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Abstract Background and Objective: Parasitic infection is one of the major health problems in the world. This study aimed at comparing the accuracy of two methods of direct examination and Formalin-Ether to detect the presence of parasitic infection among health-card applicants in Shahroud city, 2011. Material and Methods: This cross-sectional study was conducted on 801 patients seeking health-card. From each patient, three consecutive stool samples were taken and investigated, using direct examination and formalin-ether method. Results: The use of formalin-ether method in recognizing the parasitic infection specially giardia lamblia and entamobea coli is more than the direct method. Conclusion: The formalin-ether method is a more sensitive method than the direct method. But in circumstances that is urgency to respond or aims to see the shape of trophozoite, the use of direct method is recommended. Keywords: Parasitic Infections Health Card Direct Method Formalin-Ether

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Abstract Background and Objective: Stenotrphomonas maltophilia is an opportunistic nosocomial pathogen with high mortality in immunocompromised cases. The aim of this study was to isolate and identify Stenotrphomonas maltophilia in the hospitals’ environment and wards. Material and Methods: In this cross-sectional study, a total of 1108 samples were collected from environment of two hospitals during 12 months. Identification of isolates was performed using biochemical, phenotypic (intrinsic resistance to carbapenems) and molecular methods (amplification of 23S rRNA gene). Results: Of the studied samples, 186 (16.78%) nonfermentative gram negative bacilli (NFGNB) were identified. Amongst NFGNB, 18 (1.62%) isolates were identified as S. maltophiliaby using biochemical tests. Of 18 biochemically identified isolates, 15 (83.3%) were confirmed via PCR. Sinks (40%) and men surgery ward ( 33.3 %( were the most contaminated sites and wards of hospitals, respectively. Conclusion: S. maltophilia is repeatedly isolated from sink which shows that the moist hospital environments need to be considered as a source for dissemination of bacteria. Keywords: Nosocomial Infections, Nonfermentative Gram Negative, Stenotrphomonas Maltophilia, PCR

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Background and Objectives: Reduced insulin secretion in Type II Diabetes Mellitus (T2DM) results in fat accumulation in hepatocytes and increase in liver enzymes. The hepatocyte destruction due to non-alcoholic fatty liver is associated with increased risk of cardiovascular diseases. Therefore, the aim of this study is to evaluate the association of liver transaminases with lipid profile in T2DM patients compared to healthy subjects.
Methods: A total of 1000 subjects (500 males and females with T2DM and 500 healthy subjects) participated in this case-control study. Diagnosis of T2DM was made based on the World Health Organization (WHO) criteria. Fasting blood samples (5 ml) were obtained from all subjects in the morning and the serum was extracted for the assessment of biochemical parameters was used to compare parameters between healthy and T2DM patients. Data were analyzed by SPSS version 20 and using Mann-Whitney test and Spearman correlation coefficient.
Results: The serum total cholesterol (TCH), triglyceride, Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), TCH/high density lipoprotein (HDL-C) ratio and atherogenecity index plasma were significantly higher in T2DM group compared to healthy individuals (p≤0.006). Among the lipid profile parameters only Risk ratio (TCH/HDL-C) was positively correlated with ALT (p=0.037) while no significant correlation was observed for other variables (P>0.05)
Conclusion: T2DM Patients have higher lipid profile, atherogenecity index and liver enzymes compared to healthy individuals. Furthermore, TCH/HDL-C was significantly correlated with ALT.

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Background and objectives: In recent years, analytical error rates in medical laboratories have decreased significantly. It has been demonstrated that the majority of errors occur outside of the laboratory in the pre-analytical and post-analytical phases. Our study aimed to evaluate the specimen rejections that occur for various reasons in the central clinical laboratory of a teaching hospital.   
Methods: The study included all specimens (emergency and routine) that were sent from different units of the hospital to the central laboratory between January and December 2019.
Results: Based on the results, 3483 (0.27%) out of 1,307,013 specimens were rejected. The rejection rate was highest for specimens from the intensive care unit (0.69%) and lowest for specimens from the outpatient clinic (0.18%). The specimen rejection rate was 0.42% and 0.22% for specimens from the service unit and emergency department, respectively. The rejection rate for specimens from the intensive care unit was significantly higher than that for specimens from the emergency department (p<0.001), outpatient clinic (p<0.001), and service unit (p=0.010). Although the number of specimens from the intensive care unit was lowest, it had the highest rate of specimen rejection. In our study, most analysis requests were from the outpatient clinic. However, the specimen rejection rate was lowest in this unit.
Conclusion: The results indicate that the reasons for specimen rejection may be influenced by the health status of the patient rather than the patient population.

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Background and objectives: Turnaround time (TAT) is an important quality indicator for benchmarking laboratory performance. Delay in TAT may affect patient safety; thus, continuous monitoring and analysis of laboratory workflow is mandatory. This study was designed to improve the TAT of two biochemistry laboratories serving in tertiary care teaching hospitals (multispecialty and super-specialty) through the application of quality tools namely quality failure reporting, the Fishbone model, and process mapping.
Methods: First, TAT was defined for routine (four hours) and urgent samples (two hours). Then, TAT failureincidents in 2018-2019 were analyzed using the Fishbone model. The process map of TAT was studied and made more value streamed and lean after removal of waste steps.Corrective action plans were prioritized and implemented for potential causes with more adverse outcomes. Pilot solutions were implemented for six months and TAT failures incidents were reanalyzed.
Results: The quality failure in TAT reporting was reduced by 22% (from 34% to 12%) for urgent samples and by 19% (from 27% to 8%) for routine samples after the implementation of quality tools in multispecialty hospital laboratory. In the super-specialty hospital laboratory, the improvement was more profound and the TAT percentage achieved after the corrective actions was 96.57% and 98% for urgent and routine samples, respectively.
Conclusion: Implementation of quality failure reporting culture along with quality tools led to significant improvement in TAT and higher quality laboratory performance in terms of efficiency, reliability, and increased patient safety.

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Ehsan Ameri ¹, Ali Farhadi Mahali² , Mojtaba Tabari³
Background: Improving the quality of visit services in laboratories of medical-teaching centers of universities of medical sciences plays a major role in providing better services to patients. The present study aimed to evaluate the policy of improving the quality of visit services of the reform plan in laboratories of medical-teaching centers in Golestan province.
Methods: The present research was cross-sectional and had a descriptive-analytical type. A total of 384 staff in the diagnostic laboratories were selected for the study using a simple random sampling method. The data collection tool included a 35-item researcher-made questionnaire.
Results: There was a gap between the current and desired status of the fourth axis of the health system reform plan. The gap was about -0.01, indicating that there was a gap between the current and desired status and it was related to the supervision department according to the respondents in the target statistical population.
Conclusion: The implementation of this plan was effective in improving the quality of visit services in laboratories of medical-teaching centers in Golestan province but this effectiveness did not meet the goals of the fourth axis of the reform plan. Therefore, the factors, which caused a lack of supervision among the executive departments of laboratories of medical-teaching centers in Golestan province, should be removed for increasing the effectiveness of this plan.

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Human papillomaviruses (HPVs) are DNA viruses from the Papillomaviridae family. These viruses are linked to about 5% of human cancers, significantly related to cervical cancer. Infection of this virus can be screened in women for prevention of cervical cancer.
One of the most common and effective methods for human papillomavirus (HPV) screening is sampling from the cervix using the Pap smear method and molecular techniques, used in various countries. Currently, the sampling methods for HPV screening in different countries are only performed through clinical sampling. Therefore, this approach cannot cover all urban and rural populations. Self-sampling for HPV screening has been recommended and supported by the World Health Organization as a new strategy.
This mini-review discusses the self-sampling method for HPV screening, its advantages, and its application in different countries. Considering that the self-sampling method can cover all rural and urban areas, it is more economically viable and can help to minimize cultural barriers and public opinion challenges compared to clinical sampling.
The HPV self-sampling strategy can serve as an effective and efficient method for HPV screening focused on preventing cervical cancer caused by the HPV virus in various countries.