Medical Laboratory Journal

Biological evaluation of coagulation problems in COVID-19 patients hospitalized at the centre hospitalier mère-enfant monkole, kinshasa, Democratic Republic of the Congo

Gédéon N. Bongo

Background: COVID-19 is a viral infection caused by SARS-CoV-2, which enters the body via the ACE2 receptor. This study aims to evaluate the coagulation disorders of COVID-19 patients admitted to Centre Hospitalier Mère-Enfant Monkole, Kinshasa.
Methods: This descriptive cross-sectional hospital-based study of patient files was conducted between July 2020 and June 2021 at CHME-Monkole in Kinshasa. The sample size was 130 patients using a random sampling technique after interviewing the respondents. For each respondent, biological and socio-demographic data were collected on a questionnaire. The primary analyses included the determination of PT, APTT, Plasma determination of D-dimers, and platelet count. A descriptive analysis was performed for socio-demographic characteristics, while Pearson correlation was used to determine the associations between socio-demographic characteristics and different biological parameters using SPSS 25.0. For ethical reasons, informed consent from patients was sought, and confidentiality was assured. The authorization was provided by the Ethical Committee of CHME-Monkole (Ethical code: KIN/CHME/04/2020).
Results: The findings showed D-dimer levels higher than 500 µg/L in 87.7% of respondents, prolonged APTT (>40 seconds) in 43.1% of respondents, PT (<70%) in 36.9% of respondents, and thrombocytopenia (platelets <150,000) in 26.2% of respondents. A positive correlation was observed between socio-demographic characteristics and D-dimer levels.
Conclusion: SARS-CoV-2 infection has a significant impact on coagulation. Thus, determining these biomarkers could predict the risk of disease severity or death in patients with COVID-19.

The value of coagulation parameters as prognostic indicators in snake envenomation

Shalaka Saraf

Background: Snakebite is a potentially life-threatening emergency that can be treated effectively. Snake envenomation can cause hematologic and coagulation abnormalities.In this respect, tests such as prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) are commonly used. The present study aimed to determine the value of coagulation parameters in the prognostication of snakebite patients.
Methods: This prospective descriptive observational study examined the coagulation parameters, including PT, INR, and aPTT, in consecutive cases of snake envenomation admitted to a tertiary health care hospital from October 2019 to August 2021. The correlation of coagulation parameters with each other and with prognostic indicators (ie, the number of days spent in the intensive care unit [ICU], the requirement of anti-snake venom [ASV], fresh frozen plasma [FFP], and the total number of blood products) was studied.
Results: A total of 58 patients with snakebite were studied. The majority were males (69%). The highest proportion of patients belonged to the age group of 16-40 years (60%). The correlation of coagulation parameters with each other was statistically significant. The correlation of coagulation parameters with prognostic indicators (ie, the total number of ASV vials administered, the total number of days in the ICU, the total number of FFP units administered, and the total number of blood components administered) was statistically significant.
Conclusion: Coagulation parameters (PT, INR, and aPTT) are essential laboratory investigations for treatment monitoring and can be used effectively for the prognostication of snakebite patients. In cases where the coagulation profile of snakebite patients shows abnormalities, conducting repeated coagulation studies at intervals of 12 hours can contribute to improved prognostication.

Protective activity of hydroalcoholic extract of zingiber officinale rosc. on doxorubicin-induced hepatic toxicity in male rats

Habib Alla Johari

Background: Research has shown that the extract of some plants has an effective protective effect on liver cells against toxins and oxidants. In this research, the effect of hydroalcoholic extract of ginger against hepatotoxicity caused by doxorubicin (Dox) in adult male rats was investigated.
Methods: In this experimental study, 63 adult male rats were divided into 7 groups (n = 9 per group). The experimental treatments included the control and placebo groups without the use of medicines, experimental group I that received Dox at a dose of 20 mg/kg, experimental groups II and III with 300 and 600 mg/kg of ginger hydroalcoholic extract, and experimental groups IV and V that received 20 mg/kg Dox + 300 and 600 mg/kg of ginger hydroalcoholic extract, respectively. After the end of the test period, serum levels of total bilirubin and direct bilirubin were measured. In addition, the histological changes in the liver were examined after hematoxylin and eosin (H&E) staining.
Results: Serum levels of total bilirubin and direct bilirubin in the Dox group showed a significant increase compared to the control group. In contrast, serum levels of total bilirubin and direct bilirubin in Dox + ZIN 600 and Dox + ZIN 300 had a significant reduction compared to the Dox group (P < 0.05). Ginger extract prevented apoptosis and Dox-induced liver tissue damage in dose-dependent designs.
Conclusion: The hydroalcoholic extract of ginger improves the changes of serum bilirubin and liver tissue after receiving Dox due to its antioxidant compounds.

The effect of detraining following an endurance training program on bone metabolism markers in asthmatic men

Babisan Askari

Background: This study investigated the impact of a 3-week detraining period, followed by 10 weeks of aerobic training, on the serum levels of osteocalcin and alkaline phosphatase (ALP) in asthmatic males.
Methods: Thirty adult males with asthma were randomly divided into experimental and control groups. The experimental group engaged in a 10-week aerobic training program, which included running sessions 3 times per week for 30-60 minutes each, maintaining a target heart rate range of 55%-75% of their maximum heart rate (HRmax). In contrast, the control subjects did not participate in any exercise activities during the study period. Fasting blood samples were obtained at baseline, after aerobic training, and after detraining to measure the levels of osteocalcin and ALP in both groups.
Results: The 10-week aerobic training program led to a significant increase in levels of osteocalcin and ALP in the experimental group, but following the detraining period, these variables returned to their pre-training levels.
Conclusion: The effectiveness of continuous aerobic training on bone formation markers in asthmatic patients will disappear after a relatively short period of detraining. This evidence emphasizes the lack of stopping aerobic exercise in the presence of inhaled corticosteroids with the aim of improving bone metabolism in asthmatic patients.

Effects of kefir on liver function tests and histopathological changes in rats exposed to aflatoxin B1

Abdollah Jamshidi

Background: Aflatoxin B1 (AFB1) is one of the most important mycotoxins that contaminate food worldwide. Long-term consumption of foods contaminated with AFB1 endangers human health. Detoxification of AFB1 from food improves community health. A Specific approach to aflatoxin reduction is the use of probiotics. Kefir drink is a strong probiotic. The purpose of this study was to investigate the protective effect of kefir drink on AFB1-induced hepatic injury in adult male rats
Methods: In this experimental study, 24 adult rats weighing between 150 and 200 g were used. The rats were randomly divided into 4 groups: 1) control, 2) AFB1 (50 μg/kg body weight), 3) kefir drink (10 mL/kg body weight), and 4) AFB1 + kefir drink. Aflatoxin and kefir drink received through oral gavage. At the end of the experiment (8 weeks), blood and liver samples were collected for different assays. Liver function tests and histopathological examinations were performed. Data were analyzed using 1-way analysis of variance (ANOVA) and at a significance level of <0.05.
Results: Aflatoxin B1 significantly increased serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (T.Bili), as well as decreased total protein (T.P) content, compared to the control group (P < 0.05). Aflatoxin B1 induced histological changes in the liver. The results obtained from the groups treated with kefir drink with and without AFB1 were not significantly different from the control group. Histopathological changes were not found in groups treated with kefir drink with and without AFB1.
Conclusion: The consumption of kefir drink reduced AFB1-induced disruptions in rats’ livers.

Prooxidant-antioxidant balance in relapsing-remitting multiple sclerosis patients

Darioush Hamidi Alamdari

Background: Multiple sclerosis (MS) is a demyelination disorder of the central nervous system (CNS), which is believed to be associated with oxidative stress. Therefore, researchers try to find reliable biomarkers to monitor the disease and predict its prognosis. Cholesterol and lipids in the myelin sheath are vital for nerve cells. Serum low-density lipoprotein (LDL) is susceptible to lipid peroxidation induced by oxidative stress. This study aimed to evaluate oxidative stress markers in the serum of patients with relapsing-remitting MS (RRMS) and examine their correlation with lipid markers.
Methods: A total of 18 MS patients (14 women and 4 men) and 18 healthy subjects (matched by age and sex) were enrolled in this cross-sectional study. The serum samples were collected in both relapsing and remitting phases. The prooxidant-antioxidant balance (PAB), malondialdehyde (MDA), and oxidized LDL (oxLDL) were measured as markers of oxidative stress.
Results: The mean age of participants was 29.21 (22-42) years. In the comparison between the patient and control groups, the most differences were increased levels of PAB in the patient group (P < 0.05), no difference between relapsing and remitting phases (P = 0.995), increased MDA levels in the relapsing phase (P = 0.013)––but no change in the remitting phase (P = 0.068), no difference in LDL and oxLDL levels in the patient group (P > 0.05), and MDA, LDL, and oxLDL levels did not have any significant correlation with PAB (P > 0.05).
Conclusion: High levels of oxidative stress markers were present in both phases of the disease. Lipid peroxidation markers (such as MDA) increased in the acute phase, but oxLDL did not change. Also, there was no significant correlation between oxidative stress and cholesterol markers.

Evaluation of the policy of improving the quality of visit service in the reform plan in laboratories of medical-teaching centers in Golestan province, Iran

Ehsan Ameri

Background: Improving the quality of visit services in laboratories of medical-teaching centers of universities of medical sciences plays a major role in providing better services to patients. The present study aimed to evaluate the policy of improving the quality of visit services of the reform plan in laboratories of medical-teaching centers in Golestan province.
Methods: The present research was cross-sectional and had a descriptive-analytical type. A total of 384 staff in the diagnostic laboratories were selected for the study using a simple random sampling method. The data collection tool included a 35-item researcher-made questionnaire.
Results: There was a gap between the current and desired status of the fourth axis of the health system reform plan. The gap was about -0.01, indicating that there was a gap between the current and desired status and it was related to the supervision department according to the respondents in the target statistical population.
Conclusion: The implementation of this plan was effective in improving the quality of visit services in laboratories of medical-teaching centers in Golestan province but this effectiveness did not meet the goals of the fourth axis of the reform plan. Therefore, the factors, which caused a lack of supervision among the executive departments of laboratories of medical-teaching centers in Golestan province, should be removed for increasing the effectiveness of this plan.

A giant Lymphangioma circumscriptum on the flank: Case report

Hakimeh S. Sajjadi

Lymphangioma circumscriptum is a rare congenital proliferation of lymphatic vessels that may occur anywhere on the skin and mucous membranes. Based on the depth and the size of abnormal lymph vessels, these lesions are divided into two groups: the superficial vesicles are called lymphangioma circumscriptum and the more deep-seated group includes cavernous lymphangioma, cystic hygroma, and benign lymphangioendothelioma. The differential diagnosis of lymphangioma includes herpes zoster, herpes simplex, molluscum contagiosum, cutaneous melanoma, dermatitis herpetiformis, and viral warts. Herein, we report a rare case of giant cutaneous lymphangioma circumscriptum with emphasis on histopathology and differential diagnosis. Our case was a 14-year-old boy with a history of multiple, clear, pink, red, and brown vesicles protruded as a patch of wart-like growths on the flank’s skin since the 6 months of age. Histopathologic examination indicated presence of multiple thin-walled dilated lymphatic spaces in the papillary dermis lined with a single layer of endothelial cells filled with finely granular hyaline material.