International Journal of Medical Laboratory

187-195

Authors: Mehdi Taheri Sarvtin , Mohadeseh Kamali *

Psoriasis is an immune-mediated disease causing raised, scaly patches on the skin, especially the elbows, knees, and scalp due to systemic inflammation. The disease affects more than 125 million people worldwide. Psoriasis is associated with problems such as depression, reduced quality of life, cardiovascular diseases, stroke, lymphoma, diabetes mellitus, and metabolic syndrome. Psoriasis has a complex pathogenesis that is not yet fully understood. Many studies have shown the importance of the microbiome for the exacerbation of psoriasis. On the other hand, psoriasis and some other treatments can increase the colonization of some microbial agents in the body. Candida is commensal yeast that forms part of the natural microflora of the skin and mucous membranes. It has been shown that people with psoriasis are susceptible to candidiasis. In this review article, the causes of candidiasis, its diagnosis, and treatment in patients with psoriasis, as well as psoriasis aggravation methods by Candida species have also been investigated. To this end, keywords such as "psoriasis", "candida", " oral candidiasis", "cutaneous candidiasis", "vulvovaginal candidiasis", "epidemiology of Candida" and "balanitis" were searched. Articles published in national and international scientific databases, namely Google Scholar, PubMed/MEDLINE, Elsevier databases, Scopus, Science Direct, IranMedex, and SID from 2001 to 2023 were used. Oral candidiasis, cutaneous candidiasis, vulvovaginal candidiasis, and balanitis are diseases that affect people with psoriasis. On the other. This fungus may aggravate psoriasis through toxin production and activation of T lymphocytes independent of antigen presentation.

208-216

Authors: Mohammad Panji , Vahideh Behmard , Mehri Fallah Raoufi , Elnaz Sadat Mousavi Sadr Jadidi , Elham Rostami , Rahil Norbakhsh , Vajiheh Najafi , Tohid Moradi Gardeshi , Fahimeh Safizadeh , Haleh Barmaki *

Background and Aims: Cerebrospinal fluid (CSF) and blood biomarkers are widely evaluated as diagnostic tools to distinguish between bacterial meningitis and viral meningitis in emergency laboratory tests. So, this aimed to examine the levels of diagnostic parameters in blood and CSF to discriminate between bacterial and viral meningitis in young children referred to Khoy Hospital. Materials and Methods: A total of 101 young children with meningitis were enrolled in this prospective study. The diagnosis of bacterial and viral meningitis was based on clinical features and laboratory findings. Results: Of the 101 patients with meningitis, 18 (17.82%) were bacterial, and 83 (82.17%) were viral meningitis. The levels of CSF glucose and CSF/blood glucose ratio were significantly lower in the bacterial meningitis group than in the viral meningitis group (p < 0.01). In contrast, white blood cells count, CSF protein, interleukin-6, C-reactive protein, and ferritin levels were significantly higher in patients with bacterial meningitis compared to viral meningitis (p < 0.01). However, there was no difference between viral and bacterial meningitis groups concerning mean serum glucose. Conclusion: This study suggests that decreased CSF glucose and CSF/blood glucose ratio and increased white blood cells count, CSF protein, ferritin, interleukin-6, and C-reactive protein combined with clinical symptoms can help better diagnosis of bacterial meningitis, especially in comparison with viral meningitis.

229-237

Authors: Zahra Safaie , Saied Ghorbani , Zahra Salavatiha , Ahmad Tavakoli , Seyed Jalal Kiani , Seyed Hamidreza Monavari *

Background and Aims: Human herpes virus types 6 and 7 (HHV-6, HHV-7) can remain latent in the urogenital tract epithelial cells. Varicella-Zoster virus (VZV) is among the Alphaherpesviruses infecting most people during childhood. This virus can remain latent in the ganglionic neurons. The latent infection can reactivate through weakness, suppression of the immune system, and aging. Therefore, this study investigated the molecular prevalence of HHV-6, HHV-7, and Varicella-Zoster virus in sperm samples from infertile men. Materials and Methods: Sperm samples from 82 infertile patients were collected from infertility centers in Tehran. Chromatin health levels and sperm DNA examinations were carried out using sperm DNA fragmentation index kits. Viral nucleic acids were extracted from the samples. The presence of VZV, HHV-6, and HHV-7 genomes was examined through the conventional polymerase chain reaction assay. Results: The average age was 37.3 ± 6.1 years. The mean sperm motility percentage was 33.6 ± 2%. Infertile men's mean DNA fragmentation index was 27.2 ± 1.2. This study shows a 7.3% and 4.9% prevalence for HHV-6 and VZV, respectively, and the absence of HHV-7 in sperm specimens. Conclusion: Although the infection rates of these herpesviruses seem relatively low, more comprehensive and multi-center studies are required to obtain more accurate results.

247-253

Authors: Ali Gholami , Parastoo Yousefi , Alireza Tabibzadeh *

Background and Aims: The Coronavirus disease 2019 (COVID-19) pandemic began in 2020. A major problem during COVID-19 was determining the clinical severity. There are a variety of markers for assessing the COVID-19 severity and outcome. So, this study aims to introduce a new approach for determining the disease severity based on the laboratory data obtained by machine learning algorithms. Materials and Methods: In this study, we used 100 patients for modeling. We used demographical, background disease, and laboratory data of COVID-19 patients as parameters for training the convolutional neural network model to evaluate disease severity and tried to create a predictive algorithm for future data. The sequential neural network from the Keras library by TensorFlow was used for prediction. The clinical validation of prediction by model was evaluated by the receiver operating characteristic (ROC) curve. Results: The mean F1 score for our current model was 0.62 (in the range of 0-1). The F1 scores for the severe group and the mild group were 0.8 and 0.45, respectively. The ROC curve for clinical validity revealed an acceptable Area Under Curve (0.085) for both severe and mild categories. Conclusion: The current study introduces a simple machine learning algorithm as tool for determining COVID-19 severity of by acceptable ROC. This study can lead us to use such algorithms more often in laboratory medicine and clinical decision-making. Furthermore, the present study is just a preliminary study and highlights the need for further research to validate and refine the proposed model.

91-106

Authors: Mohadeseh Kamali, Mehdi Taheri Sarvtin

Candida albicans (C. albicans) is a polymorphic fungus that exists as a natural flora in the skin and mucosal surfaces of the body. However, under certain conditions, such as immunodeficiency, mucosal damage, antibiotic use, and cancer, this fungus can cause superficial and systemic infections. C. albicans is the most common opportunistic pathogenic fungus in humans and causes 60% of mucosal infections and 40% of candidemia cases. Several pathogenic factors have been identified that contribute to the pathogenic potential of this fungus. Among these factors, we can mention: hypha production, attachment, and biofilm formation, secretion of hydrolase enzymes, acquisition of micronutrients, adaptation to oxygen and nitrogen deficiency conditions, and growth at temperatures above 37 °C. This review article will investigate the pathogenic factors of C. albicans and their regulatory factors. For this purpose, articles published in national and international scientific databases, including PubMed/MEDLINE, Google Scholar, Elsevier databases, IranMedex, Scopus, SID, and Science Direct, were used. Keywords such as: “Candida,” “Fungi,” “Pathogenesis,” and “Virulence” were used to find the articles.

120-126

Authors: Mohsen Nabi-Afjadi , Hadis Karami , Kaveh Goudarzi , Zahra Abasian , Nafiseh Heidari-Kalvani , Fereshte Barjasteh , Elham Bahreini *

Coronavirus 2019 (COVID-19), an epidemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), has spread worldwide since it was first identified in Wuhan, China, in December 2019, leading to outbreaks of epidemics. Due to the increasing spread of this disease, definitive treatment and approved vaccines have not been found for it. In this study, we reviewed recent articles on the effect of vitamins (including vitamins A, B, and E) for treating coronavirus. This result suggests that some dietary supplements such as vitamins (A, B, C, D, E, etc.) have antiviral, antioxidant, and anti-inflammatory effects. Dietary supplements consisting of vitamins and individual dietary habits can therefore be used as adjunctive therapy along with antiviral drugs in the treatment of COVID-19 disease.

144-156

Authors: Farnoosh Naseri , Fatemeh Safari , Hoda Khoshnevis , Maryam Pilechian , Sara Hesami , Nazanin Taheri , Abbas Shakoori Farahani *

Background and Aims: Diagnosing hematologic malignancies requires implementing several tests. This study aims to evaluate the chromosomal changes in patients with myeloid disorders and compare the results of flow cytometry and cytogenetics with the initial diagnosis performed by the oncologist. Materials and Methods: 115 patients with myeloid disorders, 57.2% males and 42.8% females with a mean age of 50.3 years, previously diagnosed by an oncologist based on the clinical features, complete blood count, and peripheral blood smear interpretations, were considered. Moreover, flow cytometry and cytogenetic analysis were implemented on the bone marrow samples. Results: Cytogenetic results showed that 30% of patients with myeloid disorders had abnormal karyotypes. 77% of patients with myelodysplastic syndromes, 65% of acute myeloid leukemia, and 30.7% of chronic myeloid leukaemia indices showed normal karyotypes, and the others resulted in common and uncommon abnormalities, including the translocation (13;17), 92, XXYY, and del (4q). Considering the flow cytometry and karyotype results, the improved diagnoses were made for 41 patients who had not been diagnosed initially. Conclusion: This study showed that, in some cases, an initial diagnosis is inconsistent with the flow cytometry and karyotype analysis results. Also, the flow cytometry results may differ from the karyotype depending on the case. Therefore, combining the results obtained by the cytogenetic investigation, flow cytometry, fluorescence in situ hybridization, and molecular testing is preferable to provide a comprehensive report for the appropriate disease diagnosis and prognosis.

166-172

Authors: Tahereh Mikaeili Galeh , Maryam Nakhaei , Ahmad Daryani , Shahabeddin Sarvi , Seyed Abdollah Hosseini , Shirzad Gholami *

Background and Aims: The genus Gongylonema infects the upper digestive tract of birds, mammals, and humans. Livestock parasites, especially in the gastrointestinal tract, have caused irreparable damage, including death, reduced products, and economic losses. The present study aimed to reveal the prevalence and morphological and morphometric study of Gongylonema spp. isolated from the esophagus of slaughtered sheep in Sari, northern Iran. Materials and Methods: Esophagi of 340 sheep were collected from Sari's industrial slaughterhouse during the summer and autumn of 2021 (summer=115, autumn= 225). After longitudinal cutting, the surfaces of the esophageal mucosa were carefully checked under the light. The prevalence of infection was estimated, and the morphometric and morphological characteristics of the isolated worms were investigated using a calibrated light microscope and camera lucida. Results: The prevalence of infection was 7.6% (26 isolates), which was estimated for summer and autumn 12 out of 115 (10.4%) and 14 out of 225 (6.2%), respectively. A comparison of morphological features of nematodes in this study with Gongylonema morphological criteria showed that all of them were Gongylonema pulchrum. Conclusions: In the present study, a moderate gongylonemiasis infection was estimated in the sheep from Sari's industrial slaughterhouse. Morphological examination of the retrieved worms showed characteristic morphologies of Gongylonema pulchrum. To clarify the status of the infection, several morphological and molecular studies should be performed on different types of intermediate and final hosts of the parasite in different parts of the country.

1-6

Authors: Homayoon Bashiri 1,2 M.D., Mahsa Madani 3 M.D., Lotfollah Asgari 2,3 M.D., Arezoo Bozorgomid 1* Ph.D.

Background and Aims: Limited information is available on the frequency of advanced adenomas in diminutive colon polyps. Thus, this study aimed to investigate the pathological characteristics and the frequency of high-grade dysplasia in diminutive colorectal polyps in individuals referred to colonoscopy examination in Kermanshah, Iran. Materials and Methods: Demographics characteristics, location and diameter of the polyp, histological assessment of the polyps, grade, and others were retrieved from colonoscopy reports. Results and Conclusions: During the study period, 250 diminutive colorectal polyps were detected. The histological assessment showed that 36.4% were adenomatous, 32.8% were hyperplastic, and 30.8% were inflammatory polyps. Only two diminutive polyps (0.8%) had high-grade dysplasia, and the frequency of adenocarcinoma in our study was 0.4%. Besides, the frequency of adenomatous polyps was higher in the proximal versus the distal colon. These findings emphasize the urgent need for a colorectal cancer screening plan in the Iranian population to improve therapeutic outcomes.

23-34

Authors: Yasaman Issazadeh 1 M.Sc., Mohadeseh Farnaghizad 1 M.Sc., Sarvenaz Falsafi 2 Ph.D., Hoora Mazaheri 1 Ph.D., Shokoofeh Ghazi 1 Ph.D., Ava Behrouzi 1* Ph.D.

Background and Aims: Hospital infections and their antibiotic resistance have become a global concern recently. One of the most prominent factors in hospital infections is Pseudomonas aeruginosa (P. aeruginosa), which can become resistant to many antibiotics due to its ability to form biofilms. Recently, scientists have tried to replace antibiotic therapy with alternative therapies such as probiotics which can reduce or eliminate the pathogenic bacteria's ability to form biofilms. Therefore, the present study revealed that some genes, such as algD and PpyR, were involved in biofilm formation in P. aeruginosa. Furthermore, the inhibitory effect of the supernatant of lactobacillus agilis on the biofilm formation of P. aeruginosa was evaluated in the current study. Materials and Methods: In this study, the effect of the supernatant of probiotic Lactobacillus agilis on the biofilm formation of P. aeruginosa and also the expression of two genes effective in biofilm formation (algD and PpyR) were investigated. Antibiograms were performed to detect the most resistant bacteria since there is a link between biofilm formation and antibiotic resistance. Further, the effects of probiotics on the expression of PpyR and algD genes were discussed. Results: Results showed that the biofilm formation of P. aeruginosa was significantly reduced in the presence of lactobacillus agilis. Conclusions: According to the current study, it could be concluded that because of antibiotics resistance and their associated mechanisms, probiotics could be used as a replacement for antibiotics in many treatments.

46-56

Authors: Mohammad Shokouhian 1 M.Sc., Hossein Mozdarani 2 Ph.D., Masoud Soleimani 3 Ph.D., Majid Safa 1 Ph.D., Mohammad Reza Rezvany 1, 4, 5* Ph.D.

Background and Aims: The occurrence of single and double-strand breaks of DNA damage is the major obstacle for proliferation under various environmental factors and, if not repaired, can result in many consequences, including mutation, cell death, and others. So, the present study was conducted to evaluate the damage of DNA and the expression status of DNA repair system genes before and after stem cell proliferation. Materials and Methods: The MACS method isolated the umbilical cord blood hematopoietic stem cells (UCB-HSCs). In order to investigate cell death, the study of Annexin V/PI was done by flow cytometry. Comet assay made observation and identification of DNA breaks, and the expression of genes normally involved in the repair of DNA breaks was evaluated by real-time polymerase chain reaction. Results: The average number of stem cells increased by 1.9-fold after three days of proliferation. The apoptotic percentage of cells was negligible (less than 0.2%), and the purity of the CD34+ cells was reduced by about one-third in three days (67%). By examining the expression of DNA repair genes, including KU70, KU80, RAD51, and XRCC1, their increased fold change was not significant. In a microscopic examination of stem cells in the comet assay, there was no significant difference between DNA damage before (1.33% ± 0.31) and after (2.08% ± 0.92) replication. Conclusion: In our investigation, neither DNA damage nor changes in the DNA break repair were observed. However, further studies are required to clarify the DNA break repair by recruiting more UCB-HSCs samples.

67-74

Authors: Erfan Zaker 1, 2 M.Sc., Fateme Zare 3,4 Ph.D., Seyed Hossein Hejazi 5 Ph.D., Hossein Khanahmad 2 MD., Ph.D., Seyed Mehdi Kalantar 1* Ph.D.

Background and Aims: A monoclonal antibody (mAb) can unambiguously identify, quantify, and purify an antigen or particular epitope at a large scale. The superiority of these antibodies lies in their specificity for the antigenic determinant. So, this study aims to prepare mouse mAb-secreting hybridoma against human gamma interferon (IFN-γ) and determine the produced antibody's characters. Materials and Methods: Mouse splenic B lymphocytes immunized with recombinant human IFN-γ were fused with mouse SP2/0 cells. The hybridized cells were selected by hypoxanthine-aminopterin-thymidine and hypoxanthine-thymidine media to obtain monoclonal antibody-producing hybridoma cells. Finally, indirect enzyme-linked immunosorbent assay (ELISA), sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and western blot were used to confirm the creation of antibody-secreting hybridoma cells. Results: mAb against IFN-γ were produced by fusing SP2/0 mouse non-secretory myeloma cell line with the spleen cells of immunized mice. This antibody's indirect ELISA optical density was 2.055 on average, and the desired antibody bands were confirmed in SDS-PAGE compared to Septicol® (commercial antibody). Also, in the western blot, the desired antibody could bind to the antigen. IFN-γ transferred on nitrocellulose membrane. In ELISA and western blot tests, anti-mouse IgG conjugated antibodies were used; therefore, the mAb IgG isotype was taken into consideration. Conclusion: In this study, a mouse mAb was obtained by immunization of Balb/C mice and fusion of spleen cells of these mice with the SP2/0 cells, which can specifically bind to recombinant human IFN-γ and can be used to detect IFN-γ secretion in all types of intracellular infections, including latent tuberculosis.