MEDICAL LABORATORY JOURNAL
Year:2013 | Volume:7 | Issue:1|Papers Count:14

Background and Objective: Enterococci are the gram-positive bacteria existing in the intestines of humans (as a normal flora), in dairy products and in our environment that they have emerged as an important cause of opportunistic nosocomial infections in recent years. In this study, we aimed at investigating and comparing the efficiency of MALDI-TOF mass spectroscopy method through biochemical and molecular methods for detecting Enterococcus faecalis and Enterococcus faecium.Material and Methods: the clinical samples (N=75) collected for biochemical, molecular and mass spectroscopy investigation were examined by Esculin hydrolysis, Catalase, Pyrrolidonylaminopeptidase, 6.5% NaCl, Motility, 0.04% Tellurite, L-Arabinose and Sorbitol. Then, they were assessed by using Allele specific PCR and analyzed by MALDI-TOF mass spectroscopy and Biotyper software.Results: thirty samples of Enterococcusfaecium and 42 of Enterococcusfaecalis are detected and in three sample both of them recognized. In biochemical analysis, two isolates of E. faecium are Arabinose negative and one of E. faecalisis Telliurite negative. Also in PCR results, two of the samples do not have any clear bonds. In mass spectroscopy analysis, all strains are correctly detected and well defined.Conclusion: According to the results of present study, MALDI-TOF mass spectrometry is a reliable and accurate method that can easily and quickly identify Enterococcus faecium and Enterococcus faecalis, with a sensitivity of 100%. This procedure can be compared to molecular and biochemical methods, based on the exactness and rapidity of performance.

Background and objective: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases. It is a functional boweld is order characterized by chronic abdominal pain and change in 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. Because of malabsorption of the nutrients, vitamin may not be absorbed correctly; therefore, we aimed at evaluating the effectiveness of IBS on serum levels of vitamin and E.Material & Methods: This case - control study was conducted on 94 IBS patients diagnosed 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, matched by sex and age. Fasting blood samples were collected and the serum levels of vitamins A and E measured, using HPLC method.Results: the mean of vitamin A in case and control groups is 57.0±114.8 and 55.9±23.8 mg/dl, and the mean of vitamin E in case and control groups is 0.50±0.24 and 1.93±1.86 mg/dl, respectively. The deficiency of vitamin A and E are 7.70 and 7.10 percent in males and 6.76 and 3.7 in females (P<0.05). In general, 1.1 percent of IBS patients show vitamin A deficiency and 93.6 percent of them vitamin E deficiency (P<0.05).Conclusion: Conclusion: In this study, a significant decrease in vitamin E level is observed in patients with IBS. Due to antioxidant function 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.

Background and Objective: Some studies show that, there is a relationship between decrease of serum magnesium (Mg) level and the insulin resistance in diabetic type 2 patients. The aim of this study was to compare the Mg level in type 2 diabetic with non-diabetic individuals.Material and Methods: Diabetic patients (n=35) and control group (n=35) were randomly selected from over -35- year-old individuals referring to the hospital of Imam Ali, And imeshk.Results: Mg levels in diabetic and non- diabetic groups are 1.33±0.27 and 1.62±0.21 mg/dl, respectively, and the difference is statistically significant (p<0.001). A reversed significant relationship is seen between FPG and Mg among type 2 diabetic patients, whereas no significant relationship is seen between Mg and other variables, (TG, Chol and HDL). In non-diabetics group, there is a reversed significant relationship between the Mg and Chol, while no relationship between other variables and magnesium.Conclusion: In diabetic patients, with increased level of FPG, serum Mg levels are decreased significantly. Moreover, serum Mg levels in diabetic patients are significantly lower than non-diabetics.

Background and Objective: Gastroenteritis is one of the most common forms of Salmonellosis, which is a worldwide problem. The invasive characteristic of intestinal bacteria is one of their pathogenicity mechanisms, which can be easily investigated by cell culture technique. In this study, the invasive characteristic of some Salmonella serogroup was investigated by usingHEP-2 cell.Material and Methods: Therectalsoaps were prepared from 280 diarrhea patients referred to Imam Khomeyni and children medical centres, 140 with bloody diarrhea and 140 with watery diarrhea as a comparison group. The rectal soaps were obtained from the patients before taking any antibiotics, and 140 rectal specimens were taken from healthy people as a control group. All the samples were inoculated in differential and selective media, like Hektoen and Xylose lysine deoxycholate (XLD) agar. After incubation at 37C for 24 hours, the colonies were examined and identified by conventional biochemical and serological tests. Using HEP-2, cellular invasion characteristic of Salmonella serogroups was assessed. Moreover, the antibiotic resistance patterns were performed according to clinical and laboratory standards institute (CLSI).Results: Of all tested samples, 35 (8.3%) are Salmonella strains. The frequency of Salmonella is reported for bloody diarrhea (5.2%), watery diarrhea (1.7%) and control group (1.4%).The most abundant serogroups with invasive characteristic, using HEP-2 cell culture, areserogroup B (62.9%) and D (17.2%).Conclusion: The results obtained in this study show that the majority of Salmonella isolates are without invasive characteristic.

Background and objective: The effects of lactobacillus Species and their metabolites on dairy products were proved as probiotics on pathogenic bacteria. The aim of this study was to isolate the lactobacillus from dairy product (Yogurt, cheese, milk and whey …) and to determine the antimicrobial activity against some pathogenic bacteria (Salmonellatyphimurium, E.coli, Helicobacter pylori.Material and methods: Samples of dairy products were collected and were serially diluted in peptone medium. To isolate lactobacillus, diluted sample were plated on MRS Agar medium and incubated at 37oc for 48-72h in anaerobic condition. Identification of the lactobacilli was performed according to their morphological, cultural, physiological and biochemical characteristics. The inhibitory effect of isolated lactobacillus strains were performed against pathogenic bacteria by Agar Well Diffusion Assay and Disc method.Results: of 50 samples of isolated Lactobacillus from dairy products (including 11 identified Lactobacillus), 19 samples have inhibitory effect on pathogenic bacteria such as Salmonella typhimurium, Escherichia coli and Helicobacter pylori. The most identified strains are Lactobacillusbulgaris, Lactobacillus Salivarius and Lactobacillusdelbrueki.Conclusion: According to this study, some lactobacillus strains isolated from dairy products are useful in the management of diarrhea and other gastrointestinal diseases, and the use of these strains can be useful for prevention and treatment.

Background and Objective: The high occurrence of early childhood caries (ECC) is one of the most common problems in children dentistry. Streptococcus mutans and lactobacilli.spp are closely associated with the development of early childhood caries (ECC). Therefore, the aim of this study was to investigate the frequency of streptococcus mutans and lactobacilli.spp in 3-5 –year- old children with and without dental caries.Material and Methods: This case-control study was conducted on 60 children aged 3 -5-years, without any history of systemic disease, who had not received any antibiotic therapy and fluoride usage during the last month. The cases were divided into three groups of early childhood caries, usual caries and caries-free. The infected dentin samples were collected from cervical and proximal in ECC and usual caries group, respectively. Also in all the three groups, the samples of dental plaque from buccal surfaces were collected and immediately immersed into Brain Heart Infusion (BHI) broth medium. After that, the diluted sample was plated onto MitisSalivarius agar (Difco) for detecting streptococcus mutans and Rogosa agar (Difco) for detecting lactobacilli.spp. Data were analyzed by Chi- Square and ANOVA.Results: of the samples taken from dental plaque, S. mutans is observed in 90% of ECC, 80% of proxymolcarries and in 25% of caries-free individuals. Based on the results, the presence of S.mutans in the group of caries is significantly higher than that of without caries, but there is no significant difference between the two groups of caries. In addition, lactobacill.spp is isolated from 60% of thesamples, but there is no significant difference between two groups of caries and caries-free. The average of decayed, missing and filled teeth (DMFT) index in the group with early childhood caries (6.95±1.572) and usual caries (5.80±1.105) is different significantly. Pearson correlation test shows that there is a significant relationship between caries experience and the amount of S.mutans, but there isn’t this relationship with lactobacill.spp.Conclusion: The findings show that the children with early decay have the higher level of S.mutans in their dental plaque. The most common strain isolated from dentin, without consideration of their location, is S.mutans.

Background and Objective: Staphylococcusaureus is one of the important factors causing nosocomial infections. Typically 25-30 percent of healthy people carry the bacteria in their anterior nasal cavity. The physicians (50%), nurses (70%) and hospital staff (90%) are the carriers of this bacteria, leading to the infection of inpatients. The emergence of antibiotic-resistant Staphylococcus strains tovancomycin and methicillin has brought about several problems in treatment of the infections caused by Staphylococcus strains. Hence, we aimed to study the frequency of staphylococcus aureus carriers and resistance pattern among medical personnel of the surgical ward in ShahidRajaee hospital, Tonekabon.Material and Methods: this analytic-descriptive study was conducted on the samples taken from nasal carriage of medical staff of surgical ward (N=120). Antibiotic- resistant of Staphylococcus strains was assessed by antibiogram and disk diffusion (DAD), in accordance with CLSI standards.Results: of 34 (28.33%) who are nasal carriers of staphylococcus, 12 are over 30 years old and 24 under 30. Based on antibiogram, 1.97% of specimens are sensitive to Gentamicin and Co-trimoxazole, 1.94% to Ciprofloxacin, 2.88% to Vancomycin and 6.20% to Methicillin. In addition, 100% of specimens are resistant to Ampicillin, 1.97% to Penicillin and 2.88% to Amoxicillin. Four isolates areresistant, both to methicillin and vancomycin.Conclusion: In this study, the spectrum of S. aureus resistant and sensitive strains to some antibiotics is similar to other studies, but a dramatic increase is seen in the rate of MRSA and non-susceptible cases to vancomycin. The Effectiveness of Penicillin, Amoxicillin and Ampicillin is still very low on S. aureus samples.

Background and Objective: Every organization requires ongoing evaluation of existing conditions. The purpose of this study is to assess and analyze the standards and criteria that each Laboratory system is required to observe and upgrade them, to determine the gap between the ideal and the current status and finally to present the strategy and executive plan in order to achieve the desirable status.Material and Methods: This study was performed in a medical diagnostic laboratory in Gorgan by using the quality system checklist related to medical diagnostic laboratories, which was revised in 2009. Internal evaluation matrix (Internal Factor Evaluation) was used to examine the main factors in the context of establishing a quality management system in a clinical laboratory. After examining the factors, determining the laboratory status, recording the results of monitoring (in terms of strengths and weaknesses) and determining the gap between existing and desirable status, we provided the appropriate and effective solutions in line with defined standard.Results: of 164 items that should have been done in the first assessment, 111 (67.7%) items are in performed group and 53 (32.3%) are not in. After compiling and running a plan, 147 (89.6%) are performed, 15 (9.2%) needed to be modified and 2 (1.2%) still not performed. It is evident that a significant difference (p<0.05) and a tangible improvement in current problems are seen after establishing the quality system in the laboratory. The lab equipment, lab space and facilities, pre-examination process, testing process and post-examination process are considered. Regarding the health and safety in the laboratory, lab equipment, lab space and facilities, pre-examination process, testing process and post-examination process, no significant difference is observed between before and after the implementation of the program.Conclusion: after establishing the quality system in laboratory, a significant difference and tangible improvement in the current problems are observed. It is implied the importance of pre-planned responses to problems and the performance of strategic planning.

Visceral leishmaniasis (Kala-azar) is a systemic infection disease that can be diagnosed by some invasive procedures such as splenic, liver biopsy or bone marrow aspiration, which are determined as the gold standards for diagnosing of this disease. At present, a variety of noninvasive tests having different specificities and sensitivities are available for the diagnosis of visceral leishmaniasis. Direct agglutination test (DAT) can be an appropriate and applicable method provided that proper antigens are prepared. The rapid rK39 strip test (for detection of antigen) can be used for diagnosis of visceral leishmaniasis (VL), which is suitable for acute forms of disease in the field. Other tests, such as rapid KATEX strip test (for detection of antigen) and polymerase chain reactions (PCR), which are recently recommended for diagnosis and prognosis of visceral leishmaniasis, are the simple, inexpensive and easily available under field conditions. This review article focuses on different, novel and current procedures for the diagnosis of visceral leishmaniasis.

Background and Objective: Pre-eclampsia is the most common cause of maternal and neonatal mortality. Recent studies show that there may be a relationship between chorionic gonadotropin (HCG) and pre-eclampsia. Thus we aimed at assessing the serum level of bhCG after 28th week of pregnancy in mild pre-eclamptic and healthy pregnant women.Material and Methods: In this case-control study, we measured the level of bhCG in 26 pre-eclamptic and 26 normal pregnant women. The difference between groups was analyzed by Mann-Whitney test (P≤ 0.05).Results: The mean of bhCG in the case (73192±42956 IU/L) and control group (34038±21272 IU/L) is different significantly (P=0.001). Considering mother’s age, gestational age and parity, there is a significant difference between the two groups (P=0.001).Conclusion: The results of our study show that the higher level of βhCG, the greater the risk of pre-eclampsia.

Background and Objective: Helicobacter pylorus is the major cause of inflammation and ulcer in stomach, and immunoglobulin IgG is one of the antibodies produced against it, which is important in the course and diagnosis of the previous sufferers. The awareness of the prevalence of this disease can be helpful for the physicians to choose the way of treatment.Material and Methods: In this cross-sectional study, 516 patients referred to laboratory was studied. After separating the serum, Antibody Helicobacter pylori IgGtest was done by ELISA method.Results: of 516, 156 (30.2%) of the patients have a positive result, 51 (32.7%) are males and 105 (67.3%) are females. Positive percent of males (43.5%) is greater than females (26.5%).Over-45-year-old women (9.8%) have the highest percentage of disease titers.Conclusion: The percent of positive cases in men is more than that the women. Over-45-year-old women (9.8%) have the highest percentage of positive case.