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Abstract Background and objectives: Vibrio Cholera is one of the causative agents that can easily lead to death if the appropriate therapeutic measures are not taken in time. The purpose of this study is to identify the antibiotic sensitivity of the isolated V. choleras from the patients during the outbreak of Cholera in Golestan province, 2005. Materials and Methods: The Subjects were 97 positive cultured samples sent by different laboratories of Golestan province health centers .First, these samples were confirmed with microbiological and biochemical tests. Then, their antibiotic sensitivity was examined by Kirby –Bauer method (12 routine drugs were used).To obtain better results, the tests carried out in parallel by two expert technologists. Results: The participants, aged 29.8 +- 16 years, are male (52.6%) and female (47.1%). The highest antibiotic susceptibility pattern is related to Cephotaxime (91.6%), Ceftizoxime (87.8%), Oxcy Tetracycline (76.1%) while the most antibiotic resistance is referred to Nalidixic Acid (84.5%), Fourazolidin (50.7%) and Erythromycin (50.7%). During outbreak, Antibiotic resistance was not increased. Both technologists reports regarding Ampicillin, Tetracycline, Nalidixic Acid (kappa of 94%, 89%, 82%, p value<0.05) have the most agreement while it is not true about Erythromycin and Fourazolidin disks. (Kappa 67% and 62%, p value<0.05) Conclusion: Because of the resistance of Vibrio cholera to different antibiotic agent, it is important to determine their pattern to control and prevent the spread of drug resistance species. Key words: Vibrio cholera, Inaba, antibiotic resistance, Golestan

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Abstract Background and objectives: Blood culture is a critical part of evaluation of Neonate suspected wath Septicaemia. This phenomenon is one of the most important causes of neonates in Neonatal. Material and Methods: This study was carried out on 1470 somples of neonates suspected with bacteraemia , using reutine microbiologicul technique. The samples wene assessed in hazrate Masoomeh hospilal of Kermansha,Iran. Results and Conclusions: of all samples, 112 (7.62%) ane pasitive. Most of the Positive cultures were obtained after 24 hours of incubation in broth mediu. we Confirmed this result by using diseriminafiue culture media the Isolated bacteria are Coagulase-negative Staphylococus(28.6%),Alfahymolylic Streptococus(0.09%), staphylococus aureus(10.7%),Klebseilla(6.2%),pseudomonas(12.5%),moraxella(0.9%),acin eto bacter(13.4%), Alcalingenes(13.4%),protenos(1.8%) and salmonela (0.9%). Conclusion: the frequency of Coagulase-negative Staphylococus Isolated from neonates Blood culture is more than the other micro organisms. Generally, the frequency of gram negative bacteria is higher than gram Positive. Key words: Septicaemia, Blood culture, Bacteraemia, Neonatal

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Abstract Background and objectives: Since Rubella is an infectious disease with a few clinical symptoms, it is hardly diagnosed. Especially in the first trimester of pregnancy, congenital rubella is one of the major causes of neonatal mortality and permanent disablement in children. The aim of this study was to determine the sero immunity Level of The single Female student's after national rubella vaccination program in Iran. Material and Methods: This descriptive seroepidemiologic study was conducted on 129 single medical students. After taking written consent form, blood Sample was drawn. The anti-rubella IgG titer was evaluated using ELISA method. Statistical analysis was performed using SPSS (version10). Results: All Subjects had protective titer of anti-rubella antibodies. One hundred and eighteen students (91.5%) were immunized by taking rubella vaccine in the national vaccination program and only 11(8.5%) students reported that they suffered from natural rubella infection in the past. Conclusion: Based on the results of our study, vaccination against rubella in national vaccination program along with natural immunity caused by natural rubella infection in children could produce a protective immunity against rubella. Key words: Rubella, ELISA, vaccination, medical students

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Abstract Background and objectives: Genital tract infections are among the most common causes of patients referred to therapeutic centers. Nearly 75% of women suffer from genital Candida infection, at least once in their lifetime. The aim of present study was detection of Candida species causing vaginitis and the evaluation of antimycotic effects of ketoconazol, clotrimazole and fluconazole against Candida species. Material and Methods: In this study, 210 vaginal samples were obtained from the patients suspected of Vaginal Candidiasis. Direct examination and culture were carried out for all specimens to detect the yeast. The isolated yeast species were then identified, using various different tests such as culture on corn meal agar, tween-80, germ tube test, and assimilation test by API 20C kit by using Sabouraud Dextrose Agar and microdilution broth, MIC90 and MIC50 of drug were measured and determined their drug resistance. Results: In the present study, 100 yeast colonies were isolated from patients %80 are C. albicans and the rest are C. parapsilosis(2%), C. tropicalis(6%), C. glabrata(4%), C. krusei(2%), C. guilliermondii (3%), C.stellatoidea(3%). In terms of drug resistance test MIC50 and MIC90 of fluconazole for candida albicans are 5.33 and 35.27μg/ ml, respectively, and for non-albicans candida are 3 and 21.4μg/ml, respectively. Clotrimazole MIC for Candida albicans (MIC50, MIC90) 0.97 and 4.9μg/ml, respectively, and for non-albicans 0.63 and 3.4/ml, respectively. Kectoconazole MIC for Candida albicans 2.43 and 16.45μg/ml, respectively, and for non-albicans 1.12 and 6.6μg/ml, respectively. Conclusion: Clotrimazole has been better than the two other drugs for Candida species on the whole, non albicans species are more sensitive than albicans species in the presence of the drugs used in this study. Key words: Candida, vaginal candidiasis, Resistance drug , Tonekabon.

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Abstract Background and objectives: Identification and monitoring of multidrug-resistant Mycobacterium tuberculosis strains (MDR) is highlighted by the high risk of their spreading in different areas. Prevalence of these strains was evaluated in Golestan province in northeast of Iran. Material and Methods: Drug susceptibility testing to Isoniazid and rifampin was carried out for 148 clinical samples that had grown in Mycobacteria growth indicator tube (MGIT) system, according to the manufacturer's instructions (Becton-Dickinson, USA). The association of drug resistance frequency with demographic characteristics and growth time were investigated. The appropriate statistical tests, X2 and student T- test were performed for comparison of these variants. A p value>0.05 was considered significant in all cases. Results: The turnaround time required for growth of Mycobacterium tuberculosis in MGIT system was between 2 to 55 days (mean 16.3±10.4 days). Of all samples studied, 17.6% and 3.4% were resistant to Isoniazid and rifampin, respectively, and 3.4% (5 samples) were MDR (CI 95% 1-6%). The turnaround time required for determining MDR cases was 9.6 days. No statistically significant association was found between the resistance to the drugs and none of the factors including sex, age, type of clinical sample, and positivity of the smear. Conclusion: The prevalence of MDR in the studied region was determined to be 3.4% which is similar to the country-wide evaluations. The turnaround time for Mycobacterium growth and anti drug susceptibility result can be shortened by MGIT method. Key words: Mycobacterium tuberculosis, Mycobacterium Growth Indicator Tube, Multidrug Resistant

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Abstract Background and Objectives: Concurrent with the development of new chemical drugs and antibiotics, their harmful effects are gradually emerged. Due to lack of harmful effects, herbal medicines have been used in the pharmaceutical industry. The aim of this study was the use of lavender essential oil as an herbal medicine for the replacement of antibiotics and chemicals. Material and Methods: In this study, the plant essential oil was isolated by drying and distillation method using Clevenger apparatus. The antibacterial effect of this plant was evaluated by using disc diffusion method and successive dilutions. In order to control the standard of the method, antibiotic discs and standard bacterial strains were used. Results: Based on the results, Proteus mirabilis and Enterococcus faecalis are , respectively , the most sensitive and most resistant bacteria to dilutions of 1, 1/2 and 1/4. Escherichia coli and Enterococcus faecalis, respectively, are the most sensitive and most resistant bacteria to the dilution of 1/8, 1/16, 1/32 and 1/64. MIC and MBC methods also show that all bacteria have the same minimum inhibitory and fatality concentrations except Enterococcus faecalis with minimum inhibitory concentration of 16/1 and minimum concentration fatality of 8/1. Evaluating the results of the disk diffusion method with antibiotic discs, we can observe the better effect of this plant in comparison with gentamicin and streptomycin discs on the growth of five strains of Staphylococcus aureus ATCC1885, Staphylococcus epidermidis ATCC 2405, Enterococcus faecalis ATCC2321, Escherichia coli ATCC 1652 and Proteus mirabilis ATCC 2601. Conclusion: the essential oil of Lavender can be used instead of chemical drugs to treat bacterial infections. Keywords: Lavandula, Anti-bacterial effects, Essential oils, Bacterium

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Abstract Background and Objective: One of the most common diseases of keratin tissues is dermatophytosis caused by dermatophyte fungi. Because of being contagious, it has a high prevalence rate in wrestling and body building gyms. This study was designed to evaluate the process of this disease and improve the hygiene of halls. Material and Methods: The Samples (N= 540) were obtained from athletes and gyms, and a questionnaire was used to gather information. To identify various specious of dermatophyte, the routine diagnostic procedures, culture media, and supplementary tests were performed. Results: Of samples taken from athletes, 59 wrestlers and 11 body builders suffer from dermatophytosis. Trichophytontonsurans (%28.81) and Epidermophytonfloccosum (%36.36) are the main isolates in wrestlers and body builders. Also the rate of epidermophytonfloccosum (%37.5) is the highest in the samples taken from gym mats and halls. Conclusion: Because of high prevalence of dermatophytosis, pay attention to increase of hygiene and training courses for coaches and athletes are crucially important. Keywords: Dermatophytosis Wrestling and Body Building Halls Challous

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Abstract Background and Objective: This study was aimed to determine the extent of bacterial contamination and drug resistance patterns of isolates colonized in colonoscope and endoscope and in relevant personnel. Material and Methods: A total of 107 samples were obtained from staff of endoscopy and colonoscopy units (SEU and SCU) and gastroenterological imaging equipment. For isolation and identification of the bacteria, swab culture method and biochemical identification test were used, respectively. Antimicrobial resistance profiles, multi-drug resistance (MDR) patterns and phenetic relatedness of these isolates were also analyzed according to standard methods. Results: Most frequent pathogenic bacteria among the SEU and gastroenterological imaging related equipments were included S. aureus (20.8 % and 0 %) Enterococcus spp. (0 % and 5.4%) Pseudomonas spp. (0% and 13.5 %), and Clostridium difficile (0% and 12.5%). Analysis of resistance phenotypes showed a high frequency of MDR phenotypes among the SEU (82.1%), and also in endoscopes, colonoscopes, and other equipments (20%, 50% and 100%, respectively). Phylotyping of S. epidermidis isolates showed the role of staff in transmission of resistance strains to medical equipments and also circulation of strains with identical resistance phenotype among the studied samples. Conclusion: High frequency of pathogenic bacteria in colonoscopes, endoscopes and in the staff of endoscopy & colonoscopy units, and also contamination of these instruments with MDR pathogens emphasize the need for proper disinfection of endoscopes and colonoscopes and also instruction of staff in these units. Key words: Bacterial Contamination Endoscope Colonoscope Antimicrobial Resistance Gastrointestinal Disease.

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Abstract Background and Objective: C - reactive protein (CRP) is an acute phase protein produced in liver. It is less than 5 mg per deciliter in the serum and body fluids of normal individuals, but it is increased suddenly within a few hours following inflammatory reaction. In bacterial and viral infections, active rheumatic fever, acute myocardial infarction and rheumatoid arthritis are also increased. The aim of this study was to investigate CRP level by Qualitative and Quantitative methods. Material and Methods: The CRP of 200 patients was investigated by quantitative and qualitative methods. Qualitative CRP testing was conducted three times by different people, using two kit of bionic and Omega, and then the mean of the results was reported. For quantitative CRP testing, Immunoturbidimetry was used. Results: In qualitative CRP test by Bionic kit: 180 (90%) were negative, 6 (3%) weakly positive, 9 (4.5%) +1 and 5 (2.5 %) were + 2. In qualitative CRP test by Omega Kit: 148 (74%) were negative, 32 (16%) weakly positive, 13 (6.5%) +1, 4 (2%) +2 and 3 (1.5%) were +3. A high percentage of Qualitative results, which were weakly positive, became negative by Quantitative methods. The Qualitative results of +1 and the next became positive by Quantitative methods. Conclusion: It seems that in the early stages of inflammatory disease, quantitative methods are preferred to qualitative methods. Also, in cases that the CRP test results are weakly positive by qualitative methods, they should be controlled by quantitative methods too. Keywords: CRP CRP Test Quantitative Qualitative CRP Test

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Abstract Background and Objectives: Ciprofloxacin is a synthetic antibacterial agent belonging to Fluoroquinolone drugs affecting effectively on gram-negative bacterial infectious. The aim of this study was to assess the effect of ciprofloxacin in the spermatogenesis period. Material and Methods: The subjects were 20 male wistar rat randomly divided in to control (n=10) and experimental group (n=10), given 12.5mg/kg ciprofloxacin (soluble in drinking water) in spermatogenesis period. On the day of 28, the sperm was collected from cauda epididymis and sent for analysis. Results: Based on light microscopic observation and statistical analysis, the majority of seminiferous tubules of control group were healthy, in Sc 8-9 stage. But in test group, sertoli cell degeneration and absence of sex cells were confirmed, and in some parts, just basal layer of seminiferous tubule was remained in Sc 3-5 stage. Conclusion: Sex hormones (LH and FSH) and spermatogenesis (sperm count, motility and viability) were significantly decreased in test group compared to those of controls (P<0.05). Ciprofloxacin has some adverse effects on sperm related variables in 28 day period. Keywords: Ciprofloxacin, Sperm, Sex Hormones

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Abstract Background and Objective: Omega-3s are considered essential fatty acids that cannot be synthesized by human body and should be obtained from foodstuff. This study aimed at evaluating the beneficial effect of Omega-3s ,exposed in Electromagnetic Field (EMF), on sexual behavior ,Serum total testosterone level, malondialdehyde (MDA) level and total antioxidant capacity(TAC) in male rats. Material and Methods: 32 Wistar rats (males=24, females=8) were allocated to four groups of Control, EMF, omega 3 and omega 3 & EMF. Estradiol benzoate was injected to the female rats subcutaneously. Then after taking biopsy from epididym and testis of each groups, tissue preparation was performed to look through via light microscope on 28th day of study. Serum MDA, TAC and Testestrone were measured in male rat by Radio Immune Assay (RIA) method. Results: The highest degree of testicular tissue destruction and MDA level were observed in electromagnetic field group and the lowest in omega 3 group. The sexual behavior, testosterone hormone and TAC level were lowest in electromagnetic field group and highest in omega 3 group. Conclusion: Based on the Results, administration of omega 3 can significantly lower the adverse effects of EMF and have beneficial influences on sexual behavior in male rat. KeyWords: Electromagnetic Field Effect (EMF), Rat, Omega 3, Sexual Behavior

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Abstract Background and Objective: In the past, most strains of E. coli were susceptible to a wide range of antimicrobial agents, but this situation is now changed by indiscriminate use of antibiotics. Ceftriaxone and Ceftazidime are the most current antibiotics used for Enterobacteriaceae infections in hospitals. The aim of this study was to determine antimicrobial resistance of Escherichia coli strains isolated from patients. Material and Methods: During a 12-month period, 200 clinical samples taken from patients referred to Zahedan hospitals were assessed to isolate Escherichia coli. Antibiotic susceptibility was determined by disk diffusion method and micro-broth dilution and Bla TEM resistance genes were detected by PCR. Results: Following phenotype verification testing, 112 isolates (56%) were produced Extended Spectrum Beta Lactamase (ESBLs) and 130 isolates were potential producers of beta-lactamase (ESBL). Using PCR, 72 isolates (38.55%) have TEM gene. Conclusion: The rate of antibiotic resistance of Escherichia coli isolates to ceftriaxone and ceftazidime is high therefore, it seems reasonable to do antibiogram before treatment. Keywords: Extended-Spectrum-Beta-Lactamase, Esherchia coli, Disc Diffusin, Micro-Broth Dilution

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Abstract Background and Objective: Streptococcus pneumoniae is the most common cause of acquired bacterial infections in the respiratory system. In recent years, a high incidence of pneumococcal resistance to different antibiotics has also been appeared. This study was conducted to evaluate the in vivo and in vitro resistance of pneumococcal pneumonia to ceftriaxone, azithromycin and co-amoxiclave in clinical setting and laboratory. Material and Methods: In this single-blind clinical trial study, the participants were the patients with the diagnosis of pneumonia referred to infectious diseases clinic in Vali-e-Asr hospital of Birjand university of Medical Sciences, October 2012 - April 2014. The patients were randomly allocated to one of the three therapeutic regimes including azithromycin, ceftriaxone, and co-amoxiclave. After 48-72 hours that the infection was confirmed by paraclinical findings, the patients with pneumococcal pneumonia remained in the study and their in vivo and in vitro resistance to the above mentioned antibiotics were compared. Results: The most in vitro drug resistance was to co-amoxiclave (41.5%) and the least to ceftriaxone (20.8%) (P>0.05). For In vivo, the most resistance was to azithromycin (47.4%) and the least one to ceftriaxone (6.7%) (p<0.05). The agreement coefficient between the laboratory antibiogram test and the clinical responses to therapeutic regimes of azithromycin, co-amoxiclave and ceftriaxone was 0.25 (p=0.26), 0.46 (p=0.02) and 0.44 (p=0.04), respectively. Conclusion: With regard to the demographic characteristics of the patients in this study, the resistance of Streptococcus pneumoniae to ceftriaxone is less than that of co-amoxiclave and azithromycin in both clinical setting and laboratory. Keywords: Drug Resistance, Streptococcus Pneumonia, Azithromycin, Ceftriaxone, Co-Amoxiclave

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Abstract Background and Objective: Klebsiella pneumoniae is an opportunistic nosocomial pathogen causing a variety of infections including urinary tract infections, pneumonia, septicemia, wound infections and infections in the intensive care units. Since the ESBL producing Klebsiella pneumoniae strains are increasingly causing urinary tract infections, we aim to assess antibiotic resistance pattern and evaluate the prevalence of ESBL in Klebsiella pneumoniae isolated from urinary tract infections. Material and Methods: this cross-sectional study was conducted on 122 Klebsiella pneumoniae strains collected from Zahedan hospitals. After final identification of isolates, antibiotic susceptibility tests were carried out by using disk diffusion in agar method for 16 antibiotics and ESBL production was determined by the combined disk method. Results: The Klebsiella pneumoniae strains showed susceptibility to imipenem and amikacin ( 94.3%) ,chloramphenicol (88.5%) , gentamicin (81.1%) , ciprofloxacin (80.3%) , cefepime (73%) ,streptomycin (72.1%), nalidixic acid (68%) , tetracycline (65.6%), and cefotaxime, ceftazidime, cefpodoxime (62.3%) . The resistance of strains was seen to nitrofurantoin (53.3%), cotrimoxazole (39.3%), Cefpodoxime (37.7%), cefotaxime (36.9%), ceftriaxone (36.1%), aztreonam (34.4%), ceftazidime (32.8%). Thirty-eight isolates (31.1%) were shown to produce ESBLs. Conclusion: A high rate of resistance was observed to most of the antibiotics among ESBL producing strains therefore, it is important to be careful about the use of antibiotics and identification of ESBL using phenotypic methods. Keywords: Antibiotic Resistance, Extended Spectrum Beta-Lactamases,KlebsiellaPneumoniae, Urinary Tract Infection, Isolate

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Abstract Background and Objective: Lamivudine is the first orally available drug approved for treatment of chronic hepatitis B. Mutations at the YMDD and FLLAQ motifs in the domains of HBV polymerase gene contribute resistance to lamivudine. This study was aimed to determine the rate of YMDD and FLLAQ mutants in hepatitis B patients in Golestan Province, Iran. Material and methods: In this cross sectional study, 120 patients with chronic HBV infection were recruited. Of them, 55 were treated and 65 untreated with Lamivudine. HBV DNA extractions from plasma and polymerase chain reaction (PCR) were performed. For detection of Lamivudine mutants direct sequencing and alignment of products were applied using reference sequence from Gene Bank database. Results: the average age of patients was 36.31±10.07, which 35% of them were female and 65% were male. Mutations at the YMDD and FLLAQ motifs in the domains of HBV polymerase gene were detected in 12 of 55 patients (21.81%) treated with Lamivudine while no mutation was observed in in untreated patients. The YMDD and FLLAQ mutants were detected in 9.16% (11/120) and 0.83% (1/120) of chronic HBV patients, respectively. Conclusion: Usual HBV mutations, which play an important role in lamivudine resistance, detected in this study are similar to other studies. Key words: Hepatitis B Viruse, YMDD Mutation, Lamivudine, Iran.

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Abstract Background and Objective: Along with antibiotics, the use of biological methods to combat bacteria is notably considered. A natural barrier such as amniotic membrane is one of the ways of dealing with bacterial infections. The aim of this study was to determine the antibacterial effect of human amniotic membrane. Materials and Methods: This descriptive study was performed in Dezyani teaching Hospital of Gorgan University of Medical Sciences, Iran. To evaluate the antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli bacteria, 20 amniotic membranes were obtained from postpartum mothers and examined by repeated dilution, diffusion and extraction techniques. Data were collected by observation method and described by mean and standard deviation. Results: The antibacterial activity was found in 15% of the samples against Staphylococcus Aureus and Pseudomonas aeruginosa, while no antibacterial activity was found against E. coli. Given the 15% positive responses, "Diffusion" and "repeated dilution" techniques were more effective in investigating the antibacterial effect of amniotic membrane. Conclusion: The results show the probability of antimicrobial effect of amniotic membrane tissue and it seems that this property can be affected by many factors. Keywords: Amniotic Membrane, Anti-Bacterial Properties, Laboratory Methods

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Abstract Background and Objective: With the development of drug resistance in strains of fungi, there is a considerable resistance of Candida albicans strains to fluconazole. Molecular studies are developing to determine the relationship of such a drug resistance with the increased gene expression of enzymes produced in drug-resistant Candida isolates. We aimed to evaluate the relationship between extracellular lipase gene (LIP8) expression of Candida albicans isolated from candidiasis and sensitivity or resistance to fluconazole. Material and Methods: Drug susceptibility of Candida albicans was performed in oral and vaginal candidiasis to determine the proportion of strains sensitive or resistant to fluconazole using NCCLS method. To evaluate and compare the expression of these genes in the susceptible and resistant strains, RT real-time PCR reaction was used. Results: Of 46 Candida albicans, 20 were susceptible, 12 were semi-susceptible and 14 were resistant to fluconazole. By using PCR reaction, the results showed that the expression of this gene in fluconazole-susceptible isolates was moderate, while it was high in the isolates resistant to fluconazole. Conclusion: The results of lipase gene (LIP8) expression showed that the additional expression of some genes of the enzymes responsible for virulence of Candida may also play a role in resistance to fluconazole. Keywords: Candidiasis, Lipase Gene Expression, RT real-time PCR, Fluconazole

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Abstract Background and Objective: Diarrheal diseases may occur in all age groups, worldwide. Escherichia coli (E. coli O157: H7) is one of the most important bacterial agents causing this disease. The purpose of this study was to assess the prevalence of diarrhea in patients with acute diarrhea caused by this bacterium. Material and Methods: In this study, 214 stool samples were collected from acute diarrheic patients in hospitals and clinical laboratories of Malayer city, Iran. The samples were cultured in rich, differentiation, specific and selective medium. To detect E. coli O157: H7, rapid detection method and antisera were used . Results: In 12.15% of the samples, lactose fermentation was observed and E. coli was afirmed. The results of lactose positive samples showed that 6.54% were negative-β- Glucuronidases and were confirmed as E. coli O157. Finally, by using O157: H7 antisera, 1.87% of 14 samples that were negative- β-Glucuronidases were asserted as E. coli O157. Conclusion: based on the results, the prevalence of E. coli O157: H7 is higher in children and elders than the others. Food and water play a significant role in transferring E. coli. Keywords: Prevalence, E. coli O157: H7, Gastroenteritis, Patients

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Abstract Background and Objective: Leptospirosis is a zoonosis infectious disease that is prevalent in tropical and subtropical regions and is caused by the pathogenic serovars of leptospires. Hence, we aimed at investigating the prevalence of antibodies against these bacteria in the blood samples of suspected leptospirosis. Material and Methods: the human serum samples (N = 130) were obtained from patients clinically suspected leptospirosis. The Serum level of IgM antibodies were studied by ELISA kit (PrioCHECK) in Razi Vaccine and Serum Research Institute (Karaj), 2011-2012. Results: Anti-leptospira IgM class was observed in 21(16%) samples. The relative distribution of the disease was reported in men (80.95%), women (19.04%), and farmers (30.95%) and in 20-40-year group (57.14%). Contact with contaminated water was the most common cause of infection (52.38%) and fever was the most common sign of Leptospirosis (72.2%). Conclusion: Due to the occurrence of anti-leptospira antibodies in 16% of suspected cases, it is recommended that routine ELISA be done at least in major diagnostic centers. Keywords: Leptospira, Leptospirosis, Human, ELISA

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Abstract Background and Objective: C- reactive protein (CRP), as an acute phase reactant and a reliable marker of inflammation, increases due to inflammatory diseases such as Rheumatoid Arteritis and infectious conditions. New evidence shows that Vitamin D may have important effects on adjusting and reducing the Immune Responses. The aim of this study was to evaluate the association between serum vitamin D as an immunomodulator factor and CRP as an inflammatory factor in Arteritis Patients. . Material and Methods: The CRP and Vitamin D were evaluated in Rheumatoid Arteritis patients confirmed by Medical records (40 men and 40 women) and in 80 healthy adult people with normal CRP and Vitamin D and no history of arteritis (40 men and 40 women). Torbidometry was used to measure CRP and Eliza for Vitamin D. Results: In patient group, the mean of CRP and Vitamin D were 95.9±9.1 Mlg/lit and 9.17±2.9 Mlg/lit, resoectively. There was a significant inverse correlation between C-reactive protein and vitamin D in Rheumatoid Arteritis patients (Pvalue= 0.03 Pearson correlation: -0.62) and that was the case for healthy people (p value: 0.04 Pearson correlation: -0.73). Conclusion: Based on the findings, inverse correlation is observed between serum vitamin D and CRP level. Keywords: Vitamin D, CRP, Rheumatoid Arteritis