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Abstract Background and objectives: HTLV-1 virus belongs to the retrovirus and infection with this virus mostly is seen among people having more than one time blood transfusion. Because of requiring repeated blood transfusions, thalassemic patients are considered to be high risk subjects in this regard. Thus, this study was carried out to indicate the frequency of HTLV-1 infection among the thalassemic patients. Materials and Methods: Blood samples of 181 thalassemic patients referred to Taleghani hospital during nearly two years (2004-2005) were taken. By using ELISA technique, the sera were assessed to determine HTLV antibody. The positive ones subsequently were examined by western Blot (kit, 2.4) to confirm the ELISA positive samples and also to recognize the HTLV type. Results: Of 181 thalassemic patients, 93 (51.4%) were male. The age was between one and twenty five (14.11 ± 6.5). 93.4% (169) were received packed cell only once in a month. 14.9% (27) were HTLV positive by ELISA technique, while just eight out of these 27 were considered to be true positive by Western blot and to be contaminated by type one virus. Of all subjects, 4.4% were positive HTLV1. Furthermore, the contamination with this virus is increased as the patients getting older. Conclusion: The findings indicated that among the thalassemic patients in Gorgan, there are cases with HTLV-1 whose frequency is correlated with the other part of our country. Consequently, further comprehensive studies are required to identify those infected blood donated to minimize the transmission risk of this infection in the society and in particular among the people receiving blood, such as thalassemic patients. Keywords: HTLV-1 antibody, thalassemic patients, ELISA, western Blood, Gorgan Journal

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Abstract Background and Objectives: Fluoride is one of the anions existed in water and soil. Its amount is not the same in different kind of water. Since the most of body's need to fluoride should be provided by drinking water, this study was aimed at determining the fluoride level in water supply of Gorgan rural regions. Materials and Methods: In this Cross-Sectional study, the subjects were all 67 water sources of the region. Every season, a one litter Sample was taken in a plastic Container and tested by SPADS Method. After Collecting and encoding the data, ANOVA was used to analyze. Results: The Findings shows that there are 4 springs and 63 wells which are Located in the mountainous (N=16) and flat (N= 47) regions. In every season, the average fluoride Level was lower than Standard Level (1.5 mg/L). The difference between fluoride Level of wells (0.39±0.15mg/L) and springs (0.16± 0.13mg/L) is Significant (p<0.05) the fluoride Level of mountainous wells is higher than wells located in flat regions (0.13mg/L). This deference was Significant (p<0.05). Conclusion: Based on The results revealing the fluoride Level of drinking water in Gorgan Rural region is less than international Standard, we recommend adding of Supplementary fluoride in foodstuffs of The people Living in This region. Key words: fluoride, drinking water resources, Gorgan, spring

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Abstract Background and objectives: Herpes simplex virus type two (HSV-2) infections are mostly considered as a sexually transmitted disease. It causes genital herpes, newborn herpes non-pyrogenic meningitis and may act as an underlying factor for HIV infection. This study was conducted to determine the sero-epidemiologic prevalence of herpes simplex virus type two in cases referred to ten clinical laboratories of Gorgan. Materials and methods: This cross- sectional study was performed on blood Samples of 406 randomly selected Clients. These samples were analyzed for Anti HSV-2 using Specific enzyme-Linked immunoassays (ELIZA) Results: Four point nine percent of all subjects have anti HSV-2. There is Significant difference between sero-positive HSV-2 and factors such as age and Marital Status (P<0.05). Conclusion: HIV is progressively increased and HSV-2 infection is one of the major risk factors for HIV therefore, decreasing the prevalence of HSV-2 infections may Leads to the reduction of HIV prevalence. Key word: HSV-2, Antibody, Gorgan, Sero-epidemiology.

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Abstract: Introduction: Influenza is highly transmitted disease and vaccination is the most effective way to prevent influenza. This research was designed to study the variation of serum antibody level among the subjects had already been vaccinated against influenza. Materials and Methods: This research is a descriptive-analytical study, which was carried out on 196 subjects who had influenza vaccination (influvac 2005/2006) and 200 subjects matched by the vaccinated subjects, by age. The subject's serums were prepared seven weeks after influenza vaccination, and the control group's serums were also prepared. The serum antibody level was determined by haemaglutination inhibition test. Results: The mean age of case group is 52.2±11 and control group 48.64±5.17.The antibody titre of 115 of Vaccinated group and 15 of control is less than 40 1 The mean antibody titer of vaccinated subjects and control group is 143.4 ± 10.89 and 18.34± 3.2, respectively. The difference is statistically significant (P value=0.000). Conclusion: The findings show that the mean titer of antibody in vaccinated and control group is statistically different. It means that the influenza vaccine had a good efficacy. Key words: Vaccination, Influenza, Gorgan.

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Abstract Backgrounds and objectives: Herpes simplex virus type 1 (HSV- 1) infections are mostly shown as a Herpes disease, but It causes conjunctivitis, genital herpes, encephalitis and newborn herpes. This study was conducted to determine the sero-epidemiologic prevalence of herpes simplex virus type 1 in cases referred to clinical laboratories of Gorgan, Iran. Material and methods: In this cross sectional study, we did random blood sampling on 406 cases referred to the Gorgan city's clinical laboratories. These samples were analyzed for HSV-1 Immunoglobulin G and M antibodies using type- specific enzymelinked Immunoassays (ELISA). Results: Of 406 participants, the HSV-1 seroprevalence is 49% (44.3% and 4.7% for IgG and IgM respectively). There is not significant relationship between seropositive HSV-1 and gender, ethnicity, age and marital status. Conclusion: Sero-epidemiological of HSV-1 in Gorgan is the same of the other places in Iran, but it is higher than European and lower than African countries. It seems that the people’s culture is very important. Therefore it needs to be investigated more. Keywords: HSV-1, Antibody, Gorgan.

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Abstract Background and Objectives: Diarrhea is one of the most common diseases in the world. Campylobacter jejuni is one of the prevalent agents of bacterial diarrhea in most of developing countries. It is usually ignored in routine laboratory test in our country, because it has a difficult investigation method. This article aims to determine the prevalence of Campylobacter jejuni, in diarrhea samples in Gorgan City (East north of Iran) by PCR Method. Material and Methods: This descriptive study was performed on 455 diarrheal samples during one year (2005-06).255 out of them were cultured on Preston media (Himedia co.) on 42°c. DNA Extracted by phenol cholorophorm method was directly carried out on stool samples.16srDNA hipo and asp primers for detection of Campylobacter genus, C.jejuni and C.coli species were used, respectively. In addition, universal primer of 16srDNA was used for control of PCR method. Results: no sample was positive for Campylobacter in culture .only three samples were positive for Campylobacter genus and C.jejuni specific primer but none of them were positive for C.coli .99 samples were positive by universal primer of 16srDNA . Conclusion: The results indicate that C.jejuni isn't a prevalent agent in diarrhea in our region. Key words: Campylobacter jejuni -Gorgan- Diarrhea

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Abstract Background and objectives: Infection has a Leading role in pregnancy. Cytomegalovirus (CMV), listeria and Toxoplasma are the most common causes of infection in human. Based on the previous researches, about 15-25 percent of being infected during pregnancy leads to some complications such as abortion, fetal death, early labor and etc. This study was designed to determine the seroprevalence of Cytomegalovirus (CMV), Toxoplasma gondii and Listeria moncytogenes among pregnant women in Gorgan, north of Iran (2005-2006). Material and Methods: we conducted this Simple randomized study on 118 unsuccessful pregnant woman and 99 successful ones referred to Deziani hospital in Gorgan. We assayed both IgG and IgM antibodies for CMV and Toxo by Elisa and IFA method for Listeria. In addition, we fill out a Check list and then use SPSS soft ware, chi square to analyze the data. Results: The frequency of IgG for CMV and Toxo is 89.9% and 45.5% in successful pregnant women and 77.1% and 44.1% for unsuccessful pregnant women (P=0.41, P=0.01). IgM frequency for CMV and Toxo is 14.1% and 46.5% in successful women and 30.5 and 21.7% in unsuccessful ones. (P=0.003, P=0.002)Total frequency (IgG, IgM) for Listeria is 7.62% and %3.03 in successful and unsuccessful women, respectively. There is a significant relation between abortion and IgM titer against Toxoplasma in successful and unsuccessful groups. (P=0.003).This relation is true for total antibody titer against Listeria (P=0.003). Conclusion: Because of high titer of antibodies against CMV, Toxo and Listeria in unsuccessful pregnant women, suffering from these agents during pregnancy may result in abortion and fetal death. Hence, we recommend to hold some preventive and educational program and also to assay antibodies against theses agents. Key words: Listeria moncytogenes, Cytomegalovirus (CMV), Toxoplasma gondii, success and non-success pregnancy, Serology, Gorgan

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Abstract Background and objectives: After respiratory infection, Diarrhea is the second cause of mortality. Yersinia enterocolitica is the second important cause of infectious diarrhea in children of some countries. In this study, we evaluated the frequency of Yersinia entocolitica of diarrheal specimens in Gorgan, Iran. Material and Methods: This descriptive cross - sectional Study was carried out on diarrheal stools of 455 patients referred to medical centers and laboratory of Gorgan in 2004-2005. DNA extraction using phenol chloroform was performed for all samples. Using two specific primers (genus-specific16s rRNA and ail- specific species genus of Yersinia enterocolitica), we did PCR sample. Results: Yersinia genome was identified in 12 patients(2.63%) and 11 of them was Yersinia enterocolitica. The frequency infection in of girls (3%) was more than boys (2.4%), and the prevalence in winter (4%) was more them other seasons, and under one- year- group (3.4%) and 1-5 years (3.1%) is more than other age groups. It was not observed significant difference. (P> 0.05). Conclusion: The frequency of Yersinia in cases of diarrhea in Gorgan is similar to most regions of Iran and in children under 5 years is observed more in winter. Key words: Yersinia enterocolitica, Diarrhea, children, Gorgan

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Abstract Background and objectives: Recurrent Abdominal Pain (RAP) syndrome is a common disorder, especially in children with beta thalassemia major. These patients are predisposed to heart diseases which are caused by hemochromatosis (Iron overload), resulting in sudden death. Because of the role of Helico bacter pylori in causing abdominal pain and peptic ulcer, and in increasing the risk or exacerbating of heart diseases, it can be important in beta thalassemia major. This study aimed at determining the frequency of anti- H.pylori class IgA in patients suffered from beta thalassemia major. Material and Methods: In this descriptive-analytic Study, 132 beta thalassemia major Patients and 135 healthy cases were matched by age, sex and ethnic as a control group. The sera were separated from clot in first Seroepidemiology and along with the filled questionnaires sent to Immunology-hematology Laboratory of paramedical school, in which the samples were tested by ELISA method with Diagnostic kit for anti-H.pylori IgA and IgG classes detection. We analyzed the Data by chi square and Independent T and Fisher tests. Results: the results show that the difference between the anti-H.pylori class IgA in case (22.7%) and control group (17.8%) is not significant (P=0.6), But it is significant between anti-H.pylori IgG class, 81.8% for cases and 54.8% for controls (P<0.001). Conclusion: Based on the results, the rate of anti-H.P IgA class in case is 1.131 times more than control group, which is not significant. On the other hand , the rate of anti-H.P IgG is 1.478 times more than control group which is significant. Key words: Thalassemia, Helicobacter pylori, Gorgan, Sero epidemiology.

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Abstract Background and objectives: Microbial, physical and chemical properties of drinking water, considering type and quantity of the drinking water, are the factors for determining the acceptability of water. The effect of each of the above components on increasing the quality of water or threatening the health of consumers is also considerable. We aimed to investigate the trace amounts of microbial, physical and chemical parameters of drinking water in Gorgan, comparing to national and international standard. Material and Methods: In this cross sectional study, 50 samples were taken, per month, from four pilot stations in urban water network of Gorgan during one year (2009- 2010). We used instant sampling and performed Enumeration of Coliforms in water culture with most probable number (MPN).Samples taken from the stations during the month were investigated in two general categories of device test and heading-meter. All experiments were performed using standard reference method. Results: of 598 water samples 551 (92.2%) have not Coliforms, 47 (7.8%) contain Coliforms and 16 (2.7%) of them have thermo-tolerant Coliforms. Mean water hardness is 413mg/L, base on carbonate calcium. The amount of fluoride about 0.35 mg and the residual chlorine about 0.6 mg is less than national standard amount. Conclusion: The results show that Gorgan water network is, in view of microbial contamination, safe during almost all days. All the tested samples in terms of physical and chemical parameters are in the range of nation and international standards. Hardness of drinking water of Gorgan is one of the highest. Key words: Bacteriological, Physiochemical, Drinking Water, Gorgan.

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Abstract Background and objectives: Food handlers could be the main sources of intestinal parasite transmission in case of not observing the hygienic rules. Contamination can be decreased by screening food handlers through physical exam and laboratory tests. The aim of this study was determining the prevalence of intestinal parasites in 2010. Material and Methods: This cross-sectional research was carried out on 500 randomly selected individuals engaged in different food related careers. After filling out the questionnaire sheets, two specimens of feces were collected from each person and tested by brine 30% (floatation) and direct methods. Result: The results show that the prevalence of intestinal parasites is 6%. The highest prevalence is relateted to Giardia lamblia ( 17 4.3%) and the lowest to Hymenolepis nana ( 3 0.6%). in the age group of 60-51 years (11.8%) and individuals who just able to read and write (7.4%) The highest percentage is observed. The Most contamination is reported in butchery staff (25%) and the lowest in people worked in butler's pantry, without parasitic infections. Conclusion: The prevalence of intestinal parasitic infections are high relatively, especially pathogenic protozoan therefore, it is important be careful about health status of these individuals and their role in the spread of pollution. Key words: Intestinal Parasites, Food Handlers, Prevalence, Gorgan

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Abstract Background and objectives: Hepatitis B virus infection is a major health problem in worldwide. The prevalence of Occult and chronic HBV in hemodialysis patients is higher than standard in developing countries. People with occult HBV are negative for HBV surface antigen (HBsAg) but positive for HBV-DNA. We aimed to evaluate occult hepatitis B infection in patients under hemodialysis in Panje-Azar hospital in Gorgan. Material and Methods: In this study, taken place from 2009 to 2010, the participants were 100 hemodialysis patients with administration of complete HBV vaccination with negative test for HBsAg. After preparing 10 milliliter blood sample, HBV DNA testing was performed by polymerase chain reaction (PCR). Result: The mean age of the patients is 54.60 years. They are male (48%) and female (52%). They have been under hemodialysis for 48 months, averagely. There has not been any HBV-DNA in HBsAg negative patients under hemodialysis. The rate of occult hepatitis B infection in these end stage renal disease (ESRD) patients was zero. Conclusion: Results indicate that there is no any occult HBV infection in ESRD patients under hemodialysis in Gorgan, which is similar to some studies. The results could be justified by complete vaccination of the patients. Key words: Occult Hepatitis B, Hemodialysis, HBsAg, Gorgan

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Abstract Background&Objectives: High prevalence of parasitic infections can be the result of the subclinical infections. Some regular and ongoing epidemiological studies are needed to combat and control these infections. This study was conducted on elementary school students to achieve an overview of the spread of parasitic infections in Gorgan. Material & Methods: In this cross-sectional study, using random cluster sampling, 800 of 7-12 year-old students were selected from 18 primary schools in Gorgan. The stool samples taken on three consecutive days were examined by two methods including direct smear and formalin-ether concentration. Results: Overall, 230 (28.8%) are infected by intestinal parasites. The protozoa are Blastocystis hominis (122 15/2%), Entamoeba coli (93 11/6%), Giardia intestinalis (79 9.9%), and Entamoeba histolytic (8 1%). The Helminthes are Hymenolepis nana (12 1.5%), Entrobius vermicularis (10 1.2%), Ascaris lumbricoides in 4 (0.5%) and hook worms (3 0.4). Conclusion: Based on the results, the prevalence of intestinal parasites is quite high among primary school students especially in families with low education level, income and sanitary level. Hence, it is a necessity to promote the hygienic knowledge of the students . Key words: Prevalence, Intestinal parasites, Primary schools students, Gorgan

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Abstract Background and objectives: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases. It is a functional bowel disorder characterized by chronic abdominal pain and alternation of bowel habits with no structural abnormality. The prevalence of this disease was estimated 10-20 percent in the world. However, the cause of IBS is still unknown. Regarding to intestinal absorption disorder of nutrients, the malabsorption of vitamin may occur. The aim of this study is to evaluate serum levels of vitamins A and E in IBS patients. Materials & Methods: This case - control study was done on 94 patients whom their IBS disease were confirmed by a gastroenterologist in Golestan province. The control group was selected from healthy people, who didn't show any signs of digestive problems in past two years. The age and sex were matched with the cases group. Using HPLC method, Fasting blood samples were collected .Followed by measurement of Serum levels of vitamins A and E. Results: the meanserum levels of vitamin A and E in patients and control group were 57.0 ± 114.8μg / dl and23.8 ± 55.9 μg / dl, and 0.50 ± 0.24 mg / dl and 1.93 ± 1.86 mg / dl, respectively. (P <0.05). in men, the deficiency of Vitamin A and E, were7.70 and 7.10 percent and 6.76 and 3.7 in women. (P <0.05).In general, 1.1percent of IBS patients showed Vitamin A deficiency and 93.6 percent of them had vitamin E deficiency (P <0.05). Conclusion: In this study, a significant decrease in vitamin E levels was observed in patients with IBS. Due to antioxidant activity of vitamin E, the deficiency of this Vitamin, can increase the oxidative factors leading to intestinal damages and it is expected to decrease the amount of vitamins, subsequently Keywords: Irritable Bowel Syndrome, Vitamin A, Vitamin E, Gorgan

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Abstract Background and Objective: In many countries, especially in developing countries, diarrheal diseases is one of the most important causes of mortality. In these countries, due to availability transfer conditions of parasitic infections, (pathogenic and non-pathogenic parasite), have a high prevalence. This study aimed was determining the prevalence of Parasites causing diarrhea in Gorgan . Material and Methods: This cross-sectional study was performed on 1086 Patients with acute diarrhea. The test was performing by the wetmount and formalin-ether concentration method according to WHO protocol. Results: From 1086 patients in study, 197 (18.1%) were infected by intestinal parasites, that 141 (13%) were infected with Protozoan and 79 (7.27%) were infected with intestinal worms. The prevalence of wet mount method was, Entamoebahistolytica in 69 (6.4%), Giardia lamblia in 27 (2.5%), Entamoeba coli in 15 (1.4%), Chilomastixmesnili in 8 (0.7%), and with formalin-ether method was Hymenolepis nana in 26 (2.4%), Trichostrongylus in 16 (1.5%), Enterobiusvermicularis in 10 (0.9%). Conclusion: The high prevalence of Entamoeba histolytica, is indicating protozoan importance as a cause of acute diarrhea. Keywords: Intestinal Parasites Diarrhea Wetmount Formalin Ether Gorgan

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Abstract Background and Objective: The excessive use of broad-spectrum antibiotics will lead to drug resistance of microorganism and specially nosocomial organisms. Because of high incidence of antibiotic resistance in hospitals, we aimed to study antibiotic resistance to gram negative bacteria. Material and Methods: This cross-sectional study was conducted on the data of biological samples (2006-2008), with positive culture result. Using antibiogram, microbial resistance to isolated microorganism was determined, and after culturing the samples, bacteria were identified by using differential media and antiserum. Then, antibiotic resistance was performed by disk diffusion. Results: The most common gram-negative microorganism obtained from all cultures was Ecoli with the lowest drug resistance to Nitrofurantoin. Conclusion: Based on the results, antimicrobial resistance pattern is not the same in different places and furthermore it is ever changing. Therefore, further research is needed to be done to have an accurate pattern of antibiotic resistance to provide effective treatment regimens. Key words: Antibiotic Resistance Disk Diffusion Gram Negative Bacteria Gorgan

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Abstract Background and Objective: Cream pastry, because of their ingredients, making process and preserving conditions are susceptible to many types of microbes. This study was conducted to determine the level of contamination of pastry cream in Gorgan. Material and Methods: The randomly selected samples (N = 450) were tested according to national standards for microbial tests and then the data was analyzed. Results: The level of contaminations for Enterobacteriaceae and Staphylococcus aureus was 56% and 43.3%, respectively. The highest contamination occurred in summer with Enterobacteriaceae (N= 113) and the lowest in spring with Staphylococcus aureus (N= 40). Also microbial contamination in different types of cream pastries showed the maximum level in cream puff (90%) and the minimum level in roll pastry (30.6%). Conclusion: There is a significant difference in infection rate between different samples. The infection rate in this study is more than the prevalence of past studies. Keywords: Cream Pastry, Enterobacteriaceae, Staphylococcusaureus, Gorgan

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Background: The hepatitis B virus (HBV) is a major public health problem worldwide. Vertical and horizontal transmission of HBV could affect neonates and partners. This transmission can vary in populations. Also, high-risk behaviors and clinical records affect the transmission of this virus. Due to the lack of information on vaginal discharge related to HBV in the north of Iran, we aimed to assess the presence of HBV in pregnant women's vaginal secretion referred to Sayyad Shirazi Hospital in Gorgan City, north of Iran.
Methods: This cross-sectional study was performed on 315 cervicovaginal lavages from pregnant women. Viral DNA was extracted, and the gene fragments of the virus were checked by polymerase chain reaction (PCR). Clinical, demographic, and behavioral data were entered into SPSS version 16. The chi-square tests were used to determine any association between categorical data.
Results: Hepatitis B virus DNA was detected in 2.2% (7/315) of samples. The age range of patients was from 14 to 43 years. Anal sex (P = 0.043) and not using a condom (P = 0.047) were significantly associated with HBV-positive cases. Abortion, unusual discharge, and some other clinical and demographic information showed no related statistical correlation.
Conclusion: The results showed a similar rate of infection in the general Iranian population. In pregnant women, the risk of HBV transmission and chronic HBV can be critical in newborns; therefore, it is strongly recommended to conduct screening and provide management for women during pregnancy.