Showing 7 results for Laboratory
H. Zahedi, V. Akhyani, Z. Hussain Khan, M. Yunesian,
Volume 64, Issue 3 (5-2006)
Abstract
Background: Hyperglycemia is a metabolic response to surgical stress. In this study, patients’ blood glucose changes were measured before, during and after elective eye surgeries under general anesthesia, with two methods: glucometer and glucose oxidase enzyme lab assay. Probable influencing factors and the correlation rate of these two methods were evaluated.
Methods: This analytic cross – sectional original study was performed on 230 American Society of Anesthesiologists (ASA) Class 1or 2 non–diabetic patients. All the patients underwent a similar general anesthesia and their blood glucose levels were measured simultaneously with two cited methods on three occasions.
Results: In all cases, post-surgery blood glucose in comparison to pre-surgery levels increased significantly in both methods irrespective of independent variables of the study. Considering these independent variables, increase in blood glucose levels was significant in most of the patients. The mean increase in blood glucose post-surgery in comparison to pre–surgery, measured with lab assay, had significant statistical correlation with the type of eye surgery but not with other variables like age, gender and duration of surgery. Correlation of the two methods were also partially significant statistically.
Conclusion: Considering the results of this study and the fact that blood glucose changes under general anesthesia is usually unrecognized clinically, we recommend blood glucose measurement in non–diabetic patients during long surgeries. It is advantageous to use Accu–chek (Sensor model) glucometer for this purpose.
Jafari S, Soltanpour F, Soudbakhsh A, Safavi E, Rokni Yazdi H, Navipour R, Hajizadeh E,
Volume 64, Issue 8 (8-2006)
Abstract
Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias.
Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist.
Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years) and 38 young (group II, age<65years) subjects. Delirium was seen more in elderly group (p=0.05). The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02). Smoking (29.1%), neurological disturbances (19%), congestive heart failure (15.2%), chronic obstructive pulmonary disease and diabetes mellitus (13.9%) were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients.
Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.
Dargahi H, Rezaian M,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Quality assurance is a prevention-oriented system that can be used to
improve the quality of care, increase productivity and monitor the performance
management in clinical laboratories. ISO 9001: 2000 requirements are a collection of
management and technical systems designed to implement quality assurance and monitor
performance management in organizations.
Methods: A checklist was prepared to monitor the preanalytical, analytical and
postanalytical stages of laboratory performance management in 16 areas and all
laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical
Sciences (TUMS) hospitals. Collected data were stored and statistically analyzed using
SPSS software.
Results: The best performance, in which 77.73% of quality assurance indicators were
observed, was found in Sina Hospital. However, only 57.56% of these indicators were
fulfilled at Farabi Hospital, with the lowest-level performance among the clinical
laboratories of TUMS hospitals. The highest level of compliance with quality assurance
indicators was in the hematology departments and for facility demands in management
areas. Overall, quality assurance indicators were appropriately followed in only 7% of the
clinical laboratories.
Conclusion: The average quality assurance observation rate in the clinical laboratories
studied was 67.22%, which is insufficient and must be remedied with stricter
enforcement of the ISO 9001: 2000 regulations.
Eini P, Esna-Ashari F, Mobaien Ar, Hasanzadeh M,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Brucellosis is one of the most common infectious diseases in Iran with very different clinical manifestations.
Methods: In this retrospective descriptive study, all patients with brucellosis, who were admitted in Farshchian Hospital in Hamadan, Iran in 2005 to 2010, were enrolled in the study. The data were collected from the patients' medical records and were entered in forms for analysis.
Results: A total of 230 patients with brucellosis, including 130 (56.5%) male and 100 (43.5%) female patients with a mean age of 40.84±20.29 years, who mostly (72.2%) lived in rural areas were enrolled in the study. Outbreaks were most common in spring and summer and the main route of transmission was consumption of contaminated dairy products (60.3%). The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). Arthritis and epididymo- orchitis were seen in 121 (52.9%) and 48 (8.20%) patients, respectively. CBC analysis showed leukocytosis in 20.8% of the participants. ESR rise was noted in 59.5% of the patients and 52.9% had positive CRP.
Conclusion: Given to various clinical presentations, brucellosis should be considered in the differential diagnosis of individuals with chronic fever with or without other organ abnormalities.
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Hanieh Sharifian , Zahra Mollabashi ,
Volume 75, Issue 7 (10-2017)
Abstract
Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound) and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore) in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.
Ahmad Shalbaf , Nasrin Amini, Hadi Choubdar, Mahdi Mahdavi, Atefeh Abedini, Reza Lashgari,
Volume 79, Issue 12 (3-2022)
Abstract
Background: Early prediction of the outcome situation of COVID-19 patients can decrease mortality risk by assuring efficient resource allocation and treatment planning. This study introduces a very accurate and fast system for the prediction of COVID-19 outcomes using demographic, vital signs, and laboratory blood test data.
Methods: In this analytic study, which is done from May 2020 to June 2021 in Tehran, 41 features of 244 COVID-19 patients were recorded on the first day of admission to the Masih Daneshvari Hospital. These features were categorized into eight different groups, demographic and patient history features, vital signs, and six different groups of laboratory blood tests including complete blood count (CBC), coagulation, kidney, liver, blood gas, and general. In this study, first, the significance of each of the extracted features and then the eight groups of features for prediction of mortality outcomes were considered, separately. Finally, the best combination of different groups of features was assessed. The statistical methods including the area under the receiver operating characteristic curve (AUC-ROC) based on binary Logistic Regression classification algorithm were used for evaluation.
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Results: The results revealed that red cell distribution width (RDW), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV) in CBC features have the highest AUC with values of 85.29, 80.96, 79.94 and 79.70, respectively. Then, blood oxygen saturation level (SPO2) in vital features has a higher AUC with a value of 79.28. Moreover, combinations of features in the CBC group have the highest AUC with a value of 95.57. Then, coagulation and vital signs groups have the highest AUC with values of 85.20 and 83.84, respectively. Finally, triple combinations of features in CBC, vital signs, and coagulation groups have the highest AUC with the value of 96.54.
Conclusion: Our proposed system can be used as an assistant acceptable tool for triage of COVID-19 patients to determine which patient will have a higher risk for hospitalization and intensive care in medical environments.
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Mohammad Hossein Kalami , Zeinab Borjian Boroujeni , Peghah Ardi, Ahmad Abolfathi, Mohsen Babaei, Ali Asadi, Mahdi Zareei,
Volume 81, Issue 1 (4-2023)
Abstract
Background: Medical Laboratories have a great impact on patient safety and 80-90% of medical diagnoses are based on the results of laboratory tests. Medical procedures from the initial diagnostic steps such as a test or a simple injection to specialized treatment steps may be erroneous. The aim of this study was to determine the type and rate of human error, equipment, materials and procedures in all stages including before analysis, during analysis and after analysis to analyze the causes and find logical solutions to reduce of them.
Methods: This cross-sectional descriptive study was performed in a medical center in Tehran, Iran during the years 1400-1401. Data collection was considered in accordance with the instructions of the Laboratory Affairs Department of the Ministry of Health and Medical Education regarding the type of errors in the field of job description in each of the technical and non-technical sections. Data was analyzed by IBM SPSS software, version 22 (SPSS Inc., Chicago, IL, USA) software.
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Results: During the period of study, the number of referred patients was about 45,000 and the number of tests 594,000. The total number of errors was 837. The ratio of errors to the patients was 1.9% and to the tests 0.15%. The 37 types of errors were identified and reported in this study. Of these, 11 types of errors were in the pre-analysis, 14 types during the analysis and 12 types of errors in the post-analysis stage. The frequency of errors in the three stages was 180(21.5%), 312(37.3%) and 345(41.2%), respectively that the errors rate did not have a normal distribution and a significant difference was observed (P<0.05, df=2).
Conclusion: Due to the variety of reported errors and the importance of their role in other stages of diagnosis and treatment, it is necessary that all human, equipment and process errors in all stages of laboratory analysis be carefully recorded and corrective and preventive measures be taken to minimize them.
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