Medical Laboratory Journal

Determination of the Rate and Reasons of Blood Sample Rejection in the Pre-Analytical Phase in Ruhengeri, Rwanda: A Single Center Study

Jonas Bikorimana

Background and objectives: All three phases of laboratory testing are equally important for improving total quality management, but the pre-analytical phase is the most error-prone. This study aimed to determine the rate and reasons for blood sample rejection in the pre-analytical phase of laboratory testing in a referral hospital in Ruhengeri, Rwanda.
Methods: This study was a cross-sectional and retrospective study in which 222 samples with nonconformities were discovered from 19,775 clinical samples. Various data related to the rejected samples were recorded along with nonconformities.
Results: The rate of blood sample rejection was 1.045% and 1.165% for the cross-sectional and retrospective approaches, respectively. The overall blood sample rejection rate was 1.105%. The most frequent error in the cross-sectional aspect was mislabeling (38.3%), while clotting (46.4%) was the most common cause of sample rejection in the retrospective aspect.
Conclusion: Based on the results of our study, the rate of blood sample rejection is high in the study area. Thus, there should be a laboratory policy for error record keeping as well as a settlement in “laboratory sentinel events” covering the total testing process.

VGB3 Induces Apoptosis by Inhibiting Phosphorylation of NF-κB p65 at Serine 536 in the Human Umbilical Vein Endothelial Cells

Mohsen Asghari

Background: Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) inhibition results in an increase in apoptosis. It has been demonstrated that NF-κB subunit p65 phosphorylation at the IκB kinase phosphorylation site serine 536 (Ser536) is essential for the NF-κB nuclear translocation and activation. Therefore, NF-κB can be downregulated by suppressing its phosphorylation. The vascular endothelial growth factor receptor-2 (VEGFR-2) suppression could result in apoptosis induction. Therefore, targeting these pathways via VEGFR-2 inhibitors might have therapeutic potential for cancer treatment. It has been indicated that an antagonist peptide of VEGF, referred to as VGB3, could neutralize and recognize VEGFR2 in the tumoral and endothelial cells. This study aimed to induce apoptosis in human umbilical vein endothelial cells (HUVEC) cells through the inhibition of these signaling pathways.
Methods: Effects of different concentrations of VGB3 (1-200 ng/ml) were evaluated on the viability of HUVEC cells using MTT assay. In addition, downstream signaling pathways in HUVE cells were evaluated through quantitative assessment of protein expression via western blotting.
Results: The results demonstrated that VGB3 treatment inhibited the growth of HUVEC cells. Moreover, Bcl-2 was decreased in the cells treated with the VGB3 compared to the control. Furthermore, VGB3 significantly enhanced the cleaved-caspase7 levels, which is an indicator of apoptosis progression. Altogether, VGB3 enhanced apoptosis in HUVEC cells.
Conclusion: Our results indicate that the peptide might be a potential candidate for antitumor therapy via inhibiting the NF-κB pathway.

A Comparative Study of ERIC-PCR and BOX-PCR Methods for Evaluation of Genomic Polymorphism among Multidrug-Resistant Enterococcus faecium Clinical Isolates

Elham Siasi Torbati

Background: Enterococcus faecium is a normal flora of gut microbiota. This opportunistic pathogen has attracted much attention due to its multidrug resistance and ability to survive in hostile environments. Various molecular typing methods such as pulsed-field gel electrophoresis or ribotyping have been developed for clinical and epidemiological investigation of these bacteria. However, these methods are time-consuming and labor-intensive. The present study was conducted to evaluate the discriminatory power of two common fingerprinting methods i.e. BOX-polymerase chain reaction (PCR) and enterobacterial repetitive intergenic consensus (ERIC)-PCR for E. faecium clinical isolates.
Methods: Fifty multidrug-resistant E. faecium isolates were isolated from 74 clinical specimens. The isolates were identified by specific 16S rRNA PCR. All isolates were fingerprinted using BOX-PCR and ERIC PCR. The discriminatory power and reproducibility of these two methods were also assessed.
Results: According to the dendrogram with >60% similarity, 17 different genotypes were observed using ERIC PCR. In addition, BOX-PCR produced 22 distinct patterns at a genetic distance percentage of 60%, with sizes ranging from 278 bp to 1450 bp. The discrimination index of BOX-PCR was higher than that of ERIC-PCR.
Conclusion: We concluded that a combination of ERIC-PCR and BOX-PCR may be a quicker and more reliable alternative for the discrimination of E. faecium clinical isolates.

Effects of 8 Weeks of Combined Rehabilitation Training on Plasma Levels of Leptin, Adiponectin, and Resistin‎ in Middle-Aged Men after CABG

Rambod Khajei

Background: Coronary artery bypass graft (CABG) is a surgical procedure used to treat coronary heart disease. The present study aimed to investigate effects of 8 weeks of combined rehabilitation training on plasma levels of leptin, adiponectin, and resistin in middle-aged men who have undergone CABG.
Methods: The present research was a quasi-experimental study with a pretest-posttest design. The statistical population included all patients who have undergone CABG in Mashhad, Iran. Overall, 26 middle-aged men who have undergone CABG were enrolled in the study. The subjects were divided into a training group (n=14) and a control group (n=12). Data were analyzed in SPSS software (version 21) using analysis of covariance and paired t-test at significance level of 0.05.
Results: Plasma levels of leptin did not change significantly (p=0.709), adiponectin increased significantly (p=0.001), and resistin decreased significantly (p=0.005) after the training intervention.
Conclusion: As a non-pharmacological intervention, the rehabilitation training has cardioprotective effects on patients who undergone CABG.

Killing Kinetics of Carvacrol against Fluconazole-Susceptible and -Resistant Isolates of Candida tropicalis

Fahimeh Alizadeh

Background: Overuse and misuse of antibiotics in the agricultural and healthcare sectors have led to the emergence of antibiotic-resistant strains. Therefore, finding alternative antimicrobial compounds, such as phytochemicals, is of great importance. This study evaluated the feasibility of carvacrol as an antifungal agent in suppressing the planktonic and hyphal growth of clinical isolates of fluconazole-susceptible and -resistant Candida tropicalis.
Methods: Clinical isolates of fluconazole-resistant C. tropicalis were identified using the CLSI guidelines and the World Health Organization's WHONET software. The inhibitory effect of carvacrol on planktonic cells was assessed by determining the minimum inhibitory concentration (MIC) and time-kill profile. The inhibitory effect of carvacrol on hyphal growth was studied by using light field microscopy.
Results: The findings indicated that 50% of clinical isolates of C. tropicalis were resistant to fluconazole. The MIC90 and MIC50 of carvacrol against clinical isolates of fluconazole-susceptible and -resistant C. tropicalis were 25.00-300.00 µg/ml and 12.50-100.00 µg/ml, respectively. The time-kill analysis indicated that carvacrol exhibited fungicidal activity against the fluconazole-susceptible and -resistant C. tropicalis isolates 2-48 hours after exposure. Moreover, planktonic and hyphal growth of the isolates decreased significantly after exposure to carvacrol.
Conclusion: The findings revealed that carvacrol exhibits inhibitory effects on the planktonic and hyphal cells of fluconazole-susceptible and -resistant C. tropicalis isolates. Therefore, the antifungal potential of carvacrol as a natural antifungal could be further exploited for the treatment of resistant C. tropicalis infections

Protective Effects of Melissa officinalis L. Extract on Gentamicin-induced Renal Failure in Diabetic Rats

Amir Reza Karamibonari

Background: Gentamicin is an aminoglycoside antibiotic used in the treatment of Gram-negative bacterial infections. One of the side effects of this antibiotic is nephrotoxicity. In this study, the protective effect of Melissa officinalis L. extract on diabetes- and gentamicin-induced nephrotoxicity was studied.
Methods: Forty male Wistar rats were randomly divided into four groups. The first group received distilled water, and the second group received M. officinalis L. extract (100 mg/kg) for 28 days. The third group received streptozocin (60 mg/kg) for 18 days, and then received gentamicin (80 mg/kg) on day 20 for 8 consecutive days. The fourth group received streptozocin, gentamicin, and M. officinalis L. extract for 28 days. Serum levels of blood urea nitrogen (BUN), creatinine, glucose, and amylases were measured. The right kidney was maintained in 10% formalin for hematoxylin and eosin staining, and oxidative stress markers in the left kidney were assessed.
Results: In the third group, serum BUN, creatinine, glucose, amylase, and malondialdehyde (MDA) increased, while glutathione peroxidase, superoxide dismutase, and catalase activities decreased significantly compared to the other groups (P<0.05). The extract of M. officinalis L. significantly inhibited the enhancement of serum creatinine, BUN, glucose, amylase, and MDA (P<0.05). Histological examinations showed that diabetes and gentamicin could lead to kidney damage by inducing necrosis and inflammation. Finally, the extract of M. officinalis L. could significantly reduce the adverse effects of both gentamicin and diabetes (P<0.05).
Conclusion: The extract of M. officinalis L. improves biochemical parameters and histological lesions in diabetic rats treated with gentamicin.

Evaluation of Prevalence and Characteristics of Patients with Fanconi Anemia: A Study in Northeast of Iran

fatemeh shams

Background: Fanconi anemia (FA) is an autosomal recessive disorder that usually manifest in forms of pancytopenia, hyperpigmentation, and skeletal complications. Mutation in the DNA repair regulatory genes is associated with the development of FA. Examination of chromosomal breakages when chromosomes are exposed to cross-linking agents is a common method of FA diagnosis. This study aimed to evaluate the prevalence and characteristics of patients with FA in Mashhad, northeast of Iran.
Methods: In this study, we evaluated 312 suspected FA patients who had been referred to the laboratory of Ghaem Hospital during 2014-2020. The mitomycin C method was used to identify FA-positive subjects.
Results: After the examinations, 84 patients (26.9%) were cytogenetically positive for FA. Of 84 patients, 48 (57.1%) were male and 36 (42.9%) were female. Thumb abnormality was the most common congenital anomaly (43.2%).
Conclusion: Based on the findings, males are more susceptible to FA, and thumb abnormality is the most common congenital anomaly associated with FA. Combination of clinical manifestations and genetic susceptibility in patients may contribute to a more accurate diagnosis.

Comparison of the Levels of Bone Metabolic Markers between Young Female Basketball Players and Non-Athlete Females

asra askari

Background: Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue. It is the most common chronic metabolic bone disease. The purpose of this study was to compare the level of bone metabolic markers including parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus between female basketball players and non-athlete females.
Methods: Twelve female professional basketball players (aged 20-35 years) of the Super League of Golestan Province (Iran) were enrolled as the experimental group. Fifteen age-matched non-athlete females were also selected as the control group. Plasma levels of PTH, ALP, calcium, and phosphorus were compared between the study groups.
Results: The levels of PTH (p=0.004) and ALP (p=0.001) were significantly higher in the experimental group than in the control group. The levels of calcium and phosphorus did not differ significantly between the study groups (p>0.05).
Conclusion: Based on the results, it could be stated that performing weight-bearing sports activities such as basketball can improve the density of bone minerals and the factors stimulating bone formation.