Medical Laboratory Journal

Genes Associated with Coma or Recurrent Coma and Role of Next Generation Sequencing in Diagnosis of Disease-Causing Genes

hamedreza goodarzi

Coma is a state of prolonged unconsciousness. Some coma cases result from inherited disorders such as fatty-acid β-oxidation disorder, acute intermittent porphyria (due to mutations in genes CPT I, CPTII and ACADM), urea cycle defects (due to mutation in OTC gene), organic acidurias, mitochondrial diseases and familial hemiplegic migraine (due to mutations in CACNA1A, ATP1A2 and SCN1A). The evaluation of familial cases of coma or sporadic coma can be performed using next generation sequencing (NGS), a high-throughput sequencing technique that can sequence an entire genome in a single reaction. This technique has been widely applied in the genetic diagnosis of diseases. In this review, we describe some genes associated with coma or recurrent coma and discuss the role of NGS in detection of these genes.

Clinical Features of COVID-19 Patients with Preexisting Hypothyroidism: A Retrospective Study

MAHALAXMI PETIMANI

Background and objectives: Coronavirus disease 2019 (COVID-19) has been reported to be more severe and highly fatal in patients with co-morbidities. Thyroid dysfunction leads to multisystem derangements, as thyroid hormones have major role in the development and functioning of all the human cells. The present study evaluated the variation in the clinical and biochemical parameters of COVID-19 patients with preexisting hypothyroidism.

Methods: This retrospective cohort study was carried out on eight COVID-19 patients with hypothyroidism who were admitted to a tertiary care hospital in Mangalore, India. Various clinical and biochemical parameters of the patients were recorded.

Results: Out of eight patients, three were men and five were women. With respect to other co-morbidities, six patients had associated type-2 diabetes mellitus and the remaining two patients had no other co-morbidities apart from hypothyroidism. Regarding the severity of COVID-19, one patient had mild symptoms, two had moderate symptoms, and the remaining five patients had severe COVID-19 symptoms. Most biochemical and hematological parameters in all patients were deranged from normal values. Moreover, only 25% of the patients recovered from the disease.
Conclusion: Most COVID-19 patients with hypothyroidism had low oxygen saturation and high level of inflammatory markers. In addition, the risk of mortality in COVID-19 patients with hypothyroidism and type 2 diabetes mellitus was higher compared to patients with hypothyroidism alone. It is recommended to closely monitor COVID-19 patients with hypothyroidism and limit the use of steroids during the course of treatment.

Serum Prolactin: A Clue to Breast Malignancy

Gyanshankar Mishra

Background and objectives: Prolactin is a lactogenic protein hormone secreted by the anterior pituitary that initiates and maintains lactation in mammals. Previous research has linked increased serum prolactin levels to breast cancer. However, there is a paucity of studies in the Indian population on the subject. The present study evaluated and compared serum prolactin levels in patients with breast cancer and patients with benign breast diseases.
Methods: This cross-sectional, comparative study was carried out at the Government Medical College, Nagpur (India) on patients with breast diseases in the out-patient department/in-patient department from June 2018 to November 2020. Breast cancer patients were considered cases, and those with benign breast diseases were considered controls. Breast carcinoma diagnosis was based on clinical features, fine needle aspiration cytology, and tissue histopathology in operated specimens for each patient. Fasting serum prolactin levels were measured by the chemiluminescence immunoassay method using the Advia Centaur immunoassay system.
Results: There were 120 female patients with breast diseases, of whom 60 had breast malignancy, and 60 had benign breast diseases. The mean age of patients with benign breast disease and breast cancer was 33.17 (1.75) and 49.77 (1.16) years, respectively (P<0.0005). Increased serum prolactin levels were observed in 93.3% of patients with breast cancer and 13.3% of patients with benign breast diseases. The mean serum prolactin level was significantly higher among breast cancer patients (102.68±7.03) ng/ml compared with patients with benign breast disease (16.31±1.72 ng/ml). We successfully determined a new cut-off value of serum prolactin level (>40.2 ng/ml) to differentiate breast cancer from benign breast diseases using the receiver operating characteristic curve analysis.
Conclusion: Patients with breast cancer have increased serum prolactin levels compared to patients with benign breast diseases. Thus, serum prolactin level can be used as a diagnostic marker for breast cancer. This is particularly beneficial to clinicians for differentiating breast cancer from benign breast diseases.

Effects of Alginate Coating and Neutral Electrolyzed Water on E. coli O157:H7 Contamination of Salmon Fillets

saeid khanzadi

Background and objectives: Neutralized electrolyzed water (NEW) is a novel natural disinfectant. It has been suggested that application of NEW can improve the shelf life of fish. This study aimed to investigate effect of NEW incorporated in alginate coating on growth of Escherichia coli O₁₅₇: H₇ on salmon fillets over a period of 12 days.
Methods: Fish fillets were inoculated with E. coli O₁₅₇:H₇ and divided into six different treatment groups: control (no coating), distilled water, alginate, EW, EW & alginate (Samples coated with alginate solution prepared by EW), and EW+ alginate (samples immersed in EW, then coated with alginate solution). The fillets were kept at 4 °C, and the bacterial count was determined on days: 0, 2, 4, 8, and 12. Data analysis was performed using repeated ANOVA and Bonferroni post-hoctest at statistical significance of 0.05.
Results: Treatment with alginate coating and EW alone could significantly reduce E. coli O₁₅₇: H₇ count on the salmon fillets. However, maximum reduction (1.27 log CFU/g) of bacteria was achieved when using alginate coating combined with EW.
Conclusion: According to the results, the combination of alginate coating with EW can be applied as a natural antimicrobial for increasing safety of food products, especially fish, against pathogenic bacteria such as E. coli O157: H7.

Phytochemical Analysis of Garlic Hydro-alcoholic Extract and Evaluation of its Anti-bacterial Effect on Enterohemorrhagic Escherichia coli in Vitro and ex Vivo

Ezzat Allah Ghaemi

Background and objectives: Garlic is a medicinal plant with various health promoting properties including antimicrobial effects. In this study, we investigated in vitro antibacterial effects of garlic hydro-alcoholic extract against enterohemorrhagic Escherichia coli (EHEC).
Methods: Garlic hydro-alcoholic extract was prepared by maceration method. Phytochemical analysis of the extract was carried out using gas chromatography-mass spectrometry. Minimum inhibitory concentration (MIC) of the extract against EHEC was determined by micro-dilution assay. Cytotoxic effect of the garlic extract on human colon adenocarcinoma cell line (SW480) was assessed using MTT assay. Micro-dilution assay was also used to determine the MIC of the extract against EHEC when co-cultured with SW480 cells.
Results: The amount of organosulfur in garlic extract was 70.91% and the most common organosulfur compounds were trisulfide, di-2-propenyl (34.8%) and diallyl disulfide (14.83%). The MIC of garlic hydro-alcoholic extract on EHEC alone and when co-cultured with SW480 was 12.5 mg/ml. Concentrations of 12.5 mg/ml and 25 mg/ml of the extract significantly reduced the viability of SW480 cells compared to control and concentration of 6.25 mg/ml of garlic extract (p <0.0001).
Conclusion: The garlic hydro-alcoholic extract has inhibitory effects on EHEC in vitro. Therefore, it can be considered a suitable candidate for controlling infections caused by EHEC.

Anti-Diabetic Effect of Long-Term Aerobic Training in Type 2 Diabetic Rats with Emphasis on Adiponectin Expression in Subcutaneous Adipose Tissue

Mojtaba Eizadi

Background and objectives: Clinical evidence has demonstrated the important role of adiponectin in insulin signaling pathways in target tissue. The aim of this study was to determine effects of aerobic training on insulin sensitivity, glucose level, and adiponectin expression in subcutaneous adipose tissue of type 2 diabetic rats.
Methods: Type 2 diabetes was induced in 14 male wistar rats by intraperitoneal injection of nicotine amide and streptozotocin. The rats were randomly divided into an exercise group (n=7) and a control group (n=7). The rats in the exercise group performed aerobic training in from of treadmill running, five sessions a week, for 12 weeks. Subjects in the control group did not perform any training. Glucose level, insulin level, insulin sensitivity, and adiponectin expression in subcutaneous adipose tissue were determined at baseline and 48 hours after the lasting training session. Independent t-test was used for comparing the variables between the study groups.
Results: Aerobic training resulted in a significant increase in serum insulin (p=0.006), insulin sensitivity (p=0.003), and adiponectin expression in subcutaneous adipose tissue (p=0.037) compared with the control group. In addition, the training caused a significant decrease in fasting glucose level compared with the control group (p<0.001).
Conclusion: Based on these findings, the decrease in blood glucose may be attributed to the improvement of adiponectin-dependent insulin signaling pathways in adipose tissue in response to aerobic training. However, more cellular-molecular studies are needed to understand the mechanisms responsible for these changes.

Effect of Exercise Training and Atorvastatin Supplementation on Beclin1, LC3-I and LC3-П Expression in Old Diabetic Rats

parvin farzanegi

Background and objectives: Programmed autophagy is a genetically and evolutionarily conserved process that destroys long-lived cellular proteins and organelles. This study aimed to investigate effects of continuous and interval exercise training with or without atorvastatin supplementation on Beclin1, LC3-I and LC3-П expression in old rats with type 2 diabetes.
Methods: Sixty three male Wistar rats were divided into eight groups. Continuous exercise was performed at a speed of 15-29 m/min for 5-22 minutes. Interval exercise program consisted of six 2.5-minute sets that included a four-minute rest period between each set. The rats in the supplementation groups also received 20 mg/kg body weight atorvastatin daily via intraperitoneal injection. At the end of the training period, the expression of Beclin1, LC3-I and LC3-П in soleus muscle was measured by RT-PCR. One-way ANOVA was used for data analysis at statistical significance of 0.05.
Results: The results showed that both exercise trainings with or without atorvastatin significantly reduced LC3I, LC3-II and Beclin1 compared with the diabetic control group (P<0.05). In addition, the effects of the trainings and atorvastatin supplement did not differ significantly (P>0.05).
Conclusion: The results indicate that continuous and interval exercise program alone and combined with atorvastatin supplementation could significantly reduce LC3-1, LC3-II and Beclin1 level in soleus muscle of old diabetic rats.

Analysis of the Policy-Making Gap in the Hoteling Quality Promotion of the Health System Development Plan in Providing Laboratory Services in Hospitals Affiliated with the Golestan University of Medical Sciences, Iran

Ali Farhadi Mahali

Background and objectives: The hoteling quality promotion is part of the health system development plan, based on which the physical appearance of laboratories of public hospitals are improved and renovated. The present study aimed to evaluate the policy-making gap in the hoteling quality promotion of the health system development plan in providing laboratory services in public hospitals in the Golestan Province, Iran.
Methods: This descriptive-analytical and cross-sectional study was performed on 384 medical staff and physicians working in laboratories of public hospitals affiliated with the Golestan University of Medical Sciences, Golestan Province, Iran. Data were collected using a 35-item researcher-made questionnaire that was distributed and collected over a period of six months. We examined the extent of the gap between the current and expected status based on the two components: the alignment of key stakeholders with health system development policies and stakeholders' opposition to health system development policies, as well as the extent of the gap
Results: The hoteling quality promotion was about -0.05 in providing laboratory services in public hospitals of the Golestan Province, indicating a low gap between the current and favorable status in the fifth axis of the health system development plan in terms of supervision.
Conclusion: The implementation of the hoteling quality promotion plan in providing laboratory services in public hospitals of the province is not consistent with the expected goals of the fifth axis of the health system development plan. Therefore, there is a need to examine and eliminate effective factors contributing to this gap.