International Journal of Medical Laboratory

4

Authors: Zakieh Rostamzadeh *, Mohadese Nemati, Mahshid Mohammadian

Background and Aims: Hepatitis B virus (HBV) infection is a serious global health problem affects many people. Recently, because of vaccination, the incidence of HBV infection has been reduced, but in high risk population also health care students (HCS) adequate immunization is serious. The aim of this survey was to evaluate HBV immunization in the population of the paramedical students based on the demographic characteristics in Iran. Materials and Methods: Anti-HBsAg titer was prospectively assayed in all vaccinated of the 95 HCS using Enzyme-linked immunosorbent assay. Results and Conclusions: Anti-HBsAg titer in the studied population was estimated about 92.8±80.5 mIU. Anti-HBsAg titer response was significantly higher in females to males. A low proportion of vaccinated HCS had low titers antibody against HBV infection. Therefore, measuring anti-HBsAg titer may help to drop in HBV incidence in HCS. This reduction can be correlated with the effectiveness of national immunization program.

10

Authors: Shalini N. Maksane*, Rupali Parikh , Lakshmi Vaswani

Background and Aims: Six sigma is the latest version of total quality management. It is quantitative goal for process performance. With increasing demands for improved accuracy and reliability of the results, Six Sigma is gaining increased visibility in the clinical laboratory process outcomes. The aim of study was to evaluate the quality of analytical phase performance in a clinical biochemistry laboratory by calculating sigma metrics. Materials and Methods: The study was conducted in a hospital laboratory of Bhatia Hospital, Mumbai. Mean, coefficient of variation, bias, and sigma values were calculated for 24 biochemistry parameters. The guidelines used for total error allowable (TEa) values were clinical laboratory improvement amendments (CLIA), RILIBAK and college of american pathologists (CAP). Four months’ internal and external quality control data were extracted for the following parameters-albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), bilirubin direct, bilirubin total, Ca, cholesterol, creatine kinase (CK), creatinine, triglycerides (TG), Uric acid (UA), unsaturated iron binding capacity (UIBC), urea, gamma-glutamyl transferase (GGT), glucose, high-density lipoproteins (HDL), iron, lactate dehydrogenase (LDH), lipase, Mg, phosphorus and total protein. Results: Albumin, ALP, AST, ALT, amylase, bilirubin total, Ca, cholesterol, CK, creatinine, TG, uric acid, GGT, glucose, iron, LDH, lipase, Mg, Phosphorus, total protein showed the performance of more than six Sigma for both level of controls. Bilirubin direct, Urea, for level 1; UIBC, urea, HDL for level 2 showed sigma from 3-6. Conclusions: Based upon sigma metrics, laboratory quality control strategy can be planned and reevaluated for continuous monitoring and improvement of test methods.

10

Authors: Arezou Rahimi, Mehrnaz Mesdaghi, Nima Rezaei, Mahboubeh Mansouri, Iraj Mohammadzadeh, Hamid Farajifard, Mehrdad Amirmoini., Delara Babaie, Reza Alimohammadi, Zahra Chavoshzadeh

Background and Aims: Patients with Hyper-IgE syndrome suffer from fungal and bacterial infections, especially Candida albicans and Staphylococcus aureus. Due to the important role of T helper17 (Th17) lymphocytes in defense against fungal infections, the percentage of Th17 lymphocytes was studied in the patients with autosomal recessive hyper-IgE syndrome (AR-HIES). Materials and Methods: In this case-control study, six patients with AR-HIES (with DOCK-8 mutation) and seven healthy age and sex-matched controls were included. Peripheral blood mononuclear cells were isolated from their venous blood and the percentage of Th17 lymphocytes were determined by flow cytometry. Results: There was no statistical difference between the percentage of Th17 lymphocytes (p=0.15) in the case and control groups. Also in comparison to the control subjects, the numbers of eosinophils were dramatically increased (p=0.000). Also, there was a significant negative correlation between serum IgE levels and Th17 lymphocytes’ percentage (r=-0.927, p=0.006) and a significant positive correlation between eosinophils number and Th17 lymphocytes’ percentage (r=0.557, p=0.01). Serum IgE levels showed a significant positive correlation with the numbers of eosinophils in the patients’ peripheral blood with AR-HIES (r=0.961, p=0.003). Conclusions: The numbers of Th17 in the patients with AR-HIES may not show statistical differences between the cases and controls. The numbers of eosinophils significantly increased in the patients AR-HIES compare to the controls.

12

Authors: Khosrow Aghaiypour, Elham Bahreini*, Shiva Jafari

Background and Aims: L-Asparaginase II is a cornerstone of treatment protocols for acute lymphoblastic leukemia. Only asparaginase II obtained from E.coli K12 and Erwinia chrysanthemi have been used in human as therapeutic drug. The therapeutic effects of asparaginase II from E.coli K12 and Erwinia chrysanthemi are accompanied by side effects. It is desirable to search for other asparaginase II sources with novel properties that could be therapeutic and produce an enzyme with less adverse effects. Materials and Methods: Previously, we performed the in vitro studies, including cloning, sequencing and expression of L-asparaginase II genes (ansB) from Citrobacter freundii 1101, Erwinia chrysanthemi DSM 4610, E.coli BL21 and Klebsiella pneumoniae ATCC 10031. In this article, the obtained results were compared bioinformatically. The nucleotide and amino acid sequence alignments were carried out by ClustalW2. Protein localization and signal peptides were predicted by PSORT and SIG-Pred softwares, respectively. Percentages of hydrophobic and hydrophilic residues were calculated by Genscript software. The physicochemical parameters were computed using Expasy’s ProtParam prediction server. The secondary and 3D structures were predicted by SOPMA and the online server Phyre2, respectively. The antigenicity of the asparaginase IIs was predicted using Semi-empirical method. Results: E.coli BL21 and Citrobacter freundii 1101 had the most similarity in physicochemical parameters and antigenicity with E.coli K12. Also, Erwinia chrysanthemi DSM 4610 had the most similarity in physicochemical parameters and antigenicity with Erwinia chrysanthemi. Conclusions: In spite of these similarities with drug types, the potentiality of other low-similar asparaginase IIs should also be determined and compared with drug types.