Medical Laboratory Journal MLJ | Golestan University Of Medical Sciences (original) (raw)

Papers by Medical Laboratory Journal MLJ

Medical Laboratory Journal, 2024

Background: Certain trace elements, like cerium, have the potential to disrupt iron metabolism. T... more Background: Certain trace elements, like cerium, have the potential to disrupt iron metabolism. This study explored the impact of cerium on intestinal iron absorption, focusing on the initial stage of iron metabolism. We employed the rat everted gut sac (EGS) segments to assess the interference caused by cerium. The primary objectives of this study were to examine the absorption of cerium in the intestines and to compare iron absorption in the presence and absence of cerium. Methods: For the EGS experiment, segments of the rat's duodenum, ileum, or jejunum were promptly excised, cut into 5-6 cm segments, and rinsed with a physiological solution. These freshly prepared rat EGS segments were then incubated in Earle's medium containing iron (III) and/or cerium (III). We examined the impact of ascorbic acid, glucose, and different time intervals on the intestinal absorption of cerium and iron. Specifically, we investigated how glucose (5 mM) and ascorbic acid (2.8 mM) affected the absorption of cerium and iron at various concentrations (ranging from 0 to 200 mg/L). Additionally, we assessed the interfering effect of cerium on iron absorption. Results: The results indicated that the maximum intestinal absorption of Fe (III) and Ce (III) occurred at a concentration of 200 mg/L. Furthermore, it was observed that their uptake increased following the reduction by ascorbic acid. The absorption of these elements also rose in the presence of glucose, suggesting energy-dependent transport. Additionally, a consistent cerium concentration was found to decrease iron absorption by 24.3% (P ≤ 0.05). Conclusion: Based on the results, cerium likely reduces iron uptake by competing with iron. Cerium can also disrupt iron metabolism and lead to iron-related metabolic disorders. However, further studies at the molecular and intracellular levels are needed to gain a better understanding of this mechanism.

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Medical Laboratory Journal, 2024

Background: This study aimed to investigate the effect of four weeks of selected endurance traini... more Background: This study aimed to investigate the effect of four weeks of selected endurance training on neurotrophin-3 (NT-3) and tropomyosin receptor kinase C (TrkC) gene expression in hippocampal areas of rats with spinal cord injury (SCI).
Methods: In this experimental study, the rats were separated into six equal groups. First, the animals were put under general anesthesia and had their SCI. Then, for four weeks, they were subjected to two kinds of endurance training programs. However, the control injury group received no intervention or training. Following the completion of the training regimes, molecular tests were done using the qRT-PCR technique to evaluate changes in the gene expression of NT-3 and TrkC from the animals' hippocampus.
Results: The expression of NT-3 and TrkC genes were significantly reduced in the SCI model compared to the healthy control group, but it was increased in the SCI + exercise 1 and SCI + exercise 2 groups compared to the SCI group. NT-3 levels did not vary significantly between the SCI + exercise 1 and SCI + exercise 2 groups, although alterations in TrkC levels altered.
Conclusion: In addition to enhancing locomotion in animals with SCI, the endurance training regimens in this research were effective on the expression of NT-3 and TrkC genes and may play a role in axonal development and neuronal survival in SCI recovery.

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Medical Laboratory Journal, 2024

Background: Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abn... more Background: Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abnormal immune responses, leading to inflammation and scarring in the large intestine. The bacteria Prevotella melaninogenica, found in the intestine and mouth, may contribute to UC. This study focuses on the detection of P. melaninogenica in the saliva of UC patients and compares them with the healthy control (HC) group.
Methods: The present study was a case-control study including 40 UC patients and 40 healthy controls (HCs) with an average age of 43.0 3± 10.3. This study used a real-time PCR test to investigate the frequency and average number of P. melaninogenica from the 16S rRNA gene sequence of P. melaninogenica in both groups.
Results: P. melaninogenica was more frequent in UC patients (77.5%) than HCs (45%) (p = 0.003). The patient group had more bacteria (339.31 ± 1082.29) than HCs (61.29 ± 154.03) (p = 0.005). Women in the UC group had more P. melaninogenica (492.35 ± 1427.61) than the control group (56.98 ± 123.50) (p = 0.0342). Similarly, men in the UC group (262.85 ± 664.97) had more bacteria than the control group (72.62 ± 222.76) (p = 0.015).
Conclusion: The current study showed that dysbiosis in P. melaninogenica, a bacterium in human saliva, could be important in the development of UC. Further investigation is needed to evaluate its use as a potential biomarker in the UC.

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Medical Laboratory Journal, 2024

Background: Escherichia coli consists of a wide range of strains with huge diversity in their gen... more Background: Escherichia coli consists of a wide range of strains with huge diversity in their genome, distributed in nature and the alimentary tracts of animals and humans. This study analyzed the phylogenetic group determination and genetic diversity of E. coli strains isolated from domestic animals and human clinical samples.
Methods: Twenty E. coli isolates from domestic animals were analyzed for phylogenetic grouping. Also, 100 clinical samples and 20 animal samples were evaluated by the enterobacterial repetitive intergenic consensus–polymerase chain reaction (ERIC-PCR) technique. The results and the similarity between the strains were determined based on the Dice similarity coefficient in the SAHN program of the NTSYS-pc software.
Results: The frequency of phylogroups among animal samples were A = 5%, B1 = 65%, B2 = 20%, and D = 10%. Based on the ERIC-PCR results, the clinical strains were allocated into 19 clusters. Most strains were in the E7 cluster. Fifty percent of the E. coli isolated from animal specimens belonged to the E4 group, and the lowest number of strains was in the E3 and E5 (1 strain) groups.
Conclusion: The results confirmed the efficiency and usefulness of the ERIC-PCR tool for the identification and classification of bacteria. Also, we demonstrated the most phylogroup among animal samples.

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Medical Laboratory Journal, 2024

Background: Type 2 DM is a heterogeneous group of disorders characterized by insulin resistance, ... more Background: Type 2 DM is a heterogeneous group of disorders characterized by insulin resistance, impaired insulin secretion, increased glucose production, and abnormal fat metabolism. Diabetes mortality primarily results from microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy, as well as macrovascular complications like coronary artery, peripheral vascular, and cerebrovascular diseases. Patients with diabetes usually have changes in adipose tissue metabolism and abnormalities in the secretion of adipokines such as leptin. The present study aims to study the relationship between serum leptin levels and lipid profile parameters among non-obese type 2 diabetes mellitus patients and non-diabetic individuals.
Methods: This hospital-based cross-sectional study was conducted among 41 type 2 diabetic patients and 41 non-diabetic individuals of both sexes between the ages of 40 and 70. Fasting blood glucose (FBS), serum leptin, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) levels were assayed.
Results: The mean serum leptin levels among diabetic patients were lower than those of non-diabetic individuals, and this difference in mean was statistically significant. The study showed a significant negative correlation between serum leptin, TC, TG, and low-density lipoprotein (LDL), and a positive correlation with HDL. In the final regression model, serum leptin showed a statistically significant association with FBS and HDL.
Conclusion: This study demonstrated that serum leptin levels can be a strong predictor of low HDL levels in diabetic patients. It can also contribute to raised levels of total cholesterol, triglyceride, and LDL, which are responsible for macrovascular complications in diabetics.

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Medical Laboratory Journal, 2024

Background: Pyogenic infection is a significant cause of morbidity. Infection with multidrug-resi... more Background: Pyogenic infection is a significant cause of morbidity. Infection with multidrug-resistant strains poses a major difficulty in the treatment. The study was conducted to know the bacteriological profile of pyogenic infections and their antibiotic susceptibility.
Methods: A cross-sectional study was conducted in a tertiary care hospital from October 2021 to March 2022. Isolates from pus specimens were subjected to an antibiotic sensitivity test using the Kirby-Bauer method as per CLSI 2021.
Results: Out of 752 samples, etiology could be revealed in 510 (68.4%) specimens. Enterobacterales dominated the profile, with K pneumoniae isolated in the maximum number of specimens. Staphylococcus aureus was the culprit in 14% of the cases. Non-fermenters were isolated in 17% of the cases. Methicillin resistance in S aureus was 67%. Gram-positive cocci showed high sensitivity to linezolid. For both Piptaz and carbapenem, Enterobacterales and non-fermenters showed around 50% and 60% susceptibility, respectively.
Conclusion: Continuous surveillance of the aetiologic agents of pyogenic infections and their antibiotic sensitivity pattern needs to be done to design and implement the antibiotic policy for the infection in our set-up.

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Medical Laboratory Journal, 2024

Multiple myeloma (MM) is a plasma cell neoplasm that is characterized by the clonal proliferation... more Multiple myeloma (MM) is a plasma cell neoplasm that is characterized by the clonal proliferation of malignant plasma cells in the bone marrow. It is considered the second most common hematological malignancy which accounts for approximately 1% - 2% of all cancers and among 10% of hematological malignancies. Autologous peripheral blood stem cell Transplantation (PBSCT) is the best treatment for MM. Since the optimum harvested stem cell yield is a crucial factor for sufficient engraftment, the enumeration of Mononuclear cell (MNC) count in peripheral blood and harvested CD 34+ stem cell count can be considered as the best predictive markers for the best timing of apheresis which positively correlates with engraftment outcome of PBSCT.
MNC count can be obtained using either a hematological analyzer or peripheral blood smear while flow cytometry is the advanced technology that can be used to enumerate CD 34+ stem cell count other than peripheral blood smear. The unavailability of a flow cytometer, the expensiveness of this method, and the lack of trained personnel regarding this new technology, especially in lower-middle-income countries cause disturbance in the enumeration of stem cells. In such a situation, this review describes the importance of establishing an association between peripheral blood MNCs and harvested CD 34+ cells. Furthermore, this association facilitates conducting effective PBSCT for MM patients even in the absence of a flow cytometer and eventually, it focuses on decentralizing the treatment of PBSCT.

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Medical Laboratory Journal, 2024

Background: Musculoskeletal disorders are common in patients with hypothyroidism, and are also ob... more Background: Musculoskeletal disorders are common in patients with hypothyroidism, and are also observed in thyrotoxicosis. Creatine kinase (CK) is present in the muscles and is involved in energy metabolism. This study aimed to estimate the serum CK levels in patients with hypothyroidism, hyperthyroidism, and healthy individuals. Moreover, the correlation of CK levels with markers of thyroid function is assessed.
Methods: A total of 120 patients with hypothyroid and 120 with hyperthyroid were compared with 120 healthy individuals aged 20-60 years. The thyroid status was assessed by determining the serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) using chemiluminescent immunoassay. Serum CK was measured the by kinetic method. Statistical analysis was performed by analysis of variance and Pearson’s correlation to investigate the correlations between CK and thyroid hormones.
Results: A significant increase (P<0.0001) and a significant decrease (P<0.0001) in serum CK were observed in hypothyroid patients (253.98±129.04 IU/L) and in hyperthyroid patients (34.68±13.15 IU/L), respectively, compared to the control group (72.9±29.01 IU/L). A negative correlation was found between fT4 and CK (r: -0.4253, P<0.0005).
Conclusion: It could be concluded that CK activity in serum may be a useful additional test in thyroid disorders.

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Medical Laboratory Journal, 2024

Background: Urinary tract infections (UTIs) are among the most common types of infections affecti... more Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible. Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.

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Medical Laboratory Journal, 2024

Background: ‘M’ proteins or paraproteins refer to immunoglobulins that are produced by clonal pla... more Background: ‘M’ proteins or paraproteins refer to immunoglobulins that are produced by clonal plasma cells and are a characteristic feature of monoclonal gammopathies. Routine electrophoresis on agarose gel and immunofixation can be used to detect immunoglobulin paraprotein (M-protein). We aimed to evaluate the performance of agarose gel electrophoresis alone and in combination with immunofixation for detecting serum M-proteins.
Methods: One hundred and twenty-three patients suspected of paraproteinemia were evaluated. Routine serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) protocols were performed. Data from SPE, and SPE-IFE (gel images and electrophoretograms) were collected and reviewed.
Results: 21% cases were confirmed using the SPE-IFE combination, and among them, 33% had positive light chain (λ) only on IFE. Similarly, nine cases with biclonal gammopathy on SPE were characterized by IFE.
Conclusion: IFE can be a confirmatory test in cases where SPE results are not reliable and it can be a complementary test when characterization of the M protein detected on SPE is required.

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Medical Laboratory Journal, 2024

Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the femal... more Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. This local study was conducted to identify the spectrum of Candida species associated with VVC and recurrent vulvovaginal candidiasis (RVVC) using different phenotypic and genotypic methods and assess their fluconazole susceptibility.
Methods: High vaginal swabs were collected from 576 patients with VVC. Swabs were subjected to KOH 10% and cultured on Sabouraud dextrose agar. The species identification of Candida isolates was made using phenotypic methods, including the germ tube test, corn meal agar (CMA), CHROMagar Candida, and PCR-RFLP as the best genotypic methods for confirmation of Candida species in vulvovaginal candidiasis. Fluconazole susceptibility testing was performed using the disk diffusion method.
Results: The data were analyzed using the chi-square test. The prevalence of candidiasis was 61%. The socio-demographic profile corresponded to a woman aged 29.14 ± 4.8 years on average, pregnant (77%), diabetic (19%), with hypertension (10%), recurrent (9%), a history of fluconazole use (4%), and under 30 years of age (73%).
Vaginal swab cultures yielded Candida growth in 352 cases (61%). Candida albicans was the predominant isolated species (78%), while the most common non-albicans species were C. glabrata (14.7%), C. parapsilosis (4.2%), C. tropicalis (2.8%), and C. krusei (0.56%). Isolates of C. glabrata and C. krusei exhibited the highest rate of DDS resistance among all isolates tested.
Conclusion: C. albicans was the most common species. Careful periodical surveillance is needed to identify any changes in the susceptibility patterns to fluconazole with the increased use of this antifungal agent in Sayad Shirazi tertiary care hospital, Iran.

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Medical Laboratory Journal, 2024

Plasma cell leukemia (PCL) is a rare form of plasma cell dyscrasia with 2 variants: the primary f... more Plasma cell leukemia (PCL) is a rare form of plasma cell dyscrasia with 2 variants: the primary form, which occurs de novo in patients with no previous history of multiple myeloma (MM), and the secondary form, which represents a leukemic transformation in patients with a previously recognized MM. Unlike myeloma, PCL typically follows an aggressive course, and the median age at presentation is usually above 50 years. In this report, we present a case of primary PCL that manifested at 19, an exceptionally rare occurrence.

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Medical Laboratory Journal, 2024

Background: A higher occurrence of raised homocysteine levels has been reported in individuals wi... more Background: A higher occurrence of raised homocysteine levels has been reported in individuals with type 2 diabetes (T2D), particularly those with macroangiopathy and nephropathy. Given that hyperhomocysteinemia is a risk factor for T2D, mitigating this condition could potentially benefit T2D patients. This study aimed to investigate the influence of homocysteine on T2D and cardiovascular disease (CVD), as well as the factors that modify homocysteine levels.
Methods: This cross sectional, observational study was conducted on 122 individuals in a tertiary care center in Western India. Data related to anthropometry, demography, and biochemistry were gathered following established standards. Statistical analysis was performed using Chi-square test. A P-value of <0.05 was considered statistically significant.
Results: The findings indicated a significantly larger percentage of hyperhomocysteinemia in males, smokers, and individuals with elevated fasting blood sugar and HbA1c levels. The proportion of subjects with high homocysteine levels was notably greater in those with high total cholesterol and triglyceride levels. A significant correlation was observed between increased serum homocysteine levels and decreased serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
Conclusion: Elevated homocysteine levels are observed in smokers and diabetic patients, potentially leading to CVD. Furthermore, this study found a correlation between an increase in serum homocysteine levels and a decrease in serum folic acid and vitamin B12 levels in patients with ischemic heart disease.

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Medical Laboratory Journal, 2024

Background: Viral hepatitis is increasingly being recognized as a public health problem, requirin... more Background: Viral hepatitis is increasingly being recognized as a public health problem, requiring special attention. The World Health Organization (WHO) estimated that in 2019, 296 million people globally (3.8%) had chronic hepatitis B virus (HBV) infection, and 58 million people (0.8%) were living with hepatitis C virus (HCV). To add to this, every year, about 1.5 million people are newly infected with either hepatitis B or C viruses. The Global Health Sector Strategy (GHSS) has aimed to eliminate viral hepatitis as a major public health problem by 2030.
Methods: We conducted a desk review to identify strategies for preventing viral hepatitis and develop a roadmap to attain the sustainable development goals (SDG) target by 2030 (particularly in low- and middle-income countries). A search was done in PubMed via Medline on 1 December 2022.
Results: The focus has to be on key interventions, including hepatitis B vaccination (part of the routine child immunization along with rescheduling the birth dose to up to 7 days post-term, adult vaccination, for targeted groups like health care providers, rag pickers, waste handlers, and sanitation workers), ensuring safe injection practices and blood transfusion, harm reduction interventions for people who inject drugs (PWID), adequate testing for early diagnosis, and ensuring appropriate treatment.
Conclusion: It is the need of the hour to prioritize key interventions identified in the review for preventing viral hepatitis.

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Medical Laboratory Journal, 2024

Background: Urinary tract infection (UTI) is one of the most common bacterial infections of all a... more Background: Urinary tract infection (UTI) is one of the most common bacterial infections of all ages and sexes. Escherichia coli is reported as the most common predominant pathogen. Urinary tract infection treatment leads to abundant antibiotic application in hospitals and communities, continuously developing multidrug resistance (MDR). This study aimed to determine the sensitivity and resistance pattern to common antibiotics among E. coli isolates from patients with UTIs at Nemazee Hospital in Shiraz.
Methods: This retrospective cross-sectional survey studied 1910 positive urine samples with E. coli bacteria from patients referred to Nemazee Hospital from 2018 to 2019. Antimicrobial susceptibility testing was performed on 12 commonly used antibiotics for UTIs.
Results: A total of 1910 E. coli isolates were gathered during these 2 years. The most highlighted resistance was observed against quinolones and cephalosporins at 86.9% and 89.7%, respectively. Cephalexin (87.9%) and nalidixic acid (86.1%) have shown the lowest activity against E. coli isolates. Also, the highest susceptibility was determined for amikacin (88.3%), nitrofurantoin (76.8%), and gentamicin (70.6%). In addition, 1624 (85%) isolates were MDR.
Conclusion: In conclusion, resistance to antibiotics (such as ciprofloxacin, norfloxacin, tetracycline, cefotaxime, and nitrofurantoin) is increasing. Therefore, it is vital to follow an appropriate antimicrobial stewardship program.

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Medical Laboratory Journal, 2024

Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic... more Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic, clinical, laboratory, and imaging risk factors. We aimed to determine the best outcome predictors and their trends during 30 days of hospitalization.
Methods: This retrospective study was conducted on moderate to severe hospitalized COVID-19 patients from 26 January 2020 to 13 January 2021. The length of stay in the hospital was considered as the time interval between admission and discharge, and the patient's final condition was defined as either dead or alive. Demographic, clinical, and laboratory data were collected from the hospital information system. The generalized additive model and the Cox regression model were used to model data.
Results: Of the 1520 hospitalized COVID-19 patients, 232 (15.26%) died and 1288 survived or reached the end of 30 days of hospitalization. We selected demographic, clinical, and 131 independent laboratory variables. Blood urea nitrogen (BUN) had a nearly double average in the dead group (44.603 [± 25.408] mg/dL) than the survived group (21.304 [± 13.318] mg/dL), and the lymphocyte (Lymph) count showed the opposite trend. The estimated hazard ratio (HR) of these 2 factors was higher than 1 and was statistically significant. In daily stay trends, the hazard function of them also increased rapidly after 15 days.
Conclusion: Blood urea nitrogen and complete blood count provide strong predictive clues about the prognosis of hospitalized COVID-19 patients, and rapid dynamic changes in the second week can predict a poor outcome in these patients.

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Medical Laboratory Journal, 2024

Cardiovascular diseases, especially coronary artery problems, are the main causes of death. The a... more Cardiovascular diseases, especially coronary artery problems, are the main causes of death. The aim of this study was to evaluate the expression of NOs and NOX2 in coronary artery patients after aerobic exercise and omega-3 intake.
Methods: The present study was a quasi-experimental study in which 32 men with coronary artery disease in the age range of 55 to 65 years were selected and randomly divided into 4 groups: control, exercise, omega-3, and omega-3 + exercise. The training program consisted of 8 weeks of intermittent running training, 3 sessions per week, with an intensity of 55 to 65% of the subjects' heart rate reserve and with an emphasis on gradual overload. Subjects consumed 1000 mg of omega-3 daily.
Results: There was a significant increase (P <0.0001) in the mean expression of the NOS gene in the exercise + omega-3 group compared to the control group. The mean ratio of NOX gene expression changes in the exercise group, omega-3, and the combination of exercise + omega-3 was significantly reduced compared to the control group (P <0.0001).
Conclusion: According to the results of the present study, the ability of exercise and omega-3 supplementation to reduce the level of oxidant stress and increase homeostasis control in coronary artery insufficiency shows an important molecular mechanism that underlies the benefits of these interventions.

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Medical Laboratory Journal, 2024

Background: Intestinal infections with Helicobacter pylori mainly occur during childhood. If cont... more Background: Intestinal infections with Helicobacter pylori mainly occur during childhood. If contracted, these infections may cause chronic gastritis, frequently leading to peptic ulcer disease in later life. This study aims to detect the prevalence of H. pylori infections in patients with active gastritis.
Methods: The study included 150 participants who were consuming daily anti-gastritis drugs to reduce the gas and were considered active gastritis patients and were recruited from Lekhnath 12, now known as Pokhara metropolitan-30, from May 2018 to March 2019. They were screened for H. pylori antibodies for detection of infection by the immunochromatographic rapid detection kit, and the data were analyzed using SPSS 2016.
Results: Serum anti-Helicobacter pylori antibodies were used to detect the presence of Helicobacter pylori in these participants. Among the 150 participants, 54 were males (36%) and 96 were females (64%). The results showed that 47 (31.3%) of the patients were positive for anti-Helicobacter pylori test. The age group 30 to 40 had the highest prevalence of 21 (14.0%). Using public water showed the highest prevalence with a P value of 0.04.
Conclusion: There should be an additional aspect required for the diagnosis and treatment of gastritis, which is the healthcare providers' and patients' awareness of the cause and most efficient treatments for this medical condition. Using only anti-gastritis drugs is not sufficient; treatment against Helicobacter pylori requires the right pathway of treatment by the use of several antibiotics.

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Medical Laboratory Journal, 2024

Background: The complete blood count (CBC) profile has been found extremely useful in monitoring ... more Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the management of the disease may vary in different populations.
Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction [PCR]) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India).
Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels [13.43 vs 10.9 g/dL; P = 0.0001], lymphocytes [16.04% vs 30.8%; P = 0.00001], monocytes [5.53% vs 7.53%; P = 0.009], and platelet count [150 vs 186 ×103 µL; P = 0.037]) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio [PLR] with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve [AUC] = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693).
Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.

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Medical Laboratory Journal, 2024

Background: Gastrointestinal tract complaints are prevalent among individuals in rural settings, ... more Background: Gastrointestinal tract complaints are prevalent among individuals in rural settings, encompassing all age groups. This study aimed to examine histopathological lesions in the upper gastrointestinal tract through endoscopic biopsy and determine the frequency of various upper gastrointestinal lesions in relation to age, sex, and site.
Methods: The specimens included in our study comprise endoscopic biopsies of the upper gastrointestinal tract during October 2018 to October 2020. A total of 70 biopsies from the upper gastrointestinal tract were analyzed using endoscopy. All specimens were fixed in 10% formalin and processed following routine hematoxylin and eosin (HE) examination. Special stains were employed when necessary.
Results: Among the 70 upper gastrointestinal endoscopic biopsies studied during this period, 25 (35.71%) were from the esophagus, 35 (50.0%) were from the stomach, and 10 (14.29%) were from the duodenum. Of the 70 upper gastrointestinal endoscopic biopsies, 34 displayed inflammatory lesions, while 36 exhibited neoplastic lesions. There was a male predominance among the cases examined. Non-neoplastic lesions were observed in individuals aged from the second to the fifth decade, while neoplastic lesions were more prevalent in older age groups.
Conclusion: This research highlights the stomach as the predominant location for inflammatory and neoplastic lesions in the upper gastrointestinal tract. The study reveals a notable occurrence of gastric carcinoma among malignant upper gastrointestinal lesions. Thus, early detection and management of upper gastrointestinal lesions necessitate endoscopy and subsequent histopathological evaluation.

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Medical Laboratory Journal, 2024

Background: Certain trace elements, like cerium, have the potential to disrupt iron metabolism. T... more Background: Certain trace elements, like cerium, have the potential to disrupt iron metabolism. This study explored the impact of cerium on intestinal iron absorption, focusing on the initial stage of iron metabolism. We employed the rat everted gut sac (EGS) segments to assess the interference caused by cerium. The primary objectives of this study were to examine the absorption of cerium in the intestines and to compare iron absorption in the presence and absence of cerium. Methods: For the EGS experiment, segments of the rat's duodenum, ileum, or jejunum were promptly excised, cut into 5-6 cm segments, and rinsed with a physiological solution. These freshly prepared rat EGS segments were then incubated in Earle's medium containing iron (III) and/or cerium (III). We examined the impact of ascorbic acid, glucose, and different time intervals on the intestinal absorption of cerium and iron. Specifically, we investigated how glucose (5 mM) and ascorbic acid (2.8 mM) affected the absorption of cerium and iron at various concentrations (ranging from 0 to 200 mg/L). Additionally, we assessed the interfering effect of cerium on iron absorption. Results: The results indicated that the maximum intestinal absorption of Fe (III) and Ce (III) occurred at a concentration of 200 mg/L. Furthermore, it was observed that their uptake increased following the reduction by ascorbic acid. The absorption of these elements also rose in the presence of glucose, suggesting energy-dependent transport. Additionally, a consistent cerium concentration was found to decrease iron absorption by 24.3% (P ≤ 0.05). Conclusion: Based on the results, cerium likely reduces iron uptake by competing with iron. Cerium can also disrupt iron metabolism and lead to iron-related metabolic disorders. However, further studies at the molecular and intracellular levels are needed to gain a better understanding of this mechanism.

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Medical Laboratory Journal, 2024

Background: This study aimed to investigate the effect of four weeks of selected endurance traini... more Background: This study aimed to investigate the effect of four weeks of selected endurance training on neurotrophin-3 (NT-3) and tropomyosin receptor kinase C (TrkC) gene expression in hippocampal areas of rats with spinal cord injury (SCI).
Methods: In this experimental study, the rats were separated into six equal groups. First, the animals were put under general anesthesia and had their SCI. Then, for four weeks, they were subjected to two kinds of endurance training programs. However, the control injury group received no intervention or training. Following the completion of the training regimes, molecular tests were done using the qRT-PCR technique to evaluate changes in the gene expression of NT-3 and TrkC from the animals' hippocampus.
Results: The expression of NT-3 and TrkC genes were significantly reduced in the SCI model compared to the healthy control group, but it was increased in the SCI + exercise 1 and SCI + exercise 2 groups compared to the SCI group. NT-3 levels did not vary significantly between the SCI + exercise 1 and SCI + exercise 2 groups, although alterations in TrkC levels altered.
Conclusion: In addition to enhancing locomotion in animals with SCI, the endurance training regimens in this research were effective on the expression of NT-3 and TrkC genes and may play a role in axonal development and neuronal survival in SCI recovery.

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Medical Laboratory Journal, 2024

Background: Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abn... more Background: Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abnormal immune responses, leading to inflammation and scarring in the large intestine. The bacteria Prevotella melaninogenica, found in the intestine and mouth, may contribute to UC. This study focuses on the detection of P. melaninogenica in the saliva of UC patients and compares them with the healthy control (HC) group.
Methods: The present study was a case-control study including 40 UC patients and 40 healthy controls (HCs) with an average age of 43.0 3± 10.3. This study used a real-time PCR test to investigate the frequency and average number of P. melaninogenica from the 16S rRNA gene sequence of P. melaninogenica in both groups.
Results: P. melaninogenica was more frequent in UC patients (77.5%) than HCs (45%) (p = 0.003). The patient group had more bacteria (339.31 ± 1082.29) than HCs (61.29 ± 154.03) (p = 0.005). Women in the UC group had more P. melaninogenica (492.35 ± 1427.61) than the control group (56.98 ± 123.50) (p = 0.0342). Similarly, men in the UC group (262.85 ± 664.97) had more bacteria than the control group (72.62 ± 222.76) (p = 0.015).
Conclusion: The current study showed that dysbiosis in P. melaninogenica, a bacterium in human saliva, could be important in the development of UC. Further investigation is needed to evaluate its use as a potential biomarker in the UC.

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Medical Laboratory Journal, 2024

Background: Escherichia coli consists of a wide range of strains with huge diversity in their gen... more Background: Escherichia coli consists of a wide range of strains with huge diversity in their genome, distributed in nature and the alimentary tracts of animals and humans. This study analyzed the phylogenetic group determination and genetic diversity of E. coli strains isolated from domestic animals and human clinical samples.
Methods: Twenty E. coli isolates from domestic animals were analyzed for phylogenetic grouping. Also, 100 clinical samples and 20 animal samples were evaluated by the enterobacterial repetitive intergenic consensus–polymerase chain reaction (ERIC-PCR) technique. The results and the similarity between the strains were determined based on the Dice similarity coefficient in the SAHN program of the NTSYS-pc software.
Results: The frequency of phylogroups among animal samples were A = 5%, B1 = 65%, B2 = 20%, and D = 10%. Based on the ERIC-PCR results, the clinical strains were allocated into 19 clusters. Most strains were in the E7 cluster. Fifty percent of the E. coli isolated from animal specimens belonged to the E4 group, and the lowest number of strains was in the E3 and E5 (1 strain) groups.
Conclusion: The results confirmed the efficiency and usefulness of the ERIC-PCR tool for the identification and classification of bacteria. Also, we demonstrated the most phylogroup among animal samples.

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Medical Laboratory Journal, 2024

Background: Type 2 DM is a heterogeneous group of disorders characterized by insulin resistance, ... more Background: Type 2 DM is a heterogeneous group of disorders characterized by insulin resistance, impaired insulin secretion, increased glucose production, and abnormal fat metabolism. Diabetes mortality primarily results from microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy, as well as macrovascular complications like coronary artery, peripheral vascular, and cerebrovascular diseases. Patients with diabetes usually have changes in adipose tissue metabolism and abnormalities in the secretion of adipokines such as leptin. The present study aims to study the relationship between serum leptin levels and lipid profile parameters among non-obese type 2 diabetes mellitus patients and non-diabetic individuals.
Methods: This hospital-based cross-sectional study was conducted among 41 type 2 diabetic patients and 41 non-diabetic individuals of both sexes between the ages of 40 and 70. Fasting blood glucose (FBS), serum leptin, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) levels were assayed.
Results: The mean serum leptin levels among diabetic patients were lower than those of non-diabetic individuals, and this difference in mean was statistically significant. The study showed a significant negative correlation between serum leptin, TC, TG, and low-density lipoprotein (LDL), and a positive correlation with HDL. In the final regression model, serum leptin showed a statistically significant association with FBS and HDL.
Conclusion: This study demonstrated that serum leptin levels can be a strong predictor of low HDL levels in diabetic patients. It can also contribute to raised levels of total cholesterol, triglyceride, and LDL, which are responsible for macrovascular complications in diabetics.

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Medical Laboratory Journal, 2024

Background: Pyogenic infection is a significant cause of morbidity. Infection with multidrug-resi... more Background: Pyogenic infection is a significant cause of morbidity. Infection with multidrug-resistant strains poses a major difficulty in the treatment. The study was conducted to know the bacteriological profile of pyogenic infections and their antibiotic susceptibility.
Methods: A cross-sectional study was conducted in a tertiary care hospital from October 2021 to March 2022. Isolates from pus specimens were subjected to an antibiotic sensitivity test using the Kirby-Bauer method as per CLSI 2021.
Results: Out of 752 samples, etiology could be revealed in 510 (68.4%) specimens. Enterobacterales dominated the profile, with K pneumoniae isolated in the maximum number of specimens. Staphylococcus aureus was the culprit in 14% of the cases. Non-fermenters were isolated in 17% of the cases. Methicillin resistance in S aureus was 67%. Gram-positive cocci showed high sensitivity to linezolid. For both Piptaz and carbapenem, Enterobacterales and non-fermenters showed around 50% and 60% susceptibility, respectively.
Conclusion: Continuous surveillance of the aetiologic agents of pyogenic infections and their antibiotic sensitivity pattern needs to be done to design and implement the antibiotic policy for the infection in our set-up.

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Medical Laboratory Journal, 2024

Multiple myeloma (MM) is a plasma cell neoplasm that is characterized by the clonal proliferation... more Multiple myeloma (MM) is a plasma cell neoplasm that is characterized by the clonal proliferation of malignant plasma cells in the bone marrow. It is considered the second most common hematological malignancy which accounts for approximately 1% - 2% of all cancers and among 10% of hematological malignancies. Autologous peripheral blood stem cell Transplantation (PBSCT) is the best treatment for MM. Since the optimum harvested stem cell yield is a crucial factor for sufficient engraftment, the enumeration of Mononuclear cell (MNC) count in peripheral blood and harvested CD 34+ stem cell count can be considered as the best predictive markers for the best timing of apheresis which positively correlates with engraftment outcome of PBSCT.
MNC count can be obtained using either a hematological analyzer or peripheral blood smear while flow cytometry is the advanced technology that can be used to enumerate CD 34+ stem cell count other than peripheral blood smear. The unavailability of a flow cytometer, the expensiveness of this method, and the lack of trained personnel regarding this new technology, especially in lower-middle-income countries cause disturbance in the enumeration of stem cells. In such a situation, this review describes the importance of establishing an association between peripheral blood MNCs and harvested CD 34+ cells. Furthermore, this association facilitates conducting effective PBSCT for MM patients even in the absence of a flow cytometer and eventually, it focuses on decentralizing the treatment of PBSCT.

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Medical Laboratory Journal, 2024

Background: Musculoskeletal disorders are common in patients with hypothyroidism, and are also ob... more Background: Musculoskeletal disorders are common in patients with hypothyroidism, and are also observed in thyrotoxicosis. Creatine kinase (CK) is present in the muscles and is involved in energy metabolism. This study aimed to estimate the serum CK levels in patients with hypothyroidism, hyperthyroidism, and healthy individuals. Moreover, the correlation of CK levels with markers of thyroid function is assessed.
Methods: A total of 120 patients with hypothyroid and 120 with hyperthyroid were compared with 120 healthy individuals aged 20-60 years. The thyroid status was assessed by determining the serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) using chemiluminescent immunoassay. Serum CK was measured the by kinetic method. Statistical analysis was performed by analysis of variance and Pearson’s correlation to investigate the correlations between CK and thyroid hormones.
Results: A significant increase (P<0.0001) and a significant decrease (P<0.0001) in serum CK were observed in hypothyroid patients (253.98±129.04 IU/L) and in hyperthyroid patients (34.68±13.15 IU/L), respectively, compared to the control group (72.9±29.01 IU/L). A negative correlation was found between fT4 and CK (r: -0.4253, P<0.0005).
Conclusion: It could be concluded that CK activity in serum may be a useful additional test in thyroid disorders.

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Medical Laboratory Journal, 2024

Background: Urinary tract infections (UTIs) are among the most common types of infections affecti... more Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible. Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.

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Medical Laboratory Journal, 2024

Background: ‘M’ proteins or paraproteins refer to immunoglobulins that are produced by clonal pla... more Background: ‘M’ proteins or paraproteins refer to immunoglobulins that are produced by clonal plasma cells and are a characteristic feature of monoclonal gammopathies. Routine electrophoresis on agarose gel and immunofixation can be used to detect immunoglobulin paraprotein (M-protein). We aimed to evaluate the performance of agarose gel electrophoresis alone and in combination with immunofixation for detecting serum M-proteins.
Methods: One hundred and twenty-three patients suspected of paraproteinemia were evaluated. Routine serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) protocols were performed. Data from SPE, and SPE-IFE (gel images and electrophoretograms) were collected and reviewed.
Results: 21% cases were confirmed using the SPE-IFE combination, and among them, 33% had positive light chain (λ) only on IFE. Similarly, nine cases with biclonal gammopathy on SPE were characterized by IFE.
Conclusion: IFE can be a confirmatory test in cases where SPE results are not reliable and it can be a complementary test when characterization of the M protein detected on SPE is required.

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Medical Laboratory Journal, 2024

Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the femal... more Background: Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. This local study was conducted to identify the spectrum of Candida species associated with VVC and recurrent vulvovaginal candidiasis (RVVC) using different phenotypic and genotypic methods and assess their fluconazole susceptibility.
Methods: High vaginal swabs were collected from 576 patients with VVC. Swabs were subjected to KOH 10% and cultured on Sabouraud dextrose agar. The species identification of Candida isolates was made using phenotypic methods, including the germ tube test, corn meal agar (CMA), CHROMagar Candida, and PCR-RFLP as the best genotypic methods for confirmation of Candida species in vulvovaginal candidiasis. Fluconazole susceptibility testing was performed using the disk diffusion method.
Results: The data were analyzed using the chi-square test. The prevalence of candidiasis was 61%. The socio-demographic profile corresponded to a woman aged 29.14 ± 4.8 years on average, pregnant (77%), diabetic (19%), with hypertension (10%), recurrent (9%), a history of fluconazole use (4%), and under 30 years of age (73%).
Vaginal swab cultures yielded Candida growth in 352 cases (61%). Candida albicans was the predominant isolated species (78%), while the most common non-albicans species were C. glabrata (14.7%), C. parapsilosis (4.2%), C. tropicalis (2.8%), and C. krusei (0.56%). Isolates of C. glabrata and C. krusei exhibited the highest rate of DDS resistance among all isolates tested.
Conclusion: C. albicans was the most common species. Careful periodical surveillance is needed to identify any changes in the susceptibility patterns to fluconazole with the increased use of this antifungal agent in Sayad Shirazi tertiary care hospital, Iran.

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Medical Laboratory Journal, 2024

Plasma cell leukemia (PCL) is a rare form of plasma cell dyscrasia with 2 variants: the primary f... more Plasma cell leukemia (PCL) is a rare form of plasma cell dyscrasia with 2 variants: the primary form, which occurs de novo in patients with no previous history of multiple myeloma (MM), and the secondary form, which represents a leukemic transformation in patients with a previously recognized MM. Unlike myeloma, PCL typically follows an aggressive course, and the median age at presentation is usually above 50 years. In this report, we present a case of primary PCL that manifested at 19, an exceptionally rare occurrence.

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Medical Laboratory Journal, 2024

Background: A higher occurrence of raised homocysteine levels has been reported in individuals wi... more Background: A higher occurrence of raised homocysteine levels has been reported in individuals with type 2 diabetes (T2D), particularly those with macroangiopathy and nephropathy. Given that hyperhomocysteinemia is a risk factor for T2D, mitigating this condition could potentially benefit T2D patients. This study aimed to investigate the influence of homocysteine on T2D and cardiovascular disease (CVD), as well as the factors that modify homocysteine levels.
Methods: This cross sectional, observational study was conducted on 122 individuals in a tertiary care center in Western India. Data related to anthropometry, demography, and biochemistry were gathered following established standards. Statistical analysis was performed using Chi-square test. A P-value of <0.05 was considered statistically significant.
Results: The findings indicated a significantly larger percentage of hyperhomocysteinemia in males, smokers, and individuals with elevated fasting blood sugar and HbA1c levels. The proportion of subjects with high homocysteine levels was notably greater in those with high total cholesterol and triglyceride levels. A significant correlation was observed between increased serum homocysteine levels and decreased serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
Conclusion: Elevated homocysteine levels are observed in smokers and diabetic patients, potentially leading to CVD. Furthermore, this study found a correlation between an increase in serum homocysteine levels and a decrease in serum folic acid and vitamin B12 levels in patients with ischemic heart disease.

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Medical Laboratory Journal, 2024

Background: Viral hepatitis is increasingly being recognized as a public health problem, requirin... more Background: Viral hepatitis is increasingly being recognized as a public health problem, requiring special attention. The World Health Organization (WHO) estimated that in 2019, 296 million people globally (3.8%) had chronic hepatitis B virus (HBV) infection, and 58 million people (0.8%) were living with hepatitis C virus (HCV). To add to this, every year, about 1.5 million people are newly infected with either hepatitis B or C viruses. The Global Health Sector Strategy (GHSS) has aimed to eliminate viral hepatitis as a major public health problem by 2030.
Methods: We conducted a desk review to identify strategies for preventing viral hepatitis and develop a roadmap to attain the sustainable development goals (SDG) target by 2030 (particularly in low- and middle-income countries). A search was done in PubMed via Medline on 1 December 2022.
Results: The focus has to be on key interventions, including hepatitis B vaccination (part of the routine child immunization along with rescheduling the birth dose to up to 7 days post-term, adult vaccination, for targeted groups like health care providers, rag pickers, waste handlers, and sanitation workers), ensuring safe injection practices and blood transfusion, harm reduction interventions for people who inject drugs (PWID), adequate testing for early diagnosis, and ensuring appropriate treatment.
Conclusion: It is the need of the hour to prioritize key interventions identified in the review for preventing viral hepatitis.

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Medical Laboratory Journal, 2024

Background: Urinary tract infection (UTI) is one of the most common bacterial infections of all a... more Background: Urinary tract infection (UTI) is one of the most common bacterial infections of all ages and sexes. Escherichia coli is reported as the most common predominant pathogen. Urinary tract infection treatment leads to abundant antibiotic application in hospitals and communities, continuously developing multidrug resistance (MDR). This study aimed to determine the sensitivity and resistance pattern to common antibiotics among E. coli isolates from patients with UTIs at Nemazee Hospital in Shiraz.
Methods: This retrospective cross-sectional survey studied 1910 positive urine samples with E. coli bacteria from patients referred to Nemazee Hospital from 2018 to 2019. Antimicrobial susceptibility testing was performed on 12 commonly used antibiotics for UTIs.
Results: A total of 1910 E. coli isolates were gathered during these 2 years. The most highlighted resistance was observed against quinolones and cephalosporins at 86.9% and 89.7%, respectively. Cephalexin (87.9%) and nalidixic acid (86.1%) have shown the lowest activity against E. coli isolates. Also, the highest susceptibility was determined for amikacin (88.3%), nitrofurantoin (76.8%), and gentamicin (70.6%). In addition, 1624 (85%) isolates were MDR.
Conclusion: In conclusion, resistance to antibiotics (such as ciprofloxacin, norfloxacin, tetracycline, cefotaxime, and nitrofurantoin) is increasing. Therefore, it is vital to follow an appropriate antimicrobial stewardship program.

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Medical Laboratory Journal, 2024

Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic... more Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic, clinical, laboratory, and imaging risk factors. We aimed to determine the best outcome predictors and their trends during 30 days of hospitalization.
Methods: This retrospective study was conducted on moderate to severe hospitalized COVID-19 patients from 26 January 2020 to 13 January 2021. The length of stay in the hospital was considered as the time interval between admission and discharge, and the patient's final condition was defined as either dead or alive. Demographic, clinical, and laboratory data were collected from the hospital information system. The generalized additive model and the Cox regression model were used to model data.
Results: Of the 1520 hospitalized COVID-19 patients, 232 (15.26%) died and 1288 survived or reached the end of 30 days of hospitalization. We selected demographic, clinical, and 131 independent laboratory variables. Blood urea nitrogen (BUN) had a nearly double average in the dead group (44.603 [± 25.408] mg/dL) than the survived group (21.304 [± 13.318] mg/dL), and the lymphocyte (Lymph) count showed the opposite trend. The estimated hazard ratio (HR) of these 2 factors was higher than 1 and was statistically significant. In daily stay trends, the hazard function of them also increased rapidly after 15 days.
Conclusion: Blood urea nitrogen and complete blood count provide strong predictive clues about the prognosis of hospitalized COVID-19 patients, and rapid dynamic changes in the second week can predict a poor outcome in these patients.

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Medical Laboratory Journal, 2024

Cardiovascular diseases, especially coronary artery problems, are the main causes of death. The a... more Cardiovascular diseases, especially coronary artery problems, are the main causes of death. The aim of this study was to evaluate the expression of NOs and NOX2 in coronary artery patients after aerobic exercise and omega-3 intake.
Methods: The present study was a quasi-experimental study in which 32 men with coronary artery disease in the age range of 55 to 65 years were selected and randomly divided into 4 groups: control, exercise, omega-3, and omega-3 + exercise. The training program consisted of 8 weeks of intermittent running training, 3 sessions per week, with an intensity of 55 to 65% of the subjects' heart rate reserve and with an emphasis on gradual overload. Subjects consumed 1000 mg of omega-3 daily.
Results: There was a significant increase (P <0.0001) in the mean expression of the NOS gene in the exercise + omega-3 group compared to the control group. The mean ratio of NOX gene expression changes in the exercise group, omega-3, and the combination of exercise + omega-3 was significantly reduced compared to the control group (P <0.0001).
Conclusion: According to the results of the present study, the ability of exercise and omega-3 supplementation to reduce the level of oxidant stress and increase homeostasis control in coronary artery insufficiency shows an important molecular mechanism that underlies the benefits of these interventions.

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Medical Laboratory Journal, 2024

Background: Intestinal infections with Helicobacter pylori mainly occur during childhood. If cont... more Background: Intestinal infections with Helicobacter pylori mainly occur during childhood. If contracted, these infections may cause chronic gastritis, frequently leading to peptic ulcer disease in later life. This study aims to detect the prevalence of H. pylori infections in patients with active gastritis.
Methods: The study included 150 participants who were consuming daily anti-gastritis drugs to reduce the gas and were considered active gastritis patients and were recruited from Lekhnath 12, now known as Pokhara metropolitan-30, from May 2018 to March 2019. They were screened for H. pylori antibodies for detection of infection by the immunochromatographic rapid detection kit, and the data were analyzed using SPSS 2016.
Results: Serum anti-Helicobacter pylori antibodies were used to detect the presence of Helicobacter pylori in these participants. Among the 150 participants, 54 were males (36%) and 96 were females (64%). The results showed that 47 (31.3%) of the patients were positive for anti-Helicobacter pylori test. The age group 30 to 40 had the highest prevalence of 21 (14.0%). Using public water showed the highest prevalence with a P value of 0.04.
Conclusion: There should be an additional aspect required for the diagnosis and treatment of gastritis, which is the healthcare providers' and patients' awareness of the cause and most efficient treatments for this medical condition. Using only anti-gastritis drugs is not sufficient; treatment against Helicobacter pylori requires the right pathway of treatment by the use of several antibiotics.

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Medical Laboratory Journal, 2024

Background: The complete blood count (CBC) profile has been found extremely useful in monitoring ... more Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the management of the disease may vary in different populations.
Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction [PCR]) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India).
Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels [13.43 vs 10.9 g/dL; P = 0.0001], lymphocytes [16.04% vs 30.8%; P = 0.00001], monocytes [5.53% vs 7.53%; P = 0.009], and platelet count [150 vs 186 ×103 µL; P = 0.037]) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio [PLR] with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve [AUC] = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693).
Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.

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Medical Laboratory Journal, 2024

Background: Gastrointestinal tract complaints are prevalent among individuals in rural settings, ... more Background: Gastrointestinal tract complaints are prevalent among individuals in rural settings, encompassing all age groups. This study aimed to examine histopathological lesions in the upper gastrointestinal tract through endoscopic biopsy and determine the frequency of various upper gastrointestinal lesions in relation to age, sex, and site.
Methods: The specimens included in our study comprise endoscopic biopsies of the upper gastrointestinal tract during October 2018 to October 2020. A total of 70 biopsies from the upper gastrointestinal tract were analyzed using endoscopy. All specimens were fixed in 10% formalin and processed following routine hematoxylin and eosin (HE) examination. Special stains were employed when necessary.
Results: Among the 70 upper gastrointestinal endoscopic biopsies studied during this period, 25 (35.71%) were from the esophagus, 35 (50.0%) were from the stomach, and 10 (14.29%) were from the duodenum. Of the 70 upper gastrointestinal endoscopic biopsies, 34 displayed inflammatory lesions, while 36 exhibited neoplastic lesions. There was a male predominance among the cases examined. Non-neoplastic lesions were observed in individuals aged from the second to the fifth decade, while neoplastic lesions were more prevalent in older age groups.
Conclusion: This research highlights the stomach as the predominant location for inflammatory and neoplastic lesions in the upper gastrointestinal tract. The study reveals a notable occurrence of gastric carcinoma among malignant upper gastrointestinal lesions. Thus, early detection and management of upper gastrointestinal lesions necessitate endoscopy and subsequent histopathological evaluation.

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