased compared to the control group.Conclusion: Cell density in cell lines (ER-) MDA-MB-231 and line MCF-7 (ER+) after exposure to doxorubicin and increasing the dose of medication, decreased indicating a dose dependent effect. Also, apoptosis occurred in both cell lines and expression of HSP90a decreased but MDA-MB-231 cells were found to be more sensitive.

Background and purpose: Skin cancer is one of the most common types of cancer. Several studies suggest a high incidence of skin cancer in most countries. TIMP-2 is the tissue inhibitor of matrix metalloproteinase and exist in both cancer and normal cells. The aim of this study was to investigate the expression of TIMP-2 gene in patients with skin cancer and evaluating the association between the expression of this gene and the disease progression.Materials and methods: In this study 60 FFPE samples of skin cancer (n=30) and noncarcinoma cases (n=30) were collected from Tehran Milad Hospital. The cancer patients aged 30 to 80 years old. RNA was extracted using RNX solution, and then cDNA synthesis was carried out by Oligo dT and Random Hexamer primers and MMulV enzyme. The gene expression was evaluated by Real-time PCR.Results: The TIMP-2 gene expression in carcinoma samples increased 1.13 folds compared to normal tissue samples. Also a direct correlation was seen between tumor size and TIMP-2 gene expression. In fact the gene expression in tumors= 2 cm was more than 6.72 compared with normal samples (P<0.0005). The mean expression levels of TIMP-2 gene in tumors<1 cm and 1-2 cm were 0.57 and 1.003, respectively (P<0.001). Moreover, the TIMP-2 gene expression was found to be higher in male.Conclusion: According to current findings, expression of TIMP-2 gene has a considerable role in skin cancer development. In other words, the gene expression increases by increase in tumor size and patients age. So, it seems that TIMP-2 gene expression could be a reliable biomarker for evaluation of skin cancer in early stages.

Background and purpose: Fasciola hepatica and Fasciola gigantica are common liver flukes which affect both human and livestock worldwide. In this study we evaluated the loop-mediated isothermal amplification (LAMP) assay for detection and discrimination of Fasciola species.Materials and methods: Fifty adults of Fasciola worms were isolated from sheep and cattle liver form abattoirs in Mazandaran province. A total of 8 primer sets for LAMP was designed to amplify the 28S ribosomal RNA gene of Fasciola sp. Conventional LAMP was carried out in a 20mI reaction mixture under isothermal condition at 60oC for 90 minutes. Amplification result was observed by monitoring the turbidity by naked-eye, using fluorescent dye and gel electrophoresis. The specificity of LAMP method for detecting Fasciola sp. was tested by amplification of Dicrocoelium dendriticum, Trichostrongylus colubriformis, and Echinococcus granulosus DNA templates. To evaluate the detection limit of LAMP assay in detecting Fasciola genus, serial dilution of the extracted DNA was used.Results: A positive LAMP reaction by the specific primers of two species produced many bands of different sizes in 600C after 90 min. The optimal assay conditions were established with no reaction with other parasites’ DNA. The detection limit of this LAMP assay was 1 pg DNA/tube. The result of turbidity and fluorescent dye detection were consistent with agarose gel electrophoresis. Conclusion: Our results demonstrated that LAMP is a rapid, cost-effective, highly specific, easy, and reliable method for differentiation of Fasciola sp. in epidemiological and clinical researches on human and domestic animals in endemic regions of fasciolosis.

Background and purpose: In recent years nanotechnology has a significant impact on various fields of human life, especially in pharmaceutical and medical needs. Some biopolymers such as chitosan which is also biocompatible are low cost and abundantly found, so, their application for vaccine production is cost benefit. Trimethyl chitosan is a deacetylated derivative of chitosan that could be used to increase the induction of immune response. In this study, trimethyl chitosan nanoparticles containing tetanus protein were used to stimulate the immune system.Materials and methods: In this experimental study, synthesis of the tetanus toxoid loaded nanoparticles was done by ion gelation method. Physical features of the nanoparticles were investigated using scanning electron microscopy (SEM). The nanoparticles were then injected subcutaneously into mice. After the sampling process, the immune system stimulation was evaluated using indirect ELISA. Data was analyzed using one-way ANOVA and significance level of P<0.05.Results: The purity of protein was confirmed by SDS-PAGE and encapsulated proteins were loaded up to 80 percent. ELISA results showed that the immune system was stimulated significantly compared with Freund adjuvant, and antibody titer increased.Conclusion: Tetanus toxoid loaded Trimethyl chitosan nanoparticles increase the stimulation of immune system and are more effective in comparison with Freund's adjuvant.

Background and purpose: Sternal Wound Infection (SWI) is a serious complication of median sternotomy that increases the rate of mortality. We report our experience of managing SWI in a regional cardiothoracic unit in Mazandaran province, Iran.Materials and methods: We prospectively studied 4725 patients who underwent isolated coronary artery bypass grafting between March 2012 and March 2015. Information about age, sex, morbidities, surgical factors and nature of sternal wound infection were recorded. Treatment options were stratified by nature of infection, and timing and nature of management. Data analysis was done using Med calc soft ware and p-values less than 0.5 were considered significant.Results: Sternal wound infection occurred in 49 (1%) patients. There were 26 (0.55%) superficial and 23 (0.48%) deep SWIs. SWI patients were found to be mainly females, with diabetes or hypertension, high body mass indices and longer aortic cross-clamp time. All patients with superficial SWI were managed by skin debridement and closure. Patients with deep SWI who had surgery within 48 hours of diagnosis were managed using skin and bone debridement and sternal rewiring following mediastinal drain. The mortality rate was found to be high in patients with SWI (12.2%).Conclusion: Low sternal wound infection can be achieved with an ongoing focus on appropriate infection control. SWI significantly increases the risk of mortality which could be reduced through early intervention.

Background and purpose: Interferon beta-1b recombinant protein is used for reducing the relapse rate and treatment in patients with Multiple sclerosis (MS). In this study, phylogenetic and in silico analysis of interferon beta-1b were conducted by servers and bioinformatics tools to predict its structural potential.Materials and methods: Physiological and physico-chemical characteristics of interferon beta- 1b protein were evaluated by ProtScale and ProtParam servers, respectively. The 3D structure of the interferon beta-1b protein and its interaction with other proteins were studied using Swiss-Model server and the STRING platform, respectively.Results: The results of the phylogenetic analysis showed that the human interferon beta protein is closest to Daubenton's bat in the amino acid structure by 96%. The in silico analysis of interferon beta 1b protein implied the existence of signal peptide and lack of the transmembrane domain. The results of post-translational modification predictions showed that protein acetylation and phosphorylation may occur in some regions of interferon beta-1b protein. The analysis of the protein networking of interferon beta-1b revealed more interactions between this protein and interferon receptor 1 (IFNAR1) and interferon regulatory factor 3 (IRF3).Conclusion: In Silico analysis showed that interferon beta-1b, is a protein with effective regulatory role but unstable in vitro. This bioinformatic analysis of interferon beta-1b protein can provide the groundwork for practical tests and future functional studies.

Background and purpose: Increased pressure in the pulmonary circulation is of the major factors causing cardiac disorders in patients with thalassemia. The aim of this study was to investigate the relationship between splenectomy and pulmonary arterial pressure in individuals with beta- thalassemia major.Materials and methods: A cross-sectional study was carried out in patients with betathalassemia attending Hajar Hospital Shahrekord, Iran, 2015. All patients underwent echocardiography and the hemoglobin levels, platelet count, ferritin, pressure, pulmonary arterial pressure, etc. were measured. Data analysis was done in Stata 13.Results: Among the variables measured, the average age, hemoglobin level, platelet count, nucleated RBC, lactate dehydrogenase, tricuspid regurgitation flow, pulmonary arterial pressure, right diameter, main pulmonary diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter were found to be higher in patients with splenectomy, compared to those of the patients without splenectomy (P>0.05). Significant correlation was observed between platelets, NRBC and the time of splenectomy with pulmonary artery pressure (P< 0.05), but the correlations between other parameters including hemoglobin and LDH with pulmonary arterial pressure was not significant (P>0.05).Conclusion: The results showed that splenectomy could increase the susceptibility to pulmonary artery pressure in patients with beta thalassemia major or lead to the progression of pulmonary hypertension in this disease.

Background and purpose: Sleep disorders in children with cerebral palsy (CP) are complex and challenging. The aim of this study was to investigate sleep disorders in children with CP based on gross motor function levels.Materials and methods: This cross-sectional study was conducted in 76 children with CP (aged 6 to 15 years old) attending rehabilitation centers in Arak, Iran 2016. The participants were recruited by convenience sampling. The Sleep Disturbance Scale for Children (SDSC) was applied. Data analysis was performed in SPSS V.18 using descriptive statistics, T-test, and Chi-square test.Results: There were no significant differences between sleep disorders and sex and types of CP (P>0.05). But, a significant difference was found between sleep disorders and gross motor function levels (P<0.05). The most common sleep disorders were difficulty in initiating and maintaining sleep (DIMS) and sleep-disordered breathing (SDB) that were seen in the children with quadriplegic spastic in the level of V more than those with other types of CP.Conclusion: The results showed that severe level of gross motor disability (the severity of motor impairment) is related to sleep disorders in children with CP. more training is suggested for children with CP and their caregivers for improving their sleep function.

Background and purpose: Temporomandibular disorders (TMD) are manifested as a group of signs and symptoms diagnosed by pain, and malfunction of temporomandibular joint (TMJ) and masticatory muscles. The role of etiologic factors such as stress and occlusal interferences has gained much attraction. In this study, we assessed the incidence of TMD and its relationship with stress and occlusal interferences in individuals attending Sari Dental School Clinic, 2014-2015.Materials and methods: In this descriptive-analytical study 68 people (41 females and 27 males) were selected. Occlusal interferences were assessed by clinical examinations and the stress levels of the participants were determined by The Taylor Manifest Anxiety Scale (TMAS). The relation between TMD and other variables were analyzed by Chi-square and exact fisher tests. Data was analyzed in SPSS V. 22.Results: Of the total population studied 51 (75.0%) had TMD. Among TMD patients one (1.9%) had low-level stress, 30 (58.8%) had moderate-level, and 20 (39.2%) were found to have high-level stress. No significant relationship was found between TMD and stress. In TMD group, 13.7% did not have centric interferences; 70.6% showed interferences up to arch of closure, and 15.7% had interferences up to line of closure. Significant relationships were found between TMD and interferences of working side (P<0.03), protrusions (P<0.0001), arch of closure interferences (P<0.03), and interferences of nonworking side (P=0.01).Conclusion: Temporomandibular disorders were found to be more prevalent among the population studied. No relations were found between TMD and stress while TMD incidence was related to some occlusal interferences.

Background and purpose: Retinitis Pigmentosa (RP) is one of the retinal degeneration diseases affecting the eye signals. Electroretinogram (ERG) is a signal that plays an important role in diagnosis and treatment of RP. This signal includes useful information that cannot be revealed just in time domain. We aimed to investigate the effect of RP on time, frequency, and time-frequency parameters of ERG using the Fourier and wavelet transform processing methods.Materials and methods: In this experimental study Flash Xenon ERG was recorded from 18 eyes of RP patients and 20 eyes of healthy individuals. After extracting the latency and amplitude of the ERG signals, the Fourier and wavelet transforms were performed on the signals by MATLAB software. Then, the frequency mode and main frequencies along with the occurring time constituting the ERG signals were extracted. Finally, the differences between the means of all parameters were analyzed.Results: Findings indicated an increase in the latency and a decrease in amplitude of the ERG. But, no significant difference was found between the mean frequency mode of the RP patients and healthy individuals. A significant decrease was observed in the main constituent frequencies of the ERG signals and their occurrence time. In addition, with further development of the disease in the RP patients, one or two main frequencies were omitted.Conclusion: RP disease can cause variations in time and time-frequency components of the ERG signals. By applying the wavelet transform on the ERG signals of the RP patients to convert their indices into frequency domain, the position of the retina affected mainly by this disease can be found.

Background and purpose: Obesity in childhood can cause obesity and its associated health problems in adulthood. This study aimed at determining the prevalence of obesity and some related factors in high school male and female adolescents in Zanjan, Iran.Materials and methods: This cross-sectional study was conducted in 1366 adolescents aged 12 to14 years who were randomly recruited from high schools in Zanjan, 2013. The weight, height and the body mass index (BMI) of all participants were measured. A researcher made questionnaire was used to record information including birth history, feeding pattern, family history of obesity, and sleeping and activity times.Results: The participants included 57.1% (n=780) females. Among the girls and boys 4.5% and 3.1% were found to be obese, respectively. The prevalence of overweight and obesity was 12.2% and 3.9%, respectively. There was a significant relationship between obesity and birth weight, formula or breastmilk feeding, time of starting solid foods, family history of obesity, physical activity, time spent watching TV, taking snacks, and having rice during a week (P<0.05).Conclusion: High prevalence of obesity and overweight among adolescents in Zanjan calls for efficient programs to prevent childhood obesity. Therefore, families should be provided with necessary information about healthy lifestyle and nutrition.

Background and purpose: One of the most common postural disorders in today’s societies is the forward head posture (FHP) that is associated with numerous musculoskeletal complications. Considering sternocleidomastoid attachments to the neck, it seems that it would be negatively influenced by such postural deviations. The aim of this study was to compare the sternocleidomastoid muscle thickness in women with normal head posture (NHP) and FHP.Materials and methods: A case-control study was done in which 18 female students (mean age 24.5±3.3) with FHP and 18 female controls (mean age 23.4±2.5) with NHP were participated. Bilateral sternocleidomastoid muscle thickness were measured in supine position in both groups using ultrasonography. Data analysis was carried out in SPSS V.16.Results: There was no significant difference in thickness of sternocleidomastoid between individuals with FHP and NHP (P>0.05). Also, no significant difference was seen between the two groups in muscle thicknesses on either side of the neck (P>0.05). In other words, thickness was found to be symmetric on both sides of the neck in both groups.Conclusion: According to the results, FHP did not impose any morphological changes on sternocleidomastoid muscle at the fifth cervical vertebral level. Although measurement of the thickness of this muscle in other vertebral levels is recommended for future studies.

Background and purpose: Salivary gland neoplasms are heterogeneous and have low prevalence. Hematoxylin- eosin staining is used for their diagnosis, however, sometimes diagnosis may not be made by this method, so other methods are necessary. The aim of this study was to determine whether morphometry is an appropriate method in differentiating benign and malignant salivary tumors or not.Materials and methods: A cross-sectional study was done (in Babol Dental School, 2015) in which 60 paraffin embedded blocks of pleomorphic adenoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma were used. Two 5-micron sections were cut for hematoxylin-eosin and methyl green-pyronin staining. Images of stained slides of tumoral components were acquired at 100x magnification on an Olympus BX41, Japan Optical, in three microscopic thin-sections using lgvc camera, Tokyo, Japan which was connected to a computer. An average of 100 nuclei were examined in three microscopic fields. Morphometric and qualitative evaluation of the nucleoli (single- nucleolus and multinucleolar) were performed and data analysis was done applying Kruskal-Wallis and Mann-Whitney tests.Results: The maximum area of nucleus was detected in pleomorphic adenoma and the maximum area of cytoplasm was seen in mucoepidermoid carcinoma. The highest ratio of nuclear to cytoplasmic area and the highest ratio of large to small nuclear diameter were observed in adenoid cystic carcinoma and pleomorphic adenoma, respectively. There were significant differences between three lesions in terms of morphometric characteristics mentioned (P<0.001).Conclusion: The results indicated that histomorphometry using methyl green pyronin staining is not useful in differentiating the benign and malignant salivary gland tumors.

Background and purpose: In this study, we evaluated the protective effects of hydroalcoholic extract of Nasturtium officinale (watercress) against GM-induced mitochondrial dysfunction on isolated rat kidney mitochondria.Materials and methods: In this study, 36 Wistar rats were divided into six groups (n=6 per group): control, solvent, GM (80 mg/kg IP), and GM and three doses (50, 100, 200 mg/kg/day, IP) of hydroalcoholic extract of aerial parts of watercress. After 10 consecutive days of injection, the animals were killed and kidney tissues were separated. Then, the mitochondria were isolated using different centrifuge technique and the parameters of mitochondrial damage were evaluated.Results: Administration of GM for 10 days resulted in decrease in mitochondrial function in MTT test and also the glutathione content in kidney isolated mitochondria. Compared with the control group, increase in lipid peroxidation and mitochondrial swelling was observed in GM group. The Nasturtium officinale extract could significantly reduce (dose dependent) the increase in glutathione oxidation, lipid peroxidation and mitochondrial swelling due to GM on kidney isolated mitochondria.Conclusion: With the considering the protective effects of Nasturtium officinale in attenuating GM-induced mitochondrial damage, it can be suggested for prevention of pathological condition caused by mitochondrial damage.

Background and purpose: Diabetes mellitus is a metabolic disorder caused by deficiency of insulin secretion (type I) or dysfunction of insulin (Type II). Investigating the efficacy of natural compounds in treatment of various diseases such as diabetes could be so useful. So, we studied the antidiabetic effects of methanol extract of Trametes versicolor on male mice.Materials and methods: T. versicolor was collected from jungles of Neka (Mazandaran, Iran) and extracted with methanol. Thirty male mice were randomly divided into 6 groups (n=5 per group) as following: group I: nonediabitic (normal), group II, III, and IV were diabetic groups that received T. versicolor extract at 500, 1000, and 1500 mg/kg. Group V and VI were also diabetic groups that received 6 U/Kg insulin (Biphasic Isophane) and 0.9% normal saline, respectively. Diabetes was induced by intraperitoneal administration of streptozotocin (50 mg/kg body weight). Blood samples were taken 24 hr after the last injection. After centrifugation, the serum was isolated for measuring the levels of glucose, ALT, AST, ALP, cholesterol, triglycerides, BUN, creatinine, and HDL. Homogenized liver tissue (0.1 g) were also prepared for histological examination.Results: Compared with the control group, significant reductions were seen in serum glucose, triglycerides and ALT levels in treatment groups receiving the methanolic extract of T. versicolor (P<0.05). Moreover, pathology studies showed lower destruction of liver tissue in these groups. Conclusion: The results showed that the methanol extract of T. versicolor might be effective in prevention of diabetes and have a protective effect on liver tissue.

Background and purpose: Diabetes is one of the major factors that affects fertility and ovulation and can disrupt the formation of fetus. Omega-3 polyunsaturated fatty acids might be able to improve the quality of the embryo in maturation of oocytes. The aim of this study was to investigate the effects of omega-3 on ovarian tissue and the development of blastocysts in diabetic rats.Materials and methods: In this study, 32 adult female rats were divided into 4 groups (n=8 per group) including controls, diabetic, diabetic+ Omega-3 (300mg/kg /day), and diabetic+ Omega-3 (600mg/kg/day). Diabetes was induced by intraperitoneal injections of Streptozotocin (50 mg/kg). Omega-3 was administered by gavage for 45 days. Then PMSG (IU, IP25) was injected and 54 hours later HCG (IU, IP25) was injected. Afterwards, the ovarian samples were used in vitro fertilization.Results: Compared with the control group, diabetes significantly reduced the percentage of healthy follicles, percentage of zygote, two cell embryos, blastocysts, and hatching embryos (P<0.05). Data analysis revealed that administration of omega-3 fatty acids in diabetic rats increased the percentage of healthy follicles and parameters associated with fertilization and embryo development in vitro compared with the diabetic group that did not receive omega-3 (P<0.05).Conclusion: Due to the harmful effects of diabetes on pregnancy, omega-3 fatty acids has the ability to inhibit the adverse effects of diabetes on the ovaries, thereby increasing the chances of fertility.

Background and purpose: Nerve growth factor (NGF), as neurotrophin, has a role in response of hypothalamic-pituitary-adrenal axis to stress. In this study, we investigated the role of NGF by inhibiting nerve growth factor anxiety-like behaviors induced by forced swim stress in rats.Materials and methods: In this experimental study, 24 male Wistar rats (200-250 g) were randomly divided into four groups (Control group: vehicle group and treatment groups: 10, 50 and 100 mM of AVG 879 tyrphostin). Intraventricular injection of vehicle and AVG 879 is exerted before force swim stress. Morris water Maze was used to investigate anxiety levels. Data was analyzed by STATISTICA V 5.5 usig ANOVA test.Results: The duration time in closing arm reduced in the group that received AG-879 at low concentrations (10 and 50 mM) (P< 0.05), while it increased in the group that received Tyrphostin at 100 mM (P<0.05). Also, the time duration in the open arm significantly increased in rats that had AG- 79 at 10 and 50 mM, but at 100 mM of the drug this parameter decreased (P<0.05).Conclusion: Exposure to stress increased anxiety-related behavior. Compared with the control group, anxiety-like behaviors reduced in the groups that received nerve growth factor inhibitor.

Background and purpose: In recent years, consumption of commercial protein supplements and hormones that improve body appearance endangers the health of athletes especially in bodybuilding sport. Recently, use of plant extracts to reduce the side effects of drugs and improving physical activity has gained a lot of attention. The aim of this study was to investigate the effect of a supplement (mixture powder of Fenugreek seeds, rhizomes of Ginger and Alhaji manna) on increasing muscle strength and body composition in athletes in Mashhad, Iran, 2015.Materials and Methods: A quasi-experimental study with pretest and posttest design was carried out in which 40 male athletes were selected using stratified random sampling. The participants had at least one year activity in fitness clubs. They were divided into control and experimental groups (n=20 per group). The experimental group performed specific exercises for six weeks and had a daily intake of 5 grams of the supplement (in non-training days and one hr before the exercises). Data analysis was done in SPSS V.20 applying Mann Whitney and Wilcoxon tests.Results: The Wilcoxon test showed that taking the supplement in six weeks of bodybuilding exercises increased the factors influencing body composition and muscle strength in the experimental group (p≤0.05).Conclusion: According to this study, a mixture powder of Fenugreek seeds, rhizomes of Ginger and Alhaji manna is helpful in improving muscle strength and body composition in athletes.

Background and purpose: Nowadays consumers are cautious about foods and are more interested in foods that are less processed. This has led to significant approaches and replacing chemical preservatives in food products by different natural components. The essential oil of Satureja edmondi is used as a flavoring agent and known as a pharmaceutical plant because of its antimicrobial characteristics. Nisin is also an antibacterial peptide that is widely used to inhibit microbial growth in food products. The aim of this study was to investigate the inhibitory effects of Satureja edmondi individually and also in combination with bacteriocin nisin on the growth of Staphylococcus aureus in hamburgers.Materials and methods: Hamburger samples were inoculated with 5x103 CFU/g of S. aureus. Nisin treatment at 0.5% and essential oil of Satureja edmondi treatment at 0.01%, 0.02%, and 0.04% were prepared individually and in combination with nisin. The treated and control samples were packaged and kept at -12oC for 63 days. The samples were cultured on Baird-Parker Agar and the number of S. aureus were counted every seven days.Results: Compared to the control group, all treatments could significantly inhibit the growth of bacteria during the storage period. Simultaneous use of nisin and essential oil of Satureja edmondi increased bactericidal effects too.Conclusion: Results revealed simultaneous use of 0.5% nisin and 0.04% essential oil of Satureja edmondi as the best treatment that could reduce the bacterial population. Also, sensory analysis revealed that 0.04% of the essential oil was not found pleasant by testers.

Background and purpose: Enterococci as a group of bacteria infecting raw foods and dairy products can contaminate different food products. The purpose of this study was to isolate strains of enterococci based on the Real time PCR method using melting curve analysis in food samples.Materials and methods: In this experimental study, 510 samples were collected from which 138 different samples (chicken, meat, milk, and cheese) containing different strains of enterococci were investigated. Then, identification of Enterococcus species was performed by targeting specific sites and specific primers were designed according to Real time PCR-based melting curve analysis.Results: Based on melting curve analysis by Real Time PCR, the Enterococcus species identified were as follows: E.faecalis in 84 isolates (60.86%), E.faecium in 48 (34.78%), E.gallinarum in 1 (0.7%), E.avium in 4 (2.8%), and E.Caselli flavus in 1 isolate (0.7%). The most frequent isolates were detected in 29 samples of chicken meat (51.44%) and red meat (n=21, 24.63%). Considering the results of sequencing as a Gold a standard test, the sensitivity and specificity of phenotypic methods for E.faecalis, E.faecium, E.gallinarum, E.avium, and E.Caselli flavus were 94.78% and 90.74%, 89.13 % and 97.77 %, 50% and 98.52%, 66.66% and 98.52%, and 50% and 98.56%, respectively. A significant relationship was observed between the sample and distribution of Enterococcus species (P≤0.05).Conclusion: Due to extensive viability error in identification of Enterococcus species isolated from food by phenotypic methods, using a rapid and sensitive method is necessary.

Background and purpose: Mycotoxins are a group of toxic compounds produced by several species of fungi and aflatoxins are the most important toxins. M1 and M2 which are derivatives of aflatoxin B1 and B2 are resistant against thermal changes, such as pasteurization, sterilization and autoclave and their concentration will not decrease. They are transmitted to humans by milk and milk products and threaten the health of human and society. The aim of this study was to determine aflatoxin M1 in buffaloes milk in Ahvaz and Karoon, Iran using ELIZA method.Materials and methods: In a cross-sectional study, 60 milk samples were randomly collected from two farms with large number of buffalos, in autumn. ELISA method was used to evaluate of aflatoxins the samples.Results: The average level of aflatoxin M1 in two selected locations was (155.91 ng/l) which was more than standard level in Iran and the Codex Alimentarius.Conclusion: According to this research, there was a strong relationship between presence of toxin in milk with the animals’ diet and method of storing their foods.

Background and purpose: Today, due to improvement and progress of human knowledge in food industry, plastic coatings such as PET (polyethylene terephthalate) that has unique characteristics are widely used for food and beverage packaging such as water and doogh. Phthalate esters are used in order to improve flexibility, efficiency and sustainability of materials. Chronic exposure with such materials play a role in incidence of many diseases and cancer in human. The aim of this study was to investigate the presence and concentration of phthalates in different brands of doogh.Materials and methods: In this study, we synthesized multi-walled magnetic carbon nanotubes using iron oxide. Then, the synthesized magnetic nanotubes were used for absorption and extraction ofphthalate esters from doogh matrix. After sample preparation, the concentration of each phthalate esters was measured by GC-MS.Results: Concentration of phthalate esters in all samples were found to be lower than the standard levels but DEHP had the highest concentration. Statistical analysis showed no significant differences between the concentration of phthalate esters in different brands and storage time of doogh.Conclusion: According to these findings and low concentration of each phthalate ester compared with standard levels in different types of doogh, it has no health effect on consumers.

Background and purpose: Using catalysts to enhance the efficiency of the ozonation process (known as catalytic ozonation process) has received much attention in recent years. This study aimed at examining the overall feasibility of using catalysts ozone as catalyst in ozonation process for decolorization and mineralization of a real textile wastewater in presence of persulfate.Materials and methods: This experimental study was conducted on a laboratory scale reactor using a semi-batch mode. The effect of persulfate, ozone flow rate, reaction time and catalytic dose in dye and COD was investigated in an optimal state of textile wastewater. To obtain optimization test, the experiment was performed by fractional factorial method at three-level factorial (3k-p) with a high resolution (VI).Results: In this study, 15 min contact time (P = 0.006) and 0.5g/L dose of catalyst (P=0.029) had the best effect on color removal. Moreover, the interaction of these parameters were found to be significant (P=0.025). The optimum condition for color removal was achieved at 15 min reaction time, ozone flow rate of 2 L/min, 1.5 mM persulfate and catalyst dosage of 0.5 g/L. Optimum efficiency removal for color and COD in textile wastewater were 96% and 75%, respectively.Conclusion: Application of nano-magnesium oxide with ozone in presence of persulfate showed synergistic effect and buffering property in decolorization and mineralization of textile wastewater. It also increases the efficacy of color removal and improves mineralization so, there would be no need for pH adjustment.

Background and purpose: The aim of this study was to evaluate the quality of wastewater treatment plant effluent in Qazvin (Alvand) industrial area for discharge into the environment and reuse.Materials and methods: The study was conducted over a period of nine months in 2015-2016. Ninety samples of wastewater were collected to determine the concentrations of BOD5, COD, TSS, TC, FC, and heavy metals (lead, cobalt, and Cd). The levels of pollutants were evaluated according to the standards of Iran Environmental Protection Agency for discharge to the environment and reuse.Results: The mean concentration of COD in the effluent during autumn, winter and spring were 145.20±52.66 mg/L, 316.50±279.80 mg/L, and 177.00±124.2mg/L, respectively. The average concentration of BOD5 were found to be 79.40±26.76 mg/L, 154.25±122.86mg/L, and 72.00±13.74 mg/L in autumn, winter, and spring, respectively. The mean values for total coliform and fecal coliform were 6x102 MPN/100 mL and 6.21x102 MPN/100 mL, respectively. The average lead and cobalt concentrations were found to be 0.21±0.11 mg/L and 0.004±0.003 mg/L, respectively. The cadmium concentration was reported to be minimal.Conclusion: Current results showed that the wastewater quality conformed with EPA's standards for reuse, but the use of wastewater for agriculture, due to the biological and cumulative effect of some elements, should be done based on health principles.

Background and purpose: Comprehensive evaluation of jobs in industries is a practical and effective method that could identify the jobs and industries with negative effects on the environment. This study identified environmental hazards of hot rolling process and assessing their risks.Materials and methods: An observational study was carried out in which identification of human activity and job´s risks in production hall of Kavir Steel Complex was done according to ISO 14001 approaches (pollutant emissions to air, discharges to water, energy consumption, energy released as heat, wastes, side products, etc) by Job Hazard Analysis method (JHA). Then the risks identified were prioritized and assessed using William Fine method.Results: We identified 205 environmental hazards (in 9 groups) associated with production personnel (n=81), mechanics and maintenance personnel (n=44), bed personnel (n=9), personnel of cleaning services (n=33), and water plant personnel (n=38). The highest and lowest rate of risks were due to creation and distribution of wastes (n=73) and corrosion and depreciation of equipment, (n=1), respectively.Conclusion: The production personnel were mainly responsible for environmental emissions. The leading causes were stress and anxiety about stoppage of production, payment reduction, and lack of awareness and workers and supervisors on environmental issues.

Background and purpose: Shadegan wetland as the largest wetland in Iran is constantly exposed to hydrocarbons entering through the main entrance of the lagoon including Jarahi River, outbursts of seasonal rivers from upstream, Persian Gulf tides from downstream, atmospheric deposition, and possible leaks from oil pipelines. The aim of this study was to investigate toxicity and identifying the sources and spatial distribution of polycyclic aromatic hydrocarbon (PAH) in surface sediments of the study area for its appropriate management.Materials and methods: Sediment samples were collected (in 2015) from 202 stations at the top 5 cm of the sediment according to a systematic-random sampling design. The concentrations of PAHs were analyzed by GC–MS.Results: The total PAHs (sum of 30 PAH compounds) ranged from 593.74 to 53393.86 ng/g dw. The results of diagnostic ratios indicated that the study area was highly contaminated by petrogenic hydrocarbon sources. The concentrations of PAHs in this research were substantially higher than those found in many other aquatic systems and significantly more than current sediment quality criteria (ERL).Conclusion: High levels of petrogenic contamination were found in sediments of Shadegan wetland. A vast majority of the study area (90%) is subjected to chronic pollution of oil contaminants that could adversely affect benthic biota.

Background and purpose: Death depression is a common phenomenon among cancer patients that many factors could influence it. Therefore, the aim of this study was to determine the factors and finding an influencing path out of death depression.Materials and methods: A cross-sectional study (April to July, 2016) was done in 497 cancer patients who were recruited from those attending Cancer Centers in Sari (Imam Khomeini Hospital) and Kerman, Iran. The patients were selected by convenience sampling. Data was collected using demographic questionnaire, death depression scale, and Pargament's religious coping scale (the RCOPE).Results: The mean age and death depression score of cancer patients were 48.38±15.22 and 69.92±18.40, respectively. Multiple linear regression analysis showed economic status (b=5.37), cancer stage (b=-2.80), and religious coping behaviors (b=-0.34) as predictive variables of death depression. Path analysis revealed that economic status and cancer stage had both direct and indirect impacts on death depression but religious coping behaviors directly influenced death depression.Conclusion: According to the model identified by path analysis, religious coping behaviors is the only variable that has a direct impact on the level of death depression which is influenced by the stage of cancer. However, economic status and stage of cancer could explain the death depression by direct and indirect influences.

Background and purpose: Alongside men addiction, the rate of women addiction is increasing. But most studies on this subject are about men. Because addiction among women is on the rise, research is needed to be done on identifying the factors influencing addiction. This research investigated the psychological factors predisposing women to addiction.Materials and methods: This study was a qualitative study using thematic analysis. Purposive sampling of 32 women dependent on drugs was done. They were selected from those attending addiction clinics in 2015-2016. Data was collected using deep interviews. They were then coded and classified into main categories.Results: Data analysis showed that the following psychological factors could predispose women to addiction: personality characteristics including sensation seeking, neuroticism, perfectionism; harmful coping styles including emotional and avoidant coping styles; psychological conflicts including conflict in goals, gender role conflict, self conflict; negative experiences such as loss of parents, parental neglect, violence, emotional breakdown; and individual motives including physical or mental benefits.Conclusion: This research indicated that particular psychological factors could predispose women to addiction. Therefore, the factors causing this problem should be considered in preventing or treatment of these women.

Background and purpose: In hemodialysis patients, medication prescribed is essential to preserve their health and welfare, but adherence to medications is difficult. The aim of this study was to explain the experiences of patients undergoing hemodialysis about drug consumption. Materials and methods: A qualitative content analysis was conducted in Kowsar Hospital,Semnan, Iran. Twenty patients were selected using purposive sampling and semi-structured interviews were performed to obtain the relevant information. Data collection and analysis were done using Granheim and Lundman, 2004 content analysis. The accuracy and trustworthiness of the study were determined according to Lincoln and Guba criteria.Results: The main theme was "lack of adherence to medication" and the following categories: 'factors related to patients" with 'psychological dimensions', 'participation', 'lack of awareness about the benefits of drugs', and ' financial restrictions and frustration' as the sub-categories. "Factors related to medication" with 'challenges in consumption of drugs' as the sub-category. "Factors related to the health care system" with 'shortage of nurses', 'cumbersome adherence to laws and regulations' and 'adequate social support ' as the sub-categories.Conclusion: Lack of adherence to medication is a modifiable threat to health in hemodialysis patients, therefore, interventions and strategies that can motivate and promote adherence to medication could be of great benefit. So, health care authorities should take appropriate actions to improve patients’ management on adherence to medication.

Background and purpose: Papaver rhoeas L (family: Papaveraceae) is commonly known as corn poppy. Recent studies have revealed that Papaver rhoeas L extract has cytotoxic, genotoxic, and antioxidant effects. The present study aimed at evaluating the cytotoxic effect and antioxidant activity of Papaver rhoeas L. methanolic extract on monkey kidney carcinoma cell lines (Vero).Materials and methods: Methanolic extract of Papaver rhoeas L. was prepared by maceration method. Cultivated cell line Vero was incubated with different concentrations (0, 10, 50, 100, 500, and 1000μg/ml) of the extract for 72 hours and cell growth inhibition was determined using MTT assay. The antioxidant capacity was assessed using two methods: DPPH and ferric reducing ability of plasma (FRAP). The total phenolic and flavonoid contents were also determined.Results: The IC50 of cisplatin, as a common drug, is significantly lower than that of the Papaver rhoeas L. (IC50=15.96±0.26 mg/ml). Our results showed that Papaver rhoeas L. extract caused a significant decree se in proliferation in monkey kidney cancer cell line (IC50=80.07 mg/ml). The scavenging effect of the extract on DPPH radical was found to be 5.74 mg/ml. The extract’s ferric reducing ability of plasma was 2.663±0.002 mg/ml. Also, the extract had more total phenolic content rather than flavonoid contents.Conclusion: This study showed that methanolic extract of Papaver rhoeas L. has potent cytotoxic effect on cancer cell line Vero and considerable antioxidant activity. But further investigations are required to identify efficient compounds and molecular mechanism of this extract so that effective steps could be taken towards finding new drugs in treatment of diseases.

Background and purpose: Biological studies on marine fauna, especially invertebrates, has significantly increased in recent years which led to the identification of many different bioactive compounds. The sea cucumber are echinoderms with a very muscular body wall that contains 70% collagen and is considered a rich source of protein. Based on recent researches on bioactive compounds extracted from sea cucumber, it was found to have cytotoxic, antioxidant, anti-tumor, and anticoagulationproperties.Materials and methods: In this experimental study, enzymatic hydrolysis method was used to study the anticoagulant properties of hydrolysates protein in muscles of sea cucumber. Finally, the anticoagulant properties of hydrolysates protein on the human blood plasma was examined by the Activated Partial Thromboplastin Time anticoagulant test (APTT) in two concentrations (90 and 130 mg/ml), and Prothrombin Time (PT) in different concentrations (220, 440, 670, and 900 mg/ml).Results: The total amount of hydrolysates protein was found to be 55.8 mg/g in wet tissue. The results of anti-coagulation assays showed that the hydrolysates protein of the sea cucumber muscle contains anticoagulant properties on human blood plasma and could prolong the clotting time.Conclusion: Peptides from the hydrolysis in sea cucumber muscle have anticoagulant properties as already reported for heparin-like compounds.

Background and purpose: Hypertensive disorders of pregnancy are still one of the major issues in obstetrics. So far, few studies are conducted on the troponin I level of pregnant women and preeclampsia but their results are not conclusive. In this study the troponin levels were compared between patients with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure.Materials and methods: A case control study was conducted in four groups of pregnant women (n=35 per group) with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure attending Kosar Center, Qazvin, Iran 2014-2015. The troponin I level in the groups were studied. Data was analyzed in SPSS V.19 applying ANOVA, Chi-square, and T-test.Results: The mean age of patients was 29.1±6.6. The level of troponin was lower than 0.01 ng/ml in patients with severe preeclampsia, mild preeclampsia, gestational hypertension and normal blood pressure. But in one case with severe preeclampsia this level was 0.15. The findings indicated no significant difference between the groups (P=0.4)Conclusion: The level of troponin was not different in patients with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure.

Background and purpose: Gastrointestinal complications in mechanically ventilated patients with feeding tube is common and causes feeding intolerance. Discharge of gastric gases is believed to reduce these complications. This study aimed at assessing the effect of gastric gases discharge on gastrointestinal complications in ICU patients on mechanical ventilation with feeding tube.Materials and methods: A single-blind randomized controlled clinical trial was performed in 64 patients undergoing mechanical ventilation with CPAP mode in Shahid Kamyab Hospital, Mashhad, Iran in 2015. In experimental group gastric gases were discharged through a nasogastric tube but the control group did not receive any intervention. Gastrointestinal complications including abdominal distention, diarrhea, and vomiting were compared between the two groups before and after the intervention.Results: There was no significant difference between the two groups in incidence of diarrhea (P=0.23) and vomiting (P=1.00) but the groups significantly differed in distention (P=0.004).Conclusion: Discharge of gastric gases in patients on mechanical ventilation decreases gastric distention. Therefore, this method could be used in such cases but further studies are suggested to clarify its application.

Background and purpose: Gender dysphoria is a disorder that causes problems for families and societies. This research compared the level of social adjustment between mothers of transgender children and mothers of normal children. The purpose of this study was to investigate whether having a transgender child has or has not a negative effect on social adjustment of mothers. This research compared the level of social adjustment between mothers of transgender children and mothers of normal children. The purpose of this study was to investigate whether having a transgender child has or has not a negative effect on social adjustment of mothers.Materials and methods: In a case-control study 80 mothers with transgender teenagers (n=40) and normal children (n=40) were randomly selected from those attending Tehran Psychiatry Institute. The Social Adjustment Scale (Weissman & Paykel) was used which investigates social adjustment in seven main areas.Results: The results showed a significant difference between social adjustment in mothers of transgender children and mothers of normal children (P<0.001). We found no significant difference between social adjustment and demographic variables, age, mothers’ age, length of marriage, mothers’ educational level, number of children, and birth order.Conclusion: In this study social adjustment of mothers of transgender children was less than that of mothers with normal children.

Background and purpose: Oral Rehydration Therapy (ORT) is recommended in cases of mild to moderate dehydration for better treatment of acute diarrhea in children. This study aimed at assessing the knowledge and attitudes of physicians working in health centers and emergency departments in Mazandaran province about ORT in children with acute diarrhea.Materials and methods: In a cross-sectional study, in 2014-2015, 258 physicians were randomly selected from Mazandaran province. Relevant information were collected including the method/s for evaluation of patients, management of complications, and adherence to national protocol and the protocol of World Health Organization (WHO).Results: In our study 27.6% of the participants had attended courses on ORT and their information about treatment of diarrhea was significantly higher than that of other doctors who did not pass similar courses (P= 0.009). More than 50% of physicians had appropriate information about ORT and administration of ORS, antibiotic therapy, and home treatment of dehydration. But more than 50% of physicians did not have enough information about the new protocol of ORT. The most common  reasons for not using ORT was faster response to IV therapy and lack of acceptance of ORT by families.Conclusion: In this study, only about one-third of the physicians attended courses on ORS, therefore, more attention and planning is needed for participation of physicians in this courses.

Osteoid osteoma is a benign bone tumor that occurs most frequently in long bones such as femur and tibia. The spine is a rare localization of osteoid osteoma and the coccyx even more exceptional. We report a case of osteoid osteoma of the coccyx in a young man with sacrococcygeal pain which was relieved by salicylates. Computed tomography, bone scan and magnetic resonance imaging of the region demonstrated a typical osteoid osteoma lesion. After the operative curettage of the tumor, the pain and clinical symptoms dramatically stopped. Since coccygeal osteoid osteoma is a very rare condition, the disease may be confused with other common lesions such as traumatic lesions. Therefore, in chronic pains, further investigation by CT scan of the coccyx area is essential to rule out osteoid osteoma.

Post-hysterectomy vaginal cuff dehiscence in premenopausal patients and rectal prolapse during sexual intercourse are very rare. This phenomenon is potentially more dangerous than hysterectomy. In this report, a 49 year old premenopausal woman is presented with post-hysterectomy vaginal cuff dehiscence after vaginal intercourse.he was previously underwent laparoscopic hysterectomy because of uterine bleeding. Fifty one days after the surgery, she experienced bleeding following a couple of successive sexual intercourses. The patient observed an intestine-like rope that was stretched out of her vagina. The clinical examination showed vaginal cuff dehiscence (1.5-2 cm) and rectal prolapse into the vaginal entrance.Post-hysterectomy vaginal cuff dehiscence is very rare. Despite the fact that this event is rarely observed, it should be regarded as one of the life-threatening complications of hysterectomy.

Background and Purpose: Lipoid Proteinosis (LP) is a rare hereditary progressive disorder caused by a disorder of collagen metabolism. In LP, hyaline deposits in mucous membrane of true vocal folds causes hoarseness. The studies on the laryngeal and voice features of patients with LP are rare. To the best of our knowledge, this is the first research to study acoustic and perceptual voice features in two Iranian children with LP.Materials and Methods: Two children (siblings) were assessed. The main voice complaint was hoarseness. Voice samples were recorded and acoustically analyzed by Praat. Furthermore, perceptual voice assessment was performed according to the GRBAS scale.Results: Acoustic measurement represented increase in f0, jitter, and shimmer in both children. Furthermore, mean scores of the GRBAS for all voice parameters were more than 60. Conclusion: Current study is the first research that describes the voice features of Persian subjects with LP. Comprehensive understanding of the etiology in voice problems helps speech and language pathologists to provide appropriate clinical services considering the nature of pathological condition to clients.

Background and purpose: The choice of antifungal agent in treatment of Candida urinary tract infections (CUTI) is dependent on the site of infection, the underlying disease of the patient, and the pharmacokinetics/pharmacodynamics (PK/PD) of the agent. This study aimed to perform a review of antifungal therapy for CUTI.Materials and methods: Data was obtained by a search for full-text articles in Medline, PubMed, Embase, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, Irandoc, and Iran Medex published from 1994 until 2016. The search keywords included urinary tract infections, Candida species, diagnosis, and treatment.Results: Fluconazole is the drug of choice for prophylaxis and treatment of CUTI due to low toxicity, high solubility, and wide tissue distribution. Although flucytosine is concentrated in urine and has potent activity against Candida species, treatment is restricted because of its toxicity and expansion of resistance when it is used alone. In addition, amphotericin B is an active drug against most Candida species (except resistant C. krusei strains). Other azoles and echinocandins are not effective for treating CUTI due to the minimum excretion of the active compound into the urine. However, a localized renal infection followed by blood spreading might be treated by echinocandins because of its effective tissue concentrations.Conclusion: We presented diagnostic tests and treatment protocols of CUTI, but new surveillance protocols and diagnostic strategies for control and prevention of CUTI in critically ill patients are essential.