Massoud Hajia
Abstract
Clinical databases have been developed in recent years especially during the course of all medical concerns including laboratory results. The information produced by the diagnostic laboratories have great impact on health care system with various secondary uses. These uses are sometimes as publishing ...
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Clinical databases have been developed in recent years especially during the course of all medical concerns including laboratory results. The information produced by the diagnostic laboratories have great impact on health care system with various secondary uses. These uses are sometimes as publishing new extracted information of laboratory reports which have been widely applied in the scientific journals. Nowadays, some large scale or national databases are also formed from the integration of these data from smaller centers in the field of human health in many countries. These databases are beneficial for different stakeholders who may need these information. Unfortunately, reviewing some of these uses has indicated lots of errors in quality control, test validity, uniformity and so on. More importantly, some of the diagnostic procedures have been applied in the clinical diagnostic laboratories without even preliminary clinical evaluation studies. Therefore, any taken conclusion from these analyzed data may not be reliable. This use requires checking the several specifications that have been notified in this study. Current review also intends to show how the correct information should be to extract for the scientific reports, or integrated in large scale databases.
Massoud Hajia; Amir Sohrabi
Abstract
Clinical manifestations of the brucellosis may show extensive appearance because of its wide signs and symptoms. Patients with brucellosis are usually symptomatically treated by using different antibiotics at private clinics due to misdiagnosis of clinical laboratory findings specially those chronic ...
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Clinical manifestations of the brucellosis may show extensive appearance because of its wide signs and symptoms. Patients with brucellosis are usually symptomatically treated by using different antibiotics at private clinics due to misdiagnosis of clinical laboratory findings specially those chronic forms. These subjects will have been hospitalized with a complicated form of signs after changing a few therapies (1). At this time, classical methods such as culture based and serological procedures could not alone meet of clinicians’ demands. Many researchers have been being tried to introduce an alternative method better in accuracy, reliability and efficiency aspects. However, most reported comparison studies were not able to present desired results. There are not any significant points in existence of various and even contradictory results in laboratory interpretation reports. Those patients with recent brucellosis involvement or acute disease are better diagnosed than those hospitalized or chronic cases. Unfortunately, it is being observed the most researchers are not attending the patient clinical infectious form. Obviously, in-patients have more problematical conditions that results to have lower sensitivity rate in some test or even different from each other. Unfortunately, this concern has not been noticed in the majority of molecular epidemiology studies. Analyzed results of various tests are not fully in agreement with each other in these reports, confirming each test is better suited for some specific clinical conditions (2). Another important problem is applying home brew protocols in all comparative studies. This type of non-commercial diagnostic protocol are being surprisingly applied in most small Iranian clinical laboratories. These assays have been being followed from some reported papers without any proper optimization experiments or exact clinical trial specifically for Iranian populations, particularly when several of the effective parameters in the optimization may not be well reflected in these released reports. Some of them for proper optimization and standardization are mentioned in other studies (3). Proper selecting sampling is additional problems. Serum specimens would not be preferred samples since Brucella spp. agents are intracellular which is integrated in PMN cells. Serum specimens may give positive results, but in those has high antibody titer or acute cases. Although it is used as applied specimens instead of peripheral anti-coagulated blood (4). The chance of the recovery Brucella spp. DNA is obviously reduced in those chronic and complicated subjects. In addition, sampling from patients undergoing treatment may have low positive predictive value results (5,6). It would seem international approved extraction method accompanied with internal control as control the DNA isolation procedure and to check for possible PCR inhibition should be used in molecular diagnostic settings (4,7). Finally the last point, various pathogenic Brucella species involve in many countries. At present, we have no significant documentary reports in frequency rate of Brucella spp. in our community. Some reports represent considerable rate for B. abortus while some not. Therefore, applied protocol must be enough sensitive to detect and even differentiate at least B. abortus from B. melitensis, although some reports illustrate the presence of B. canis as well as in Iran (8).
Amir Sohrabi; Massoud Hajia
Abstract
Background: The accuracy of diagnostic assays in Human Papillomavirus (HPV) genital infection and cervical cancer has remained a clinical challenge in diagnosis. Evidence indicates that a large proportion of cervical cancer can be prevented through organized care for HPV and testing. Countries ...
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Background: The accuracy of diagnostic assays in Human Papillomavirus (HPV) genital infection and cervical cancer has remained a clinical challenge in diagnosis. Evidence indicates that a large proportion of cervical cancer can be prevented through organized care for HPV and testing. Countries with low per capita income, such as Iran and its neighbours, have no national organized program for cervical cancer screening and vaccination. The aim of this study was to review recent published papers in this region for evaluating the efficacy of released data regarding HPV genotyping system in genital infections and cervical cancer Methods: Investigating various medical search engines retrieved 46 reports, mostly after 2010, consisting of either home brew protocols or commercial technologies in this field. Results: Summarized results demonstrated that except a few cases, all reports were limited studies performed in confined populations focusing on attending patients at clinics for regular checkups. In the present study, 52.8% of papers were from Iran and the rest belonged to other countries. The rate of HPV infection was reported in the range of 0.62% to 25% in the normal population, while it varied from 18.75% to 100% in females with cervical cancer. In HPV genotyping surveys, only 26.1 % (12/46) of reports had validated and World Health Organization (WHO) proficient procedures. Also, multiple infections were not mentioned in 56.52% (25/46) of researches. Conclusions: Employing reliable genotyping methods is the best way for regular screening of cervical cancer related to HPV and precancerous diseases in females of these areas. The focus of most surveys was to come up with the best national policies for establishing a preventive program in Iran and Persian Gulf area.
Microbiology
Massoud Hajia; Ali Akbar Amirzargar; Mina Nazari; Neda Razavi Davodi; Morteza Karami Zarandi
Abstract
Background: Tuberculous meningitis (TBM) is a severe form of extra pulmonary tuberculosis with high mortality and morbidity rate in all age group patients specific in adults and children. The incidence and prevalence are not exactly known in Iran. In this study, we tried to evaluate the role of rapid ...
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Background: Tuberculous meningitis (TBM) is a severe form of extra pulmonary tuberculosis with high mortality and morbidity rate in all age group patients specific in adults and children. The incidence and prevalence are not exactly known in Iran. In this study, we tried to evaluate the role of rapid diagnosis and to find out the highest risk group patients.
Methods:Totally, 1783-suspected patients with tuberculous meningitis whose CSF specimens were admitted at Noor Pathobiology Laboratory, Tehran, Iran were enrolled in this study from January 2009 until December 2013.All specimens were checked for MTB by direct examination, culture and PCR tests, andfor the adenosine deaminase (ADA).
Results:Confirmed positive cases were aged from 13 to 82 yr old with mean age 46.63 yr (SD±18.84). The number of diagnosed positive MTB was different by the 3 applied protocol, 64 by PCR, 28 by culture and 33 by direct examination. Considering the result of PCR protocol theTBM was approved in 64 patients with rate of 3.59%. Two patients had other infection as well, one 56 years old with VZV and the other patient who was HIV positive was 27 years old. Increased ADA titer higher than cutoff was relevant with other results of positive samples except in two cases.
Conclusion:Analysis of the results proved adults are more at risk for tuberculous meningitis than children in Iran are. It is also confirmed PCR method provide the most efficient, rapid and reliable results for these patients who are at the critical situations.
Mohammad Rahbar; Massoud Hajia; Mona Mohammadzadeh
Volume 7, Issue 1 , January 2012, , Pages 32-37
Abstract
Background and Objective: Early diagnosis of Streptococcus agalactiae remains difficult, since symptoms are very nonspecific. Its frequency has not been completely investigated in urinary tract pathogen of pregnant ant and non pregnant women in Iran. The aim of this study was determining the frequency ...
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Background and Objective: Early diagnosis of Streptococcus agalactiae remains difficult, since symptoms are very nonspecific. Its frequency has not been completely investigated in urinary tract pathogen of pregnant ant and non pregnant women in Iran. The aim of this study was determining the frequency of Group B Streptococci in female patients.
Materials and Methods: A Total of 11800 urine specimens were received from female out-patients admitted during June till December 2010. Group B Streptococci isolates were confirmed by typical colony morphology, and identified by differential tests as well as by the growth characteristics in chromoagar. A provisional urinary tract infection diagnosis was defined by the presence of single group B Streptococci (>10 CFU/liter) with at least one of urinary tract infection symptom. Susceptibility testing was carried out by disk diffusion method.
Results: Of all specimens 498 specimens (4.22%) yielded significant bacteriuria caused by group B Streptococci. The mean age of these patients were 26.6 + 19.37. Pregnant patients were 3.82% and the rest were non-pregnant. Antibiotic susceptibility test revealed that vancomycin, clindamycin and cefazolin had the lowest and penicillin showed the highest resistant rate.
Conclusion: Pattern onantibiotic susceptibility test showed high resistant rate to some antibiotic that made it difficult for pregnant patients, although its frequency was low. It was not possible to compare the antibiotic susceptibility pattern of pregnant women with non-pregnant because of the low number of pregnant women registered in this study.
Massoud Hajia; Abbas Mahmoodzadeh; Hassan Morovati
Volume 3, Issue 4 , September 2008, , Pages 197-202
Abstract
Background and Objective: Pneumocystis pneumonia (PCP) has been historically the most prevalent opportunisticinfection in patients infected with the human immunodeficiencyvirus. Culture of the organism has not been faced with suitable success in artificial media, while various results have been ...
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Background and Objective: Pneumocystis pneumonia (PCP) has been historically the most prevalent opportunisticinfection in patients infected with the human immunodeficiencyvirus. Culture of the organism has not been faced with suitable success in artificial media, while various results have been reported for cell culture media. The aim of this study was proliferation of Pneumocystis carinii on the Razi Bovine Kidney (RBK) cell line and to compare growth rate with ‘Vero’ and ‘MRC-5’ cell lines. Materials and Methods: We used 6 rats (Sprague-Dawley) provided from Razi Institute to infect with Pneumocystis carinii after suppressing the immune system with methylprednisolone acetate (40 mg/kg). Methylprednisolone acetate was used subcutaneously once a week for 8 weeks. Samples were homogenized after separation of the lung tissue. Microscopic examination was applied for prepared smears to confirm the presence of Pneumocystis carinii. Purified trophozoites were then inoculated into the cell line flasks. Growth rate was estimated by counting the trophozoite in each day. Results: Number of cultivated organisms was increased after 5 days incubation in all applied cell lines. Growth rate of Vero, MRC-5 and RBK were 3, 3, and 3.75 times more respectively in comparison with number of the calculated cells in first day. Hence the difference between RBK and two other cell lines was significant (p = 0.023). Conclusion: RBK cell line is suitable to proliferate Pneumocystis carinii.