فصلنامه آزمایشگاه و تشخیص
پیاپی 23 (بهار 1393)

Insulin resistance (IR) is typically defined as decreased sensitivity or responsiveness to metabolic actions of insulin. IR is a central feature of metabolic syndrome and strongly associated with an increased risk of cardiovascular disease and diabetes. Therefore, quantifying of IR is of great importance for epidemiological, clinical and basic studies. There are many methods available for estimation of IR which range from complex techniques down to simple indices. The gold standard method for the determination of IR is the euglycaemic hyperinsulinaemic clamp. The clamp technique is both expensive and complex to undertake and has prompted the use of simple methods, notably the homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI) and biological markers. These indices are useful for use in large population studies where a relatively simple, inexpensive assessment is necessary. However, these tests all suffer from important limitations, including poor precision.

One of the main concern in medicine as a profession is respect for dignity, wishes and needs of health care consumers. In some cases legitimate benefits of some parties are in conflict with the goals of profession. This has obscured the matter and can be the basis for argument about conflict of interest. Despite during recent years, fidelity of health care professionals including medical laboratory staffs has been under the influence of conflict of interest and weakened. Conflict of interest in medical profession occurs when from view point of an impartial observer judgment, decision and actions of professionals are unduly influenced by personal interest. Conflict of interest can be developed in many situations as clinical and health care practice, medical laboratory, biomedical researchers, standardization of treatment, and financial support of researches and literatures which are send for publication. Some cases of financial conflict of interest exist in biomedical ethics and laboratory practice including: Fee splitting, self referring of patient, accept of gift and money for referring patient for researches, lectures or publication of papers about product by payments of the same industry, and so on. There are some different policies and strategies for management of conflict of interest in medical laboratories. Some of these policies are preventive and in the field of ethical legislation and ethical codes. Other policies are used in the case of conflict of interest. Although conflict of interest in medical and laboratory professional is extensive and has considerable outcome but it has not been seriously studied and its management has not been described in our country. Any argument in this case can be helpful and be considered as a way for management. The matter which is discussed in this paper.

Clinical laboratory instruments are very essential in disease diagnosis and therapy. From several years ago until now, many changes are established in maintenance management of these instruments. Generally, it seems assessment of usability criteria as a simple using of the instruments. Cause forming of users, satisfaction. Therefore, This research is aimed to introduce and assess the usability criteria as a new approach in designing and construction of laboratory instruments. This research was a systematic review study that induced at 2013 in school of Allied Medicine, Tehran University of Medical sciences, We could collect the data by new books and articles were available in several search engine like Google Scholar, PubMed, Medline with using clinical laboratory instruments, usability criteria and Assessment, choosing 46 references, as the key words. Discussion & Usability criteria are related to new specification of clinical laboratory instruments just learnability, efficiency, Memorability, errors and users, satisfaction. Assessment of this criteria showed that these criteria are unsatisfied in Iran. But joint of Commission International (JCI) and Quality management system recommend the manufacturersُ to use there criteria in designing and construction of the instruments for improvement of clinical care and laboratory services.

Pre-analytic errors occur in collection, processing and storage of samples. Most of illusory results in coagulation tests due to pre-analytic errors. These errors are very dangerous because the most of coagulation tests are diagnostic evaluation. So, a false positive result causes a healthy person enter to the treatment process or a false negative result causes dis-diagnosis of a disorder. In this review, we examine the effect of pre-analytic errors in results of coagulation tests.

Objective & The HTLV virus known as first human Retrovirus, it’s a member of the Oncoviridea family. The most important feature of this virus is it's limits in geographical spread and Northern part of Razavy Khorasan province is one of the endemic district for HTLV infection. The aim of this study is to survey incidence of HTLV1, 2 in patients who came to Iranian Academic Center for Education, Culture and Research (ACECR)-Mashhad laboratory in Nyshabor. Methods and materials: This descriptive- cross – sectional study was performed on 2118 patients by ELISA method from March 2012 to February 2013. Variables are age and gender. HTLV1, 2 infections were positive in 7.2% (153/2118) of the participants according to the results of enzyme linked immunosorbent assay (ELISA). Infection was significantly associated with age and gender. It seems that HTLV infection is highly endemic in Neyshabour. So, it necessitates special care and awareness especially among women to stop its spreading in community. (With 6.3% of positive infection rate).

Stem cells are primitive cells that can differentiate into cell types including embryonic stem cells, adult stem cells and umbilical cord blood stem cells. These cells divide, regenerate themselves and change to the specialized cells such as neurons, chondrocytes, hepatocytes and osteoblasts. Stem cells are able to treat different disease in the future, such as diabetes, arthritis and spinal cord injury but problems with the host immune response, cancer and infection that must be resolved.