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Background and Objectives Chelation therapy is essential for beta-thalassemia major. This study aims to determine the complications clinical and laboratory symptoms of monotherapy and combined treatment of iron chelators in beta-thalassemia major patients in Yasuj. Materials and Methods In this cross-sectional-descriptive-analytical study, 103 patients with beta-thalassemia major in Yasuj city were evaluated during 2021-2022. After collecting the demographic, clinical and laboratory information of the patients, the results were reported as mean ± standard deviation and percentage. The degree of statistical differences between ratios was calculated using the Kruskal-Wallis test. Results The average age of our patients was reported to be 24.74 ± 8.34 years. 54.4% (n = 56) of the study patients were men and 45.6% (n = 47) were women. The results of the present study showed that there was a statistically significant difference in mean ferritin among different study groups (p = 0.028). Patients treated with deferoxamine showed the highest mean serum ferritin (5925.5 ± 3397ng%) and patients who took deferoxamine together with deferiprone or deferasirox had a lower mean ferritin compared to deferoxamine alone (3348 ± 2560, 4269 ± 3322 ng%), respectively. Also, the present study showed that after taking iron removers, 47.6% of patients (n = 49) had no clinical complications and 52.4% (n = 54) had at least one complication. Conclusions Our results showed that Deferoxamine can have a great effect in reducing iron deposition and serum ferritin levels in combination with oral drugs. [ABSTRACT FROM AUTHOR]

Background & Aims: Sepsis is the principal cause of death in the first months of life and leads to 30- 50% of infant mortality in developing countries (1). The prevalence of sepsis is reported differently in many countries. In developed countries, the prevalence of sepsis is 1-4 per 1,000 live births, while in poor and developing countries it is almost ten times higher (2). Neonatal sepsis leads to 25.2% of all neonatal deaths in Iran (3). The clinical signs of neonatal sepsis are nonspecific and may be mixed with noninfectious disorders such as aspiration syndrome and respiratory distress syndrome (4,5). The most important factor in reducing infant mortality from sepsis is appropriate and quick treatment (6). On the other hand, the clinical signs of affected infants, including decreased neonatal reflexes, bradycardia, hypo/hyperthermia, respiratory distress, seizures, weakness and lethargy, apnea, and abdominal distension, are not sensitive enough to definitively diagnose sepsis. Blood tests and immunological tests also have less sensitive and specific compared to blood culture (7). Since sepsis is one of the most important causes of mortality and disability in the neonatal stage, with early diagnosis and treatment of the disease and improving the quality of care during delivery, neonatal survival can be increased, the clinical signs, predisposing factors, laboratory findings, treatment and outcome of neonates with the diagnosis of sepsis who admitted to Afzalipour hospital in Kerman were evaluated. Methods: This was a descriptive and cross-sectional study. The statistical population was all infants admitted to Afzalipour Hospital in Kerman from 2015 to 2017.The sample size was determined with the census method (sample size = 200 infants). Infants with Complete Blood Count (CBC), arterial gas measurement, C Reactive Protein (CRP), blood and urine cultures, and Cerebrospinal fluid (CSF) were included in the present study. All neonates with a diagnosis other than sepsis were excluded from the study. Based on clinical and laboratory findings, neonates were classified into three groups: 1- Infants who had positive blood culture sepsis in addition to clinical and laboratory findings. 2- Neonates who had only laboratory and clinical findings of sepsis but their blood culture was negative. 3- Infants who had clinical signs of sepsis but were negative for laboratory findings and blood culture. All infants were treated with antibiotics immediately after the tests. Clinical and laboratory findings as well as the type of antibiotic and maternal and neonatal risk factors were collected using a checklist. Outcomes of treatment were expressed as improvement and discharge, complications, and death. The collected data were analyzed using SPSS software version 25 (version 25, SPSS Inc., Chicago, IL). Quantitative data were presented as Mean ± SD (standard deviation) and frequency and percentage. Results: The highest age of infants was related to the birth group (91%). 59.5% of infants were male and 40.5% were female. The mean duration of admission was 9.76. 1.05 days. The most common clinical signs were tachypnea (74%), poor nutrition (36%), apnea (32%), and hypo/hyperthermia (25%) respectively. The results showed that 91.5% of participants used ampicillin, 93% of them gentamicin, 84% of them used vancomycin, 52% of them used meropenem, 18.5% of them used metronidazole, 19.5% of them used amikacin, 18 % of them took cefotaxime, 19% of them used fluconazole, 1% of them used clindamycin and 1.5% of them used ceftazidime Regarding the frequency distribution of risk factors, the results showed that 23.5% of participants had PROM (Premature rupture of Membrane), 11 % had maternal urinary tract infection, 12 % had maternal fever and 91.5% had low birth weight. The results showed that the mortality rate for participants was 78% and the rate of discharge and recovery was 22%. The results showed that the mean number of white blood cells was 16.468 ± 0.103 × و 103 and the mean CRP of the participants was 22.6 ± 2.8. The results of this study also showed that 14.5% of participants had positive blood cultures and 85.5% of them had negative blood cultures. Conclusion: Systemic and local infections are very common in infants. Sepsis is a systemic response to infection and is divided into early, late and nosocomial types (17). The results showed that 59.5% of the participants who had early sepsis were male and 40.5% of them were female, which is consistent with the results of Khalili et al. (13). While in the textbooks, the incidence of male infants is twice as high as female infants (18). In the study of Arab Mohammadi et al., 60% of patients were boys and 40% were girls. In this study, the most common clinical symptoms were tachypnea (74%), hypo/hyperthermia (25%), and tachycardia (5%), respectively, which is consistent with the results of Hengst et al. (10) while it is not similar to the results of Khalili et al. (13), Santana et al. (9) and Vergnano et al. (14). In other textbooks, the most common clinical symptoms are fever, jaundice, respiratory distress, hepatomegaly, anorexia, vomiting, and cyanosis (19). In the study of Shiva et al. (20), a total of three symptoms of tachycardia, tachypnea, hypothermia had a sensitivity of 53.6% and a specificity of 100% in identifying sepsis with positive blood culture. In the study of Arab Mohammadi et al. (21), hyperthermia, jaundice, respiratory distress, hepatomegaly, anorexia, vomiting, lethargy, and cyanosis were reported as the most common symptoms of sepsis. Investigation of 500 infants suspected of sepsis, temperature instability, and respiratory symptoms were the most common symptoms. The results showed that 14.5% of the participants had positive blood cultures and 85.5% of them had negative blood cultures. This rate (positive blood culture) was 15.4% for the study of Khan et al (22). This rate was 14% in the study of Manucha et al. (23) in India. The reason for the lack of positive blood culture is neonatal SEPSIS is one of the diseases in which the actual number of cases is much less than the number of suspected cases and laboratory-related problems also play an important role in this results (24). The prevalence of sepsis with positive blood culture has been reported in the study of Shiva et al. 25% (20), Samaei et al. 41% (25), and Hosseini et al. The results showed that the mean CRP of the participants in our study was 22.6. 2.8. According to textbooks, if CRP is performed in combination with other tests, it is effective in screening for sepsis, but if used alone as a primary test to look for infection, it helps in less than 10% of definite diagnoses (26, 27). CRP sensitivity has been reported from 46 to 74% in various studies (28). In the meta-analyzes about this subject, the first time CRP sensitivity was 39%, CPR specificity was 92.5%, positive predictive value was 53.2% and negative predictive value was 93.6%. Therefore, it seems that the serum level of CRP for the first time at the time of admission in infants suspected of early neonatal sepsis in the neonatal intensive care unit (NICU) has no value in determining sensitivity (29). In the study by Zecca et al, the negative predictive value of CRP was 100% (30 %). A study by Cetinkaya et al on 100 infants suspected of having early neonatal sepsis showed that the diagnostic power of CRP increased over time and peaked 24 to 48 hours after the onset of sepsis, which is consistent with our study (31). Therefore, if serum CRP levels remain negative 24 hours after the onset of clinical symptoms, the high negative predictive value is 99%, and antibiotic therapy can be discontinued in the absence of strong clinical suspicion of sepsis (32). [ABSTRACT FROM AUTHOR]

Background Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited. Objective This study aims to investigate the frequency of oral lesions in Rasht, Iran. Methods In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded. Results A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions. Conclusion Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin. [ABSTRACT FROM AUTHOR]

Background and Aims: Escherichia coli O157:H7 is one of the main causes of transmitted diseases by food, including meat and meat products. The purpose of this study was to investigate the prevalence of E. coli O157:H7 contamination in Mashhad with the detection of rfbE gene. Materials and Methods: For this study, 148 slaughtered beef samples from Mashhad (spring to winter, 2018) were randomly collected and transferred to the laboratory. The identification of E. coli O157:H7 was performed by biochemical methods and rfbE gene was detected by PCR colony method. Results & Discussion: Based on biochemical tests, E. coli O157:H7 was isolated in 7 (4.73%) samples of slaughtered beef and after PCR colony; only 2 (1.35%) of these 7 samples were approved. According to the results of this study, it can be concluded that beef can be considered as a major reservoir for E. coli O157:H7 and there is a potential for transmission of this pathogen to humans through the consumption of beef and its products. Also, the specific primers of rfbE gene were able to differentiate the E. coli O157:H7 colonies from other cultured colonies on the culture medium during the PCR process. The present research was performed for the first time in the city of Mashhad. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B DNA polymerase chain reaction (HBV-DNA PCR) is a test that is used in the evaluation and treatment of hepatitis B but this test is pretty expensive and may not be available everywhere. Quantitative test of serum hepatitis B surface antigen may be a surrogate test, which is available with much low price. The aim of this study was to compare the accuracy of these two tests. Materials and Methods: Patients with positive HBsAg who referred to Boali laboratory in Yazd, Iran for HBV DNA test in 2012-2014 were selected and divided into three groups as inactive carriers, those at the beginning of treatment, and those on treatment (30 patients in each group). HBV DNA PCR was performed with real-time PCR method with sensivity of 150 IU/mL. HBsAg and HBeAg levels were measured by electrochemiolance. The level more than 0.05/mL was considered positive for HBsAg. Results: Serum hepatitis B surface antigen quantitative level was significantly different between group one and group two, and also between group one and group three (p = 0.001) but it was not different between group two and three (p = 0.7). Serum HBV quantitative level and HBV DNA had a positive relation (p = 0.001, R = 0.527). There was a relation between HBsAg and viral load in group one (p = 0.017, R = 0.431) and group two (p = 0.023, R = 0.427) but there was not such a correlation in group three (p = 0.27, R = 0.22). Conclusion: HBsAg quantitative measurement may be a surrogate test for evaluation of patients with hepatitis B because it is simpler and economic. [ABSTRACT FROM AUTHOR]

Background and Aim: In recent years, Multidrug resistance has been increasing among Klebsiella isolates. The aim of this study was to survey existence of integrons and its relation with antibiotic resistance among clinical isolates of Klebsiella. Materials and Methods: From Jun 2015 to May 2016, 129 Klebsiella isolates collected from Karaj hospitals and laboratories. Statistical population included 80.6% female and 19.4% male. Antimicrobial susceptibility was performed using Kirby-Bauer disk diffusion and ESBLs producer were screened. Integrons were detected using PCR. Ethical Considerations: This study with research ethics code IR.IAU.K.REC.1396.16 has been approved by research ethics committee at Islamic Azad University of Karaj, Iran. Findings: The highest and lowest percentage of sensivity were found to ofloxacin (89.1%) and amoxcicillin (6.2%), respectively. 82.9% of isolates were resistant to more than two antibiotics from different classes. Among 129 isolates, 19.3% of the isolates harbour integrons. Frequencies of MDR among integron-positive isolates were 100%. Also, 71.3% and 28.7% of isolates were ESBLs positive and negative respectively. Conclusion: Results showed integron elements were prevalent among MDR isolates. Integron-associated resistance genes can be served as reservoirs of multi drug resistance within clinical isolates and presence of integron can be used as a marker to identify MDR isolates. Prevalence of ESBLs among clinical isolates of Klebsiella showed that antibiotics like ampicillin or amoxicillinclavulanic acid are not effecvtive anymore in treatment of UTIs. [ABSTRACT FROM AUTHOR]

Background and Aims: Cervical cancer is the second most common cancer in women worldwide. The presence of HPV has been implicated in more than 99% of cervical cancer worldwide. Human papillomavirus is a heterogeneous virus, categorized to two groups of highrisk and low-risk genotyped according to the level of infection that leads to cervical cancer. HPV screening is recommended for the further evaluation of abnormal pap test or during follow-up after treating precancerous lesions. Genotyping of different high-risk HPV (hrHPV) types obtained from smear tests has not yet gained widespread acceptance in clinical practice. Genotyping of hrHPV could be helpful for the risk stratification of HPV-positive. Materials and Methods: In this study 143 women residual samples were available for HPV assays in Masoud laboratory in Tehran. After extracting DNA by kit, for genotyping detection of human papillomavirus PCR amplification, Reverse dot blot hybridization methods was used. Results: Among these samples, 34.2% were HPV positive. In this research, the most common genotype was HPV-18 from high risk HPV genotype and HPV-6 was the most common from low risk genotype of HPV. The most Age category that has been detected positive HPV from category 26-35 years. Conclusions: The variety of HPV genotype detection in cervical cancer screening increases the importance of epidemiological study controversially in world. Therefore for characterizing genotype of HPV, Reverse dot blot hybridization can be of great help in this regard. [ABSTRACT FROM AUTHOR]

Background: Acinetobacters are aerobic gram-negative bacteria which are distributed widespread in soil and water. The bacteria are isolated from cultured skin, mucous membranes, secretions and hospital environment. Acinetobacter baumannii, is a strain that more frequently isolated. Acinetobacter strains are often resistant against antimicrobial agents. Materials and Methods: The method of this study was based on field, observation and test. On August and October 2015, samples were isolated from the soil and water of the Sadeghieh Square river in Tehran, respectively, and were transferred to the laboratory in the ice pack. 50 baumannii samples were isolated by biochemical methods (TSI, SIM, OF and gram test). November 1394, 100 clinical samples were isolated from Imam Khomeini hospital by biochemical method, and in the culture media Mueller Hinton agar plates were transferred to the laboratory. Antibiogram test for 150 baumannii samples was performed. Biofilms formation of Acinetobacter baumannii environmental and clinical samples was investigated by Congo red agar and culture plate methods. Results: In all samples (clinical and soil), most of antibiotic resistance was 92% for imipenem and the resistance of water samples to imipenem was 99.9%. Biofilm formation by Congo red agar in water, soil, and clinical samles was resprctively 44%, 40% and 1%. All isolates were negative biofilm culture plate. Conclusion: Considering Acinetobacter baumannii resistance to antibiotics and the lack of biofilm formation of in clinical and environmental isolates, it was concluded that there wasn't any relationship between antibiotic resistance and biofilm formation [ABSTRACT FROM AUTHOR]

Background and Aim: Nowadays, clinical laboratories play important roles in health care systems and well-trained staff are in need more than ever before. Thus, educating students in this field is one of the best approaches in saving energy and expenditure of health-care systems in any community. The aim of this descriptive study was to assess the different aspects of the pedagogical curriculum for Iranian laboratory science students compared with that of world's leading universities. Materials and Methods: In 2014, pedagogical curriculum of this major in Iran was compared to the curriculum of 17 prestigious universities in the world. Also, a questionnaire was filled out by the faculty members of medical universities who were involved in training clinical laboratory science's students. Results: The results showed that the Iranian curriculum has various drawbacks in clinical apprenticeship for students, and is short of specific credits such as Microbiology and Immunohematology. In addition, lack of practical or applied credits like Urine Analysis, Body Fluids, Microscopy and Medical Ethics was noticed. It was discovered that little attention was paid to preparing students for research. Conclusions: Considering the findings of the current survey, decreasing the credits offered in each semester with proper training course scheduling and monitoring the students, will not only help the students to proper learning, but also lead to the delivery of other goals. Also, due to the significant role of these students in the healthcare system, it is necessary to hold practical and theoretical exams of this course before entrance of students to the labor market in order to prevent the probable detrimental impacts on the healthcare system. [ABSTRACT FROM AUTHOR]

Background: Brucellosis is a major cause of zoonosis disease and is endemic in hamadan Province in Iran. The purpose of this study was to isolate Brucella species from brucellosis patients and identify different species of this bacterium in order to determine the prevalence of the species. Materials and Methods: This study was descriptive- cross sectional and fifty blood samples were obtained from brucellosis patients with clinical symptoms. The samples were cultured in BACTEC system and incubated for 14 days. Then, the samples were cultured on Brucella agar and biochemical tests were done for identification of bacteria. Finally, Polymerase Chain Reaction (PCR) applied for confirmation and isolated identification with specific primers. Results: Seven Brucella strains were isolated from 50 blood samples of the patients with brucellosis by blood culture and PCR. The PCR results on blood specimens showed 4 positive in spite of the negative results of blood culture. PCR and biochemical methods revealed that all the 11 isolated bacteria were Brucella Melitensis. Conclusion: This study was designed to evaluate PCR technique as a diagnostic tool for brucella spp in comparison to conventional techniques. This study showed a high prevalence of brucellosis due to Brucella Melitensis in Hamadan Province and efforts in this region should be aimed at the eradication of this bacterium. [ABSTRACT FROM AUTHOR]