Medical Laboratory Journal

Epidemiological and Geographical Features of Cutaneous Leishmaniasis in Southwestern Khuzestan

Ali Jamshidi

Background: Cutaneous leishmaniasis (CL) is a protozoan infection caused by a flagellated parasite complex known as Leishmania spp. Iran is an endemic area for CL. The present study aimed to investigate the epidemiological factors and geographical distribution of CL in Southwestern Khuzestan using the GIS method.

Methods: In this cross-sectional study, epidemiologic and demographic data from 787 individuals affected by CL in Behbahan County, spanning the years 2002 to 2021, were collected. Patient locations were plotted on a point shapefile of villages, towns, and cities in Behbahan County, and geographic data were analyzed using ArcGIS version 10.

Results: Out of the 787 studied cases, 512 (65%) were male. Lesions appeared in various regions of the body, with 41% of cases involving the hands. The highest annual incidence rate was recorded in 2009, at approximately 40 cases per 100,000 population, whereas the lowest incidence rate occurred in 2002, at 5.8 per 100,000 population. Noticeable variations in disease prevalence were identified among non-Iranian individuals, rural populations (including pastoral and peri-urban areas), males, and younger individuals. Geographic Information System (GIS) analysis indicated that the most affected areas were located in the central region (Behbahan or Markazi area) and the southern region (Zeydoon) of the mapped topography.

Conclusion: The findings highlight the necessity of implementing effective prevention and control measures to alleviate the burden of CL in Behbahan County. These measures should include targeted health education campaigns and vector control strategies, with a particular focus on regions identified as high-prevalence areas through GIS topographic analysis.

Evaluation of Prevalence of Malaria and Risk Factors Associated with Symptomatic Malaria Pregnant Women Attending Antenatal Care in South-South, Nigeria

Ifeanyi O. Oshim

Background: An evaluation of prevalence of malaria and the risk factors in pregnancy across various transmission contexts is necessary. Methods: This is a cross-sectional study conducted in a health facility in April and May,2024. The convenient sampling technique was used to enrol 120 pregnant women attending antenatal in Health center, South-south, Nigeria. A questionnaire was used, to gather clinical and sociodemographic data. Blood smears were done using a standard technique. The factors associated with malaria were evaluated using pearson Chi-square and p- value of less than 0.05 was considered statistically significant. Result: Among symptomatic pregnant women, the prevalence of malaria was 83.3% (100/120). The following factors were significantly associated with the prevalence of malaria in pregnant women with malaria symptoms: not being on antimalarial treatment for 1-5 months (p<0.001), being higher degree (p<0.018), being primigravidae (p<0.001), being in the first trimester (p= 0.081), and those pregnant women between 26 and 30 years old (p= 0.001). Conclusion: Malaria remains the main public health concern among pregnant women, even though, there is an increased rate of intervention on antimalarial drugs in this region. Pregnant women who are at risk for these conditions should therefore recieve extra care.

A Case Series of Melioidosis: The great imitator in MAPIMS hospital, Melmaruvathur, Tamil Nadu, India

Arulananthi Venkataraman Arumugham

Background: Burkholderia pseudomallei is a saprophytic, aerobic, non-sporing, nonfermenting, facultative intracellular, motile, Gram-negative bacillus found in tropical and subtropical regions. Melioidosis can range from asymptomatic infection to life-threatening disease affecting the internal organs, particularly when host immunity is compromised. Delayed clinical presentation and lack of access to critical care resources in high-prevalence areas contribute significantly to this disease burden. This disease has a high case fatality rate in endemic areas. Written consent was obtained from the patients after the study was explained to them. This case series aimed to increase physicians' awareness of melioidosis in high-risk patients presenting with diverse clinical symptoms, thereby improving diagnostic accuracy and ensuring timely and appropriate treatment.
Case Presentation: Case series: Case 1: a 40-year-old male with septic pulmonary emboli; Case 2: a 72-year-old female with chronic obstructive pulmonary disease and Type II respiratory failure; Case 3: a 25-year-old female with septic arthritis; Case 4: a 69-year-old male with pneumonia and bacteraemia; and Case 5: a 54-year-old male with diabetic nephropathy and chronic kidney disease. Appropriate samples were collected from all cases, and identification of the isolated organisms and antibiotic susceptibility testing were performed using the VITEK 2 automated compact system. The patients were treated with appropriate supportive measures. Among the five cases, three had better outcomes, whereas two cases deteriorated.
Conclusion: This case series emphasizes that clinicians should be aware of the risk of melioidosis, particularly during the rainy season. Diagnostic testing should be improved to ensure timely detection and treatment.

Optimum cultural conditions to achieve the best biofilm formation and high level icaA transcription by Staphylococcus aureus

Abdolmajid Mohammadzadeh

Abstract
Background: Biofilm formation in Staphylococcus aureus (S. aureus), mediated by the ica operon, is a key virulence factor. This study examined how different glucose-supplemented broth culture media influence biofilm production and ica gene expression in S. aureus.
Methods: The phenotypic ability to adhere to a polystyrene surface and to produce slime layer were evaluated using microtiter plate test (MtP) and Congo red tube test, respectively. Using PCR, the presence of intercellular adhesion (ica) locus in S. aureus strains was confirmed and subsequently, quantitative real-time RT-PCR was performed to investigate transcription of icaA in various media including Tryptic soy broth (TSB), Brain-heart infusion broth (BHIB), (Nutrient broth) NB and (Muller-Hinton broth) MHB contained 0, 0.25, 0.5, 1 and 2% glucose.
Results: Our results showed that although all of the studied strains adhered to the wells of polystyrene microtiter plates, the optimum rate of biofilm formation was observed for TSB medium contained 1% glucose, but biofilm formation was not significantly different in NB, MHB and BHIB media. Supplementation of all media with 1% glucose led to the highest production of biofilm formation and in all media transcription of icaA was increased with glucose addition to one present.
Conclusions: The results of the present study indicated that TSB medium supplemented with 1% glucose was the most appropriate medium for evaluation of biofilm formation by S. aureus isolates.

Metallo-β-lactamase detection in imipenem-resistant Acinetobacter spp. and pseudomonas aeruginosa: A combined phenotypic and molecular study

Zahra Nasirzadeh

Background: The incidence of healthcare-associated infections (HAIs) is increasing rapidly, primarily driven by multidrug-resistant Gram-negative pathogens, notably Pseudomonas aeruginosa and Acinetobacter spp. Metallo-beta-lactamases (MBLs), including IMP and VIM types, are frequently produced by these organisms and contribute to therapeutic challenges through gene dissemination and prolonged colonization in clinical settings. This study, conducted in Rasht, Iran, aimed to evaluate phenotypic resistance and MBL production in imipenem-resistant clinical isolates of P. aeruginosa and Acinetobacter.
Methods: In this descriptive cross-sectional study, 52 Acinetobacter and 25 P. aeruginosa isolates were obtained from healthcare facilities in Rasht. Species identification was confirmed using standard biochemical assays. Antimicrobial susceptibility was assessed using the disk diffusion method in accordance with CLSI recommendations. MBL-producing isolates were screened using the imipenem-EDTA combined disk test. Genomic DNA was extracted with a commercial kit, followed by PCR amplification to detect the bla_IMP and bla_VIM genes.
Results: According to the findings of this study, the highest percentage of resistance in Acinetobacter was observed against cefotaxime at 94.23%, and in P. aeruginosa against ceftazidime at 84%. Among the isolates not susceptible to imipenem, 18 (40%) Acinetobacter and 2 (15.38%) P. aeruginosa isolates were identified as MBL producers by the combined disk method. Both P. aeruginosa and Acinetobacter isolates demonstrated high resistance to ceftazidime. The bla_IMP and bla_VIM genes were detected in 7 (13.46%) and 11 (21.15%) Acinetobacter isolates, respectively, and in 8 (32%) and 5 (20%) P. aeruginosa isolates, respectively.
Conclusion: Early detection of Acinetobacter and P. aeruginosa strains producing metallo-β-lactamases is key to guiding effective clinical treatment and improving patient outcomes. These results suggest that the bla_IMP and bla_VIM genes play important roles in antibiotic resistance and may potentially influence the virulence of Acinetobacter species and P. aeruginosa in the region.

Clinicopathological features and survival outcomes of pediatric mediastinal tumors: A 10-year retrospective study

Mahlagha Zahedi

Background: Primary mediastinal masses account for 3% of all chest tumors. Owing to their heterogeneous clinical presentations and the need for precise diagnosis, this study evaluated the clinicopathological features and survival outcomes of children with primary mediastinal masses admitted to Shahid Sadoughi Hospital, Yazd, Iran, between 2011 and 2021.
Methods: In this descriptive cross-sectional study, 17 children under 18 years of age with primary mediastinal masses were evaluated using census sampling. Data were collected with a checklist that included age, sex, tumor location, presenting symptoms, tumor type, treatment received, and malignancy status. Prognosis and survival were subsequently assessed. Statistical analysis was performed using SPSS 22, with Kaplan-Meier and Log-rank tests applied for survival assessment.
Results: Among the 17 patients, 12 (70.6%) were girls and 5 (29.4%) were boys. Five patients (29.4%) died during follow-up. Nine tumors (53%) were benign and eight (47%) were malignant. Ganglioneuroma was the most frequent tumor type (29.4%). Survival analysis showed no statistically significant association between survival and surgery (P=0.222), malignancy status (P=0.158), neural origin (P=0.666), chemotherapy (P=0.057), radiotherapy (P=0.752), tumor location (P=0.661), sex (P=0.670), or age (P=0.877).
Conclusion: The findings suggest that the distribution of histological types of primary mediastinal masses in children is influenced by anatomical location. However, age, sex, treatment type, and tumor location were not significantly associated with survival outcomes in this cohort.

Effects of Resistance Training Following Bone Marrow Stem Cell Transplantation on Cardiac Oxidative Stress and Left Ventricular Function in a Rat Model of Myocardial Infarction

Seyed Abdollah Hashemvarzi

Background and objectives: This study aimed to evaluate the effects of resistance training following bone marrow stem cell transplantation, a regenerative approach targeting damaged cardiac tissue, on myocardial oxidative stress markers and left ventricular function in a rat model of myocardial infarction (MI).
Methods: Sixty male Wistar rats (7–8 weeks old) were randomly assigned to six experimental groups (n=10 per group): healthy control, MI control, sham, stem cell, exercise, and exercise + stem cell. MI was induced by permanent ligation of the left anterior descending coronary artery. Stem cells (1×10⁶) were injected via the tail vein. Resistance training protocol consisted of climbing sessions performed five days per week for six weeks. Each session included three sets of five repetitions, with a one-minute rest interval between sets. Oxidative stress markers (CAT and MDA) were analyzed biochemically, and left ventricular function was assessed by echocardiography. Data were analyzed using one-way ANOVA and Tukey’s post hoc test.
Results: MDA levels were significantly increased and CAT levels decreased in the MI group compared to controls. Resistance training and combined therapy significantly reduced MDA levels; however, CAT changes were not statistically significant. Cardiac output and ejection fraction were significantly improved in the intervention groups compared to the MI group.
Conclusion: Six weeks of resistance training after bone marrow stem cell transplantation effectively reduced oxidative stress and improved left ventricular function in MI rats. This combined approach may serve as a promising therapeutic strategy for myocardial infarction recovery.

Blood product reservation management in teaching hospitals: A case study from northeastern Iran

Fatemeh Shams

Background: Blood products are vital yet scarce medical resources. In teaching hospitals, inefficient transfusion practices often result in unnecessary waste, compromising both patient safety and healthcare costs. This study investigated the patterns and underlying causes of unused blood products at Imam Reza Hospital, a major tertiary center in northeast Iran, with the aim of delineating modifiable factors contributing to this issue.

Methods: This retrospective cross-sectional study was conducted at Imam Reza Hospital, Mashhad. Data were extracted from the Laboratory Information System (LIS) and the hospital’s dashboard for the period of March 2022–2025. Blood component reserve and return data for five large clinical departments were examined.

Results: Although the total number of returned units declined over time, the return percentage increased in the final year, indicating persisting inefficiencies. By department, Neurology and Gynecology exhibited the highest return percentages, while the Hematology-Oncology ward, Intensive Care Unit (ICU), and Emergency Department reported the highest absolute numbers of returns. Platelets were the most frequently returned product, whereas fresh frozen plasma had the highest relative return rate. The most consistently reported reason for returns was “Physician Decision / Order Canceled,” with returns due to “Patient Death” also showing a gradual increase over the study period.
Conclusion: Despite gradual improvements, systemic challenges—especially poor documentation, absence of digital monitoring tools, and knowledge gaps in transfusion handling—continue to undermine efficient blood product use. Implementing real-time dashboards, enforcing mandatory documentation, educating clinical staff, and adopting AI-based demand prediction tools could dramatically reduce waste and enhance transfusion practices.

Effect of urtica dioica agglutinin on breast cancer cell growth

Azam Rashidbaghan

Background: Breast cancer remains a leading cause of mortality among women globally, necessitating the exploration of novel therapies with minimal side effects. Urtica dioica agglutinin (UDA), a lectin derived from stinging nettle, exhibits antiproliferative properties in various cancers; however, its effects on breast cancer cells remain underexplored. This study evaluates the cytotoxic potential of UDA against MCF-7 breast cancer cells while assessing its impact on normal mammary (MCF-10A) and embryonic kidney (HEK-293) cells.
Methods: UDA was purified from Urtica dioica rhizomes by affinity chromatography and confirmed by SDS-PAGE (8.5 - 9.5 kDa) and agglutination assays. MCF-7, MCF-10A, and HEK-293 cells were treated with different concentrations of UDA (7.5 - 480 µg/mL) for 24 and 48 hours. Cytotoxicity was assessed using MTT assays to measure cell viability.
Results: UDA significantly inhibited MCF-7 proliferation in a dose- and time-dependent manner (P < 0.01 at 24 hours; P < 0.0001 at 48 hours). At 240 µg/mL (During 48 hours), viability dropped below 50%, while normal HEK-293 cells showed < 30% toxicity. MCF-10A proliferation remained unaffected, even at 480 µg/mL.
Conclusion: UDA selectively targets breast cancer cells (MCF-7) with minimal toxicity to normal cells, positioning it as a promising anticancer candidate. Further studies are needed to elucidate its mechanism of action and apoptosis-inducing potential.

The Role of Anthocliesta djalonensis in Mitigating Mercury Chloride-Induced Hematological Alterations

Joseph Raymond Enoghase

Background: Mercury chloride is a well-established toxicant known to induce hematological alterations, including oxidative hemolysis, anemia, and thrombocytopenia. Medicinal plants with antioxidant properties have been explored as potential protective agents against toxicant-induced damage. Anthocleista djalonensis, widely used in traditional medicine, has been reported to possess bioactive compounds with therapeutic potential. This study aimed to investigate the role of Anthocleista djalonensis in mitigating mercury chloride-induced hematological alterations.
Methods: This experimental randomised controlled animal study was kind of weirdly done, with thirty-six adult Wistar rats, randomly assigned into six groups, (n=6 each). Group A was basically the control, Group B got only 2 mg/kg of mercury chloride , just that. Groups C and D were given mercury chloride alongside 150 mg/kg and 300 mg/kg of Anthocleista djalonensis extract, respectively , while Groups E and F received just A. djalonensis at doses 150 mg/kg and 300 mg/kg. The extract was freeze dried, and then the haematological parameters were checked using an automated haematology analyser. For the statistics, it was handled with one-way ANOVA, and the significance cut off was p < 0.05.
Results: Mercury chloride exposure significantly reduced red blood cell count, hemoglobin concentration, and platelet levels, indicating hematotoxicity. Co-administration with A. djalonensis, particularly at 150 mg/kg, significantly improved these hematological indices, suggesting a protective effect. The plant extracts also enhanced mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration, indicating potential erythropoietic support.

Trichomonas vaginalis and challenges in laboratory diagnosis: A Narrative Review

Hossein Hooshyar

Background: Trichomoniasis is considered one of the most common non-viral sexually transmitted diseases globally. Early diagnosis of Trichomonas vaginalis (T. vaginalis) infection plays an important role in effective treatment, infection control, and interruption of the transmission chain. The present narrative review was conducted to gather updated data and evaluate the challenges associated with available laboratory methods for the diagnosis of T. vaginalis.
Methods: A broad review of the published literature and electronic international databases, including ISI Web of Science, PubMed, Scopus, Science Direct, and Google Scholar, was conducted to identify relevant data on existing and newly developed diagnostic methods for trichomoniasis in both sexes. The search covered studies published from 2000 up to 2025. The benefits and limitations of these methods were compared.
Results: This review demonstrated that wet mount preparation and examination under a light microscope, accompanied by staining methods, are the most frequently used approaches worldwide. However, the sensitivity of this method is low. Direct microscopic examination accompanied by culture or staining provides a diagnostic strategy with good performance. Moreover, molecular- and immunological-based methods are recommended as complementary tests.
Conclusion: Direct microscopic examination is an economical and rapid method. Fully automated PCR systems for the simultaneous identification of the most common vaginal pathogens can be established as a diagnostic strategy in non-endemic areas and developed countries.