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The most common type of muscular-skeletal disorders among health care worker is low back pain (LBP). This study aimed to investigate the effects of an educational program based on the Social Cognitive Theory (SCT) on low back pain severity in healthcare workers in hospitals located in Qom, Iran. In this interventional research study, 125 nursing aides were divided into two experimental and control groups. Data gathering instruments were a demographic questionnaire and a questionnaire based on the predictor constructs of SCT. For the intervention group, training was administered by health education specialist in four 2-hour sessions In each session discussion regarding self-efficacy, self-control, outcome reinforcement, and emotional coping were taken into account carefully, respectively. Data were analyzed SPSS version18.0, IBM Corp.

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Background: The role of the hospital environment as a source of dissemination of pathogens is critical. Environmental surfaces in the Intensive Care Units (ICUs) are suitable for the growth of Gram-negative bacteria that normally circulate between the environment and patients and can cause outbreaks of nosocomial infections. In this study, the prevalence of Gram-negative bacilli in the environment of the ICUs and neonatal ICU (NICU) of hospitals in the city of Qom was evaluated. Materials and Methods: During a 6 month period from November 2012 to April 2013, samples were collected from environmental surfaces of ICUs of four hospitals and NICU of one hospital located in the city of Qom. Sampling was done from equipment, fluids, and surfaces and identification was carried out based on culture and biochemical tests for Gram-negative bacilli. Results: A total of 230 swab samples was collected and 50 colonies of Gram-negative bacilli were isolated from environmental surfaces. Overall, 64% of the isolates belonged to non-fermentative bacteria and 36% of the isolates belonged to Enterobacteriaceae family.  Strains of Pseudomonas aeruginosa and Acinetobacter baumannii complex accounted for the highest rates of environmental isolates. In addition, Klebsiella pneumoniae was isolated from NICU. Conclusion: The high frequency of genus Acinetobacter among Gram negative bacteria isolated from environmental surfaces has a public health impact and Acinetobacter spp. should be considered in the infection control programs in hospitals. Isolation of K. pneumoniae should be regarded as a risk factor for fatal neonatal infections.

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Background: Iranian (Lahijan) black tea caffeine has been previously shown to have antifungal activity against Candida albicans. The aim of this study was to investigate whether the combination of caffeine and fluconazole (FLU) has an effective antifungal activity on a FLU-resistant (MIC >64mgL^-1) C. albicans PTCC5027. Materials and Methods: Caffeine from Lahijan black tea was extracted and its pharmacological effects against 20 clinical isolates of FLU-sensitive and resistant C. albicans was evaluated by Colony Forming Units (CFU) method. Furthermore, the synergistic effect of caffeine and FLU against PTCC-5027strain was investigated. Results: Our results indicate the antifungal efficacy of Lahijan black tea caffeine on C. albicans isolates and subsequent identification of caffeine in combination with FLU againstPTCC-5027 strain. The concentrations of caffeine causing 90% growth inhibition (MIC₉₀) for  PTCC-5027 strain, FLU-resistant and -sensitive C. albicans isolates were 25mgL^-1, 24.4mgL^-1 and 37.2mgL^-1,respectively. The combination of caffeine with FLU showed stronger antifungal activity against C. albicans PTCC5027. The addition of 12.5mgL^-1 caffeine to FLU 10-50 mgL^-1 (below MIC₉₀) inhibited the growth of C. albicans PTCC5027 by 99.3%–99.7%, the concentrations at which neither caffeine nor FLU alone affected the growth. Conclusion: It can be concluded that caffeine has antifungal effect on C. albicans and in combination with FLU can enhance the antifungal activity of FLU against C. albicans. The synergism of the combination of caffeine and FLU induces multiple antifungal effects, resulting in the use of lower doses of the FLU. It suggests that this can decrease the side effects of antifungal drugs.

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Background: Campylobacter jejuni and Campylobacter coli are identified as the major causes of acute gastroenteritis in humans. Because of the fastidious nature of Campylobacters, many clinical laboratories fail to routinely culture them. The detection of Campylobacter spp. using molecular-based techniques can be useful for diagnostic and epidemiological applications. This study aimed to developa multiplex PCR assay for the simultaneous detection of C. jejuni and C. coli strains from clinical specimens
Materials and Methods: During a 19-month period, stool samples were collected from 980 children admitted to a hospital in Tehran, Iran and then examined. The samples were cultured on both Brucella agar and Modified Charcoal-Cefoperazone-Deoxycholate agar (mCCDA) media at 42°C for 48 h. To confirm suspected bacteria, Gram staining and other biochemical tests were carried out. Finally, after extracting DNA from pure cultures using the boiling method, the multiplex PCR assay was performed.
Results: The multiplex PCR assay showed that Campylobacter spp. can be detected using 400 bp target product of cadF. It can also accurately distinguish between C. jejuni and C. coli species with different bands of 735 bp and 500 bp using hipO and asp genes, respectively
Conclusions: Results showed that the multiplex PCR assay can replace the biochemical assays for differentiating between C. jejuni and C. coli strains in a single-step PCR test.

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Aims: Streptococcus mutans (S. mutans) is part of human oral cavity microbiome and is known to be responsible of dental caries. The aim of this study was to evaluate the inhibitory effects of Punica granatum, Ricinus communis, and Allium sativum extracts on biofilm formation caused by S. mutans.
Materials and Methods: In this experimental study, the biofilm formation was carried out by broth dilution method with glucose -supplemented Tryptic Soy Agar (TSB) in 96-well microtiter plates. Seven serial dilutions from the aqueous extracts of the Punica granatum, Ricinus communis, and Allium sativum were prepared. Then, a suspension of S. mutans was added to the wells. The anti-biofilm effects of the extracts and turbidity were measured by an ELISA reader apparatus at OD₄₉₂nm. Experiments were completed in triplicate.
Findings: Ricinus communis was more active on S. mutans than other extracts. In comparison with others, the mean OD obtained in the presence of a concentration of 50mg of the plant extract (OD=0.083) was close to the negative control (OD=0.068). This plant was effective in higher concentrations (50, 25, 12.5 and 6.25mg/ml). Allium sativum extract has a moderate effect on S. mutans. The lowest activity belonged to Punica granatum extract.
Conclusion: The extract of Ricinus communis has strong anti-biofilm activity against Streptococcus mutans, when compared to other extracts, Allium sativum extract show moderate activity on the biofilm formation. Aqueous extract of Punica granatum peel isn’t very effective on S. mutans.

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Aim: Many patients with chronic renal failure are prone to depression and anxiety. A self-efficacy promotion-training program can be effective in these mental disorders. Thus, the aim of this study was to investigate the effect of education based on self-efficacy theory on improvement of mental health in hemodialysis patients.
Methods: This interventional study that conducted in 2016 on 70 hemodialysis patients (35 in experimental group, 35 in control group). The data collection instruments consisted of demographic questionnaire, self-efficacy (SUPPH) and researcher-made validated and relied questionnaire of mental health (6 questions). The data were collected in two steps: before and three months after the training intervention. The educational program was performed for the experimental group in two half-hour sessions. The obtained data were analyzed by SPSS 16, Paired-test, Independent t-test, Chi-square and Mann-Whitney’s test at the significance level of α=0.05.
Findings: The groups did not differ significantly regarding the mean of mental health before the study (p=0.56). However, three months after the intervention, the mean of self-care in the field of mental health in the experimental group was significantly higher than in the control group (p<0.001).
Conclusion: The research results showed that employing the educational program based on self-efficacy theory was positively effective as for promotion of self-care in the field of mental health in hemodialysis patients.

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Aim: Certain Mycoplasma species, the smallest and simplest free-living bacteria which lack a rigid cell wall, are considered as important pathogenic organisms in human and recognized to have a role in rheumatoid arthritis. The aim of this study was to use molecular methods to detect Mycoplasma spp. in synovial fluid of patients with reactive arthritis in comparison with patients suffering from non-inflammatory arthritis as a control group.
Materials & Methods: Synovial fluid samples were collected from 99 patients with arthritis, all of which fulfilled the standard criteria of American College of Rheumatology for the diagnosis of inflammatory arthritis (59 patients) or non-inflammatory arthritis (40 patients). The DNA of all synovial fluid samples was extracted, and PCR was performed with a specific set of general primers for 16S rRNA of Mycoplasma genus. The PCR products were confirmed via restriction enzyme digestion using BamH1 and sequencing.
Finding: A total of 11 out of 99 (11.1%) samples of patients with reactive arthritis revealed a 270bp amplification band. Digesting the PCR product of 16S rRNA by BamH1 confirmed the PCR assay. The sequencing also confirmed the amplified products.
Conclusion: The pathophysiology of inflammatory arthritis could be attributed, at least in part, to the persistence of bacterial DNA in the joint of patients with reactive arthritis.

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Aims: Hemodialysis patients experience numerous problems in the fields of self-care in adherence to dietary and fluids-intake restriction. For increasing their self-care, they require controlling these problems. This can be done with the education based on a behavior change theory, this study attempted to determine the effect of the educational intervention based on SET (Self-efficacy Theory) on adherence to diet and fluid-intake restriction in patients with hemodialysis.
Materials & Methods: The present study is a randomized clinical trial that was conducted on 70 hemodialysis patients of Qom City in 2016 (35 in the trial group, 35 in the control group). The data were collected by demographic questionnaire, self-efficacy (SUPPH) and researcher-made validated and relied questionnaire of adherence to dietary and fluids-intake restriction (8 and 6 questions, respectively) in two steps (before and three months after education). The educational program was performed for the trial group in two half-hour sessions. The data were analyzed by SPSS 16, using paired-test, Independent t-test, Chi-square and Mann-Whitney test.
Findings: Before the test, there was no significant difference in adherence to dietary (p=0.49) and fluids-intake restriction (p=1.00). After training, significant differences were observed between the two groups in adherence to dietary (p<0.001) and fluids-intake restriction (p<0.001). There was significant difference between pre-test and post-test in the control group (p<0.05).
Conclusion: The educational intervention based on Self-efficacy Theory has the effect on adherence to diet and fluid-intake restriction in patients with hemodialysis.

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Background: Acinetobacter baumannii is a gram-negative pathogen that is highly resistant to antibiotics. This bacterium can cause severe systemic infections, especially in hospitalized patients. Recently, antimicrobial-resistant Acinetobacter baumannii has become a life-threatening pathogen in Iran and around the world.
Materials & Methods: In this study, several Iranian and English databases were systematically searched to find all original and review articles investigating the prevalence of imipenem resistance in their sample size, while mentioning the source of clinical isolates, as well as the prevalence of antimicrobial resistance genes.  
Findings: Among genes, blaOXA-23 with a prevalence of 31% to 100% was responsible for global outbreaks of imipenem-resistant Acinetobacter baumannii and was presented in most of the hospital isolates. Our meta-analysis also revealed that 74.2% of Acinetobacter baumannii were resistant to imipenem in 122 clinical studies.
Conclusion: Our study highlighted a rapid increase in the rate of imipenem resistance in clinical isolates of Acinetobacter baumannii in Iran. The need for periodic antibiotic care system programs to monitor the administration and use of antibiotics

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Aims: COVID-19 outbreak in China affected all age groups. Among these groups, pregnant women are among the most important ones. This study aimed to investigate the effect of educational intervention in terms of the pattern of health beliefs to promote preventive behaviors against COVID-19 among pregnant women.
Material & Methods: This descriptive study was performed as an intervention on pregnant women in Qom in 2021. One hundred-six women were chosen by multi-stage sampling. The pre-test questionnaire was electronically given to the target group, and the educational protocol was provided to the group for a 2-month duration during several virtual sessions through videos, posters, and pamphlets. Thereafter, the questionnaire was completed again by all the individuals. The required data were collected in SPSS 20 software and then analyzed by t-test.
Findings: Before conducting the educational intervention in terms of some variables, including age, education, occupation, spouse occupation, number of abortions, number of deliveries, weeks of pregnancy, illness during pregnancy, family illness, relatives, and death in family members due to diseases, no statistically significant difference was found between the intervention and control groups (p>0.05). After conducting the educational intervention, a significant difference was observed in the intervention group in terms of all constructs of the health belief model compared to the control group (p<0.05).
Conclusion: The results of this study support the effectiveness of the intervention based on the health belief model in promoting preventive behaviors against COVID-19.

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Background: Gastroenteritis is the second leading cause of death worldwide, with a high prevalence in children. Among pathogenic microorganisms, viruses are one of the main causes of this disease. Thus, the aim of this research was to investigate the prevalence of diarrhea caused by human adenovirus (HAdV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) in children with hematological diseases for the first time in Iran.
Materials & Methods: This study was conducted on 120 stool samples stored in the clinical sample bank of the Cellular and Molecular Research Center of Qom University of Medical Sciences. These samples were obtained from immunocompromised children with gastrointestinal symptoms, who referred to one of the children's hospitals in Qom during 2018 to 2019. Genomes were extracted from the stool samples and evaluated using the polymerase chain reaction (PCR) method.
Findings: The prevalence of HAdV and EBV was reported in seven (5.8%) and one (0.8%) cases, respectively, and CMV was detected in none of the samples. No cases of co-infection were observed.
Conclusion: This study results show that there are diarrhea-causing viruses among patients in the study area. Fortunately, the prevalence of these infectious agents in patients with underlying conditions was relatively low. However, monitoring of these viruses in the feces of all patients, especially immunocompromised patients, is recommended.
 

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Vibrio cholerae is one of the important human pathogens that is transmitted through contaminated water and food. In Qom province, due to special weather conditions, diseases caused by Vibrio cholerae are endemic. The aim of this study was the prevalence of Vibrio cholerae in water and vegetables of Qom province and the presence of two virulence genes, hlyA and toxR. During two years (2020-2021), 120 samples of agricultural water (70) and vegetables (50) in Qom province were collected. The samples were cultured on specific media. Suspicious colonies were evaluated by Gram staining and biochemical tests and the serotype Vibrio cholerae was identified by serology test. Finally, Then, the presence of virulence genes was investigated by PCR method and also the antibiotic resistance pattern by disk diffusion method was evaluated in the isolates.  Vibrio cholera bacteria were isolated from 17 samples (16.14%), all of which were Non-O1. The rate of contamination of water and vegetables was 28.14% (10 cases) and 14.00% (7 cases), respectively. In molecular evaluation, the abundance of virulence genes including: toxR (88.32%), rtxA (58.82%), hlyA (47.05%), chxA (5.88%), and 100% of isolates did not have ctxA, ace and tcpA genes. The most antibiotic resistance is related to ampicillin and amoxicillin (34.29%), followed by cefuroxime (17.46%), imipenem (11.76%), and cefoxitin and trimethoprim-sulfamethoxazole (5.88%). The results of this study showed that Vibrio cholerae Non-O1 is present in water and vegetables of Qom province, and as an important source of disease for humans therefore, continuous health monitoring of water and vegetables and proper disinfection of these foods is very important.