Vol. 6 (2020)

Research/Original Article- Bacteriology


The Mechanism of Resistance in AmpC-Producing Escherichia coli Isolated from Urinary Tract Infections

Alireza Dolatyar Dehkharghani, Setareh Haghighat, Marjan Rahnamaye Farzami, Mohammad Rahbar

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-9 (e6)
https://doi.org/10.22037/amls.v6.32573

Background and Aim: AmpC β-lactamases are capable of hydrolyzing all β-lactams except cefepime and carbapenems. The detection of AmpC-producing Escherichia coli has a high priority in infection management. This research is aimed to investigate the resistant AmpC- generating E. coli isolates and identify their genetic variety.

Methods: In this study, 230 E. coli isolates from patients having urinary tract infection symptoms were investigated in 2017-2018 to assess their susceptibility toward antimicrobial agents. AmpC genes were evaluated by PCR and molecular typing using the 10-loci MLVA method. MLVA images were examined by BioNumerics 6.6 software through the use of the UPGMA algorithms.

Results: The highest frequencies of susceptibility among E. coli isolates were to meropenem 96.08%, piperacillin-tazobactam 90.43%, followed by gentamicin 66.54%, ceftazidime 50%, ciprofloxacin 48.26%, ceftriaxone 41.74%. All E. coli isolates were resistant to amoxicillin-clavulanate. Thirty-eight AmpC-generating E. coli isolates were detected. The most abundant determinant was CIT and EBC, FOX, and DHA had the next ranks, respectively. Six major clusters and a singleton were identified by MLVA.

Conclusion: AmpC-generation ability is an effective feature in the resistance of E. coli isolates and its investigation is of crucial significance in infection management. The major mechanisms of AmpC beta-lactamase vary depending on time and geographical location.

*Corresponding Author: Mohammad Rahbar; Email: rahbar@health.gov.ir

Please cite this article as: Dolatyar Dehkharghani A, Haghighat S, Rahnamaye Farzami M, Rahbar M. The Mechanism of Resistance in AmpC-Producing Escherichia coli Isolated from Urinary Tract Infections. Arch Med Lab Sci. 2020;6:1-9 (e6). https://doi.org/10.22037/amls.v6.32573

Comparison of Reasoner’s 2A Agar and Muller Hinton Agar Media for Microbiological Monitoring of Dialysis Water

Iman Pouladi, Somayeh Delfani, Babak Hadian, Setareh Soroush, Khatereh Anbari, Faranak Rezaei

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-5 (e10)
https://doi.org/10.22037/amls.v6.32905

Background and Aim: Microbiological culture of dialysis water is a routine safety measure. In, Khorramabad laboratories perform these cultures on Muller Hinton Agar (MHA) at 35–378C for 48 h, not on the Reasoner’s 2A agar (R2A agar) at 17–238ºC for 7 days recommended by international standards, the objective of the present study was the comparison of the efficiency of R2A and MHA media in the counting of heterotrophic bacteria in the samples of water collected in dialysis centers from 2 hospitals in Khorramabad, from September to November 2019.

Methods: A total of 165 samples of treated water in dialysis centers were collected aseptically and then transported in ice‑packs to the Department of Medical Microbiology of the Lorestan University of Medical Sciences and the pour plate technique was carried out for the enumerating of heterotrophic bacteria. Finally, bacterial colonies were counted after incubation at 34±2ºC for 48 hours on MHA and 25ºC for 1 week on R2A.

Results: Results showed heterotrophic bacterial counts in R2A were greater than those in MHA in 89% of the samples, so enumeration of heterotrophic bacteria should be carried out in R2A agar associated with longer incubation times, because of the greater sensitivity. The proportion of water samples yielding colony counts ≥200 CFU/mL by R2A -7d was significantly different from the proportion by MHA-48h (p<0.001).

Conclusion: The results proposed using R2A agar combined with relative low culture temperature (20-25°C), and an extended incubation time (7-10 days) is more efficient. However, as the spectrum of bacterial contamination is not similar for dialysis centers and countries, many studies using different media and culture parameters are required to confirm this.

*Corresponding Author: Faranak Rezaei; Email: Rezaei.f@lums.ac.ir

Please cite this article as: Pouladi I, Delfani S, Hadian B, Soroush S, Anbari K, Rezaei F. Comparison of Reasoner’s 2A Agar and Muller Hinton Agar Media for Microbiological Monitoring of Dialysis Water. Arch Med Lab Sci. 2020;6:1-5 (e10). https://doi.org/10.22037/amls.v6.32905

Background and Aim: Urinary tract infections (UTIs) are one of the most common infectious diseases. Although UTI is mostly associated with several members of the family of Enterobacteriaceae, Escherichia coli (E. coli) is the most common pathogen among them. This study aims to determine the prevalence and resistance pattern of ESBL producing E. coli isolated from patients with urinary tract infection in Sari, Iran.

Methods: From December-2016 to June-2017, a hospital-based cross-sectional work was accompanied, and a total of 200 urine samples were cultured on blood agar and MacConkey agar for the identification of etiologic agents. After detection and confirmation of E. coli isolates, susceptibility testing was assessed using the following antibiotics: cefotaxime, ceftazidime, imipenem, nalidixic acid, cefixime, amikacin, ofloxacin, ceftriaxone, cefepime, gentamicin, tobramycin, meropenem, piracetam, and ciprofloxacin with Kirby–Bauer disk-diffusion technique according to the CLSI guidelines. Double-disk synergy (DDS) methods were used for the detection of ESBL-producing strains.

Results: In the current study, 120 urinary isolates of E. coli were detected, which ESBL-producing phenotypes were detected in 55% (n = 66) of the isolates. ESBL producing strains of E. coli showed the highest susceptibility to meropenem (100%) and ofloxacin (96%); and showed the highest rates of resistance to ceftazidime (91%), cefepime (87%), cefotaxime, and ceftriaxone (84%).

Conclusion: Markedly high resistance to third-generation cephalosporins among E. coli strains was found in the current study. Considering the high prevalence of resistance to third-generation cephalosporins in infections caused by organisms producing ESBL, performing comprehensive tests before prescribing antibiotics is essential for the management of infections caused by these strains in community/hospital-acquired UTIs. Furthermore accompanying molecular-based works on ESBL variants will assistance to achieve better results.

*Corresponding Author: Mehrdad Gholami; Email: me.gholami@mazums.ac.ir

Please cite this article as: Ahanjan M, Salehian M, Gholami M. Prevalence and Resistance Pattern of Extended-Spectrum β-Lactamase Producing Escherichia coli Isolated from Patients with Urinary Tract Infection. Arch Med Lab Sci. 2020;6:1-7 (e13). https://doi.org/10.22037/amls.v6.33081

Investigation of Pediatric Brucellosis

Zahra Babaei, Fatemeh Azizi Abi, Susan Rostampur, Iman Pouladi, Faranak Rezaei

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-4 (e15)
https://doi.org/10.22037/amls.v6.30546

Background and Aim: Brucellosis (also known as undulant fever, Mediterranean fever, or Malta fever) is a zoonotic infection transmitted to humans from infected animals (sheep, cattle, goats, pigs, camels, or other animals) by ingestion of food products (such as unpasteurized dairy products) or by contact with tissue or fluids.  This disease occurs on average in 11 to 56 percent of children in endemic regions. Despite being long recognized and controllable, the disease still causes substantial morbidity, affecting especially the young population. The objective of this research was to examine the clinical, laboratory results of childhood brucellosis and brucellosis epidemiological features in patients up to 15 years in the province in Pol-e Dokhtar city, Iran.

Methods The diagnosis of brucellosis was established on the basis of clinical features, and positive results from Serologic evaluation included Wright test and the 2-mercaptoethanol (2ME) test. This information includes medical records of brucellosis patients in the years 2016 to 2019. SPSS software (version 22.0) was used for the data analysis.

Results: Among the patients infected with Brucella, 19 males (70.37%) and 8 females (29.63%) were diagnosed and  11 patients (40.74%) were 5-9 years of age, 10 patients (37%) were 10-15 years of age, and 6 patients (22.26%) were < 5 year of age. Also 27 (100%) patients were from rural regions (the total of affected children) that confirmed direct contact with infected animals in all of them was already established. The most frequent seasons of disease occurrence were summer (33.38%) and winter (29.6%).

Conclusion: Considering that 100% of the infection of children has been seen in those who lived in the village, it requires regular vaccination of livestock and proper training in the field of disease prevention.

*Corresponding Authors: Faranak Rezaei, Email: Rezaei.f@lums.ac.ir; Iman Pouladi, Email: imanpouladi96a@gmail.com

Please cite this article as: Babaei Z, Azizi abi F, Pouladi I, Rezaei F. Investigation of Pediatric Brucellosis in Pol-e Dokhtar city, Iran. Arch Med Lab Sci. 2020;6:1-4 (e14). https://doi.org/10.22037/amls.v6.30546

Research/Original Article- Biochemistry


Background and Aim: Regular exercise training is the principal non-pharmacological method for the prevention and treatment of metabolic syndrome or other obesity-related diseases. We investigated the effects of aerobic training on leptin and cardiovascular risk factors in middle-aged men with metabolic syndrome.

Methods: Twenty-six sedentary middle-aged males with metabolic syndrome aged 40 ± 5 years were randomly assigned to two groups as exercise (aerobic training, n =13) and control (no training, n =13). The exercise programs were performed 3 days a week for 10 weeks at 55-75% of HRmax. Fasting blood samples were taken before and after the training period for measuring serum leptin and triglyceride (TG), total cholesterol (TC), LDL, and HDL as cardiovascular risk factors.

Results: No significant differences were observed between groups concerning anthropometric and clinical markers at baseline (p>0.05). Aerobic intervention resulted in significant decrease in anthropometric markers (abdominal circumference, body mass index, body fat percentage; p < 0.05), serum leptin (p = 0.026), TG (p = 0.001) and HDL (p = 0.032) in exercise group, but significant changes were not found in TC (p = 0.522) and LDL (p = 0.546). There were no changes in all measured variables in the control group.

Conclusion: Based on our finding, it seems that regular aerobic exercise is associated with improved serum leptin and cardiovascular function in patients with metabolic syndrome.

*Corresponding Author: Mojtaba Eizadi; Email: izadimojtaba2006@yahoo.com

Please cite this article as: Naseri Rad R, Eizadi M. Regular Exercise Training as a Principal Non-Pharmacological Method Affects Serum Leptin and Cardiovascular Risk Factors in Men with Metabolic Syndrome. Arch Med Lab Sci. 2020;6:1-8 (e1). https://doi.org/10.22037/amls.v6.31643

The Study of the Protective Effect of Vitamin E and Retinoic Acid on Testicular Tissue in Mice Treated with Cyclophosphamide

Akbar Karimi; Vahideh Behmard; Shima Toghiani, Fatemeh Sadat Moravej

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-8 (e9)
https://doi.org/10.22037/amls.v6.31520

Background and Aim: One of the side effects of anticancer drugs is spermatogenesis disorder. Hence, the evaluation of sperm production after chemotherapy has been the subject of several studies today.

Methods: Adult male albino mice weighing 20±2 g were randomly divided into 5 groups (n = 4);control, cyclophosphamide (12 mg/kg/day), cyclophosphamide and vitamin E (200 mg/kg/day), cyclophosphamide and retinoic acid (500 µL/72h), cyclophosphamide and retinoic acid (250 µL/72h) and vitamin E (100 mg/day). The treatment was continued for 35 days and at the end of the rats was anesthetized and testicular tissue was isolated, weighed, fixed, and stained with hematoxylin-eosin.

Results: A significant decrease (p-value ≤ 0.0001) in the mean diameter of seminal vesicles, epithelial thickness, and index of tubular differentiation was observed in the testis tissue of mice treated with cyclophosphamide compared to the control group. In cyclophosphamide recipients with retinoic acid or vitamin E, parameters significantly increased to the level of the control group (p-value ≤ 0.0001), whereas cyclophosphamide co-administration with retinoic acid and vitamin A had a less tissue-protective effect.

Conclusion: Vitamin E and retinoic acid can offset the adverse effects of cyclophosphamide on spermatogenesis and may be inducers of spermatogenesis, while the combination of these two antioxidants has fewer efficacies.

*Corresponding Author: Fatemeh Sadat Moravej; Email: akbar.karimi@es.isfpnu.ac.ir

Please cite this article as: Karimi A, Behmard V, Toghiani S, Moravej FS. The Study of the Protective Effect of Vitamin E and Retinoic Acid on Testicular Tissue in Mice Treated with Cyclophosphamide. Arch Med Lab Sci. 2020;6:1-8 (e9). https://doi.org/10.22037/amls.v6.31520

Evaluation of Matrix Metalloproteinase 2 and 9 Activity in Patients with Prostate Cancer and Benign Prostate Hyperplasia Compared with Healthy Individuals

Maryam Shojaee, Parisa Mohammadi, Hamed Jafarpour, Somayeh Pouriamehr, Haleh Barmaki, Abbas Khonakdar-Tarsi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e12)
https://doi.org/10.22037/amls.v6.32378

Background and Aim: Prostate cancer (PC) is one of the most prevalent cancers with high mortality and morbidity in men, which can be treated in different ways before the progression and metastasis to distant organs. Destruction of extracellular matrix by matrix metalloproteinase (MMP), particularly by the 2 and 9 subtypes, has an important role in the metastasis of PC. We aimed to assess the activity of MMP 2 and 9 and some related metalloproteinases in PC and with benign prostate hyperplasia (BPH) patients in comparison to healthy individuals.

Methods: In this case-control study, 72 individuals referred to Imam Khomeini hospital (Tehran, Iran), have been divided into 3 groups, including PC, BPH, and healthy control. Age and body mass index (BMI) for all groups have been matched. Venous blood samples were used to assess the enzyme activity by the zymography technique.

Results: The activity of MMP-2 and 9 was significantly higher in PC than BPH and control groups. But there was no difference in the activity of enzymes in patients with PC according to the Gleason score.

Conclusion: The results suggested that MMPs activity can be considered a diagnostic marker for PC. However, further studies are required to establish this concept.

*Corresponding Author: Abbas Khonakdar-Tarsi; Email: a.khonakdar@mazums.ac.ir

Please cite this article as: Shojaee M, Mohammadi P, Jafarpour H, Pouriamehr S, Barmaki H, Khonakdar-Tarsi A. Evaluation of Matrix Metalloproteinase 2 and 9 Activity in Patients with Prostate Cancer and Benign Prostate Hyperplasia Compared with Healthy Individuals. Arch Med Lab Sci. 2020;6:1-6(e12). https://doi.org/10.22037/amls.v6.32378

Association between Bone Marrow Mesenchymal Stem Cell Characterization and Taking Inotropic Drugs in Patients with Severe Left Ventricular Dysfunction After Off-pump Bypass Surgery

Mansour Esmailidehaj, Seyed Jalil Mirhosseini, Zakieh Sadat Sheikhalishahi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e14)
https://doi.org/10.22037/amls.v6.31298

Background and Aim: Left ventricular dysfunction is a frequent complication after coronary artery bypass graft (CABG) and is often treated with inotropic drugs to achieve suitable hemodynamic status. Bone marrow-derived mesenchymal stem cells (BMSCs) have potential effects on cardiac function. In this study, we aimed to identify the predictor role of MSCs in taking inotropic drugs in patients with severe left ventricular dysfunction undergoing CABG.

Methods: The study included 30 patients who underwent off-pump CABG at Afshar Hospital and Seyed Al-Shohada Hospital. For investigating the possible association of BMSCs proliferation rate with taking inotropic drugs, the bone marrow samples aspired from patients' sternum during surgery. MSCs were isolated and counted after 4, 7, and 14 days using trypan-blue color, and then doubling times were calculated.

Results: After cardiac surgery, the number of female patients who take inotropic drugs was significantly higher than men. Our data showed that the BMSCs doubling time in female patients who received inotropic drugs was less than that of male patients who received inotropic drugs (p < 0.05).

Conclusion: Based on this investigation, we concluded that there was a clear relevance between the MSCs' doubling time and the inotropic drug requirements in patients who received inotropic drugs.

*Corresponding Author: Zakieh Sadat Sheikhalishahi; Email: z.sheikhalishahi@gmail.com

Please cite this article as Esmailidehaj M, Mirhosseini S.J, Sheikhalishahi Z.S. Association Between Bone Marrow Mesenchymal Stem Cell Characterization and Taking Inotropic Drugs in Patients with Severe Left Ventricular Dysfunction After Off-pump Bypass Surgery. Arch Med Lab Sci. 2020;6:1-6 (e14). https://doi.org/10.22037/amls.v6.31298

Effects of Pomegranate Juice with and without Aerobic Training on Glycemic Control and Lipid Profile in Women with Type 2 Diabetes

Roya Vaziri Javid, Fahimeh Safizadeh, Mozhdeh Rastegary, Mohsen Nabi Afjadi, Abbas Khonakdar-Tarsi, Zahra Zare, Setareh Zarpour, Fariba Mohammadi Tahroodi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e17)
https://doi.org/10.22037/amls.v6.30381

Background and Aim: Type 2 diabetes is a common metabolic disease, which is associated with obesity and inactivity. Plant-based dietary patterns are recommended for the treatment of type 2 diabetes. On the other hand, the effect of aerobic training on the improvement of type 2 diabetes is also highly emphasized. The purpose of this study was to investigate the effects of 2-months of pomegranate juice consumption with and without aerobic training on the levels of HbA1c, fasting blood glucose (FBG), lipid profile in women with type 2 diabetes.

Methods: In this study, 58 women with type 2 diabetes who were referred to Tehran Lorzadeh clinic were randomly divided into four groups: control, pomegranate juice, aerobic training, combined pomegranate juice with aerobic training. The aerobic training plan consisted of 2-months and three times per week (training time from 20 minutes to 45 minutes). Three days before and after this interventional study, serum levels of FBG, total cholesterol (TC), triacylglyceride (TG), and low-density lipoprotein (LDL) were measured by colorimetric methods.

Results: Results showed that combined pomegranate extract consumption with aerobic exercise training significantly decreased the levels of FBG, HbA1c, and TG in women with type 2 diabetes compared to the control group after the intervention (P<0.01), while TC, LDL-c, and BMI remained unchanged. There was no statistically significant difference in the levels of TC, TG, HbA1c, and FBG in pomegranate extract or aerobic training groups compared to the control group after intervention.

Conclusion: The results of this study indicate that combined pomegranate juice with aerobic training has beneficial effects on type 2 diabetes and could be recommended in their therapeutic program.

*Corresponding Author: Fariba Mohammadi Tahroodi; Email: faribamt93@yahoo.com

Please cite this article as: Vaziri Javid R, Safizadeh F, Rastegary M, Nabi Afjadi M, Khonakdar-Tarsi A, Zare Z, Zarpou S, Mohammadi Tahroodi F. Effects of Pomegranate Juice with and without Aerobic Training on Glycemic Control and Lipid Profile in Women with Type 2 Diabetes. Arch Med Lab Sci. 2020;6.1-6 (e17). https://doi.org/10.22037/amls.v6.30381

Apoptosis Induction with Enhancement of BAX/BCL2 Gene Expression Ratio via Combination Therapy in HT29 Colon Cancer Cells

Roya Bazzaz, Parichehreh Yaghmaei, Siavoush Dastmalchi, Nadereh Rashtchizadeh

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-7 (e21)
https://doi.org/10.22037/amls.v6.33489

Background and Aim: Combination therapy is one of the new strategies that minimize resistance to chemotherapy and reduces drug toxicity. Here, we investigated the effect of combination therapy with 5-Fluorouracil and Gamma Tocopherol on cell survival and BAX/BCL2 gene expression ratio in HT29 colon cancer cells.

Methods: The proliferation of cancer cells was determined via colony formation assay.

BAX/BCL2 ratio was evaluated after incubation with concentrations of 5-Fluorouracil and Gamma Tocopherol via real-time-PCR.

Results: The average number of colonies in the cells treated with 5-Fluorouracil, Gamma Tocopherol and their combination of them was 63±4, 78±3, and 28±2, respectively which significantly decreased in the combination group. In contrast with the control group, the BAX/BCL2 ratio remarkably increased when the cell underwent combinational treatment (p<0.05).

Conclusion: 5-Fluorouracil and Gamma Tocopherol reduced HT 29 cell proliferation. Our results suggest that combination therapy with 5- Fluorouracil and Gamma Tocopherol can be considered as a strategy for induction of apoptosis via increasing the BAX/BCL2 ratio.

*Corresponding Author: Nadereh Rashtchizadeh; Email: rashtchizadeh@rocketmail.com

Please cite this article as: Bazzaz R, Yaghmaei P, Dastmalchi S, Rashtchizadeh N. Apoptosis Induction with Enhancement of BAX/BCL2 Gene Expression Ratio via Combination Therapy in HT29 Colon Cancer Cells. Arch Med Lab Sci. 2020;6:1-7 (e21). https://doi.org/10.22037/amls.v6.33489

Evaluation of 25-hydroxy Vitamin D Serum Levels and Thyroid-related Parameters in Patients with Type 2 Diabetes Mellitus and Healthy People in Shiraz, Iran

Elham Rostami, Vajiheh Najafi; Vahideh Behmard, Mohammad Panji; Fatemeh Sadat Moravej, Sina Dalvand, Amin Namdari, Negar Yavari, Zakieh Sadat Sheikhalishahi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e22)
https://doi.org/10.22037/amls.v6.31301

Background and Aim: The prevalence of type 2 diabetes mellitus (T2DM) is increasing globally. There is increasing evidence in the correlation between altered vitamin D levels, thyroid dysfunction, and T2DM. The goal of this study was to evaluate the association between serum 25-hydroxy vitamin D (25(OH) D), lipid profile, glucose and thyroid-related parameters among patients with T2DM and non-diabetic individuals.

Methods: This case-control study was conducted on 228 individuals (110 type two diabetics and 118 healthy controls). The serum concentration of 25(OH) D was determined by chemiluminescence assay. Photometric methods measured serum levels of fasting blood glucose (FBG), calcium, phosphorous, total Cholesterol (TC), triacylglyceride (TG), high-density lipoprotein (HDL). Low-density lipoprotein (LDL) and VLDL levels were estimated from the Friedewald equation (LDL-C=TCHDL-C–(TG/5)). The Elisa kit measured serum T4 and TSH.

Results: 80% of Patients with T2DM and 71% of healthy individuals were suffering from vitamin D insufficiency. A non-significant relationship between TG (P=0.36), HDL (P=0.33), VLDL (P=0.36), T4 (P=0.56) calcium (P=0.39) and phosphorus (P=0.41) levels were showed in control and diabetic groups.  The levels of FBG (P=0.000), TC (P=0.001), LDL (P=0.004), TSH (P=0.000) were significantly higher, and the levels of 25 (OH) D (P=0.001) was significantly lower in the T2DM group compared to the non-diabetic group.

Conclusion: We revealed that the serum level of 25 (OH) D is lower in patients with T2DM, and the TSH level is significantly higher compared to the non-diabetic group. Thyroid dysfunction and a low level of 25 (OH) D are associated with a high risk of T2DM.

*Corresponding Author: Zakieh Sadat Sheikhalishahi; Email: z.sheikhalishahi@gmail.com

Please cite this article as: Rostami E, Najafi V, Behmard V, Panji M, Moravej FS, Dalvand S, Namdari A, Yavari N, Sheikhalishahi ZS. Evaluation of 25-hydroxy Vitamin D Serum Levels and Thyroid-related Parameters in Patients with Type 2 Diabetes Mellitus and Healthy People in Shiraz, Iran. Arch Med Lab Sci. 2020;6:1-6 (e22). https://doi.org/10.22037/amls.v6.31301

Research/Original Article- Biotechnology


Design and Fabrication of Gold Nanoparticles for Anti-Asthma Drug Delivery

Didar Mehrabi Nasab, Alireza Taheri, Seyyed Shamsadin Athari

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-7 (e4)
https://doi.org/10.22037/amls.v6.32580

Background and Aim: Nanoparticle drug delivery has recently found a special place in medicine and treatment. Different nanoparticles have different capabilities and functions. Gold nanoparticles are one of the most widely used nanoparticles and have many uses in pharmaceuticals and medical purposes, including diagnostic, therapeutic, and imaging methods, and due to their unique characteristics, such as high contact surface area compared to volume. Gold nanoparticles have many advantages over other nanoparticles such as their neutral nature, stability, high diffusion property, non-toxicity, environmental compatibility, optical adjustment. Our goal is to synthesize and characterization gold nanoparticles with specific applications to produce the best delivery system of drugs to the asthmatic lung.

Methods: Turkevich method has been used for the synthesis of gold nanoparticles and approving studies have been done.

Results: The produced GNP has the average diameter 100-200 nm and the Z-average was 137.9 d.nm and in positive charge area. PDI for GNP was 0.358.

Conclusion: In this study, we were able to produce the applicable gold nanoparticles for carrying drugs to asthmatic bronchi. Gold nanoparticles easily reach target cells due to their high dispersion power. Drug side effects are reduced when gold nanoparticles are used in conjunction with the drug for drug delivery purposes.

*Corresponding Authors:

Alireza Taheri, Email: taheri@ilam-iau.ac.ir; Seyyed Shamsadin Athari, Email: ss.athari@zums.ac.ir

Please cite this article as: Mehrabi Nasab D, Taheri A, Athari SS. Design and Fabrication of Gold Nanoparticles for Anti-Asthma Drug Delivery. Arch Med Lab Sci. 2020;6:1-7 (e4). https://doi.org/10.22037/amls.v6.32580

Research/Original Article- Genetics


Prevalence of JAK2 V617F Mutation in Iranian Patients with Myeloproliferative Neoplasms

Mohammad Hamid, Zahra Shahbazi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-7 (e5)
https://doi.org/10.22037/amls.v6.32758

Background and Aim: Multiple lines of evidence have been suggested that JAK2 is likely the main candidate gene responsible for the pathogenesis of myeloproliferative neoplasms. The V617F mutation in the pseudokinase domain of JAK2 protein has been detected in a majority of patients. We aimed to evaluate the frequency of this somatic missense substitution among Iranian patients with myeloproliferative neoplasms.

Methods Peripheral blood samples were collected from patients with myeloproliferative neoplasms across different regions of Iran. The JAK2 V617F mutation was identified by allele-specific PCR. To confirm the PCR results, randomly selected positive and negative samples were sequenced.

Results: Among 72 identified patients, 45 (62.5%) were found to harbor JAK2 V617F. The frequencies of the mutation ranged 100% for primary myelofibrosis, 75% for chronic myelogenous leukemia, 67% for polycythemia vera, 62.5% for myelodysplastic/myeloproliferative neoplasms, and 52% for essential thrombocythemia. Our findings revealed that the mutation was more common among men in comparison with women and the correlation between the mutation and gender was statistically significant (p-value<0.01). Additionally, the presence of JAK2 V617F was associated with older ages (p-value =0.009).

Conclusion: The JAK2 V617F mutation was detected in 62.5% of patients with myeloproliferative neoplasms. We have shown that this single acquired point mutation was presented in at least half of the patients. Hence, it seems that the identification of JAK2 V617F mutation in myeloproliferative neoplasms can be very effective in disease diagnosing and management.

*Corresponding Author: Mohammad Hamid; Email: hamidi@pasteur.ac.ir

Please cite this article as: Hamid M, Shahbaz Z. Prevalence of JAK2 V617F Mutation in Iranian Patients with Myeloproliferative Neoplasms. Arch Med Lab Sci. 2020;6:1-7 (e5). https://doi.org/10.22037/amls.v6.32758

Evaluation and Optimization of Lipofectamine 3000 Reagents for Transient Gene Expression in KYSE-30 Esophagus Cancer Cell Line

Reihaneh Alsadat Mahmoudian, Moein Farshchian, Mohammad Reza Abbaszadegan

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-9 (e8)
https://doi.org/10.22037/amls.v6.31081

Background and Aim: Transfection of DNA/RNA sequence into eukaryotic cells has a major effect on scientific studies. Various methods are used to transfer the DNA/RNA sequence into cells, such as lipid-based carriers as the available and easy procedure. Transfection with cationic lipid liposome is introduced as a simple and efficient procedure for monitoring the DNA/RNA sequence through gene function analysis, including fluorescence imaging RNA and protein expression. This study aimed to investigate the transfection efficiency and cell death through GFP expression in human esophageal squamous cell carcinoma (ESCC) cell line KYSE-30 using Lipofectamine 3000 reagent. Methods: The pCDH-513b plasmid DNA was transfected into KYSE-30 cells using Lipofectamine 3000 in different concentrations of the plasmid DNA and reagent. The transfection efficiency was evaluated by fluorescence microscope and flow cytometry analysis to determine the percentage of GFP-expressing cells. Moreover, the viability and death of transfected KYSE-30 cells were evaluated using a trypan blue exclusion assay. Results: The transfection efficiency of KYSE-30 with Lipofectamine 3000 was increased with higher plasmid DNA concentration and a lower amount of Lipofectamine 3000 reagent. The Optimized concentration of 1.5 µg plasmid DNA and volume of one µl of lipofectamine 3000 reagents were identified for 95% transfection efficiency in the KYSE-30 cell line. The viability and death of transfected cells were 43% and 58% after transfection, respectively. Conclusion: The results indicated that Lipofectamine 3000 might not be suitable for transfection in KYSE-30 cells due to increased cell death.

*Corresponding Author: Mohammad Reza Abbaszadegan; Email: abbaszadeganmr@mums.ac.ir

Please cite this article as: Mahmoudian RA, Farshchian M, Abbaszadegan MR. Evaluation and Optimization of Lipofectamine 3000 Reagents for Transient Gene Expression in KYSE-30 Esophagus Cancer Cell Line. Arch Med Lab Sci. 2019;5(4):1-9. https://doi.org/10.22037/amls.v5i4.31081

Research/Original Article- Immunology


Background and Aim: Atrial fibrillation is the most common arrhythmia after coronary artery bypass grafting (CABG) and occurs in up to 30% of patients with heart failure. Mesenchymal stem cells (MSCs) can regenerate and improve cardiac function after tissue damage and are used in clinical trials. Due to the possible ability of MSCs to improve cardiac functions, in this work, we aimed to examine the probable association of the MSCs proliferation rate with the requirement for antiarrhythmic drugs in patients with severe left ventricular dysfunction after off-pump CABG.

Methods: Bone marrow samples were obtained from the sternum of 30 patients who underwent off-pump CABG at Afshar Hospital and Seyed Al-Shohada Hospital. For calculating MSCs doubling time, the cells were counted after 4, 7, and 14 days using trypan-blue color and a hemocytometer.

Results: There were no significant differences between MSCs' doubling time and the patient's age and gender. The percentage of women patients who require antiarrhythmic medicine was significantly higher than men after surgery. Also, we demonstrated that the BMSCs doubling time in female patients who received antiarrhythmic drugs was less than that of male patients who received antiarrhythmic drugs, but these differences were not significant.

Conclusion: Based on this research, we concluded that women patients who received antiarrhythmic drugs were significantly higher than men, but there was no apparent relevancy between MSCs doubling time and antiarrhythmic drugs requirement in patients with severe left ventricular dysfunction.

*Corresponding Author: Zakieh Sadat Sheikhalishahi; Email: z.sheikhalishahi@gmail.com

Please cite this article as: Esmailidehaj M, Mirhosseini SJ, Sheikhalishahi ZS. Association between Bone Marrow Mesenchymal Stem Cell Characterizations and the Administration of Antiarrhythmic Drugs in Patients with Severe Left Ventricular Dysfunction after Off-Pump Bypass Surgery. Arch Med Lab Sci. 2020;6:1-5 (e2). https://doi.org/10.22037/amls.v6.31297

Research/Original Article- Mycology


The Relationship between Decreased Lung Vital Capacity in Children with Respiratory Asthma Associated with Aspergillus and Candida in North of Iran

Mohsen Ebrahimi, Seyed Ali Aghapour, Susan Zamanpour Ziolaei

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e19)
https://doi.org/10.22037/amls.v6.33170

Background and Aim: Environmental factors play an important role in the development and progression of respiratory diseases. In this regard, the species Aspergillus and Candida fungi are very important environmental factors, which play a prominent role in the development, persistence, and severity of respiratory diseases, especially asthma. The study aimed to investigate the relationship between susceptibility to fungi and lung function in children referred to Deziani Allergy Clinic patients in 2010-2011.

Methods: Children with age less than 12 years (n=40) were volunteered to participate in this case-control research. Two groups of patients susceptible to fungal (20/40) and not susceptible to fungal allergens (20/40) were selected. The groups were age and sex-matched. Demographic data and Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1) and Tiffeneau-Pinelli index was obtained from patient records. Statistical analysis performed by SPSS 16.0 program.

Results: Examination of the lung function variables showed that the mean of FVC in the control group (76.075 liters/s) was higher than the patient group (71.5 liters/s). FEV1 was also higher in the control group than in the patient group (p<0.05). The Tiffeneau-Pinelli index was also higher in the control group than in the patient group (p<0.05).

Conclusion: Allergy to fungi, such as Candida and Aspergillus, decreases lung function in children with asthma, which is directly related to reduce vital capacity in these patients.

*Corresponding Author: Mohsen Ebrahimi; Email: m1355ebrahimi@gmail.com

Please cite this article as: Ebrahimi M, Aghapour SA, Zamanpour Ziolaei S. The Relationship Between Decreased Lung Vital Capacity in Children with Respiratory Asthma Associated with Aspergillus and Candida in North of Iran. Arch Med Lab Sci. 2020;6:1-6 (e19). https://doi.org/10.22037/amls.v6.33170

Research Article- Other


Clinicopathological Characteristics of Gastric Cancer in Iranian Patients Referred to Imam Reza Hospital During 2008 to 2017

Babak Sattartabar, Mahyar Nourian, Esmaeil Samizadeh, Narjes Mehrvar, Hassan Jalaeikhoo, Azim Mehrvar, Shahrokh Iravani

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e18)
https://doi.org/10.22037/amls.v6.33309

Background and Aim: There are a limited number of studies regarding the clinicopathological features of gastric cancer. Here, the clinicopathological features of gastric cancer including tumor type and size, degree of differentiation, tumor operability, and immunohistochemically results of E-cadherin and P53 expression was investigated in Iranian patients.

Methods: This retrospective study was performed on patients who were admitted at Imam Reza Hospital in Tehran-Iran from 2008 to 2017 with a diagnosis of gastric cancer. Required information including age, sex, type of cancer, pathology, and immunohistochemistry (IHC) results and treatment were extracted from the hospital archive.

Results: Out of 264 enrolled patients (with the mean age of 70.03±14.01 years), 180 cases were men. The frequency of intestinal-type, Diffuse-type, lymphoma and GIST tumor were 54.5%, 27.7%, 12.25% and 5.92% respectively. In addition, 67.58% and 13.83% of the tumors were undifferentiated and poorly differentiated respectively.

Surgery was less probable in less differentiated tumors (r=0.582 P=0.001). The surgery rate in GIST, intestinal-type, and Diffuse-type tumors were 100%, 57%, and 14.4%, respectively. IHC results showed that E-cadherin expression was present in 78.6, of which 50.9% were weakly positive (+1). Also, the high expression of P53 was observed in 60.7% of patients.

Conclusion: According to the data, we can conclude that poorly differentiated tumors, decreased expression of E-cadherin, and increased expression of P53 is linked to poor prognosis in Iranian patients with gastric cancer. In this regard, further clinical trials and multicenter studies should be done to evaluate the possible factors for improving the prognosis and survival rates of Iranian patients with gastric cancer.

*Corresponding Author: Shahrokh Iravani; Email: iravanishahrokh@ajaums.ac.ir

Please cite this article as: Sattartabar B, Nourian M, Samizadeh E, Mehrvar N, Jalaeikhoo H, Mehrvar A, Iravani S. Clinicopathological Characteristics of Gastric Cancer in Iranian Patients Referred to Imam Reza Hospital During 2008 to 2017. Arch Med Lab Sci. 2020;6:1-6 (e18). https://doi.org/10.22037/amls.v6.33309

The Effect of Aerobic Training on Parathyroid Hormone and Alkaline Phosphatase as Bone Markers in Men with Mild to Moderate Asthma

Mojtaba Eizadi, Laleh Behboudi, Zohreh Afsharmand

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-9 (e20)
https://doi.org/10.22037/amls.v6.33535

Background and Aim: Inhalation of corticosteroids in patients with asthma is associated with an increased risk of osteoporosis. This study aimed to assess the effect of aerobic training on alkaline phosphatase (ALP), parathyroid hormone (PTH) as bone biomarkers in men with mild to moderate asthma.

Methods: Twenty four sedentary middle-aged men with asthma aged 40±5 years were randomly assigned to two groups as exercise (aerobic training, n=12) and control (no training, n =12). Aerobic training was performed 3 days a week for 12 weeks in the form of running on a flat surface at 60-75% of HRmax. Fasting blood samples were taken before and after the training program for measuring serum ALP and PTH.

Results: There were no statistically significant differences between groups with regard to anthropometrical and bone markers at baseline (p>0.05). Aerobic training resulted in significant increase in ALP (p = 0.023) and PTH (p = 0.016) in exercise individuals. All variables remained unchanged in the control group (p>0.05).

Conclusion: With an emphasis on the increase in ALP and PTH, it is concluded that relatively long-term aerobic exercise is associated with improved bone formation markers in patients with asthma treated with inhaled corticosteroids.

*Corresponding Author: Mojtaba Eizadi; Email: izadim@iau-saveh.ac.ir

Please cite this article as: Eizadi M, Behboudi L, Afsharmand Z. The Effect of Aerobic Training on Parathyroid Hormone and Alkaline Phosphatase as Bone Markers in Men with Mild to Moderate Asthma. Arch Med Lab Sci. 2020;6:1-9 (e20). https://doi.org/10.22037/amls.v6. 33535

Berberine Improves Meat Quality and Carcass Traits in Broilers Challenged with Mycotoxins

Pouyan Malekinezhad, Nazar Afzali, Seyed Homayoun Farhangfar, Arash Omidi, Abbas Mohammadi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-9 (e23)
https://doi.org/10.22037/amls.v6.33330

Background and Aim: Mycotoxin-contaminated feed causes significant concern in poultry production and public health because of serious economic losses and health problems caused by them.  Berberine hydrochloride (Berberine), a natural plant alkaloid derived from Chinese medicine, is characterized by diverse pharmacological effects. This study is designed to evaluate the effects of different levels of Berberine (BBR) on carcass traits and meat quality of broilers fed diets contaminated with Aflatoxin B1 (AFB) and Ochratoxin A (OCT).

Methods: A 42-day floor pen trial was performed with 288 Ross 308 broilers. A randomized design, with 4 replicates of 8 birds each, was conducted with the following 9 treatments: (1) negative control diet with no additives (NC); (2) NC + 2 ppm AFB (positive control AFB; PCAFB); (3) NC + 2 ppm OCT (positive control OCT; PCOCT); (4) PCAFB + 200 mg/kg BBR; (5) PCAFB + 400 mg/kg BBR; (6) PCAFB + 600 mg/kg BBR; (7) PCOCT + 200 mg/kg BBR; (8) PCOCT + 400 mg/kg BBR; and (9) PCOCT + 600 mg/kg BBR. At the end of the experiment, from every group, eight birds were selected, slaughtered, and subjected to analyses. The analyzed parameters carcass and cut yields and meat quality according to water-holding capacity (WHC) and breast level MDA.

Results: Both PCAFB and PCOTA diets decreased carcass relative weight, breast level MDA, and WHC values compared with the NC diet (p<0.05). Meat level of MDA in PCAFB and PCOTA treatments were higher than in the NC treatment (p˂0.05), and supplementation with BBR at multiple levels partially these effects (p˂0.05). The addition of 600 mg/kg BBR to PCAFB diets increased WHC value to levels not different from that in the NC group (p>0.05). Carcass efficiency in PCAFB and PCOTA treatments was lower than in the NC treatment (p˂0.05), and supplementation with BBR at multiple levels partially or fully reversed these effects. The addition of 600 mg/kg BBR to PCAFB diet increased carcass relative weight compared to PCAFB alone (p>0.05).

Conclusion: These data provided supplementation of BBR (600 mg/kg) improves meat quality in broiler fed diet contaminated with mycotoxins.

*Corresponding Author: Nazar Afzali; Email: nafzali@birjand.ac.ir

Please cite this article as: Malekinezhad P, Afzali N, Farhangfar SH, Omidi A, Mohammadi A. Berberine Improves Meat Quality and Carcass Traits in Broilers Challenged with Mycotoxins. Arch Med Lab Sci. 2020;6:1-9 (e23). https://doi.org/10.22037/amls.v6.33330

Review Article


COVID-19 pneumonia signs and symptoms are not specific and it may be similar to other cases of pneumonia caused by other microorganisms such as Mycoplasma pneumonia. This study aimed to investigate the prevalence of M. pneumonia co-infection among patients with COVID-19 by a systematic review and meta-analysis.

Two authors performed the search process independently in Scopus, Web of sciences, and PubMed for studies reporting COVID-19-associated Mycoplasma pneumonia co-infections published in the English language from December 2019 to 1st June 2020. The MeSH terms used in the present review were; “COVID-19”, “co-infection”, “secondary infection”, “2019 novel coronavirus”, “2019-nCoV”, “COVID-19 virus”, “coronavirus disease 2019 virus”, “Mycoplasma pneumoniae”, “M. pneumoniae”, “prevalence”, and “respiratory pathogens”. Data analyzed using Comprehensive Meta-analysis (CMA) software. Heterogeneity among included studies was checked by I2 statistic and the Q2 test. M. pneumonia co-infection was varied between 1 and 40.6% in the included studies. The combined prevalence of M. pneumoniae co-infection among patients with COVID-19 was reported by 17% (95% CI: 7.4–34.3).

Overall, our systematic review and meta-analysis showed a quite high co-infection of M. pneumonia in patients with COVID-19 infection, therefore, routine diagnostic tests are recommended for respiratory pathogens like M. pneumonia, because on-time treatment has a beneficial effect on patient survival. Also, an increasing number of cases of asymptomatic COVID-19 infection, the differentiation and diagnosis of pneumonia caused by COVID-19 from non-COVID-19 pneumonia be considered. It helps avoid unnecessary quarantine and waste of medical resources.

*Corresponding Author: Hakimeh Akbari; Email: akbarih@gerums.ac.ir

Please cite this article as: Akbari H. Prevalence of Mycoplasma pneumonia Coinfection among Patients with COVID-19; a systematic review. Arch Med Lab Sci. 2020;6:1-6 (e3). https://doi.org/10.22037/amls.v6.32399

A Snapshot of Different Types of Under Research Vaccines Against COVID-19: A Review

Milad Zandi, Samira Rashid, Sepideh Nasimzadeh, Behzad Pourhossein, Maryam Fazeli

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-7 (e7)
https://doi.org/10.22037/amls.v6.32379

SARS-CoV-2 as an emerging coronavirus, which first emerged in late 2019 in China causes a respiratory disease called “Coronavirus Disease 2019 (COVID-19)’’. SARS-CoV-2 has since infected more than 26 million people worldwide and caused more than 864000 deaths as of September 04, 2020. The SARS-CoV-2 spike (S) protein consists of two subunits: S1 and S2, which plays a role in binding to cellular receptors and mediating the fusion process between the membranes of the virus and host cells. The S protein has an important role to induce neutralizing-antibody, as well as protective immunity, during SARS-CoV-2 infection. In this review, we focused on different types of the vaccine against COVID-19.

*Corresponding Author: Maryam Fazeli; Email: m.fazeli@umsha.ac.ir

Please cite this article as: Zandi M, Rashid S, Nasimzade S, Pourhossein B, Fazeli M. A Snapshot of Different Types of Under Research Vaccines Against COVID-19: A Review. Arch Med Lab Sci. 2020;6:1-7 (e7). https://doi.org/10.22037/amls.v6.32379

Implementation of Epidemic Restrictions to Disrupt the COVID-19 Pandemic in Iran: A Mini-Review

Amin Talebi Bezmin Abadi, Farid Rahimi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-3 (e11)
https://doi.org/10.22037/amls.v6.32966

The number of cases infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, has been steadily rising globally. Iran, one of the countries with a relatively high number of positive cases, has an inevitable role to play in controlling the pandemic by implementing effective policies and countermeasures to interrupt the viral transmission chain. Epidemic restrictions implemented following an Iranian presidential mandate were especially effective following the Nowruz holidays—the solar New Year celebration in the Persian-speaking culture. These restrictions started flattening the incidence curve of the epidemic in Iran two weeks after implementation, from 10 April 2020. Supplying sufficient face masks, disinfectants, sanitizers, and medical equipment to all government-run and non-for-profit hospitals were included in the presidential mandate. We believe that continuing this policy strictly will be required for further controlling the pandemic throughout the country.

*Corresponding Author: Amin Talebi Bezmin Abadi; Email: amin.talebi@modares.ac.ir

Please cite this article as: Talebi Bezmin Abadi A, Rahimi F. Implementation of Epidemic Restrictions to Disrupt the COVID-19 Pandemic in Iran: A Mini-Review. Arch Med Lab Sci. 2020;6:e11. https://doi.org/10.22037/amls.v6.32966

Evaluating Extracorporeal Membrane Oxygenation and Ventilation Treatment of Patients with COVID-19: A Review

Habib Hybar, Azin Samimi, Mahmood Maniati, Javad Jodat, Zahra Gatavizadeh

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-6 (e16)
https://doi.org/10.22037/amls.v6.33550

The prevalence of COVID-19 in the world is rapidly increasing. Although some patients show mild symptoms of the virus, some others need special care due to the exacerbation of the disease. Therefore, invasive treatments are needed to treat these patients. Data were collected from PubMed and Google scholars at various time points up to the 2020 academic year. The related keywords are listed as follows: "COVID-19", "Treatment", "Pathogenesis", and "Lung disorder". Studies have shown that although the use of ECMO and ventilation can provide oxygen to patients and improve their clinical status; these procedures can lead to the activation of inflammatory responses and the activation of the renin-angiotensin system. Inflammation and activation of the renin-angiotensin system are among the weak prognoses for COVID-19-infected patients. ECMO and ventilation treatment procedures are like double-edged swords, and monitoring patients during treatment is essential to prevent renin-angiotensin activation.

*Corresponding Author: Zahra Gatavizadeh; Email: z-gatavizadeh@ajums.ac.ir

Please cite this article as: Hybar H, Samimi A, Maniati M, Jodat J, Gatavizadeh Z. Evaluating Extracorporeal Membrane Oxygenation and Ventilation Treatment of Patients with COVID-19: A Review. Arch Med Lab Sci. 2020;6:1-6 (e16). https://doi.org/10.22037/amls.v6.33550

Change in Attitude in Renal Function in Major Beta Thalassemia

Majid Malaki, Malihe Najafpour, Mehdi Talebi, Ako Azimi

Archives of Medical Laboratory Sciences, Vol. 6 (2020), 20 January 2020, Page 1-5 (e24)
https://doi.org/10.22037/amls.v6.33057

Thalassemia is a multisystemic disease in the field of hemolysis and chronic anemia caused by the erythropoietic disorder. The severe effects of iron overload from continuous blood transfusion iron chelators side effects, and involvement of multiple organs in thalassemias such as heart failure, liver, and endocrine dysfunction can all affect kidney function. Although there has been much debate about changes in renal function in thalassemia for many years, the presence of hyperfiltration and ultimately, decreased renal function in almost all studies. It seems for the researchers to look beyond kidney function in a thalassemia perspective, because of secretory biomarkers of proximal tubular renal cells that are sensitive to pathologic agents, which may be a good indicator of the courses of treatment and prognosis of patients. Future studies will be sooner or later.

*Corresponding Author: Malihe Najafpour; Email: malihe_najafpour@modares.ac.ir

Please cite this article as: Malaki M, Najafpour M, Talebi M, Azimi A. Change in Attitude in Renal Function in Major Beta Thalassemia. Arch Med Lab Sci. 2020;6:1-5 (e24). https://doi.org/10.22037/amls.v6.33057