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Background and purpose: Pharmacovigilance is a science that focuses on the detection, assessment, and prevention of adverse drug reactions (ADRs) in the post-marketing phase. Its back bone is spontaneous reporting by health care workers via completing the yellow cards. Due to the low reporting of ADRs in the Mazandaran province, this study was designed to evaluate the knowledge, attitude and performance of pharmacists and nurses regarding ADRs reporting.
Materials and Methods: This descriptive study was done on 286 health care workers including 67 pharmacists and 219 nurses, selected randomly from different cities of the province. The standard questionnaire of European pharmacovigilance research group was used as the data collection tool. In the field of knowledge, definition of pharmacovigilance, awareness of the national criteria for reporting the ADRs and awareness about the terminology occurrence rates of ADRs were questioned. To evaluate the attitude, reaction of subjects to the some simulated ADRs and reasons of underreporting were assessed. In the field of performance, numbers of reported ADRs and also the sites where reports sent from were asked. Data were analyzed using independent sample t-test for quantitative variables and Chi-square and Kendall’s tau-b for nominal and ordinal variables, respectively using SPSS software. P< 0.05 was considered as significant level.
Results: There was no satisfying knowledge in each of the two groups. In spite of exposure of more than 80% of subjects to the ADRs, the mean reported ADRs values for pharmacists and nurses were very low as 0.72 ± 2.8 and 0.17 ± 0.67 respectively (P<0.01). Nurses liked to report most of ADRs to the physicians, nursing stations and pharmacist in spite of the national center. Considering these reports, they were more active than the pharmacists (P<0.001). The main causes of underreporting of the suspected ADRs were not being sure about the causative effect of the drug, unawareness of the existence of a national center, the ADRs were too well known to report and the ADRs were too trivial.
Conclusion: Since most of the heath care workers were not familiar with the spontaneous reporting system, interventions such as presenting pharmacovigilance workshops in the hospitals of the province focusing on the aims of pharmacovigilance, completing the yellow card, clarifying the reporting criteria and also considering the pharmacovigilance in the training courses of students are recommended.

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Background and Purpose: The clinical and epidemiologic features of Kawasaki disease (KD) suggest an infectious etiology however, the agent(s) remain unknown. Our purpose was to isolate the causative bacterial gene from peripheral blood leukocytes of patients with acute KD, by Universal polymerase chain reaction (UPCR), in Tehran Children’s Medical Center.
Materials and Methods: Universal polymerase chain reaction (UPCR) assay was used to amplify the bacterial 16S ribosomal RNA gene (rDNA).
Results: Forty three (28 boys and 15 girls) were diagnosed with acute Kawasaki disease included in this study. The median age at diagnosis was 3.5 years (range: 0.5 –9 years). Twenty Nine (29) cases had typical KD criteria and 14 patients had atypical KD at diagnosis. Two of the 43 KD patients were positive for the Universal PCR assay for 16S rRNA, prior to intravenous g-globulin therapy (IVGT), while all specimens were negative by conventional blood culture. In our study, there was fever in 100%, conjunctivitis in 62.7%, rash in 83.72%, oral mucosal changes in 76.74%, peripheral changes in 37.20%, and cervical lymphadenopathy in 39.53% cases.
Conclusion: The 16S rDNA sequence was positive in 4.65% of acute KD patients this data shows that an infectious KD agent is traced in peripheral leukocytes. The question remains as to what true frequency of the16S rDNA sequence in KD is.

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Background and purpose: Diabetes type 1 is a chronic disease in children during their childhood, which may have unfavorable effects on children, family and society. By enhancing self- care in children having diabetes type 1, we can reduce these effects. Self- care in children also can be affected by factors such as family reaction. The purpose of this research is to determine the relationship between self-care in diabetic children and their family’s reaction.
Materials and methods: This research is a non- experimental and correlative study which determines and specifies the relationship between diabetic self- care in children, who are affected by diabetes and their family’s reaction. 133 children between the ages of seven to fourteen suffering from diabetes type 1 were chosen with above continuous method for two months from selected centers. Collecting information, observation and questionnaire forms were used.
Results: The results obtained from this study, showed there is a meaningful relationship between child's self- care and reaction of their family (p=0.000). Variants such as age, sex, rank of birth and length of disease period are not considered as an interfering element in relation between self caring and family reaction.
Conclusion: The results from this research reveal that the self caring of children in an average level has a direct influence and relationship with family reaction and at the same time, the direct and strong correlation with the diabetic child’s knowledge regarding their functions and performances. We suggest that educational programs should be provided for these children and their families, in order to promote self caring of children and their family’s reaction. We also propose conducting similar research, by using case- control method, to identify other factors in this regard.

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Background and purpose:Adverse drug reactions (ADRs) are one of the leading causes of morbidity and mortality, worldwide. Mortality rate due to ADRs are ahead of pulmonary disease, AIDS, pneumonia and automobile accidents. This study evaluated the admission rates in a University teaching hospital related to ADRs.
Materials and methods:During this retrospective study between 2001 and 2007, all patients admitted due to adverse drug reaction in Sari Bo-Ali Sina Hospital were evaluated.
Results:In these years, 31 patients out of 71,680 were admitted, due to ADRs. Most common ADRs were skin reaction (74%) and fever (22%). Phenobarbital and penicillin were the most common drugs causing ADRs.
Conclusion:Only 0.04% of hospital admissions were drug related, while reported admission due to ADRs in other countries were 2.4 to 6.2%. It appears that less drug-depended hospital admissions in Iran rational drug administration, but are due to lack of enough detection, records and reporting procedures.

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Background and purpose: The association of nasopharyngeal carcinoma (NPC) and Epstein-Barr virus (EBV) was firmly established as early as 1973. A clear understanding of its etiology is still lacking, but nasopharyngeal carcinoma is widely suspected to be the result of both a genetic susceptibility and exposure to environmental factors or Epstein-Barr virus infection. NPC is more prevalent in young age and Iran is a country with young population, therefore we set forth to study the level of infection with EBV. Materials and methods: A 25-person group of NPC patient as the case group and a 25-person group of patients considered to be at risk of developing NPC as the control group were studied. DNA extraction of the tissue samples kept at hospital and laboratory archives was done as template in PCR. Results: The mean ages of patients in case and control groups were 44.64 and 32.28 years, respectively. In case group 23 patients were positive for EBV-DNA while in control group 12 patients were positive for EBV-DNA. Conclusion: Our data demonstrates that EBV is present at the site of tumor development in low-risk population. This survey supports the concept of NPC pathogenesis as a multifactorial process.

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Background and purpose: TNFα, ÇRP, and ÏL-6 are new cardiovascular inflammatory markers that an increase in their concentration results in an increase in cardiovascular diseases. This study is designed to compare the effect of a single acute exercise on plasma TNFα, ÇRP and ÏL-6 in immature obese and normal-weight boys.
Materials and methods: Â quasi-experimental study was designed and 21 healthy boy students of 11-14 years old were selected based on systematic randomization. Then, they were assigned into two groups of obese (77.07 ± 17.33 kg) and normal-weight boys (54.7 ± 8.28 kg). Âfter a five-minute warm-up, every participant started cycling on ergometer cycle with 65-70% of his maximum oxygen uptake (VÔ2 max) for 40 minutes, and then he ended his exercise with a five-minute cool-down. Blood samples were taken before, immediately and one hour after exercise to measure TNFα, HS-ÇRP, and ÏL-6 levels. Data were analyzed using the independent T-test, analysis of variance with repeated measures (R-ÂNÔVÂ) test, and the LSD post hoc test.
Results: Ït was shown that the level of ÇRP, TNFα, and ÏL-6 in obese boys were significantly higher than that of the normal-weight group in all three times of measurement (P<0.05).
Çonclusion: The results of this study showed that exercise with 65-70% of VÔ2 max can increase inflammatory factors in immature obese and normal-weight boys. Thus, exercise can stimulate their inflammatory and immune responses and increase the level of some of the mentioned markers.

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Background and purpose: Mupirocin is a topical antibiotic. This antibiotic can inhibit most of gram-positive cocci. Shortly after consuming the antibiotic mupirocin, resistance has emerged. The main purpose of this study was to determine mupirocin resistance in Staphylococcus strains isolated from nosocomial infections in the city of Arak. Material and Methods: A total of 150 Staphylococcus isolates (sensitive and resistant to methicillin S.aureus, coagulase negative staphylococcus) were subjected to the present study. In this study, 150 isolates of staphylococci were examined. PCR amplification of Sa442 gene was used as the identification marker for the confirmation of phenotypic diagnosis through biochemical and biological methods. In order to determine the presence of mecA gene in S. aureus isolates that were resistant to methicillin. All isolates were tested for mupirocin susceptibility by a disc diffusion method according to CLSI guideline. The minimum inhibitory concentration (MIC) was determined by an E-test and they were also analyzed by a PCR for the presence of ileS-1, mupA and mupB genes. Results: Among the 150 strains examined, 11 isolates were known resistant in disc diffusion and E-test. PCR result indicated that one isolate contains gene ileS-1, four isolates contain genes mupA and 6 strains containing both genes mupA and ileS-1. There was no strain that contained genes mupB and PCR results were fully consistent with the results of the E-test. Conclusion: This is a report of low frequency of mupirocin resistance in the city of Arak. This result illustrated that the prescription of mupirocin by physicians in this geographical region is limited. However, incorrect use can lead to rise in resistant rate. In addition, the combination of phenotypic methods and PCR for the detection of resistance to mupirocin is recommended.

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Background and purpose: Ovarian tumor is a common neoplasm of the female genital tract and one of the most lethal gynecologic malignancies. The etiology of ovarian cancer remains unclear. Oncogenic viruses can contribute in different stages of the carcinogenic process. Papilloma viruses are Oncogenic viruses that could induce proliferation of epithelial cells. Materials and methods: In this study samples were 50 Paraffin-embedded blocks of ovarian carcinoma tissue and 58 normal Paraffin-embedded blocks (without malignancy) as control group. After DNA extraction, all samples were analyzed to detect beta-globin gene and suitable samples were screened for presence of L1 HPV-Common. The data was analyzed using one-way ANOVA in SPSS 15. Results: All positive samples for beta-globin gene were amplified by HPV-common primers. Among the samples seven of 44 (15.90%) ovarian carcinoma and five of 50 (10%) normal ovarian tissue were found positive for the common marker of HPV. Overall, 12 of 94 samples were positive (12.76%). The correlation between HPV infection and ovarian cancer was not statistically significant (p= 0.397). Conclusion: No significant correlation was found between HPV infection and ovarian cancer. Therefore, the results of this study do not confirm the role of HPV in ovarian cancer.

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Background and purpose: Staphylococcus aureus is the most common causes of hospital and community acquired infections. Nasal carriage of S. aureus in staff provides a source for infection in hospitalized patients. The aim of this study was to evaluate the spa gene patterns of clinical and nasal carriage isolates of S. aureus using polymerase chain reaction. Materials and methods: Clinical specimens and staff nasal swab were collected from Tehran university hospitals. S. aureus isolates were identified by cultural and biochemical methods. The evaluation of spa gene patterns of S. aureus isolates was carried out from staff nasal carriage and clinical specimens of patients using polymerase chain reaction. Results: A total of nine patterns of spa gene were distinguished. Seven and five different patterns were identified from S. aureus nasal carriage and clinical specimens, respectively. Conclusion: The presence of similar patterns from spa gene may indicate a common source of infection in the hospital wards. Analysis of the patterns may help to break the chain of transmission of infection in hospitals.

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Background and purpose: Breast cancer is one of the most common malignancies in women and early diagnosis of this cancer is a key element for successful treatment. Breast cancer is a multistep disease in which a virus can play a role. Epstein-Barr Virus (EBV) is identified as an important factor in human cancer. This study investigated the relationship between EBV and breast cancer. Materials and methods: Sixty seven paraffin-embedded tissue blocks of breast cancer were used and 53 paraffin blocks of non-cancerous breast tissue (26 fibroadenoma and 27 fibrocystic) were collected as the controls. DNA was extracted using the Roche kit, then all samples were analyzed for the presence of beta-globin gene and suitable samples were evaluated for the existence of DNA-EBV through Polymerase Chain Reaction (PCR). X2 test of homogeneity and SPSS ver.15 were used to analyze the data. Results: Two cases negative for beta-globin gene in paraffin-embedded tissue blocks of breast cancer were excluded from the study. EBV was detected by PCR in 23 (35.38%) cases of breast cancer specimens and in 11 (20.75%) cases among the control samples (7 fibroadenoma and 4 fibrocystic). From the total of 118 samples 34 cases (81.28%) were found positive. Conclusion: This study found significant correlation between EBV infection and breast cancer. Further epidemiological, biological and molecular assessments are needed to confirm the possible association between this virus and the process of carcinogenesis.

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Background and purpose: Chlamydia trachomatis and Neisseria gonorrhoeae are the most common causes of sexually transmitted infections. The aim of this study was detection of N. gonorrhoeae and C. trachomatis in patients with symptomatic urethritis using Multiplex PCR, gram stain and urine culture. Materials and methods: This cross sectional study was conducted in 137 patients with symptomatic urethritis, referring to Yasuj Sahid Mofateh Clinic. After completing a demographic questionnaire, 10-15 ml of first void urine was obtained. After centrifugation of the urine, sediments were used for polymerase chain reaction based on plasmid primers and then cultured on chocolate agar medium. The data was analyzed using descriptive statistics and Chi-square test. Results: The patients included 28 (20%) male and 109 (80%) female. The frequency of infection with C. trachomatis and N. gonorrhoeae was 3.65% and 5.11%, respectively. N. gonorrhoeae was detected in two (7.14%) male and five (4.65%) female and C. trachomatis was observed in two (7.14%) male and three (2.6%) female. No coinfection with C. trachomatis and N. gonorrhoeae was detected. Using culture, gram stain and Multiplex PCR for detection of N. gonorrhoeae we found 5.11, 4.38 and 5.84% positive cases, respectively. Through Multiplex PCR assay for detection of C. trachomatis 3.6% of the cases were found positive. Conclusion: The results of this study showed a relatively low frequency of C. trachomatis and N. gonorrhoeae in Yasuj.

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Background and purpose: Dihydropyrimidins are bioisoester of dihydropyridine. In addition to blocking of calcium channels, they have antimicrobial, antiviral, antifungal, antiparasital and antiinflammatory activities. Monastrol is an anticancer dihydropyrimidine derivation that inhibits mitosis. Several marine alkaloids with dihydropyrimidine skeletal have been isolated. In this study, several compounds with dihydropyrimidines skeletal were prepared by reaction of imidazole aldehyde, urea and β-keto ester. Material and methods: Imidazole derivatives were synthesized by the reaction of the starting materials, methyl amine hydrochloride and dihydroxyaceton dimer with potassium thiocyanate under the reflux condition, using acetic acid and n-Butanol as solvent. In the next step, corresponding product was methylated by methyl iodide. This product was then oxidized by MnO2 to corresponding aldehyde. The reaction of aldehyde, urea and β-ketoester (methyl, ethyl, propyl and butyl acetoacetate) in the presence of Lewis acid, gave the final products. Results: The yields were 50 to 70%. The structure of all products was confirmed by analytical methods such as NMR, IR and Mass spectra. Conclusion: Changing the solvent of a reaction is one method for increasing the yield of reaction. In this study, acid acetic was used as solvent instead of ethanol. The goal of this study was to obtain the structures with antimicrobial and anti-inflammatory activities. Because of known antimicrobial and anti-inflammatory activities of imidazolering, it seems that the combination of these two nucleuses may create structures with improved activities.

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Background and purpose: Multiple sclerosis (MS) is a chronic disease of the central nervous system which is accompanied by cognitive dysfunction. The aim of this study is to compare the sustained attention and reaction time in patients with MS and healthy normal individuals considering their level of depression, anxiety, and stress. Material and methods: This causal-comparative study recruited 108 participants. The patients were 54 with relapsing-remitting and 54 healthy people were included in control group. To collect the data DASS-2 questionnaire was used and computerized continuous performance test was administered. Results: Results showed significant difference in sustained attention and reaction time between the two groups. We also observed significant differences in cognitive function considering the levels of depression, anxiety and stress. Conclusion: MS could result in impairment in sustained attention and reaction time. Also, depression, anxiety, and stress intensify these cognitive impairments.

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Background and purpose: Rapid detection of Staphylococcus aureus in clinical specimens is essential to minimize the transfer and spread of this pathogen. An appropriate method for rapid and suitable detection of S. aureus is detection of one of its genes. The aim of this study was to identify the S. aureus using scaF gene. Material and Methods: The study was conducted on 45 isolates of S. aureus separated from clinical specimens of patients who referred to hospitals affiliated with Tehran University of Medical Sciences in 2013. At first, scaF gene was analyzed by bioinformatic tools. S.aureus isolates were confirmed using biochemical and diagnostic tests. Following DNA extraction, scaF gene was amplified by polymerase chain reaction using gene-specific primers. The results of PCR were examined by gel electrophoresis. Results: The scaF gene was present in all studied isolates. Bioinformatics evaluation revealed that this gene encodes a protein with a molecular weight of 33kDa and contains 297amino acids with a PI value of 6.3. Conclusion: The scaF gene belongs to Staphylococcal conserved antigen family which is conserved in S. aureus strains recorded in JCVI database. Furthermore, due to lack of the same gene in Staphylococcus epidermidis and other species, it could be used for detection of S. aureus infections.

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Antibiotics residues in animal derived food products are a great concern for public health. The major risk associated with this problem is drug resistance in pathogenic bacteria in consumers.This survey is a comprehensive review of many studies carried out by scientists in Iran in food hygiene, livestock breeding and toxicology over the last thirty years. Food samples were examined by different analytical methods. Data was collected from databases including pubmed, science direct, SID, magiran, etc.High levels of antibiotic residues in food products need revision of national standards for antibiotic residues in these products. Also, application of appropriate techniques for measuring antibiotic residues in food products in Iran is essential for quality control.

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Background and purpose: 1,2 diarylethylene or stilbenes are hydrocarbon derivatives with two phenyl group bonded to the double bond carbons. There are two isomers of stilbenes that Z-isomer is less stable than E-isomer. However, the Z-isomer is stronger than E-isomer as potent cyclooxygenase-2 (COX-2) inhibitor. E and Z isomers are interconverted through photochemical irradiation. In this research, Z-isomer was converted to E-isomer by irradiation in photoreactor that could be used as COX-2 inhibitor. Materials and methods: The reaction of p-bromothiophenol with dimethyl lsulfate in an aqueous sodium hydroxide solution produced p-bromothioanisole. Mentioned product was reacted with 4-x-styrene via Heck olefination. The olefination was performed with Bu4N+Cl-, LiOAc and LiCl in the presence of Pd (II) as a catalyst in DMF. E-1,2 diarylethylene derivatives were irradiated in photo-reactor and their photochemical products were isolated after irradiating by column chromatography. Results: 1,2–diarylstilbene derivatives were produced and their chemical structure were evaluated by 1H-NMR and IR spectroscopy. UV-vis absorption spectra were measured for all compounds before and after radiation. The photochemical product was isolated and identified Conclusion: E–diarylestilbenes were produced in the presence of Pd (II) and converted to more important Z-isomer by irradiation in photo-reactor

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Background and purpose: Methicillin-resistant Staphylococcus. aureus (MRSA) is specific strain of S.aureus that is a major cause of nosocomial infection. Nowadays, Vancomycin is the first-line treatment of severe MRSA infections. However, resistance to Vancomycin is reported in the form of Vancomycin-resistant Staphylococcus aureus (VRSA) too. This study aimed at determining the prevalence of MRSA and VRSA in healthcare staff and inpatients.

Materials and methods: The study was performed in 447 healthcare workers and inpatients in Teaching Hospitals, in Sari, Iran, 2015. Staphylococcus aureus were isolated from the subjects using diagnostic tests. Then antibiotic resistance patterns of the isolates was determined by disk diffusion method. E-TEST was used for the methicillin and Vancomycin resistant isolates. Prevalence of mecA resistant gene in the isolates was analyzed by PCR. Finally, Induced resistance to Clindamycin was investigated.

Results: E-TEST showed that 31.31% of the isolates were resistant to methicillin and 16.1% were vancomycin-intermediate S. aureus (VISA). Prevalence of mecA gene in resistant isolates was 96.8%. The highest resistance was detected against Gentamicin (45.5%) and the lowest resistance rates were found against Vancomycin (0%) and Amikacin (14.1%). We also found that 12.9% of MRSA isolates were inducible resistance to Clindamycin.

Conclusion: This study revealed that MRSA isolates have a high resistance to Erythromycin, Clindamycin, Gentamicin, and Ciprofloxacin. Also, a high rate of multidrug-resistant was seen in MRSA isolates. But despite intermediate resistance to Vancomycin, this antibiotic can be used as a valuable drug in treatment of MRSA.

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Visceral leishmaniasis (VL) or kala-azar is a parasitic disease caused by Leishmania donovani complex. Evidence suggests that visceral leishmaniasis is prevalent in some areas of Mazandaran and Golestan provinces. This study aimed to investigate the cases and also determining the causative agents of VL in these provinces. In this study, seven VL patients (mean age 1.5 years) admitted to the pediatric departments in Sari Booali Sina and Gorgan Taleghani hospitals, 2013–2016, were examined. The most common clinical and laboratory findings included prolonged fever, hepatosplenomegaly, anemia, pancytopenia, and hypergammaglobulinemia. Blood and bone marrow (B.M) samples were taken. Direct agglutination test (DAT) and rapid rK39 strip test were used as serologic tests and B.M microscopic slides were checked by species-specific PCR to identify the parasite species. All patients had positive rK39 and DAT tests. Examination of bone marrow smears demonstrated amastigotes of Leishmania (Leishman bodies) in the samples. The species of Leishmania in all B.M smears was Leishmania infantum. According to the identification of L. infantum as the major agent of VL in Mazandaran and Golestan provinces, increasing physician awareness (especially pediatric specialists) of the disease and conducting control programs in these areas are recommended.

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Background and purpose: Colorectal cancer is one of the most common cancers in the world and Iran. This cancer is a multifactorial disease that is induced by interaction of various genetic and environmental factors. In this study, we investigated the interactions between different environmental factors and candidate polymorphisms of two genes in colorectal cancer X-ray repair cross-complementing-1(XRCC1) and Oxo guanine DNA-glycosylase 1 (OGG1), which play roles in the DNA repair pathway and maintaining the integrity of the genome.
Materials and methods: This case-control study was conducted in 150 patients with colorectal cancer and 150 healthy controls selected from hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. Polymerase Chain Reaction - Restriction Fragment Length Polymorphism (PCR-RFLP) was used to determine the allele of the polymorphisms. After determining the different genotypes, the interaction of these genotypes with environmental risk factors in two groups of patients and controls was analyzed and compared.
Results: The study showed that XRCC1 (Arg399Gln) polymorphism in body mass index and obesity was significantly correlated with colorectal cancer (p= 0.009). Also, the Lur race was found to be highly susceptible to developing colorectal cancer (p= 0.003), but there was no significant correlation between these items and other risk factors and OGG1 (Ser326Cys) polymorphism in colorectal cancer.
Conclusion: In this study, XRCC1 Arg399Gln gene polymorphism was significantly associated with obesity and Lur race had a high potential for developing colorectal cancer.

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Background and purpose: Adverse drug reaction (ADR) is one of the major causes of mortality and morbidity in patients that results in high healthcare costs. This study was conducted in Food and Drug Deputy at Mazandaran University to evaluate ADRs in Mazandaran province.
Materials and methods: The analysis was performed during 2004-2018, based on the frequency of the drugs that had side effects, routes of administration, the number of reports per year, patient characteristics (gender, age), the frequency of the organ damaged, and the reporter.
Results: A total of 4425 reports of ADRs were submitted to Adverse Drug Reactions Center in Food and Drug Department, Mazandaran province, Iran. More than half of the reports (61%) were reported by nurses and 58.4% of the ADRs occurred in women. Injectable drugs were found with more adverse effects (75.7%) and the most prevalent were skin and hair disorders (50.6%). Anti-infective agents were the top drugs that caused ADRs (52.2%) and ceftriaxone was the most prevalent.
Conclusion: Due to the low number of ADRs in Mazandaran province and its low concordance with international standards, it seems that trainings based on the needs and preferences of medical groups about pharmacovigilance and focuses on how to report, can increase their awareness and knowledge about ADR and bring the data closer to world standards.