فهرست مطالب

فصلنامه آزمایشگاه و تشخیص
پیاپی 21 (پاییز 1392)

بهای روی جلد: 40,000ريال
تاریخ انتشار: 1392/09/20
تعداد عناوین: 12

فارسی
English

انتخاب همه

Laboratory errors that give clues to diagnosis of hematological diseases

Dr. Habiballah Golafshan, Mr. Reza Ranjbaran Page 5

It is interesting that some errors in hematology laboratory can give sign and clue to disease diagnosis: in this review we have gathered some of these common errors. For example: lymphocytosis in association with smudged cell can be helpful in diagnosis of chronic lymphocytic leukemia. Smudged cell is a lab artifact that is produced by spreader pressure during smear preparation. Extreme false thrombocytosis in presence of microcytic and hypochromic anemia strongly suggest hemoglobin H disease. The platelet satellitism that is an in vitro phenomenon, is sometimes accompanied with antiphospholipid syndrome. Turbidity of drabkin solution in hemoglobin measurement can lead to suspecious of hemoglobinopathies.
Keywords: errors, hematology laboratory

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Clinical laboratories as high reliability organizations: is it possible?

Dr. Hosein Dargahi Ghazaleh Sadat Tehrani Page 11

High Reliable Organizations (HROs) as a paradigm is essential for establishment of health care system with decreased of human errors and increased of safety. Clinical laboratories as a component of healthcare system should think about the induction of HRO as a new structure. This research is an article review which aimed to introduce the nature and goals of HRO among a clinical laboratory. We studied 118 references from Google, Google Scholar, Scopous, PubMed, Springer, Web of Science, Cochrane Library by high reliability organization, clinical laboratory, patient safety and human error key words and selected 43 references. Clinical laboratories as HRO should highly pay attention to increased quality and empowerment on knowledge and learning of their staffs and have a sense of commitment to human errors and probable accidents. There are several factors for attainment of HRO goals such as commitment to resilience, reluctance to simplify interpretations, sensitivity to operations, preoccupation with failure, and deference to expertise. The high reliability theory is not a prescription of road map for success. But it is in their infancy for medicine and health care system. HRO is a tool through which healthcare organizations can better understand how safe and reliable performance.
Keywords: High reliability organization, Clinical laboratories, Patient safety, Human errors

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The Effect of Audit and training on Standardization of Medical Laboratories

Dr. Mahmoud Javid, Dr. Roya Savadi, Dr. Mohammadreza Hamzeh, Dr. Shahram Shaghayegh Masoumeh Heydarian Page 19

Maintenance of standard principles in medical laboratories results in ensuring quality of output processes and reporting accurate test results. The aim of this study was to examine the effect of training and audit on establishing standardization in medical laboratories. To achieve this goal, the states of observing standards as "quality control, safety requirements, space, utilities, and documentation principles" in the medical laboratories after and before providing training programs and audit s were compared with each other.
Methodology
Using a standardized checklist of Health Reference Laboratory and also respecting "preliminary audit results and needs assessment of employee training", monthly training programs for the staff of the medical laboratory were designed and also regular audits of lab management in the Social Security of Chaharmahal va Bakhtiari was carried out. The results of the compliance plan during the 18-month period of the study began in (2012) were recorded.
Results
The results of the study showed that although training, per se, is helpful, mostly they indicated no existence of its significance in establishment of standardization. Conducting planned audit after training programs showed significant difference as for standardization.
Conclusions
Training along with auditing standards has an apparent impact on medical laboratories, but this important issue is not realized unless senior managers support the plan and changes in staff's approaches to standardization happen.
Keywords: Training, Audit, Standardization, Medical

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Importance of Avidity IgG for differentiation of Acute Toxoplasma gondi infection

Dr Mohammad Reza Bonyadi Shahindokht Pouzesh Page 27

Objective
Toxoplasmosis has been well known as an important human infection to consider especially in pregnant women. Although many serologic methods are available, the diagnosis of early toxoplasmosis can be extremely difficult. The aim of this study is detecting Toxoplasma IgG antibodies developed at early stage of infection in pregnant women.
Method
225 pregnant womens who were in 2-4 months of their pregnancy, enrolled in this study. They were categorized into three groups. Anti toxoplasma IgG, IgM and IgG Avidity were evaluated by ELISA method.
Results
Group A: 124 case (IgG+, IgM+) (55.1 percent), group B: 99 case (44percent)(IgG+,IgM-), and group C: 2 case (0.9 percent)(IgG -, IgM +). Fifty five percent of the pregnant women had positive IgG and IgM among whom 7.1 percent had low avidity that reveals the active infection in the pregnant women.In the current study 44 percent of the pregnant women had positive IgG and negative IgM that all had high avidity which indicates that in our society the level of toxoplasma infection is high and women have contact with this parasite before pregnancy.
Conclusion
In this study the low avidity was 7.1 percent which shows that in different societies, the occurrence of toxoplasma infection is still a serious issue. Observation of 45.8 percent high avidity among group A suggests that either IgM has a high half-life or the false existence of IgM in Rheumatologic disorders makes it positive falsely. Therefore, avidity test has a high value and by a timely differential diagnosis of active toxoplasma infection, it would be cured.

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Advertising in medical laboratory

Dr Majid Reza Khalajzadeh Page 31

Advertising in healthcare and medicine is usually accompanied with ethical issues, so far as it makes challenging professional problems. There are many advertisements about medical laboratories, healthcare services and medical centers in public media including TV, journals and websites every day. Here is a question that, what is the aim and role of advertising in health care services especially medical labs? and how can we get them? Medicine as a profession by considering human dignity, patients wishes and benefits has attained valuable position. Most medical professional associations have prohibited advertising as unprofessional and undignified in virtually all countries. In some countries advertising based on market economy is promoted to decrease the cost of medical services, whereas some other countries have limited advertising. In IRAN according to the enacted laws & regulations I.R.I Medical Council is responsible to permit a license for medical advertising. Reviewing laboratory advertisements shows some ethical and legal issues such as: inattention and disregarding of patient and professional beneficence, no licensure, insufficient information about regulations, supervision.
Keywords: Laboratory, Ethics, Rules

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Campylobacter Jejuni

Dr. Alireza Pourreza Page 37

Diarrheal disease is the second leading cause of death in children under five years old in the world. In developing countries such as Iran, children under three years old experience on average three episode of diarrhea every year. Diarrhea is usually a symptom of an infection in the intestinal tract which can be caused by variety of bacterial, viral, and parasitic organism. Campylobacter one of the most common cause of human bacterial gastrointestinal disease, accounting for 5-7 % of caused gastrointestinitis. The large numbers of campylobacter infections were missed by laboratories, because there is no enough cultural facility for detection of campylobacter sp. In this issue you study a case report and in the following suggested that a simple direct gram stain of stool may be very useful to diagnosis Campylobacter infection.

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