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Abstract Background & Objectives: Thalassemia syndromes isone of the inherited disorders in which one or more globulin chains are affected. On the basis of clinical symptoms, thalassemias are categorized as minor, intermediate, and major. Minor beta -thalassemia is a mild microcytic hypo chromic anemia in most cases asymptomatic and HbA2 is more than normal. Materials & Methods: This study carried out on 813 blood samples obtained from male high school students of Aliabad Katool, in the north of Iran. After detecting red blood cell indices of the subjects whose MCV was less than 80fl HbA study performed. Results: The MCV of 8.24% of the subjects was less than 80fl.34 of 67 had HbA2 of less than 3.5 %(normal) while the rest more than 3.5%(minor). Conclusions: Since about 50% of microcytic anemic patients were the carrier of beta-thalassemia and it is highly Prevalent in this region (4.06%), we recommend to investigate HbA2 in people with MCV less than 80 fl. Keyword: Thalassemia, Thalassemia minor, HbA2, Iran

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Abstract Background & Objectives: Giardia lamblia is one of the most common protozoa in human being throughout the world. The different isolates of this parasite have various potential pathogenicity. Clinical demonstrations of Giardiasis are acute diarrhea, chronic diarrhea syndrome and malabsorbtion.The aim of this study has been the observation of the different kinds of clinical features in patients with Giardia lamblia referred to the Hamadan faculty of medicine, 2004- 2005 Materials & Methods: The fecal samples of 274 patients referred to Hamadan faculty of medicine were examined via direct and Formol- Eter methods. By a questionnaire, the subjects’ clinical manifestations were recorded and then analyzed. Results: In this study, 20.4% of the patients (55.4% male, 44.6% female) were infected with Giardia. 46.5% of them complained of abdominal pain. The prevalence of Giardia was 30.8 %( 6-10 years) and 23.1% (1-5 years). The most common signs observed were abdominal pain, diarrhea and vomiting, respectively. Conclusion: The most common sign observed in this study was abdominal pain, partially similar to studies carried out in other parts of Iran and the world too. Key word: Giardiasis, Clinical Signs,Epidemioloy,Hamadan

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Abstract Background and objective: Exposure of red blood cells to oxygen radicals can induce Lipid proxidation, hemoglobin damage and hemolysis of erythrocyte .The present study was designed to determine the alteration of plasma lipid peroxidation and erythrocyte Superoxide Dismutase and Glutathione Peroxidase enzyme activities in stored blood and to find out the quantitative alterations and the useful length of stored blood. Materials and Methods: First, the whole blood form 10 donors was taken. Then Red Blood Cells(RBC) were counted, the levels of Potassium(P) and lactate dehydrogenate activity(LDH) were measured to determine the amount of hemolysis, the plasma levels of malondialdehyde (MDA), erythrocyte Superoxide Dismutase(SOD) and Glutathione Peroxidase(GPx) were studied for determination of lipid peroxidation and antioxidant enzyme activities at the days of 0,1,3,5,7,9,11,13,15,17,19,21,23,25,27,29,31,33 and 35 of the storage. Results: upon storage time, the plasma levels of malondialdehyde (MDA) and Potassium and lactate dehydrogenate activity increased (P< 0.05) whereas erythrocyte Superoxide Dismutase and Glutathione Peroxidase enzyme activities and Red Blood Cells decreased (P< 0.05). The alterations of MDA, SOD, GPx, P, LDH and RBC in the measurement days were as follows: MDA, P and LDH significantly increased at the day of 9, 5 and 5 whereas SOD,
GPx and RBC decreased at the day of 11, 7 and 29 respectively. Conclusion: The results of this study showed that the increased level of MDA and decreased SOD and GPx in stored blood can cause the beginning of hemolysis of erythrocyte therefore, it is necessary to control these factors before storing the donated blood. Keywords: lipid peroxidation, Superoxide Dismutase, Glutathione Peroxidase

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Abstract Background and objectives: Acquired immunodeficiency syndrome (AIDS) is acquired by infection with human immunodeficiency virus. (HIV).Parasite caused infection is the most common problem in AIDS Patients. Sometimes unusual and opportunistic infections such as intestinal parasitic infections may cause serious gastric intestinal (GI) disorders, which can finally lead to death. The aim of this study is to find intestinal parasites in AIDS patients referred to Disease Consultation Center of Kermanshah province. Materials and methods: In this study, the stool samples were collected from 75 AIDS patients admitted to Kermanshah consultation disease center. Then, all samples were tested by direct and formalin ether methods. Results: As shown in results , 13 patients (17.4%) are infected with Entamoeba coli, two( 2.7%) with Entamoeba histiolyticaly,one(1.4%) with Giardia lumbelia ,six (8%) with Blastocystis hominis ,two( 2.7%) with Isospora belli ,one(1.4%) with Ascaris lumbericoides ,two( 2.7%) with Endolimax nana . Conclusion: This study indicated that the frequency of pathogenic and non-pathogenic parasites was low in HIV+ patients. This may be related to anti-parasitic drugs used in all HIV+ patients admitted to Kermanshsh nsultation Disease center. Key words : Intestinal parasitic Infections, AIDS, Kermanshah consultation Disease center

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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 Background and objectives: Human T-Lymphocyte Virus-1 (HTLV- 1) is known as the etiologic factor of acute T-Lymphocytic Leukemia (ATL) and tropical spastic paralysis. (TSP). Endemic factors causing infection with Human T Lymphocyte Virus-1 (HTLV-1) is based on environmental, socio-economical and health behaviors of the individuals. This virus is well distributed in families with involved members. Golestan province is located in North West part of Northern Khorasan province that had already been known as an endemic area for HTLV-1. This virus is also known as the main etiologic factor for cancers and ATL, therefore we studied the prevalence of HTLV-1 seroepidemiology in Golestan province. Material and Methods: The subjects selected by cluster sampling were 2034 healthy cases residing in different parts of Golestan province. ELISA method using Dia- pro anti HTLV-1 antibody kits was applied for serological assessment. Western Blot (HTLV BLOT 2.4) was used for confirmation purposes. Results: The subjects aged 38.66±16.54 were 2034 healthy persons. Forty-one point seven of these cases were males and the rest females. Based on ELISA method there were15 HTLV-1 positive cases (0.7%). -1. (0.7%) Six out of 15 were confirmed by western blot method (95%, CI: 0.06-0.53%). The highest prevalence sigllificant) aiology is in the highat rate in 31-40 year old gro0.7%). onclusion: This study shows that HTLV-1 is prevalent in Golestan the same as the other parts of the world. There fere: we urse on performing screening test (HTLV-) on donated blood components before delivering (OK labeling). Key words: HTLV-1, Seroepidemiology, ELISA, Western Blot, Golestan ATL(Acute T lymphocytic Leukemia) Six cases out of 15 were confirmed by western blot method (95%, CI: 0.06-0.53%). The highest prevalence was 2.6% seen in Kalaleh city (east part of the province) [95%, Cl: 0.06-0.53%). There was significant difference between the prevalence of HTLV-1 and the dwelling place. (p=002). HTLV-1 seroepidemiology was in the highest rate in 31-40 year old group (0.7%). Conclusion: This study shows that HTLV-1 is prevalent in Golestan province, the same as the other parts of the world. Therefore, we recommend performing screening test (HTLV-) on donated blood components before delivering (OK labeling). Key words: HTLV-1, Seroepidemiology, ELISA, Western Blot, Golestan province, ATL (Acute T lymphocytic Leukemia)

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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: Hydatid cyst is one of the most important zoonotic parasitic diseases produced by means of Larva stage of Echinococcus granulosus. Since this Hydatid cyst is a widespread disease in many regions of the world and Iran, we decided to study the epidemiological situation of patients infected with hydatid cyst who were operated in hospitals of Qom, Iran (2004-2007). Material and Methods: In this Cross-sectional retrospective study, we surveyed the Medical records of 19 patients infected with hydatid cyst, who were operated in hospitals of Qom (2004-2007). Patients’ demographic data including gender, age, career, dwelling place, number of cysts and the infected organ were collected and analyzed by SPSS software. Results: of the 19 patients, 12 cases (63.2%) are female and seven cases (36.8%) male. The highest rate of infection is related to 21-30 year group (31.65%) homemakers (52.7%) and urban (89.5%). The results show that the organs involved are liver (73.7%) and lung (26.3%). All patients infected with pulmonary hydatid cyst are male. Conclusion: Since 63.2 percent of infected people are female and homemaker, having contact with vegetables contaminated with parasite ova is the most important way of infection transmission. Key words: Hydatid cyst, Epidemiology, Surgery, Iran

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Spring summer 2010, Vol.4, No.1 /72 Medical Laboratory Journal Evaluation of Cholesterol Panel Changes in Fish Consumers in the West of Mazandaran Province, Iran Abstract Bachground and objectives: Eating fish reduces low-density lipoprotein cholesterol (LDL-C) and increases high density lipoprotein cholesterol (HDLC). Because of different factors, such as physiological conditions and kind of fish consumption, the findings can be different. We decided to investigate the reducing effect of regular fish eating on plasma lipids and lipoproteins of different groups. Material and Methods: the Subjects were 50 clients (control group) with normal Lipid and 50 ones with high Lipid (case group). The subjects, with different sex and age, were asked about smocking, heart disease and diabetes. Fast blood samples were collected and analyzed for total cholesterol (TC), low and high density lipoprotein cholesterol (LDL-C, HDL-C and VLDL), TG, HDLC, apolipoprotein A and B. Results: The data shows a significant difference in cholesterol, LDL, apoA and VLDL levels in moderate and high consumers. (P<0.005). In subjects with high LDL, the kind of fish consumption was stir- fried (0.96%) and grilled and boiled (7.4%). The Subjects with high-fish consumption is 32.2% for normal LDL Level and Just 1.1% for ab normal Level. There is no significant effect on HDL and apoB levels due to fish intake in any dosage. The relation is seen between abnormal lipid and rare fish consumption. Conclusion: Present study shows the reducing effect of fish consumption on cholesterol level and LDL-C. More studies are needed to be conducted to evaluate the type of faty acids in fishes. . Key words: Fish, dietary, cholesterol panel. Shargh SH FacultyMember of Dept of Laboratory Sciences, Islamic Azad University, Chaloos Branch Yeghaneh MA FacultyMember of Dept of Laboratory Sciences, Islamic Azad University, Chaloos Branch Mohades SM (PhD) Assistant Professor of Health Faculty, Tabriz University of Medical Sciences Ayetollahi AA (MD) FacultyMember of Dept of Lab Sciences, Paramedical Faculty, Golestan University of Medical Sciences Khalaj E (BSc) Daghigh Clinical Laboratory Khandan Del A Laboratory Technician, Islamic Azad university,Chaloos Braneh Corresponding: Shargh, SH Email:shohrehshargh@gmail.com

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Abstract Bachground and objectives: Dientamoeba fragilis is a habitant protozoa in human colon causing clinical symptoms, such as local stomach pain, weight loss, lack of appetite and flatulence. It is important to diagnose this infection correctly and differentiate it from other Protozoa. In this study PCR and Iron Hematoxylin methods were used to detection of this protozoa in Chalous Medical centers refers in 2010. Material and Methods: The stool samples (n=302) of this cross-sectional study were selected via cluster random sampling. After wet mount study the samples were preserved in PVA (for staining) and Ethanol (for molecular). The samples were studied both Staining and Molecular methods. Sensitivity and specificity were assessed. Results: Of 302 samples, six of them are positive via staining method (1.99%) and five by molecular method. All negative results with staining method are also negative with PCR. Contamination with E.coli in 2 samples and with Balstocystis homonis were seen in one sample. Sensitivity and specificity of PCR was 85% and 100% respectively. Conclusion: The discrepancy between two methods maybe caused by observer errors in staining method and unsynchronized molecular and microscopic studies. Key words: Dientamoeba fragilis, PCR, Iron Hematoxylin, Chalous region

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Abstract Background and objectives: Yoghurt is a milky, fermented and semi-solid production that is produced by Microorganism starters. These microorganisms are known as lactic acid bacteria, which are responsible for the formation of the tissue, scent and flavor of yoghurt. Their presence in digestive system makes people healthy. The aim of this study was determination of the number of Lactic Acid Bacteria and Yeasts in the combination of traditional yoghurts of villages of East-Azerbaijan- province. Material and Methods:In this study, we gathered 90 samples of traditional yoghurt from the villages of East- Azerbaijan province and transferred, in a standard condition, to the laboratory of pharmaceutical-applied research center of Tabriz medical science university. We used 10-6dilution to measure the number of lactobacilli in MRS Agar medium and 10-3 dilution to count the Yeasts in Saborodextros Agar medium. Then, the grown colony has been enumerated and the kind of bacteria was specified via biochemistry tests. Results: The mean number of lactobacilli in 1 ml of traditional yoghurts is about 62 × 106 CFU/mL and the number of Yeasts 41×104 CFU/mL. Delbrueckii and plantarum are the most common Lactobacilli, and Saccharomyces is with the highest frequency. Conclusion: According to findings of this research, there is considerable amount of microorganisms such as useful bacteria, in the traditional yoghurts of villages of East- Azerbaijan province. They have been used as a starter and probiotic in Dairy and milk factories to produce good production in the future. Key words: Lactic acid bacteria, East-Azerbaijan, Yoghurt, Yeasts

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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 Objective: Urinary tract infections and bacteremia are the major problems in renal transplant patients, which are mostly due to immunesuppressive regimens, surgery, and exposure to the germs in hospital. The aim of this study was to determine the prevalence of bacterial agents in the blood and urine samples of kidney transplant candidates. Material and Methods: In this one-year-long study, thirty-three renal transplant candidates were assessed for urine and blood cultures. One urine and blood samples from each patient before transplantation and three samples after transplantation were collected. The Samples, using standard microbiological methods, were investigated and infectious organisms identified. Results: In 133 urine samples, Escherichia coli (20.5%), Enterobacter spp. (5.3%), Klebsiella spp. (3 %) and Staphylococcus epidermidis (1.5%) were isolated. In the blood samples, Enterobacter spp. (9.1%), Escherichia coli (6.8%), Staphylococcus epidermidis (3.8%) and Klebsiella spp. (0.8%) were isolated. Conclusion: The results indicate that urinary tract infection was high in patients with transplanted kidney, and E. coli is the most common cause of this infection. Keywords: Kidney Transplantation Bacterial infections Urinary Tract and Blood Infections Escherichia Coli

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Abstract Background and Objective: Bacterial infectioins in particular meningitis, pneumonia and septicemia are still some of the most causes of mortalities in children.The aim of present study was to identify the most common bacterial agents causing infectionis in children under 14 and detection of antibiotic resistance paterns. Material and Methods: During two years,1897samples were obtained from the patients suspected bacterial infectioins. They were investigated for bacterial cultures, age, sex and antibiogram patterns. The species were identified by biochemical and serological methods. Results: Of 1897 samples, 563 (29.6%) had positve bacterial culture. Of these 74.7% were gram negative and 25.3% gram positive . The most common species were Escherichia coli(34.1%), Staphylococcus aureus (17.1%), Psuedomonas aeroginosa (12.4%), Kelebsiella (11%) and Staphylococcus epidermidis (5.7%). The most effective antibiotics against both gram positive and gram negative bacteria were ceftriaoxne, nitrofurantoin, nalidixic acid, amikacin and gentamycin. Conclusion: The gram negative bacteria in particular Escherichia coli, Psuedomonas aeroginosa and Kelebsiella are the predominant causes of bacterial infections in children under 14 in these regions. Most species showed a high relative resisitance to routine antibiotics such as ampicillin, trimethoprim and chloramphenicol. Key Words: Bacteria Infection Children Antibiotic

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Abstract Background and Objective: Transmission of pathogens by cosmetics is one of the major health complications. Direct contact with contaminated non-standard cosmetics can have irreparable side effects for the consumers. Thus, the evaluation of microbial contamination in cosmetic products is important. The aim of this study was to assess the microbiological contamination of one of frequently used cream. Material and Methods: In the present study, 135 samples of a special moisturizing cream were randomly selected from pharmacies in Tehran. The microbial contamination assessment, sampling and culturing method were based on the protocol (No.3978) of Iranian Institute of Standard and Industrial Research. Results: sixty-two (46%) out of 135 samples were contaminated. The highest and lowest contaminations observed were Pseudomonas aeruginosa and Bacillus, respectively. Conclusion: Due to the high contamination rate of cosmetic creams, we recommend extremely monitoring and controlling these products by health centers. Keywords: Cosmetics, Microbial Contamination, Pseudomonas Aeruginosa

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Abstract Background and Objective: Imbalance Between antioxidant defensive system and increased production of free radicals leads to oxidative stress that can be effective in making cellular damage and causing some diseases such as diabetes. The aim of the current study was to investigate the effect of eight-week purslane extract consumption on some peroxidant and antioxidants indicators in patients with type 2 diabetes. Material and Methods: The Participants were 16 women with type 2 diabetes who had not the history of once a week regular physical activity program, in previous five years. They were randomly divided into two groups of experimental, purslane supplementation for eight weeks, and control. Blood sampling was performed in two stages. Results: After eight weeks of purslane consumption, resting levels of MDA, SOD and CAT in Supplementation group showed a significant decrease compared to those of control group. Conclusion: Purslane consumption can improve peroxidant/antioxidant balance in women with type2 diabetes. Key words: Purslane, Peroxidant Balance, Antioxidant, Type 2 Diabetes

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Abstract Background and Objective: The hormonal responses are different, according to type, intensity and the duration of training. We aimed to compare the effect of endurance and resistance training in untrained men on the level sexual hormone including testosterone, estradiol, and on sex hormone binding globulin (SHBG). Material and Methods: this study was conducted on male Student Volunteers divided randomly into three groups of eight members, including endurance, resistance and control. To measure the variables, we performed sampling before and after the training program. Results: the levels of testosterone and estradiol, in both groups have a significant (p<0.05) increase and decrease respectively. SHBG level was significantly increased only in endurance group (p<0.05), But LH level was meaningfully increased only in the resistance group (p<0.05). Conclusion: The endurance and resistance training can increase the production of testosterone .Increased testosterone and decreased estradiol in men lead to sperm production and improve fertility. Keywords: Endurance training, Resistance Training, Testosterone, Estradiol

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Abstract Background and Objective: Onychomycosis is a fungal nail infection causing ulcers, diabetic foot and enhance nail infection. This study was designed to evaluate the prevalence of onychomycosis in type II diabetes. Material and methods: This descriptive-analytic study was conducted on 300 diabetic patients selected randomly among those referred to Panje Azar endocrinology clinic. They were examined for peripheral vascular disease, Skin lesions, diabetic foot and Peripheral neuropathy. The Laboratory tests such as FBS, HbA1c, Direct smear and fungal culture were used. Results: The patients with onychomycosis were 19 (6.3%) their mean age was 53.65±1.04 the youngest was 28 and the oldest 84. The male to female infection ratio was of 1.08 that was not statistically significant. There was no significant difference in regards to ethnicity, age, BMI, FBS, HbA1C. The location of the infection was 16 on feet (29.6%), and three on both hands and feet (P = 0.000) Conclusion: The prevalence of fungal infection was less frequent than that of other studies. Given that there was no significant relationship between different demographic data and its prevalence, further studies with larger sample size are needed. Keywords: Prevalence, Fungal Infections, Diabetes

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Abstract Background and Objective: Escherichia coli is the most common cause of urinary tract infections in children and the leading cause of intra-abdominal infections (peritonitis and abscess) followed intestinal injuries. Urinary tract infection, including cystitis and pyelonephritis, is a common childhood infection. E. coli causes more than 90 percent of the community acquired and 50% of hospital acquired urinary tract infections therefore, the determination of E. coli antibiotic susceptibility is a paramount importance to clinical and epidemiological purposes. Material and Methods: In this cross-sectional study, 50 E. coli strains isolated from urine samples of children less than 7 years of age with urinary tract infections. They were compared for drug susceptibility testing by disc diffusion method with 50 strains of Escherichia coli isolated from stool samples of healthy children with the same age and sex pattern. Results: The actual amount of drug sensitivity of uropathogenic and intestinal Escherichia coli strains to amikacin was 94 and 100%, nitrofurantoin 90 and 88%, gentamicin 66 and 94%, cefixime 56 and 60%, nalidixic acid 38 and 44% and to cotrimoxazole 28 and 32%, respectively. Conclusion: the rate of resistance to gentamicin, Cefixime and nalidixic acid in urinary tract infection isolates were more than intestinal strains. The highest rate of drug resistance in urinary Escherichia coli isolates was associated with cotrimoxazole and the lowest one with amikacin. Keywords: Escherichia Coli, Intra-Abdominal Infection, Drug Resistance, Urinary Tract Infection, Children

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Abstract Bachground and Objective: most of environmental microorganisms have the genes resistance to antibiotics and metals. The aim of the current study was to survey resistance pattern to some antibiotics and heavy metals in three pseudomonas aeruginosa isolated from different ecological areas. Material and Methods: first, the isolates were identified by biochemical methods and phylogenetic analysis. Then, the evaluation of antibiotic resistance was conducted by disc diffusion and that of Heavy metal resistant by agar dilution, in a range of 50-500 µg/ml. Results: The results showed that all three isolates were resistant to beta lactam antibiotics. Although these isolates were highly resistant to heavy metals, no relationship was observed between ecological sources and the resistance pattern in ICT1 and Abt2 strains. However, strain Q isolated from digestive system of ParmacellaIberica showed high resistance to antibiotics and low resistance to heavy metals. Conclusion: given that environmental bacteria have a high potentiality for carrying resistance genes and this can be an advantage environmentally, they could be used to remove heavy metals from polluted areas. On the other hand, resistance genes medically are a concern due to probability of transferring to pathogen strains. Keywords: Antibiotic Resistance, Heavy Metal Resistance, Pseudomonas Aeruginosa