Unsuccessful suicidal attempts by sewing needle introducing to chest: Removing 17 ones from the right ventricle and breast tissue in two stages; case report and literature review.

INTRODUCTION AND IMPORTANCE: Penetrating cardiac injuries among the whole injuries confronting the trauma surgeon is more alarming. The introduction of needles as an attempt to inflict self-injury has rarely been described, so we only found 34 reported cases reviewing the available English literature since 1967. CASE PRESENTATION: We have reported a case of a 35-year-old depressed female who had introduced 17 sewing needles through her chest wall, causing myocardial puncture and mastitis; underwent exploratory sternotomy and mammoplasty in two stages and survived. CLINICAL DISCUSSION: Penetrating cardiac trauma is rare enough for surgeons to deal with direct injuries by sewing needles. Penetrating wounds in the "cardiac box" anatomic area" should elicit the highest concern for potential cardiac injury. The mentioned region is demarcated superiorly by the clavicles, inferiorly by the xiphoid, and the nipples laterally in an area of the anterior thorax. CONCLUSION: Anterior aspect penetrating traumas to the cardiac box myocardial injuries should be in mind, and immediate and proper intervention should be needed. Ventricles, for their anatomical condition, are exposed to be injured.

Surface plasmon resonance biosensors for early troponin detection.

Acute myocardial infarction (AMI) is one of the life-threatening causes that decrease blood flow to the heart, leading to increased mortality and related complications. Recently, the measure of blood concentration of cardiac biomarkers has been suggested to overcome the limitations of electrocardiography (ECG) analyses for early diagnosis of this disease. Troponins, especially cardiac troponin I and cardiac troponin T, with high sensitivity and specificity, are considered the gold standards in myocardial diagnosis. Recently, the use of new biosensors such as surface plasmon resonance (SPR) for early detection of these biomarkers has been greatly appreciated. Due to the rapid, sensitive, real-time, and label-free detection of SPR-based biosensors, they can be applied for selective and nonspecific absorption that is intended to be used as an in situ cardiac biosensor. Here, we exclusively discussed the updated developments of these valuable predictors for the possible occurrence of AMI detected by SPR.

Biomarkers and optical based biosensors in cardiac disease detection: early and accurate diagnosis.

Rapid and precise detection methods for the early-stage detection of cardiovascular irregularities are crucial to stopping and reducing their development. Cardiovascular diseases (CVDs) are the leading cause of death in the world. Hence, cardiac-related biomarkers are essential for monitoring and managing of process. The necessity for biomarker detection has significantly widened the field of biosensor development. Bio-sensing methods offer rapid detection, low cost, sensitivity, portability, and selectivity in the development of devices for biomarker detection. For the prediction of cardiovascular diseases, some biomarkers can be used, like C-reactive protein (CRP), troponin I or T, creatine kinase (CK-MB), B-type natriuretic peptide (BNP), myoglobin (Mb), suppression of tumorigenicity 2 protein (ST2) and galectin-3 (Gal3). In this review, recent research studies were covered for gaining insight into utilizing optical-based biosensors, including surface plasmon resonance (SPR), photonic crystals (PCs), fluorescence-based techniques, fiber optics, and also Raman spectroscopy biosensors for the ultrasensitive detection of cardiac biomarkers. The main goal of this review is to focus on the improvement of optical biosensors in the future for the diagnosis of heart diseases and to discuss how to enhance their properties for use in medicine. Some main data from each study reviewed are emphasized, including the CVD biomarkers and the response range of the optical-based devices and biosensors.

Educational needs assessment of medical and midwifery students about prevention of mother-to-child transmission of HIV: a cross-sectional study.

Mother-to-child transmission (MTCT), is an important way of acquired immune deficiency virus (AIDS) transmission. Medical and midwifery students need to have sufficient knowledge in terms of MTCT. The aim of this study was to evaluate the educational needs of these students regarding MTCT of HIV. This cross-sectional study was conducted on 120 medical (extern and intern) and midwifery Bachelor (semester 4 and above) and Master students in Gonabad University of Medical Sciences in 2019. The real needs questionnaire on MTCT AIDS and the perceived needs questionnaire on MTCT were used for need assessment evaluation. Majority of the participants were female (77.5%) and single (65%). Study participants included 48.3% medical and 51.7% midwifery students. High real educational need was reported by 63.5% of medical and 36.5% of midwifery students. More than half of the participants (59.2%) felt a great need for education on MTCT of HIV. OF the areas of real educational needs, the highest and lowest scores were related to the areas of prevention and symptoms, respectively. Students in higher semesters had the highest percentage of real need compared to other students (p = 0.015). The real need for MTCT of HIV prevention was higher among medical students compared to midwifery students (p = 0.004). The observed high real and perceived needs of students, especially in the higher semesters and the field of medicine, necessitates the re-examination of their educational curricula.

Mitoprotective effect of mesenchymal stem cells-derived conditioned medium in myocardial reperfusion injury of aged rats: role of SIRT-1/PGC-1α/NRF-2 network.

BACKGROUND: The aged myocardium experiences various forms of stress that cause reduction of its tolerance to injury induced by ischemia/reperfusion (I/R). Developing effective cardioprotective modalities to prevent the amplification of I/R injury during aging is under focus of investigation. Mesenchymal stem cells (MSCs) have the ability to regenerate infarcted myocardium mostly by producing multiple secretory factors. This study aimed to explore the mechanisms of mitoprotection by MSCs-conditioned medium (CM) in myocardial I/R injury of aged rats. METHODS: Male Wistar rats (n = 72, 400-450 g, 22-24 months old) were randomized into groups with/without I/R and/or MSCs-CM treatment. To establish myocardial I/R injury, the method of LAD occlusion and re-opening was employed. MSCs-CM was administered intramyocardially (150 µl) at the onset of reperfusion in recipient group. After 24 h reperfusion, myocardial infarct size, LDH level, mitochondrial functional endpoints, expression of mitochondrial biogenesis-associated genes, and the levels of pro-inflammatory cytokines were evaluated. After 28 days reperfusion, echocardiographic assessment of cardiac function was performed. RESULTS: MSCs-CM treatment improved myocardial function and decreased infarct size and LDH level in aged I/R rats (P < .05 to P < .001). It also decreased mitochondrial ROS formation, enhanced mitochondrial membrane potential and ATP content, upregulated mitochondrial biogenesis-related genes including SIRT-1, PGC-1α, and NRF-2, and lessened TNF-α, IL-1ß, and IL-6 levels (P < .05 to P < .01). CONCLUSIONS: MSCs-CM treatment attenuated myocardial I/R injury in aged rats, in part by improving mitochondrial function and biogenesis and restraining inflammatory reaction. the upregulation of SIRT-1/PGC-1α/NRF-2 profiles is a possible target for the mitoprotective effects of MSCs-CM following I/R injury during aging.

Association between bacterial vaginosis and 25-Hydroxy vitamin D: a case-control study.

INTRODUCTION: Bacterial vaginosis (BV) is the most common vaginal dysbiosis among women of reproductive age. Micronutrient deficiencies, including vitamin D deficiency, can increase the risk of BV. The findings of previous studies regarding the relationship between vitamin D deficiency and BV were conflicting. Therefore, this study aimed to evaluate the association between BV and serum level of 25-hydroxy vitamin D. MATERIALS AND METHODS: This case-control study was conducted in Gonabad County in 2021. One hundred and twenty-five confirmed BV cases and 125 controls who were matched based on age and intercourse frequency (maximum difference of two days per week) enrolled in the study. Data collection was performed using a demographic and reproductive data questionnaire and a checklist for recording Whiff test results, serum 25-hydroxy vitamin D level, litmus paper observation, and microscopic findings (clue cells). Serum level of vitamin D was evaluated based on enzyme-linked immunoassay method (Monobind kit) from 0.5 ml venous blood drawn from each participant. The conditional logistic regression model was used to analyze data. RESULTS: The BV cases had significantly lower 25-hydroxy vitamin D serum levels than controls. The odds of BV increased with vitamin D deficiency (Adjusted odds ratio (AOR): 4.34, 95% confidence interval (CI): 1.39-13.4, p = 0.011, FDR q-value = 0.051), vitamin D insufficiency (AOR: 3.65, 95% CI: 1.23-10.85; p = 0.020; FDR q-value = 0.053), cigarette/hookah smoking (AOR: 3.65, 95% CI: 1.23, 10.85; p = 0.020; FDR q-value = 0.053) and lower age at first intercourse (AOR: 1.16, 95% CI: 1.05, 1.28; p = 0.004; FDR q-value = 0.048). The odds of BV was 0.80 and 0.78 times lower in participants who had coitus interruptus (AOR: 0.20, 95% CI: 0.06, 0.63; p = 0.006; FDR q-value = 0.048) and condom use (AOR: 0.28, 95% CI: 0.10, 0.79; p = 0.016; FDR q-value = 0.051), respectively, compared to participants who did not use contraceptives. CONCLUSION: These findings suggested that lower serum vitamin D levels were associated with an increased risk of developing BV. However, further studies are needed to confirm the results of the present study.

The effects of Chlorella vulgaris on cardiovascular risk factors: A comprehensive review on putative molecular mechanisms.

High incidence rate of cardiovascular disease (CVD) make this condition as an important public health concern. The use of natural products in treating this chronic condition has increased in recent years one of which is the single-celled green alga Chlorella. Chlorella vulgaris (CV) has been studied for its potential benefits to human health due to its biological and pharmacological features. CV contains a variety of macro and micronutrients, including proteins, omega-3, polysaccharides, vitamins, and minerals. Some studies have indicated that taking CV as a dietary supplement can help reduce inflammation and oxidative stress. In some studies, cardiovascular risk factors that are based on hematological indices did not show these benefits, and no molecular mechanisms have been identified. This comprehensive review summarized the research on the cardio-protective benefits of chlorella supplementation and the underlying molecular processes.

MicroRNA-122 in human cancers: from mechanistic to clinical perspectives.

MicroRNAs (miRNAs) are endogenous short non-coding RNAs that can regulate the expression of target genes post-transcriptionally and interact with mRNA-coding genes. MiRNAs play vital roles in many biological functions, and abnormal miRNA expression has been linked to various illnesses, including cancer. Among the miRNAs, miR-122, miR-206, miR-21, miR-210, miR-223, and miR-424 have been extensively studied in various cancers. Although research in miRNAs has grown considerably over the last decade, much is yet to be discovered, especially regarding their role in cancer therapies. Several kinds of cancer have been linked to dysregulation and abnormal expression of miR-122, indicating that miR-122 may serve as a diagnostic and/or prognostic biomarker for human cancer. Consequently, in this review literature, miR-122 has been analyzed in numerous cancer types to sort out the function of cancer cells miR-122 and enhance patient response to standard therapy.

Relationship Between Amoxicillin Use in Pregnancy and Congenital Anomalies: A Systematic Review.

OBJECTIVE: Amoxicillin is among the most used antibiotics in the treatment of a wide spectrum of bacterial infections. Although amoxicillin is categorized as group B in pregnancy, the findings of studies regarding its effects on the fetus are controversial. The aim of this systematic review was to review the reported effects of amoxicillin administration in pregnancy on congenital anomalies. METHODS: Published articles in PubMed, Scopus, SID, and Magiran databases, as well as Google Scholar were searched till May 2021 based on a search strategy. Case-control and cohort studies in Persian or English language were included. Four studies, including two case-control and two cohort studies, with an overall sample size of 260491 pregnant mothers, were included in the review. RESULTS: A review of case-control studies revealed an increased risk for cleft palate in one study. Cohort studies did not reveal a significant relationship between amoxicillin use and major congenital anomalies. CONCLUSION: The findings of this systematic review showed that although no major congenital anomaly was reported for the administration of amoxicillin consumption with or without clavulanic acid, there is a possibility that amoxicillin administration in pregnancy might be related to some anomalies, including cleft palate. Amoxicillin should be administered with caution during pregnancy till more evidence is provided regarding its safety.

Adsorption performance of Enterobacter cloacae towards U(VI) ion and application of Enterobacter cloacae/carbon nanotubes to preconcentration and determination of low-levels of U(VI) in water samples.

Keeping the high potential of some microorganisms in adsorption of radionuclides in view, the adsorption properties of Enterobacter cloacae towards uranium were attentively scrutinized, and then it was used for preconcentration of uranium in different samples, using Enterobacter cloacae/carbon nanotube composite. First, using ultrasonic agitation, the effects of operational factors on biosorption of uranium on the inactive Enterobacter cloacae were appraised and modeled by central composite design, and a comprehensive study was performed on the equilibrium, kinetics, thermodynamic, and selectivity aspects of biosorption. The optimization studies along with the evaluations of the adsorption properties revealed that Enterobacter cloacae have a high affinity for fast and selective biosorption of uranium ions, at pH 5.1. Second, the Enterobacter cloacae/carbon nanotube was synthesized, characterized, and utilized for preconcentration of uranium in different samples, using a mini-column packed with the composite. The optimization of operational factors on recovery of uranium, using the central composite design, showed that uranium can be quantitively adsorbed at a sample flow rate lower than 4.5 mL min-1 and the desorption could be accomplished with 3.0 mL HCl 0.6 M solution. Finally, the mini-column was exploited for preconcentration and determination of uranium in different samples. The results revealed the low detection limit (0.015 µg.L-1), high precision (RSDs ≤3.92%), and good accuracy of the proposed procedure.

Identification and Evaluation of Pathogenic Genes (traT, hly, aer, pap, and fimH) and Antibiotic Resistance Genes (blaTEM, blaSHV, and blaCTX) in Escherichia coli in Patients Referred to Gonabad Hospitals, Iran.

Background: Urinary tract infection (UTI) is one of the common bacterial infections. Escherichia coli is the most common cause of UTI. In this research, the prevalence of several virulence factors and beta-lactam resistance genes was investigated. Methods: One hundred E. coli isolates were collected from patients' specimens with UTI referred to Allame-Bohlol Gonabadi hospital. Polymerase chain reaction (PCR) was performed to identify five pathogenic genes (fimH, aer, pap, hly, traT) and three antibiotic resistance genes (blaTEM, blaCTX, blaSHV). Results: The frequencies of blaSHV, blaTEM and blaCTX beta-lactamase genes among extended-spectrum-beta-lactamases (ESBLs) positive isolates were 11.1%, 48.1%, and 93.3%, respectively. A significant number of isolates were resistant to the most commonly used antibiotics. Conclusion: Pathogenic genes may also increase the severity, progression, and expansion of urinary tract infections. Therefore, identifying these genes as critical controllers of illness can use for better manage the treatment.

Iranian Hydatid Disease Registry: Establishment and Implementation of a Neglected Tropical Disease Registry.

BACKGROUND: Cystic echinococcosis (CE) or hydatid disease is a global public health concern which imposes considerable economic costs on the communities in endemic regions. CE surveillance data are not adequately reliable. The present study reports the development and outcomes of a CE registry in Iran. METHODS: Hydatid Registry (HydatidReg) was initially established as a single-center registry in 2014 after the ethical approval of KMU. Following a call from MoHME to promote registry of different diseases and health outcomes, a call for participation was announced and all the Iranian Universities of Medical Sciences were requested to contribute to the registry. Subsequently, a nation-wide registry of hydatid disease was established in 2016. With a global perspective, HydatidReg joined the European Register of Cystic Echinococcosis (ERCE). A data collection form based on minimum dataset was designed and standard operating procedures (SOPs) were prepared to ensure standardized patient enrolment in the registry. A biobank system with two-dimensional barcoding was established along with HydatidReg for management and organization of biological specimens. RESULTS: As of March 2021, a total of 690 patients were enrolled in the registry. HydatidReg registered 362 (17.3%) out of the total 2097 patients enrolled in ERCE. Quality control (QC) of the data demonstrated 91.2% completeness and 80% timeliness. In the biobank, 322 biological specimens from 184 CE patients have been deposited including 70 blood, 96 sera and 156 parasite materials. CONCLUSION: High-quality data in the HydatidReg registry provided opportunities for health professionals to improve quality of care and organize meaningful research.

Topic Analysis and Mapping of Tuberculosis Research Using Text Mining and Co-Word Analysis.

Tuberculosis is still one of the most severe progressive diseases; it severely limits the social and economic development of many countries. In the present study, the topic trend of scientific publications on tuberculosis has been examined using text mining techniques and co-word analysis with an analytical approach. The statistical population of the study is all global publications related to tuberculosis. In order to extract the data, the Scopus citation database was used for the period 1900 to 2022. The main keywords for the search strategy were chosen through consultation with thematic specialists and using MESH. Python programming language and VOSviewer software were applied to analyze data. The results showed four main topics as follows: "Clinical symptoms" (41.8%), "Diagnosis and treatment" (28.1%), "Bacterial structure, pathogenicity and genetics" (22.3%), and "Prevention" (7.84%). The results of this study can be helpful in the decision of this organization and knowledge of the process of studies on tuberculosis and investment and development of programs and guidelines against this disease.

Prevalence, Antibiotic Resistance and Virulence of Enterococcus spp. Isolated from Traditional Cheese Types.

Background: Enterococci are naturally found in the gastrointestinal (GI) tract of animals and humans, as well as animal-derived foods and vegetables. We here aimed to determine the prevalence, antibiotic resistance, and virulence determinants of E. faecium and E. faecalis in traditional cheese in the North-west of Iran. Materials and Methods: Fifty specimens of popular traditional cheese from dairy stores of Urmia and Tabriz, Iran, were collected. Identification of the genus and species of enterococci was done using molecular and phenotypic techniques. Results: Forty-eight (96 %) of 50 traditional cheese samples were harboring Enterococcus spp, including Enterococcus faecalis (n= 40; 83.33 %) and E. faecium (n= 8; 16.67 %). The prevalence of enterococci ranged from 1.1×105 to 9.7×104 CFU/g, and 1.1×103 to 9.8×103 CFU/g in Urmia and Tabriz samples, respectively. Rifampicin resistance (n= 38; 79.2 %) was the most common pattern observed in the susceptibility test, which was followed by quinupristin/dalfopristin (n= 33; 68.75 %). Among E. faecalis isolates, cpd (100 %), ace (92.5 %) and gelE (87.5 %), and among E. faecium isolates, gelE (100 %) and asa1 (75 %) were found to have the most common virulence genes. Conclusion: E. faecalis was the predominant species, displaying more virulence determinants. It also had high antibiotic resistance, as compared to E. faecium. The enterococci identified here commonly expressed virulence and antibiotic resistance determinants. So, it is required to improve the maintenance and production quality of traditional cheese to avoid enterococci contamination.

Advanced bioengineering of female germ cells to preserve fertility.

Oogenesis and folliculogenesis are considered as complex and species-specific cellular differentiation processes, which depend on the in vivo ovarian follicular environment and endocrine cues. Considerable efforts have been devoted to driving the differentiation of female primordial germ cells toward mature oocytes outside of the body. The recent experimental attempts have laid stress on offering a suitable microenvironment to assist the in vitro folliculogenesis and oogenesis. Despite developing a variety of bioengineering techniques and generating functional mature gametes through in vitro oogenesis in earlier studies, we still lack knowledge of appropriate microenvironment conditions for building biomimetic culture systems for female fertility preservation. Therefore, this review paper can provide a source for a large body of scientists developing cutting-edge in vitro culture systems for female germ cells or setting up the next generation of reproductive medicine as feasible options for female infertility treatment. The focal point of this review outlines advanced bioengineering technologies such as 3D biofabricated hydrogels/scaffolds and microfluidic systems utilized with female germlines for fertility preservation through in vitro folliculogenesis and oogenesis.

Enhanced antibacterial activity of uniform and stable chitosan nanoparticles containing metronidazole against anaerobic bacterium of Bacteroides fragilis.

In this paper, the salt-assisted chitosan nanoparticles (CS NPs) containing metronidazole (MTZ) were prepared using the ionic gelation technique in the presence of NaCl. The effect of different concentrations of NaCl on particle size, zeta potential, polydispersity index (PDI), and entrapment efficiency (EE %) was investigated. Also, the stability of MTZ-loaded CS NPs in the absence/presence of NaCl was evaluated over a 6-month storage period. Furthermore, drug release at pH = 7.4 was examined and the corresponding mechanism was explored. Finally, the time-kill assay of free MTZ and salt-assisted MTZ-loaded CS NPs against Bacteroides fragilis was performed by applying the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). It was found that in the presence of 20 mM NaCl, the optimum NPs can be achieved with the particle size of 284 nm, PDI of 0.099, EE% of 57.4 %, and zeta potential of +46.32 mV. More stability of salt-assisted nanoparticles, as well as lower size enhancement versus time, were observed due to higher surface charge density calculated using the Gouy-Chapman theory. The in-vitro drug release profiles demonstrated a more controlled drug release of MTZ from CS NPs compared to free MTZ, because of the shrinkage properties of CS at high pH. The kinetic modeling of drug release approved the Fickian diffusion of drug based on the Korsmeyer-Peppas model. The time-kill plots confirmed the higher antibacterial activity of salt-assisted MZ-loaded CS NPs compared to the free MTZ against B. fragilis bacterium. In conclusion, the salt-assisted MTZ-loaded CS NPs prepared in the presence of a proper concentration of NaCl, can be an acceptable nanoparticle form for designing MTZ drug delivery systems.

Prevalence and Subtype Analysis of Blastocystis hominis Isolated from Patients in the Northeast of Iran.

Blastocystis hominis is the most common intestinal parasite found in humans and many other hosts. Pathogenicity of Blastocystis spp. remains controversial, and it has been suggested that it may be associated with specific subtypes of the organism. This study identified the B. hominis subtypes and their prevalence rates in the northeast of Iran. A total of 1878 samples were collected from the northeast of Iran from January to December 2017. The patients' demographic details were recorded. Samples were examined by a wet mount, and genomic DNA was extracted from positive samples. Also, PCR was done on the positive samples, and sequencing and phylogenetic analysis were subsequently performed. From 1878 collected stool samples, 152 (8.1%) Blastocystis samples were detected by the microscopic method. Of the 152 samples, Blastocystis spp. were found in 53.6% of the men and 28.9% of the women who showed clinical gastrointestinal symptoms, and a significant relationship was observed between gender and clinical symptoms (P = 0.002). A meaningful relationship was found between the season and infection with this parasite (P value = 0.003). The results of the sequencing of 22 PCR products showed the dominance of ST3, which was isolated from 10 (45.45%) patients, while ST1, ST2, and ST7 were found in 4 (18.19%), 7 (31.81%), and 1 (4.55%) patients, respectively. In this study, ST7 had a low prevalence in the northeast of Iran, and similar to previous studies, ST3 was the dominant subtype.

The Effects of WW2/WW3 Domains of Smurf2 Molecule on CD4+CD25+/CD4+ Proportion in Spleen of 4T1 Tumor Bearing BALB/c Mice.

Background: TGF-ß has long been considered as the main inducer of Tregs in tumor microenvironment and is the reason for the aberrant number of Tregs in tumor-bearing individuals. Recently, it has been suggested that the enzyme arginase I is able to mediate the induction of Tregs in a TGF-ß-independent fashion. The recombinant WW2/WW3 domains from smad ubiquitination regulatory factor 2 molecule was demonstrated to increase TGF-ß signaling while reducing arginase I gene expression. In this study, we aimed to examine the effects of this recombinant protein on CD4+CD25+/CD4+ proportion in the spleen of 4T1 mammary carcinoma-bearing BALB/c mice. Methods: Flow cytometry was used to evaluate CD4+CD25+ spleen cell populations of the tumor-bearing mice that received WW2/WW3 protein treatment and those of the control group. Results: The results indicated a significant rise in CD4+CD25+/CD4+ ratio, along with an average increase in tumor mass of the subjects that underwent protein treatment. Conclusion: It can be inferred that the heightened CD4+CD25+/CD4+ proportion in the spleen of protein-treated tumor-bearing mice can be the result of the increased TGF-ß signaling despite the reduced arginase I expression.

A Meta-Analysis of the Prevalence of Class 1 Integron and Correlation with Antibiotic Resistance in Pseudomonas aeruginosa Recovered from Iranian Burn Patients.

The role of integrons has been highlighted in antibiotic resistance among Pseudomonas aeruginosa isolates. Therefore, we here reviewed the prevalence of class 1 integrons and their correlations with antibiotic resistance of P. aeruginosa isolated from Iranian burn patients. This review was conducted according to the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Cross-sectional and cohort studies published from January 1, 2000 until December 31, 2018 were enrolled. Meta-analysis was performed by Comprehensive Meta-Analysis (CMA) software using the random effects model, Cochran's Q, and I2 tests. Publication bias was estimated by Funnel plot and Egger's linear regression test. Nine out of 819 studies met the eligibility criteria. The overall combined prevalence of class 1 integrons in P. aeruginosa isolates was 69% (95% confidence interval [CI]: 50.5-83%). The highest combined resistance was reported against Cloxacillin (87.7%), followed by Carbenicillin (79.1%) and Ceftriaxone (77.3%). The combined prevalence of multidrug-resistant (MDR) isolates was 79.3% (95% CI: 31.1-97%). Also, a significant correlation was noted between the presence of class 1 integrons and antibiotic resistance in 55.5% of the included studies (P < .05). The results showed high prevalence of class 1 integrons, antibiotic resistance, and MDR strains in P. aeruginosa isolated from Iranian burn patients. Also, most of the included studies showed a significant correlation between the presence of class 1 integrons and antibiotic resistance.

Chemical and microbial quality of bottled drinking water in Gonabad city, Iran: Effect of time and storage conditions on microbial quality of bottled waters.

Reports from bottled water (BW) industries show a rapidly increasing rate of global bottled water consumption. The present paper contains data on chemical and microbial quality of bottled waters marketed in Gonabad city, Iran. The data on the effect of time and storing conditions on microbial quality of bottled water also is reported. The physical and chemical parameters of all 9 studied BW brands meet well with those mentioned on the labels. All BW sampled also were free of pathogenic indicators (total coliforms, fecal coliforms, fecal streptococci and clostridium perfringens). BWs kept in refrigerator have minimal heterotrophic and pathogenic bacterial count. The highest bacterial count was observed when BWs were exposed to indirect sunlight at room temperature. Presence of heterotrophic and especially pathogenic bacteria reduced significantly when the samples were placed to direct sunlight. In all samples, apart from where they were kept, the heterotrophic and pathogenic bacterial counts showed an increasing trend after bottling.