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Background Registries are considered valuable data sources for identification of pediatric conditions treated with growth hormone (GH), and their follow-up. Currently, there is no systematic literature review on the scope and characteristics of pediatric GH registries. Therefore, the purpose of this systematic review is to identify worldwide registries reported on pediatric GH treatment and to provide a summary of their main characteristics. Content Pediatric GH registries were identified through a systematic literature review. The search was performed on all related literature published up to January 30th, 2021. Basic information on pediatric GH registries, their type and scope, purpose, sources of data, target conditions, reported outcomes, and important variables were analyzed and presented. Summary Twenty two articles, reporting on 20 pediatric GH registries, were included in this review. Industrial funding was the most common funding source. The main target conditions included in the pediatric GH registries were: growth hormone deficiency, Turner syndrome, Prader Willi syndrome, small for gestational age, idiopathic short stature, and chronic renal insufficiency. The main objectives in establishing and running pediatric GH registries were assessing the safety and effectiveness of the treatment, describing the epidemiological aspects of target growth conditions and populations, serving public health surveillance, predicting and measuring treatment outcomes, exploring new and useful aspects of GH treatment, and improving the quality of patient care. Outlook This systematic review provides a global perspective on pediatric GH registries which can be used as a basis for the design and development of new GH registry systems at both national and international levels.

Introduction: Cytolethal distending toxin (Cdt) is one of the bacterial toxins that present in a variety of Gram-negative human pathogens, such as E. coli, Salmonella spp., and Campylobacter spp. CDT composed of three subunits encoded by three adjacent genes, including cdtA, cdtB and cdtC. It is approved that cdtB had toxic activity and caused DNA damage of the host cell. Despite its presence in different bacterial species, role of Cdt in acute and chronic infections, such as gastroenteritis and irritable bowel syndrome (IBS) is unclear. To analyze this correlation, we studied the prevalence of cdtB among different enteropathogenic bacteria in patients with gastroenteritis and IBS compared with healthy people.Materials and Methods: In this cross-sectional descriptive study, 230 stool samples were collected from patients with gastroenteritis, IBS, and healthy people. The presence of Cdt-B encoding bacteria, including Escherichia coli, Campylobacter spp., Yersinia entercolitica, Providencia alkalifacience, and Salmonella enterica was examined by polymerase chain reaction using genus specific primers. Results: Out of 230 stool samples, Cdt-B encoding Campylobacter spp. were found in 34.6% (52/150), 6.25% (5/80), and 4% (2/50) of the patients with gastroenteritis, IBS, and the control group, respectively. Carriage of Cdt-B encoding Salmonella enterica was characterized among 5.3% (8/150) of the patients with gastroenteritis and 17.5% (14/80) of the IBS patients. Although none of the patients carried cdtB of E. coli and Providencia spp., cdtB of Y. enterocolitica was detected in 1 of the patients with gastroenteritis (0.6%). Statistical analysis showed significant correlation between infection with CdtB-encoding Campylobacter spp. and IBS-D subtype. No significant correlation was found between infection with Cdt-B encoding bacteria, and other clinical and demographic data.Conclusion: Our results confirmed relatively higher frequency of Cdt-B encoding bacteria in the intestine of IBS patients and those with gastroenteritis compared with healthy individuals. Regarding the frequency of Cdt-B encoding Salmonella and Campylobacter bacteria, it was proposed that infection with these enteropathogens could be considered as a risk factor for the development or progression of IBS among the Iranian patients. Further studies are needed to establish this involvemet.

Background: Diarrhea remains a serious public health problem, which could be life- threatening in children. Salmonella and Shigella are among the main responsible agents. Fluoroquinolones are the most common antibiotics prescribed to treat these infections; however, increasing rate of resistance and its spread through plasmid- mediated quinolone resistance (PMQR) genes should be considered for medication in each country. To achieve this aim, the current study was conducted to determine the frequency of PMQR genes in Shigella and Salmonella isolates of pediatric patients with acute diarrhea. Methods: In this study, Shigella and Salmonella isolates from fresh stool samples of diarrhea patients were included from May 2017 to May 2018. All the isolates were characterized by conventional phenotypic and molecular methods. The antibiotic resistance profiles and the frequency of PMQR genes were determined by standard susceptibility and molecular test methods. Results: The highest antibiotic resistance rate among Shigella and Salmonella isolates was related to trimethoprim-sulfamethoxazole (37/40; 92.5%) and cefoxitin (5/45; 11.1%), respectively. Although qnrS, qepA, and aac (6¢)-Ib-cr genes were characterized in 32.5%, 2.5%, and 2.5% of the Shigella strains, qepA (17.7%) and qnrS (4.4%) were among the common PMQR determinants in the Salmonella isolates, respectively. The reduced susceptibility to ciprofloxacin was detected among 25% and 22.2% of PMQR-harboring strains of Shigella and Salmonella, respectively. Conclusion: Low rates of ciprofloxacin resistance and low frequency of MDR Salmonella and Shigella isolates were characterized in this study. Most of the isolates that carried PMQR determinants presented only low-level resistance and reduced susceptibility to ciprofloxacin.

Objective: Sexual Quality Of Life (SQOL) is an important dimension of women's quality of life and several factors affect it. In this study, the relationship between SQOL with sexual function and sexual distress of clinical married employed women was investigatedMethods: The present study is a cross-sectional study that was performed on 385 clinical married employed women in hospitals of Tehran city Universities of Medical Sciences, using multi-stage sampling method during 2018. The research instruments include demographic information questionnaire, standardized Persian versions of female sexual function, female sexual distress scale, SQOL-F and Beck depression questionnaires and a researcher-made questionnaire of factors related to SQOL. The study data were analyzed using SPSS18 statistical software and the application of independent t-test, one-way ANOVA, chi-square and multiple linear regression.Results: 43.4% and 41.8% of the participants respectively had poor quality of sexual life and high sexual distress; While 64.7% of them had low sexual function. The variables of job type, education (postgraduate, bachelor’s and master’s degree) and domains of desire, satisfaction and pain in FSFI, total sexual function score and sexual distress score, were related factors to SQOL score.Conclusions: The majority of subjects in this study had good sexual quality of life but low sexual function, so the sexual quality of life in women can be affected by various factors (not just sexual function).

The antimicrobial susceptibility testing of 284 Enterobacteriaceae isolates responsible for urinary tract infections to ampicillin, ceftazidime, ciprofloxacin, nitrofurantoin, trimethoprin-sulfamethaxole, and fosfomycin was performed by disk diffusion method. Additionally, in fosfomycin-resistant and intermediate susceptible isolates using disk diffusion method, the minimum inhibitory concentration (MIC) of fosfomycin was determined by agar dilution. The presence of fosA and fosA3 genes and ESBL genes was investigated in fosfomycin-resistant isolates and ESBL-producing isolates, respectively. Klebsiella pneumoniae 72.34% (34/47), and Escherichia coli 58.23% (138/237) were identified as ESBL-producers by phenotype. These isolates were positive for the presence of blaTEM, blaSHV, blaCTX-M genes in 56.97% (n = 98), 55.23% (n = 95), and 78.48% (n = 135), respectively. Resistance to fosfomycin was detected in 9.4% (13/138) and 5.9% (2/34) of the ESBL-E. coli and ESBL-K. pneumoniae isolates. In fosfomycin-resistant isolates, the presence of the fosA gene was detected in two ESBL-E. coli isolates; the fosA3 gene in one non-ESBL E. coli isolate; and the fosA3 gene co-harboured with blaCTX-M in six ESBL-E. coli (n = 5) and one K. pneumoniae isolates. A high prevalence of ESBL-producing Enterobacteriaceae (72.6%) was detected in urine samples. Fosfomycin showed the highest susceptibility rate (>= 87%) of antimicrobials tested in ESBL-producing E. coli and K. pneumoniae isolates. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.

Rhamnolipid (RL) biosurfactant which is produced by Pseudomonas species is one of the most effective surface-active agents investigated in the literature. Over the years, many efforts have been made and an array of techniques has been developed for the isolation of RL produced strains as well as RL homolog characterization. Reports show that RL productivity by the best-known producer, Pseudomonas aeruginosa, is very diverse, from less than 1 gr/l to more than 200 g L−1. There are some major parameters that can affect RL productivity. These are culture conditions, medium composition, the mode of operation (batch, fed-batch and continuous), bioengineering/gene manipulation and finally extraction methods. The present paper seeks to provide a comprehensive overview on the production of rhamnolipid biosurfactant by different species of Pseudomonas bacteria. In addition, we have extensively reviewed their potential for possible future applications.

The bursting increase in requesting wireless data has caused several issues in network peak-traffic duration. This negatively results in significant data delivery delay imposed on users that can eventually impact the network’s quality of service and users’ quality of experience. In this research, regarding mobile edge caching as a potential solution to decrease such delay, we propose a new framework in which we introduce the concept of the flexible user where he requests for a set of multiple files from the library with a unique feature, e.g., 5 movies within comedy genre from the library in the peak-traffic duration. The satisfactory criterion for the flexible user is to receive any of the files within the requested set. This definition of the flexible user indicates a new concept which captures interesting scenarios. In order to model this concept, we generalize the conventional Zipf distribution to a multivariate one as the modeling method for popular data. We formulate the problem of finding the optimal cache data placement, which minimizes the average total delivery delay in the network while satisfying the helpers’ cache size constraints. To this end, we derive the average delivery delay per user as well as the average total delivery delay in the network, according to the new generalized Zipf distribution. Finding the optimal solution is proved to be NP-Hard. We leverage on the problem property to propose an efficient approximation method, called greedy algorithm, which performs within a constant factor as good as the optimal solution. Afterwards, we propose an algorithm called speedy-greedy to significantly reduce the computational complexity of the greedy algorithm while achieving the same performance. Simulation results indicate that our proposed framework significantly decreases the average total delivery delay of the system model that can help the network maintain its quality of service in network peak-traffic duration.

Health authorities have always faced the challenge of organizing health-related processes. One of the most important processes is locating health centers, clinics, hospitals, etc. Is. With increasing demand, efforts have been made to increase the efficiency of existing systems and the use of new efficient systems (their type of facilities and location) by health managers. Therefore, the use of new and efficient scientific methods in the direction of health planning has always been of interest to managers and researchers in this field. Considering the huge costs of establishing health centers and their importance, this important issue has been taken into consideration. Accordingly, in this paper, we have presented a multi-objective locating model with maximum coverage. In this model, the distance of centers from demand points, demand rates, and service rates are expressed as triangular fuzzy numbers and also queue theory has been used to improve the quality of the system.

Background: Cytolethal distending toxin (Cdt) is one of the bacterial toxins that present in a variety of Gram-negative human pathogens, such as E. coli, Salmonella spp., and Campylobacter spp. CDT composed of three subunits encoded by three adjacent genes, including cdtA, cdtB and cdtC. It is approved that cdtB had toxic activity and caused DNA damage of the host cell. Despite its presence in different bacterial species, role of Cdt in acute and chronic infections, such as gastroenteritis and irritable bowel syndrome (IBS), is unclear. To analyze this correlation, we studied the prevalence of cdtB among different enteropathogenic bacteria in patients with gastroenteritis and IBS compared with healthy people. Materials and Methods: In this cross-sectional descriptive study, 230 stool samples were collected from patients with gastroenteritis, IBS, and healthy people. The presence of Cdt-B encoding bacteria, including Escherichia coli, Campylobacter spp., Yersinia entercolitica, Providencia alkalifacience, and Salmonella enterica was examined by polymerase chain reaction. Demographic data and type of disease was collected through interview and a questionnaire.Results: Out of 230 stool samples, Cdt-B encoding Campylobacter spp. were found in 34.6% (52/150), 6.25% (5/80), and 4% (2/50) of the patients with gastroenteritis, IBS, and the control group, respectively. Carriage of Cdt-B encoding Salmonella enterica was characterized among 5.3% (8/150) of the patients with gastroenteritis and 17.5% (14/80) of the IBS patients. Although none of the patients carried cdtB of E. coli and Providencia spp., cdtB of Y. enterocolitica was detected in 1 of the patients with gastroenteritis (0.6%). Statistical analysis showed significant correlation between infection with CdtB-encoding Campylobacter spp. and IBS-D subtype. No significant correlation was found between infection with Cdt-B encoding bacteria, and other clinical and demographic data.Conclusions: Our results confirmed relatively higher frequency of Cdt-B encoding bacteria in the intestine of IBS patients and those with gastroenteritis compared with healthy individuals. Regarding the frequency of Cdt-B encoding Salmonella and Campylobacter bacteria, it was proposed that infection with these enteropathogens could be considered as a risk factor for the development or progression of IBS among the Iranian patients. Further studies are needed to establish this involvement.

Rhamnolipid (RL) biosurfactant which is produced by

To evaluate the ground susceptibility of urinary Escherichia coli and Klebsiella pneumoniae to temocillin, the susceptibility of temocillin and comparators against 500 clinical isolates (231 E. coli and 269 K. pneumoniae) was tested. Temocillin was either found as the most active antibiotic (susceptibility rate of 92%) or the fourth most active antibiotic (65%), as per its urinary and systemic breakpoint, respectively. No difference of activity was observed in isolates expressing ESBL/AmpC enzymes. Considering the percentage of isolates expressing beta-lactamases and the need to spare broad-spectrum antibiotics, temocillin seems promising for treating urinary tract infections.

The aim of this study was to characterize virulence factors and antibiotic resistance patterns in E. faecalis strains obtained from community-acquired urinary tract infections. A total of 70 E. faecalis isolates from Labbafinejad Hospital in Tehran were collected. Antibiotic resistance and virulence determinants were examined by phenotypic and molecular methods. Among 70 E. faecalis isolates, efba (97.1%), ace (95.7%), and gelE (94.3%) were the most prevalent virulence genes. The most common antibiotic resistance pattern was tetracycline (88.6%) and minocycline (87.1%). Multi-drug resistant phenotype was detected among 10% of them. Our results showed capability of E. faecalis strains for infection of the urinary tract in community. Involvement of virulence determinants in the pathogenesis of community acquired E. faecalis strains was proposed due to their high prevalence rates. Food producing animals were proposed as their environmental reservoirs, due to dominance of tetracycline resistance phenotype among them.

Lactobacillus dellbrueckii cultured in MRS and harvested in the late log phase was entrapped in the inner aqueous phase of a water-in-oil-in-water (W1/O/W2) Pickering emulsion stabilized by inclusion complexes having d32 of 3.6 μm formed from β-cyclodextrin (β-CD) and the results were compared to the corresponding double emulsions with Tween-80 as the secondary emulsifier. The stability of emulsions prepared at various primary emulsion contents and emulsifier concentrations was investigated. Emulsion morphology was observed by polarization microscopy and size distributions of dispersed droplets were examined to establish emulsion stability. The solid-like property of the test W1/O/W2 emulsions was found to dominate based on the oscillatory experiments results (G′>G″). The precipitated fraction obtained upon centrifugation of the emulsion phase was structurally characterized using 1H nuclear magnetic resonance (NMR) spectroscopy and scanning electron microscopy (SEM) and the solid inclusion complex formation between β-CD and double emulsion contents was confirmed. The existence of L. dellbrueckii in β-CD containing emulsions was evidenced by Fourier transform infrared (FTIR) spectroscopy in ATR geometry and fluorescence microscopy. Moreover, the survival of the entrapped cells (initial number = 8.17 log CFU/ml) increased significantly with use of β-CD compared to Tween-80. It is concluded that the double emulsion prepared using β-CD protected L. dellbrueckii and the experimental findings of the present study are a fundamental guide for practical applications in food industry.

Background: eHealth has a notable potential to help in prevention, diagnosis, treatment, screening, management, and control of the COVID-19 pandemic. Since ehealth is considered here broadly, as an umbrella term, it also covers subsets like telehealth and mhealth. This study aimed to review the literature to identify and classify subdomains of eHealth solutions that have been utilized, developed, or suggested for the COVID-19 pandemic. Methods: A comprehensive literature search was performed using the PubMed, Scopus, Embase, and Cochrane library databases in April 2020, with no time limitation. The search strategy was built based on 2 concept domains of eHealth solutions and covid-19. For each concept domain, the search query comprised a combination of free text keywords identified from reference papers and controlled vocabulary terms. Obtained results were classified, graphically presented, and discussed. Results: Of the 423 studies identified initially, 35 were included in this study. From related papers, general characteristics, study objective, eHealth-related outcomes, target populations, eHealth interventions, health service category, eHealth solution, and eHealth domain were extracted, classified, and tabulated. Most publication types were ideas, editorials, or opinions (46%). The most targeted populations were people of the community and medical staff (80%). The most implemented or suggested eHealth solution was telehealth (63%), followed by mhealth, health information technology, and health data analytics. Most of the COVID-19 ehealth interventions designed or suggested for improving prevention (48%) and diagnosis (48%). Most of the studies applied or proposed eHealth solutions for general practice or epidemiological purposes (48%). Conclusion: eHealth solutions have the potential to provide useful services to help in COVID-19 pandemics in terms of prevention, diagnosis, treatment, screening, surveillance, resource allocation, education, management, and control. The obtained results from this review might be used for a better understanding of current ehealth solutions provided or recommended in response to the COVID-19 pandemic.

Methicillin resistant Staphylococcus aureus (MRSA) is one of the most important etiology agent of community and hospital acquired infections. In our country, the prevalence of MRSA is estimated to be 50%. The aim of present study was to determine the prevalence of MRSA and Vancomycin resistant Staphylococcus aureus isolates in an Iranian 1000-bed tertiary care hospital. During a period of September 2013 and June of 2014 a total of 220 nonduplicate S.aureus strains were isolated from clinical specimens. PCR and Cefoxitin disk diffusion methods were used for detection of MRSA. Vancomycin screen agar (BHI agar containing 6µ/ml Vancomycin) and E-test MIC method were used for detection of VISA VRSA. The susceptibility testing of isolates to other antibiotics was used by the disk diffusion method as recommended by CLSI. In our study 145 (65.90%) out of 220 isolates were isolated from urine and the others were isolated from other specimens such as wound and tracheal aspirates. By PCR method 105(47.72%) isolates were found to be MRSA. In our study the results of Cefoxitin disk diffusion method was in accordance to PCR. No VISA and VRSA isolates was determined by Vancomycin screenagar and E-test. The sensitivity and specificity of Cefxoitin disk diffusion method for detection of MRSA was 100%.It is concluded that the rate of MRSA and VRSA in our study was 47.72% and 0% respectively. In laboratories with limited sources for performance PCR, other methods such as Cefoxitin disk diffusion and Vancomycin screen agar are the best alternative methods for detection of MRSA, VISA and VRSA. ______________________________________________________

In this work, the adsorption of cadmium ions (Cd (II)) and lead ions (Pb (II)) in a single and binary component system with activated carbon were investigated in series of batch laboratories studies. The effective operating parameters like initial pH (pH0), initial concentration of metal ions, contact time, and temperature on the adsorption were investigated. The validation of the kinetic study shows that the adsorption process is better prediction by the pseudo-second-order model. The extended Freundlich and Langmuir isotherms were applied to the study of the binary system. The results show that the metal ion adsorption capacities of activated carbon have increased with increasing pH, and it was found that pH solution about 5.5–6 was the optimal pH value for maximum Pb capacity and 7–8 for Cd (II). Response surface methodology (RSM) was applied to find optimal conditions, that were perceived as follows: the initial pH: 6.3, temperature: 56.8 °C and shaking speed: 308 rpm. The order of adsorption capacity values for each metal ions was as follows: Pb (II): 9.30 mg. g−1 > Cd (II): 9.26 mg. g−1.

Among microorganisms, bacteria are the main group of biosurfactant-producing organisms. Different types of bacteria including Pseudomonas sp., Acinetobacter sp., Bacillus sp., and Arthrobacter sp. are among the most commonly studied bacteria in the realm of scientific research. However, due to the pathogenic nature of the producing organisms, the application of these compounds is restricted, therefore, not suitable for use in food-related industries. Given that probiotic bacteria impact human health, applying probiotics as nonpathogenic and safe organisms have gained much attention for the production of biosurfactants in recent years. Most biosurfactants obtained from probiotic bacteria are related to a number of lactic acid bacteria (LAB). These types of biosurfactants are classified based on their structures as protein-carbohydrate complexes, lipids, or fatty acids. The present paper seeks to provide comprehensive and useful information about the production of various kinds of biosurfactants by different probiotic bacteria. In addition, we have extensively reviewed their potential for possible future applications.

Broad-spectrum β-lactams are used for empirical therapy of severe infections with non-typhoid Salmonella serotypes; however, activities of these drugs against the strains producing different β-lactamase is not so clear. This study investigated the prevalence of β-lactamase genes among isolates of S. enterica serovars from human faecal samples and determined their diversity in activity against different β-lactams.Antimicrobial resistance of faecal isolates of S. enterica to extended-spectrum cephalosporins was analysed and MIC values were determined for the strains presenting extended-spectrum β-lactamases (ESBLs) phenotypes. The β-lactamase genes were identified by PCR and sequencing. β-lactamase activity of the Salmonella strains exhibiting ESBL phenotype was detected by biological, iodometric, spectrophotometry and nitrocefin assays.Out of 202 S. enterica isolates, ESBLs phenotype was detected among 3.4% (7/202) of the strains. blaTEM-1 and blaCTX-M-15 were among the frequent β-lactamase genes. Detection of blaTEM-169 in S. enterica serovar Typhimurium and S. enterica serovar Bredeney and blaPER-1 in S. enterica serovar Infantis was a new finding in this experiment. Location of blaCTX-M-15/blaTEM-169/blaPER-1 genes on plasmid was confirmed in a transformation experiment. While crude extracts of the enzymes from each strain showed higher activity against cephalothin and cefotaxime, the lowest activity was detected against ceftazidime. The greatest synergistic activity was seen in a strain of S. enterica that carried blaCTX-M-15 and blaPER-1 genes compared with those presenting blaCTX-M-15/blaTEM-169 or blaCTX-M-15/blaTEM-1 genotypes.The results show dissemination of ESBLs encoding genes and their combined activity among different serovars of S. enterica that are a threat for future treatment options.

The green reaction of isatoic anhydrides with α-amino acids in presence of the ionic liquid 1-butyl-3-methylimidazolium bromide afforded 1,4-benzodiazepine-2,5-diones in excellent yields in absence of a catalyst. The reaction workup is simple and the ionic liquid was easily recovered from the reaction and reused. The methodology was quite general and a range of cyclic and acyclic α-amino acids were examined to produce 1,4-benzodiazepine-2,5-diones.

Background: Infectious diarrhea is one of the most frequent diseases among children, especially in developing countries. Objectives: The aim of this study was to determine the etiological agents and drug resistance patterns of common enteric pathogens isolated in an Iranian 1000-bed tertiary care hospital.. Patients and Methods: In a retrospective study, we analyzed the etiology and drug resistance patterns of enteric pathogens associated with diarrheal cases. The study was carried out in the Milad hospital of Tehran over two years, from April of 2012 to January of 2014. Stool specimens from patients with diarrhea (n = 7321) were examined for enteric pathogens using routine microbiological culture methods. Strains of Salmonella, Shigella, and enteric pathogenic E. coli (EPEC) were serotyped and their susceptibility to commonly used antimicrobial agents was determined by a disk diffusion method, as recommended by the clinical and laboratory standards institute (CLSI) guidelines. Results: Enteric pathogens were isolated from 310 (4.23%) of the patients. The most frequently isolated microorganisms included enteropathogenic E. coli (EPEC), Salmonella, and Shigella spp. The majority of the isolates of EPEC were resistant to commonly used antibiotics such as ampicillin (85.61%), cefixime (79.41%), and nalidixic acid. Resistance among other enteric pathogens was also prevalent. About 45.70% of the Salmonella isolates were resistant to chloramphenicol, and 87.95% were resistant to sulfamethoxazole/trimethoprim. Resistance of the Shigella isolates to nalidixic acid in comparison to the resistance recorded in previous studies was higher. Conclusions: The results show that enteric bacteria, including EPEC, Salmonella spp., and Shigella spp. are the major causative agents of diarrhea in the hospital. The emergence of antimicrobial resistance among enteric pathogens is an important problem for public health. Considering the threat of emerging antimicrobial resistance among enteric pathogens, a better surveillance system is necessary.

Purpose: Cancer is a most important disease, and female reproductive system cancers are the most common cause of women mortality rate. Materials and Methods: This cross-sectional study analyzed medical record data for 4460 patients in Mazandaran population-based cancer registry. Results: The mean (standard deviation) age of these patients was 53.45 years, and the incidence rate of female reproductive cancers (age-standardized incidence rate) was 8.51 per 100,000 persons-year. These cancers incidences were more in urban than rural, but this difference was not significant. Differences between frequency of uterus and ovary cancers with tumor behavior are significant (P = 0.046). Conclusion: This certainly calls for further attention to preventive and treatment planning on female reproductive system cancers.

Background: Urinary tract infection (UTI) is one of the most common infectious diseases and nosocomial infections worldwide, and uropathogenic Escherichia coli is the primary cause of UTI. Due to increased antibiotic resistance and the emergence of multidrug resistant (MDR) UPEC clones, the treatment of UTI is difficult. The occurrence of MDR in E. coli has been attributed to the AcrAB-TolC complex of efflux pumps. Objectives: The aim of this study was to complete a frequency evaluation of acrA and acrB genes among UPEC MDR strains isolated from patients with UTI who were admitted to Milad hospital in Tehran. Methods: For 123 UPEC strains that were isolated and diagnosed from the urine samples of patients using biochemical tests, antibiotic susceptibility was carried out using the disc diffusion method according to CLSI guidelines. Isolates that were resistant to at least one antimicrobial agent in three or more of the categories were considered to be MDR. The presence and frequency of acrA and acrB genes was determined using PCR. Results: The rates of antibiotic resistance to ampicillin, cefalotin, tetracycline, cefazolin, ceftriaxone, ceftizoxime, ceftazidime, ciprofloxacin, and cotrimoxazole were 82.9%, 78.1%, 61.1%, 49.5%, 38.2%, 30.2%, 26.1%, 42.2%, and 60.1%, respectively. The isolates were most sensitive to nitrofurantoin (95.9%), gentamicin (77.2%), and amikacin (71.5%). A total of 78% of the isolates were MDR. The frequency of the acrAgene was 82.90%, the acrBgene was 95.90% andacrA+acrBwas 95.90%. There was no significant difference between acrA and acrB frequency relating to bacterial antibiotic resistance. Conclusions: Our results showed that ways to control the treatment of UTI for the prevention of MDR occurrence should be sought. For a better study of efflux pumps, a comprehensive and detailed study regarding the presence of efflux pumps gees is required.

Optimum reaction conditions are studied for the regioselective and diastereoselective synthesis of spiro-isoxazolidines of type (V) or (VII) via 1,3-dipolar cycloaddition reaction of the stable isatin ketonitrone (III) and various dipolarophiles of type (IV) or (VI).

The green reaction of isatoic anhydrides with α-amino acids in presence of the ionic liquid 1-butyl-3-methylimidazolium bromide afforded 1,4-benzodiazepine-2,5-diones in excellent yields in absence of a catalyst. The reaction workup is simple and the ionic liquid was easily recovered from the reaction and reused. The methodology was quite general and a range of cyclic and acyclic α-amino acids were examined to produce 1,4-benzodiazepine-2,5-diones.