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Abstract Background and objectives: Influenza virus is the sixth cause of death in the world. We cannot differentiate it from other respiratory viruses upon clinical signs alone. This study was aimed at determining the frequency of influenza A&B antigen in pharyngeal secretion of children with upper Respiratory Infection (URI). Materials and methods: This cross sectional -descriptive study was done in pediatrics clinic of Rasoul hospital and Shahid Heidari clinic, Tehran (2006-2007). We studied the immunochromatography 149 children aged less than 14 years with URI. Rapid test was performed on pharyngeal samples of all cases. We used independent T test to compare the means of variables. (CI 95%, p<0.05). Results: The Signs of the studied children are fever (58.4%), sore throat (60.4%), coughing, runny nose and hoarseness (45%) and gastric signs (<20%) while in Influenza cases, they are 86.7%, 40% and 40% respectively. Fifteen (10.1%) of the subjects have positive rapid influenza test. The average age of the influenza case is 80 months, which is not significantly different from non-influenza cases. While no under one-year-old child has Positive influenza test, by increasing age the number of positive test is increased. As the frequency in children, aged over 10 is increased to 15.4%. There is significant difference between positive influenza test and signs such as fever, sore throat and previous antibiotic usage (p<0.5). Conclusion: Although this study was not done in epidemic period for influenza, it indicated Influenza as the etiology of 10.6% of URI. Since the cost for prevention and treatment of influenza is high and drug resistance is problematic, we can decrease the URI in non-epidemic period by mass vaccination in children, at least in high-risk cases. Key words: URI (upper respiratory infection), Influenza virus, rapid Immunochromatography Influenza test, Influenza vaccine.

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Abstract Background and objectives: Germ tube-producing ability of C.albicans in human serum is one of the most important virulent factors inducing transformation yeast to mycelia form. This phenomenon can be altered by some environmental and nutritional factors. The purpose of this study was to investigate the effect of temperature, pH and glucose concentrations in germ tube formation of C. albicans in an in vitro system. Material and Methods: The germ tube production test in human serum (with normal glucose titer) in different temperature, pH, and glucose concentrations was conducted invitro using standard strain of C. albicans (ATCC 10231). The average number of cells with germ tube after 2 hours and the rate of yeastmycelial transition were analyzed using one-way ANOVA test. Results: Maximum germ tube production rate is seen in temperature of 37°C, pH of 6.5 and glucose concentration of 30 mg/ml (P= 0.0001) and also germ tube is seen in earliest time in these conditions in invitro. Conclusion: It seems that these environmental and nutritional factors in human body particularly in diabetics can make this fungus to produce germ tube and invade to the different tissues. Key words: Candida Albicans, germ tube, in vitro, Temperature, pH, Glucose

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Abstract Background and Objectives: one of the endemic foci for Cutaneous Leishmaniasis in Iran is Mashhad in which limited outbreak have recently been reported. The commonly used method for diagnosis is the clinical features confirmed by direct microspic examination and culture or biopsy. We compared these two tests to determine the level of their sensitivity, specificity and positive predictive value. Material and Methods: we performed this comparative-analytic study on 73 patients suspected of having ulcers Leishmaniasis in Mashhad, Iran. Giemsa was staining the smears and the samples cultivated on Di-phasic N.N.N. culture media . Analysis was performed by SPSS version 11.5 and Chi square test. A P- value less than 0.05 were considered as a significant. Results: In 43 cases (58.9%), both the smear and culture are Positive. In 13 cases (17.8%), the smear is negative but the culture Positive. In 17 cases (23.2%), both smear and culture are negative. The two methods are positively correlated (82%). Sensitivity, Specifity, Positive predictive Value and negative predictive value are 76.7%, 100%, 100% and 56.7%., respectively. Conclusion: when the smear is positive, there is no need for culture. However, the opposite is not true. Key words: Cutaneous Leishmaniasis, Laboratory Diagnostic, Direct Microspic Examination, Culture.

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Abstract Background and objectives: Infectious diseases are the leading cause of mortality in the world. With the increase of Microbial resistance to chemical antibiotics and low side effects of medicinal herbs, it has become of great importance to use herbs as a source of antimicrobial compounds. Material and Methods: In this study, the extract of Trigonella foenum leaf and seed was prepared using 70% ethanol. Minimum Inhibitory Concentrations (MIC) and antimicrobial Sensitivity were determined using microdilution broth and disk diffusion method, respectively. The Results were compared with Gentamicin, Ciprofloxacin and Fluconasole. The tested strains were: clinical strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Enterococcus faecium, Candida albicans and two standard strains of Staphylococcus aureus and Pseudomonas aeruginosa. Results: The least MIC of the leaf extract against the standard strain of S. S. aureus, E. faecium and clinical S. aureus is 64 μg/ml and for seed extract against E. faecium and Standard S. S. aureus is also 64 μg/ml. The largest diameter of inhibitory zone caused by leaf extract on Standard S. S. aureus is 23mm, and for seed against E. faecium is 18 mm. Conclusion: Because of antimicrobial effects of leaf and seed extract of Trigonella foenum, these extracts can be used as anti microbial compounds in pharmaceutical and food industries. Therefore, the isolation, identification and purification of the antimicrobial compounds of the extracts are recommended. Key words: Trigonella foenum, Antimicrobial effects, Minimum inhibitory concentration.

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Abstract Background and objectives: Paratuberculosis or John's disease is a chronic infectious disease of ruminants caused by Mycobacterium avium subsp. paratuberculosis (MAP). It results in major economic losses to dairy farm of all over the world and it is the agent causing crohn's disease. The aim of this study was to detect the MAP using PCR in raw-milk samples of cows in shahre-kord. Material and Methods: In this cross–sectional study, 100 raw milk samples of cows were collected from both industrial and semi -industrial farms in shahre-kord. The DNA of all Samples was isolated by MAP, using PCR method. Results: The results Show that only three (3%) Samples were positive for Mycobacterium avium subsp. paratuberculosis. Conclusion: Based on our results, Milk -PCR was useful for detection of MAP in milk samples. Key words: Mycobacterium paratuberculosis, milk, polymerase chain reaction.

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Abstract Background and objectives: Smokers are exposed to significant quantities of ROS (Reactive Oxygen Species) and The Level of Nitric Oxide (NO), the primary vasodilator produced by endothelial cells, is changed by cigarette smoking. Cigarette smoking is associated with impaired endothelium-dependent vasodilatation and cardiovascular disease (CVD). The aim of this study is to determine the level of serum nitrite, nitrate and malondialdehyde (MDA) levels in smokers. Material and Methods: In this descriptive analytical study, 60 healthy male smokers and 60 male non-smokers (control group) were selected by a Purposive sampling and then serum levels of nitrite, nitrate and MDA in all patients were determined and compared to together. Results: Serum nitrite and nitrate level in smokers are 10.4±3.1 and 19.6±5.9 and in non-smokers is 14.6±4.4 and 29.3±6.7 (p<0.00001) μmol/L, respectively. The results show that smokers’ are significantly lower than non-smokers’. Serum MDA level in smokers (11.7±2.6 μmol/L) is significantly higher (p<0.00001) than non-smokers (8.3±1.9 μmol/L). Conclusion: Based on the results, serum level of nitrite and nitrate are lower and MDA is higher in smokers. This difference can be related to CVD in smokers. Keywords: Smokers, Non-smokers, Nitrite, Nitrate, Malodialdehyde (MDA), cardiovascular disease (CVD).

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Abstract Bachground and objectives: Improvement of the effectiveness of services is one of the most important strategies in many clinical and research laboratory centers. The increased client satisfaction (researchers or patients), resource development innovation efficacy, continuity of services and income are also the important strategies of these centers. For achieving these strategies, we combined the qualitative and the quantitative approaches to evaluate the effective model based on frameworks of the Balance Scorecard (BSC) and the Laboratory Quality Management Systems (LQMS). Material and Methods: This paper describes the basic steps required for designing and developing of a model for performance measurement in laboratory centers. For model validation, the relationship between the criteria, the strategies and the strategic objectives was evaluated using both the AHP method and the evaluation by the experts. Results: Implementation of the above mentioned model, conducted in one of the largest Laboratory centers, has resulted in a remarkable enhancement in the efficiency (22%), profit (33%), and level of quality of service (27%) and in the clients' satisfaction (4%). Conclusion: This research model is a valuable tool for effective evaluation and continuous improvement of the clinical and research laboratory centers. Applying this model leads to increased resource productivity as well as the clients and community satisfaction from the laboratories services. Key words: Laboratory Centers, Performance Management, Balance Scorecard (BSC), Laboratory Quality Management Systems (LQMS)

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Abstract Background and objectives: Acquired immune deficiency syndrome(AIDS) is one of the most well-known disease in the world .It is not only A heaththrapeutic problem but also with politic ,social, cultural and economic aspects. Paying attention to high-risk groups such as Lab staff is important. we decided to study and compare the knowledge of public and private Laboratories staff. Material and Methods: This cross sectional study, descriptive-analytic,was conducted on 350 personnel of private laboratories and educational centers of Shiraz University of Medical Sciences,2011.We collected Information by using a questionnaire including three parts of demographic characteristic questions, questions about knowledge in different fields of AIDS and those related to the performance of personnel. The results were reported as tables and graphs and analyzed by ANOVA,t-test and square. Results: The data, in different areas of AIDS, in public and private laboratories are similar and the difference statistically is not significant. Regarding to symptoms and treatment, the knowledge of privale Lab staff is higher than stste ones and this difference is significant (P=0.01).As a whole,the results show the knowledge of staff about the transmission modes(92.7%),the pathologic agent(99.2%),at risk people (61.2%)and preventive measure (53.1%).both group have good practice in wearing gloves and using disposable syringes.Regarding to disposing infectious waste material,private and state center practice are 92.6% and 77%,respectively. Conclusion: Based on the result,the knowledge relating to preventive procedures and at risk people of AIDS is not enough.Thereforeit is a necessity to hold in service training for Lab staff,stressing on disposing infectious waste materials. Key words: AIDS, laboratory personnel, knowledge, practice

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Abstract Background and objectives: C-Met is a proto-oncogene that encodes a protein known as hepatocyte growth factor receptor (HGFR). The HGF receptor possesses tyrosine -kinase activity and it is essential for embryonic development, wound healing and cancer. Many proteins are proteolytically released from the surface by a process known as ectodomain shedding. Shedding occurs under normal physiologic conditions and can be increased in certain pathologies. C-Met can be seen among many receptors for which ectodomain shedding has been shown. The aim of this study was to determine the concentration of soluble c-Met in the cerebrospinal fluid (CSF) and serum samples of patients with viral and bacterial meningitis. Material and Methods: in this study, 75 CSF and serum samples of patients with bacterial meningitis, 71 with viral meningitis and 82 normal controls were investigated. The soluble c-Met concentration was determined by enzyme linked immunosorbent assay (ELISA). Result: the amount of soluble c-met in CSF of patients with bacterial meningitis ( 83.91±5.50), viral meningitis ( 80.41±4.71) and control group ( 22.66±3.39) are compared with that in serum of patients with bacterial meningitis ( 561.58±25.87), viral meningitis ( 550.50 ±34.34) and control group ( 256.25±18.55). There is significant increase in the CSF and serum’s soluble c-Met expression in the patients with meningitis, in comparison with control group. Conclusion: The data presented here indicate that soluble c-Met is a constant component of human serum and CSF, but it can not be used for differentiating bacterial meningitis from viral meningitis. Key words: Soluble c-Met, concentration, cerebrospinal fluid, serum, meningitis

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Abstract 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 thatshould 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 qualitysystem 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. Keywords: Strategic Planning, Medical Diagnostic Laboratory, Quality Control

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Abstract 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, whichare 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 reaction (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. Key words: Laboratory diagnosis,visceralleishmaniasis, Kala-azar,rk39, Katex, PCR

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Abstract Background and Objective: Having knowledge about potential risks and the usage of safety equipment in laboratories can decrease the risk of occupational exposure. The aim of this study was to evaluate the predisposing factors for occupational exposure and to assess the usage of safety equipment among personnel of medical diagnostic laboratories in Birjand. Material and Methods: In this descriptive analytic study, all staff of laboratories was assessed by using a questionnaire including demographic data, type of accidental exposures and the use of protective equipment. Using SPSS software, we analyzed the data. Results: Of 110, 84 (76%) have at least one accidental exposure to patients’ specimens in that 55% of accidents are related to sample preparation step. In 82% of contacts, carelessness is the underlying cause of exposure. Gown, glove, fume hood and mouth mask are routinely used by 97%, 48%, 34%, 1% of personnel, respectively. Nearly all of (97%) personnel were vaccinated against hepatitis B and 78% of them have performed routine blood test for detecting any infections. Conclusion: The results of current study show that accidental exposures to patients’ samples are common among personnel of medical diagnostic laboratories. The level of preventive education and the rate of safety equipment usage are low therefore, we recommend planning of some training sessions to persuade the personnel for using safety equipment. Keywords: Medical laboratory, Occupational Exposure, Specimens, Vaccination

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Abstract Background and Objective: Nowadays, downsizing the government to have an effective and flexible organization is considered to be government’s top priority in the world and outsourcing is one of the ways to achieve this goal. Accordingly, Shahid Beheshti University of Medical Sciences has delegated some of its hospitals' duties to the private sectors. The present study has been carried out to assess the performance of outsourced clinical laboratories. Material and Methods: This Descriptive Evaluation study was carried out during 6 month (May 2011 till February 2012). The data was collected by two questionnaires with close-ended questions and one with open-ended questions, and analyzed by Wilcoxon, using SPSS software. Results: There is an improvement in outsourcing laboratory services. For example, increase in the number of tests (32%) and in the type of tests (37%). Consequently, increase of hospital income (51%). The number of personnel is decreased and their responsibility and behavior are improved. Conclusion: Overall, it seems that outsourcing laboratory program could achieve its major goals such as: Absorbing non-governmental resources in both administrative and financial aspects, omitting extra expenditure, acquiring benefits, and upgrading productivity of laboratories. Key words: Outsourcing Laboratory Peformance

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Abstract Background and Objective: Nowadays, downsizing the government to have an effective and flexible organization is considered to be government’s top priority in the world and outsourcing is one of the ways to achieve this goal. Accordingly, Shahid Beheshti University of Medical Sciences has delegated some of its hospitals' duties to the private sectors. The present study has been carried out to assess the performance of outsourced clinical laboratories. Material and Methods: This Descriptive Evaluation study was carried out during 6 month (May 2011 till February 2012). The data was collected by two questionnaires with close-ended questions and one with open-ended questions, and analyzed by Wilcoxon, using SPSS software. Results: There is an improvement in outsourcing laboratory services. For example, increase in the number of tests (32%) and in the type of tests (37%). Consequently, increase of hospital income (51%). The number of personnel is decreased and their responsibility and behavior are improved. Conclusion: Overall, it seems that outsourcing laboratory program could achieve its major goals such as: Absorbing non-governmental resources in both administrative and financial aspects, omitting extra expenditure, acquiring benefits, and upgrading productivity of laboratories. Key words: Outsourcing Laboratory Peformance

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Abstract Background and Objective: Laboratory personnel have always accidental exposure to clinical samples, which can cause the transmission of infection. This threat can be prevented and controlled by education for the use of safety instruments. The purpose was to determine the frequency of accidental exposure to laboratory samples among Yazd laboratory personnel in 2011. Material and Methods: This descriptive cross-sectional study was conducted on 100 of Yazd clinical laboratory personnel. The data was collected, using a valid and reliable questioner, via interview and analyzed by means of SPSS software. Results: Eighty-six percent of the subjects reported an experience of accidental exposure to clinical samples, such as blood, serum and urine. The causes were carelessness (41%) and work overload (29%). Needle- stick was the most prevalent injury (52%) particularly in sampler workers (51%) and in their hands (69%). There wasn’t significant relationship between accidental exposure to laboratory samples and the variables such as private and governmental laboratories (p=0.517), kind of employment (p=0.411), record of services (p=0.439) and academic degree (p=0.454). The subjects aged 20-29 (p=0.034) and worked in sampling unit had the highest accidental exposure. Conclusion: Based on the results, inexperience of the personnel especially in sampling room, overload at work and ignorance of applying safety instruments are known as the most important reasons for accidental exposure to clinical samples. Keywords: Contamination Accidental Exposure Infectious Agents Laboratory Personnel

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Abstract Background and Objective: Proficiency testing schemes as a part of quality system in clinical and research laboratory centers provides the opportunity to evaluate the quality of test results. In this paper, we try to introduce the proficiency testing schemes as a useful method for achieving standardization and homogenization of test results in clinical and research laboratory centers. Keywords: Proficiency Testing Schemes, Quality Improvement, Laboratory Centers

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Abstract Background and Objective: Acanthamoeba species are free-living protozoa that can be isolated from all environments. They can bring about different diseases in healthy individuals and immune suppressed patients, for example, Granulomatous Amoebic Encephalitis (GAE), Acanthamoeba Keratitis (AK), Cutaneous and Nasopharyngeal infections. The aim of this study was to evaluate the Acanthamoeba prevalence in rural water sources of Markazi province. Material and Methods: In this cross sectional study, 54 water samples were collected from 36 villages of Markus province. First, the Samples were filtered by filter paper (watchman 42). Next, the filtered paper were placed in page saline solution and centrifuged. Then, the obtained sediment was cultured on non-nutrient agar (NNA) plates overlaid with heat-killed Escherichia coli. After that, the provided smear (after 4 - 7 days) stained with Geimsa. Results: The samples were positive (33 61.11%) and negative (21 38.89%) for Acanthamoeba cyst. The best result for isolation of Acanthamoeba cysts was obtained after shaking of filter paper. Conclusion: A high percentage of rural water sources have been contaminated with Acanthamoeba, which can be the major factor in causing human infections. Therefore, some effective methods are required to prevent from water sources contamination. Keywords: Acanthamoeba Acanthamoeba Keratitis Markazi Province Rural Water Sources

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Abstract Background and Objective: Respiratory tract infections (RTI) are the most common infectious disorders, worldwide. About 80%-90% of RTI are caused by four viruses such as Adenoviruses, 51 serotypes have been introduced so far. The aim of this survey was to evaluate the frequency of Adenovirus in respiratory infected patients by PCR method in Golestan province, Iran. Material and Methods: This descriptive cross-sectional study was conducted on 400 patients with clinical diagnosis of flu-like respiratory infection, 2010-2012. In addition to collecting demographic and clinical data, nasopharyngeal swabs were taken and transferred to the virology laboratory in viral transport medium (VTM), and evaluated by PCR method for Adenovirus after genomic extraction. Using SPSS v.11 software, we analyzed the data. Results: Thirty-seven (9.2 %) were positive for Adenovirus. No significant correlation was found between being positive for Adenovirus and the variables such as age, gender and season. Clinical signs were coughing (27 73%), body pain (25 67.6%), and fever (24 64.9%). Thirty-five of the patients (94.5%) had at least one symptom. Conclusion: Our findings are consistent with other research conducted in Iran and other countries. There is a significant correlation between Adenovirus infection and clinical symptoms. Keywords: Respiratory Infection, Adenovirus, PCR, Golestan, Iran

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Abstract Background and Objective: Cervical cancer is the second most common cancer in women. Boswellia serrata is a medicinal herb with anticancer, antibacterial, antiulcer, antifungal properties. Since the antitumor effect of this medicine has not been studied on cancer cell lines, we aimed to investigate the antitumor effect of Boswellia serrata on cervical cancer cell lines. Material and Methods: To assess the anti-cancer effect of Boswellia serrata extract, HeLa cell lines were cultured , propagated and placed with different doses of Boswellia serrata (12.5,25, 50 and100 µg/ml) for 24,48and72 hours. After that, MTT test was used to determine the cellular toxicity of the extract. Results: The results of the MTT test showed that this extract has dose-dependent and time-dependent anti cancer effect on Hela in that the highest effect was seen with 100 µg/ml of extract for 72 hrs. The half maximal inhibitory concentration (IC50) for 24 and 48 hrs were 12.5 and 50 µg/ml, respectively. In 72 hours, due to increase of incubation period in all concentrations, the number of killed cells was more than 50 percent. Consequently, IC50 was not observed for this period of time. Conclusion: Considering dose-dependent and time-dependent anti cancer effect, Boswellia serrata extract can inhibit the growth of Hela cells. Keywords: Hela Cell MTT Test Boswellia Serrata Extract Cervical Cancer

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Abstract Background and Objective: Omega-3s are considered essential fatty acids that cannot be synthesized by human body and should be obtained from foodstuff. This study aimed at evaluating the beneficial effect of Omega-3s ,exposed in Electromagnetic Field (EMF), on sexual behavior ,Serum total testosterone level, malondialdehyde (MDA) level and total antioxidant capacity(TAC) in male rats. Material and Methods: 32 Wistar rats (males=24, females=8) were allocated to four groups of Control, EMF, omega 3 and omega 3 & EMF. Estradiol benzoate was injected to the female rats subcutaneously. Then after taking biopsy from epididym and testis of each groups, tissue preparation was performed to look through via light microscope on 28th day of study. Serum MDA, TAC and Testestrone were measured in male rat by Radio Immune Assay (RIA) method. Results: The highest degree of testicular tissue destruction and MDA level were observed in electromagnetic field group and the lowest in omega 3 group. The sexual behavior, testosterone hormone and TAC level were lowest in electromagnetic field group and highest in omega 3 group. Conclusion: Based on the Results, administration of omega 3 can significantly lower the adverse effects of EMF and have beneficial influences on sexual behavior in male rat. KeyWords: Electromagnetic Field Effect (EMF), Rat, Omega 3, Sexual Behavior