The high prevalence of antibiotic resistance in Helicobacter pylori has become a great challenge in Iran. The genetic mutations that contribute to the resistance have yet to be precisely identified. This study aimed to investigate the prevalence of antibiotic resistance and virulence markers in Iranian H. pylori isolates and to analyze if there is any association between resistance and genotype. Antibiotic susceptibility patterns of 68 H. pylori isolates were investigated against metronidazole, clarithromycin, amoxicillin, rifampicin, ciprofloxacin, levofloxacin, and tetracycline by the agar dilution method. The frxA, rdxA, gyrA, gyrB, and 23S rRNA genes of the isolates were sequenced. The virulence genotypes were also determined using PCR. Metronidazole resistance was present in 82.4% of the isolates, followed by clarithromycin (33.8%), ciprofloxacin (33.8%), rifampicin (32.4%), amoxicillin (30.9%), levofloxacin (27.9%), and tetracycline (4.4%). Overall, 75% of the isolates were resistant to at least two antibiotics tested and considered as a multidrug resistance (MDR) phenotype. Most of the metronidazole-resistant isolates carried frameshift mutations in both frxA and rdxA genes, and premature termination occurred in positions Q5Stop and Q50Stop, respectively. Amino acid substitutions M191I, G208E, and V199A were predominantly found in gyrA gene of fluoroquinolone-resistant isolates. A2143G and C2195T mutations of 23S rRNA were found in four clarithromycin-resistant isolates. Interestingly, significant associations were found between resistance to metronidazole (MNZ) and cagA-, sabA-, and dupA-positive genotypes, with p = 0.0002, p = 0.0001, and p = 0.0001, respectively. Furthermore, a significant association was found between oipA “on” status and resistance to amoxicillin (AMX) (p = 0.02). The prevalence of H. pylori antibiotic resistance is high in our region, particularly that of metronidazole, clarithromycin, ciprofloxacin, and MDR. Simultaneous screening of virulence and resistance genotypes can help clinicians to choose the appropriate therapeutic regime against H. pylori infection.

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Learning is the most important issue in teaching and regarding class atmosphere is one of the main issues that has special place in partial quality of learning. This study was performed to investigate the relationship of Atmosphere on the Quality of Learning (QoL). This study was done in Guilan University of Guilan that about 0.5 of students were selected through cluster sampling method with regard to the size of population (7200 students) and through systematic random sampling. 360 persons were selected and 357 questionnaires were filled and returned among 360 distributed questionnaires in various disciplines. Also 35 academic staffs (about 0.1) were participated in this research for conducting interview. Instruments for collecting the information of questionnaire have been researcher-made and interview. Descriptiveanalytic method has been used in this research. In all cases null hypotheses rejected and research hypotheses were confirmed. Also in analysis of interview with academic staffs that questions were related to research main hypotheses, much emphasis has been put on the effect of factors influencing on class atmosphere and quality of teaching and learning. It should be stated that there is a positive and direct relationship between class atmosphere and its factors (order and organization in class, clearness of rules in class academic staff control over the class, academic staffs and student mutual respect) and quality of learning.