Medical Laboratory Journal

Prevalence of Malassezia species isolated from skin of patients with seborrheic dermatitis reffered to Tonekabon clinics by PCR- Sequencing method

A Raefi

Abstract

Background and Objective: Malassezia yeast is considered lipophilic normal flora of human skin and warm-blooded vertebrates. This fungus is an opportunistic pathogen in causing seborrheic dermatitis. In this study, the yeasts isolated from the crust of the patients with seborrheic dermatitis were identified by PCR-Sequencing.

Material and Methods: In this study, 65 samples of the skin of ear, nose and dandruff were cultured in selective medium Sabouraud agar and modified Dixon agar to prevent dehydration. After biochemical tests, ITS1-4 Universal PCR primers were used to determine the species of yeast. Obtained PCR products were sequenced for the determination and identification of Malassezia species.

Results: Of nine samples obtained from scalp, four were Malassezia globosa, two Malassezia restricta, two Cryptococcus albidus and one Cryptococcus albidus milis.

Conclusion: The results of Malassezia globosa and Malassezia Restericta are very similar with those in studies elsewhere.

Keywords: Malassezia, Sequencing, Seborrheic Dermatitis, Tonekabon

comparison study of wood lamp & direct exam for diagnosis of superficial mycoses

Mikaeili, A

Comparison of clinical and paraclinical diagnosis of vulvovaginal candidiasis in females referred to hospitals in Hamedan city

Habibipour, R

Abstract

Background and Objective: Vulvovaginal candidiasis (VVC) often refers to yeast infection, which is a common gynecologic problem, affecting 75% of women during their lifetimes. This study was conducted to evaluate clinical and paraclinical diagnosis of VVC in females.

Material and Methods: In this cross-sectional study, Vulvovaginal samples were collected from 350 women suspected vulvovaginitis verified by gynecologist. After checking microscopic fungal elements, samples were cultured on Chrom Candida Agar and Sabourraud Dextrose Agar. Using a checklist, their personal, social and hygienic status were evaluated.

Results: The rate of infection was 21.1% with wet mount , 21.7% with staining and 26% with culture procedure. Physicians' diagnoses were not in line with para-clinical experiments in 80.2 percent (P<0.05).

Conclusion: based on the results , vulvovaginal candidiasis can only be diagnosed by using clinical criteria related to vulvovaginal symptoms and Candida cultures. This matter can be helpful to prevent and reduce the side effects of some unnecessary medications.
Keywords: Candida Albicans, Clinical Experiments, Vaginitis, Para- Clinical Experiments

Identification of keratitis factors by PCR and culture method and determination of drug- resistance in the East of Mazandaran

Nikpour, Sh

Molecular detection of hepatitis delta virus in blood donors with RT-PCR

Tajbakhsh, E

Abstract

Background and Objective: Hepatitis delta virus is an imperfect virus with RNA and its activity depends on the presence of hepatitis B virus. This virus can lead to acute and chronic diseases in the liver. This study aimed to detect the hepatitis delta virus in blood donors with positive Hepatitis B Surface Antigens (HBsAg).

Material and Methods: In this Study, 350 serum samples were obtained from the people infected with hepatitis B blood in Transfusion organization of Shahrekord city, Iran. After extracting RNA by RNA Plus kit and making cDNA, the samples were evaluated by using RT PCR.

Results: Of 350, two samples (0.57%) were infected by HDV.

Conclusion: Low prevalence of HDV infection shows that Hepatitis B is being controlled in Shahrekord.

Keywords: Hepatitis Delta Virus, Blood Donors, Hepatitis B Surface Antigens

Qualitative and Quantitative Approaches for Determination of Hemolyzed Serum

Takhshid, MA

Abstract

Background and Objective: Prevention of medical laboratory errors is a major goal of quality control programs. Hemolyzed specimen is one of the common issues causing medical laboratory errors. Apart from the visual assessment, the measurement of serum hemoglobin concentration can be another method to evaluate the intensity of hemolysis. We aimed to assess hemolyzed serum specimens using two quantitative and qualitative methods.

Material and Methods: the serum samples (n=890) were evaluated for the presence and degree of hemolysis, using quantitative and qualitative methods. In qualitative method, the samples were investigated visually and in quantitative with the measurement of serum free hemoglobin concentration. Furthermore, the relative frequency of hemolyzed specimens was calculated.

Results: the hemolyzed samples were 23.4 % in qualitative and 65.8% in quantitative method. In quantitative, 71.2% of the specimens had mild hemolysis (sfHB<50 mg/dL), 26.8% intermediate (50mg/dL< sfHB <250mg/dL), and 2% high (sfHB >250 mg/dL). The percentage of hemolyzed specimens was higher in intensive care unit than those of other departments (P < 0.05).

Conclusion: given that hemolysis in small amount is not detectable visually, we recommend using quantitative method for evaluating hemolyzed specimens.

Keywords: Hemolysis, Diagnostic Errors, Qualitative Research, Quantitative Research

Evaluation of accuracy, precision and consensus of four laboratory glucose measurement kits with reference method

Ghasemi Falavarjani, M

Abstract

Background and Objective: According to recent changes in diagnostic criteria for diabetes, the harmonization of results obtained from various methods and systems by considering their accuracy and precision is essential. This study aimed to evaluate the accuracy, precision and consensus of some routine laboratory glucose kits in comparison with Hexokinase reference method.

Material and Methods: The participants were 38 diabetic patients with fasting blood sugar (FBS) ≥126 mg/dl, nine prediabetic patients with FBS of 100-125 mg/dl, 15 non-diabetic people with FBS of 60-100 mg/dl and 9 hypoglycemic patients with FBS of ≤60 mg/dl. Their FBS were measured by four routine laboratory glucose kits: Glucose oxidase on BT3000 analyzer with an open system and Hexokinase reference method on a close system (COBAS INTEGRA^®400plus analyzer, Roche kit). Accuracy and precision were determined and compared with reference method.

Results: Glucose oxidase methods showed a good agreement with the reference method, in Correlation Coefficient>0.99. based on regression analysis, the slope of 1.114 for Pars Azmoon, 1.105 for Bionik, 1.121 for Elitech and 1.087 for Human were reported (P<0.05). Error of the mean for ParsAzmoon was 12.79, for Bionik 10.86, for Elitech 12.58 and for Human were 8.46. Coefficient of Variation showed more imprecision for Bionik and Human kits.

Conclusion: given the same almost standard errors, standard devisions and regression analysis, the precision in four methods is the same but in comparison with Hexokinase, reference method has not the accuracy.

Keywords: Blood Glucose, Glucose Oxidase, Hexokinase, Methods, Consensus

Antimicrobial effect of Stachys lavandulifolia Vachl essential oil on Listeria monocytogenes

Noroozi, M

Abstract

Background and Objective: It has been proved that plant essential oils have antimicrobial effects. Stachys Lavandulifolia Vachl is a medicinal plant growing wild in many parts of Iran, and is used as a brewed drink to treat some diseases.

Material and Methods: Aerial parts of Stachys lavandulifolia Vachl at flowering were collected from the Sabalan mountainous area of Ardabil and its essential oil was extracted using a Clevenger-type apparatus. A GC/MS machine was used to identify the chemical constituents of this Essential oil. We used microdilution method to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Essential oil against Listeria Monocytogenes ATCC19118 bacteria.

Result: Sixteen chemical compounds were identified in this essential oil. Of these, γ-terpinene (28%), Phenol (18.16%), Myrcene (17.87%), and α-Pinen (12.7%) were the major ones. The MIC and MBC of the essential oil for Listeria Monocytogenes bacteria were 600 and 2400 ppm, respectively.

Conclusion: Results showed that the Monoterpene and Sesquiterpene groups are the main constituents of this essential oil having bactericidal effects against Listeria Monocytogenes bacteria.

Keywords: Essential Oil, Stachys Lavandulifolia, Listeria Monocytogenes

Isolation of the Bacteria Producing Antibiotic from the Phylosphere of two Families of Fabaceae and Asteraceae

Sardari, S

Abstract

Background and Objective: Antibiotics are the chemical compounds, which are produced by microorganisms, belong to a larger group of antimicrobial compounds that are used for treatment of infections caused by microorganisms.

Material and Methods: the isolates of four plant species, Astragalus obtusifolius, Prosopis juliflora, Xanthium strumarium and Hippocrepis unisiliqousa were obtained using Trypticase Soy Agar. First, the purified isolates were screened from the viewpoint of their ability in producing antimicrobial metabolites against three typical microorganisms Escherichia coli, Candida albicans and Saccharomyces cerevisiae. Then, the microbial products were extracted using organic solvent ethyl acetate and their minimum suppression concentration was determined against three strains Candida albicans ATCC 10231، Staphylococcus aureus ATCC 25923 و Escherichia coli ATCC 25922.

Results: After 4-7 days of incubation, 104 bacterial samples were isolated from isolates four plants. Out of this number, 26 isolates were antimicrobial producing metabolites by making inhibition zones against three typical microorganisms, after initial screening for production of antimicrobial compounds using agar diffusion method. Minimum inhibitory concentration of ethyl acetate extracts from target microbes were between 125-1000 µg/ml.

Conclusion: The results showed that the bacterial extracts of phylosphere produce some compounds with antimicrobial properties.

Keywords: Antibiotic Producing Bacteria, Fabaceae, Asteraceae

Relationship between Antimicrobial Resistance to Bacteria in the Vagina and Rectum of Pregnant Women and Early Neonatal Sepsis

Gharahjeh, S

Abstract

Background and Objective: Neonatal sepsis is a remarkable factor in mortality, morbidity, neonatal and perinatal complications. Group B Streptococcus (GBS) is the primary cause of invasive disease in infants and pregnant women. This study aimed to determine the relationship between antimicrobial resistance of the bacteria colonized in the vagina and rectum of pregnant women and early neonatal infection.

Material and Methods: In this prospective study conducted on 282 pregnant women, bacterial sensitivity to ampicillin, cefazolin, erythromycin, vancomycin, gentamicin, amikacin was measured. Furthermore, the relationship between rectal and vaginal colonization of mothers and early neonatal sepsis was evaluated.

Results: Of 98 positive rectal cultures, 49 (50%) were Gram-positive cocci and 49 (50%) E.coli. of 143 positive vaginal cultures, 136 (95.1%) were Gram-positive cocci, 7 (4.9%) were E.coli and two were positive GBS. We could find definitive neonatal sepsis. Significant correlation was found between a history of urinary tract infection and the mother's positive rectal culture (P =0. 03).

Conclusion: Clinical sepsis in neonates is correlated with positive rectal culture (P =0. 001) and the positive E.coli vaginal cultures is associated with suspected neonatal sepsis (P =0.007). Gram-positive cocci were resistance to ampicillin and gentamicin, and E.coli was resistant to ampicillin, erythromycin and vancomycin. Because of resistance to ampicillin, we recommend cefazolin due to its sensitivity to organisms and safety in pregnancy.

Keywords: Antibacterial Agents, Escherichia Coli, Gram-Positive Cocci, Newborn, Sepsis

Prevalence of Gram Negative Bacilli Isolated from the Equipment and Surfaces of Hospitals in Gorgan

Amini, A

Abstract

Background and Objective: Nosocomial infection is one of the main factors of mortality in hospitals . One of the most important measures to control infection in hospitals is sampling of equipment and culturing the samples . This study aimed to investigate the prevalence of gram-negative bacilli obtained from the equipment of the hospital wards .

Material and Methods: This Descriptive study was carried out on 488 specimens taken from medical and non-medical devices and equipment of various wards, via census sampling. the samples taken by sterile swabs in Tryptic Soy Broth (TSB) were inoculated in blood agar and Eosin-Methylene Blue agar, and by biochemical standard tests the isolated colonies were identified.

Results: Of 488 isolates, 157 (32.17%) were positive for the presence of gram-negative bacilli. The highest bacterial contamination was related to Enterobacter (37.58%). Of hospital wards, the highest infection related to the surgical wards (19.75%), and the highest contamination is related to laryngoscope blades (12.74%) and ECG sensor device and the monitoring interface (7%).

Conclusion: Microbial infection with gram-negative bacilli is an overwhelming condition in hospital equipment.

Key Words: Gram Negative Bacilli, Nosocomial Infection, hospital wards, hospital equipments, Gorgan

Antibiotic Susceptibility of Staphylococcus aureus and Enterococcus Spp. Isolated from some Hospitals in Tehran

Mohabati Mobarez, A

Abstract

Background and Objective: Vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) are the leading nosocomial pathogens in Iran. We aimed at evaluating the resistance patterns of Staphylococcus aureus and enterococci to the antibiotics recommended by Clinical and Laboratory Standards Institute (CLSI).

Material and Methods: Two-hundred forty Staphylococcus aureus and 203 Enterococcus isolated from urine, wound, blood, trachea, stool and other clinical specimens of inpatients and outpatients were obtain from some hospitals in Tehran. Sensitivity of S. aureus to oxacillin, vancomycin, chloramphenicol, nitrofurantoin, erythromycin, clindamycin and linezolid were determined by disk diffusion according to CLSI (M100-S22) guidelines. Likewise, sensitivity of enterococci to ampicillin, vancomycin, teicoplanin, tigecycline, linezolid, tetracycline, chloramphenicol and nitrofurantoin was invesditated by the same method.

Results: Of 240 S. aureus isolates, 56%, 46.6% and 40.4%were resistant to oxacillin, erythromycin and clindamycin, respectively. We found one S. aureus isolate with low susceptibility to vancomycin (VISA; 0.5%). All S. aureus isolates were sensitive to chloramphenicol, nitrofurantoin and linezolid. Of 203 Enterococcus spp., 47.3%, 24.6%, 9.4%, 85.2%, 11.3% and 4.4% were resistant to ampicillin, vancomycin, teicoplanin, tetracycline, chloramphenicol and nitrofurantoin, respectively. All these isolates were sensitivity to tigecycline and linezolid.

Conclusion: Resistance of S. aureus isolates to oxacillin, erythromycin and clindamycin was significant. Enterococci isolates were remarkably resistant to ampicillin, vancomycin, teicoplanin, tetracycline, chloramphenicol and nitrofurantoin. Given our results, we suggest vancomycin, chloramphenicol, linezolid and nitrofurantoin for S. aureus infections and tigecycline and linezolid as drugs of choice for enterocoocal infections treatment.

Keywords: Staphylococcus aureus, Enterococcus, Tehran, Hospitals

A Survey of Frequency and pattern of Methicillin-Resistant Staphylococcu s aureus Isolated from nosocomial infections

Karbasizade, V

Abstract

Background and Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen involved in nosocomial infections. Because of increasing antibiotic resistance of these strains, treatment of these infections has become very difficult. This study aimed to determine the frequency and drug resistance pattern of MRSA isolates from nosocomial infections in hospitals.

Material and Methods: the isolates of S.aureus (n= 100) isolated from clinical samples such as: urine, blood, wound, throat, sputum, cerebrospinal fluid, catheter and other purulent discharge from in patients were identified using biochemical tests. MRSA strains were isolated by using agar screening method and then drug resistance pattern of them was determined by disk diffusion method.

Results: Out of 100 S.aureus strains, 65 (65%) were MRSA. Drug resistance of MRSA isolates to most antibiotics were high: penicillin100%, oxacillin 100%, nitrofurantoin 80%, tetracycline 63%, erythromycin 58.4%, gentamicin 46.1%, clindamycin 33.8%, cotrimoxazole 35.3% and ciprofloxacin 26.1%. Also 35 of MRSA isolates were multiple drug resistance (MDR).

Conclusion: The prevalence of MRSA isolates and also their resistance to other antibiotics were high.

Keywords: Drug Resistance, Methicillin-Resistant Staphylococcus Aureus, Multi-Drug Resistant

Ferequency of Staphylococcus Aureus in Traditional Ice Cream and Homemade Juices

Sadeghi, M

Abstract

Background and Objective: Staphylococcus aureus is an important cause of food poisoning. Due to the high consumption of fruit and ice cream in summer, this study aimed to determine the prevalence of S. aureus in traditional ice cream and juice in Gorgan, Iran.

Material and Methods: This cross-sectional study was conducted on 25 places selling traditional ice cream and juice in the summer of 2014 in Gorgan, Iran.

Results: Results showed that the microbial contaminants in traditional ice cream and juice centers were 56% and 14.28% of S. aureus, 44% and 33.3% of yeast, 28% and 28.57% of B. cereus, 12% and 4.76% of Listeria, 8% and 14.28% of Bacillus subtilis and 4% and 4.76% of Bacillus licheniformis ,respectively.

Conclusion: The findings of this study indicated a high contamination of traditional ice cream and juice with Staphylococcus aureus and various microorganisms.

Keywords: Ice Cream, Food Contamination, Staphylococcus Aureus

Seroepidemiology of Leishmania infantum in rural dogs in Golestan province, Iran

Namroodi, S

Abstract

Background and Objective: Dogs have been introduced as a major reservoir of Leishmania infantum. Concerning the increased sporadic reports of humeral visceral leishmaniasis in Golestan province, we aimed to study seroepidemiology of leishmania infantum in Rural Dogs.

Material and Methods: this study was conducted in 2012 - 2014 on 150 Serum samples of rural dogs, from 10 districts of Golestan province. The samples were analyzed by ELIZA kit.

Results: the frequency of leishmania infantum was 15.3% and it was higher in the dogs aged more than four. There were no differences in Leishmania infantum infection between sexes and seasons.

Conclusion: our findings indicate the presence of Leishmania infantum in Golestan Province. Given the presence of positive titer of Leishmania infantum in dogs without clinical signs, we emphasize the main role of rural dogs in transmitting Leishmania infuntum to villagers in the studied area.

Keywords: Leishmania Infantum, ELIZA, Rural Dogs, Golestan Province

Study of zoonotic intestinal helmiths of alimentary tract of rodents in Hamadan, 2012

Fallah, M

Abstract

Background and Objective: Assessment of alimentary tract helminthes of rodents has a great zoonotic importance. This study aimed at determining the prevalence of helminth infections in rodents in Hamadan.

Material and Methods: a total of 100 rodents trapped from different parts of city were transported to laboratory. After anesthetizing by chloroform, the animals were undergone an operation to isolates the helminthes. The isolates were stained by Carmine and identified at the genus and species levels. Furthermore, age, sex, weight of rodent and size of various organs of body were determined.

Results: Totally, 62% of the rodents were infected to intestinal helminthes. All trapped rodents were Rattus norvegicus. Six species of helminthes, including three Nematode (45%), 3 Cestode (51%) and no Trematode were isolated from rodents. The infection rate for different helminthes was as follow: Hymenolepis nana 21%, H. diminuta 29%, Heterakis spomosa 43%, Strongyloides sp. 1% Trichuris muris 1% and Cysticercus fasciolaris 1%.

Conclusion: in this area, infection rate of alimentary tract helminthes in the Rattus norvegicus, especially zoonotic helminthes, is relatively high, and the rate of Cestodes is higher than those of Nematodes and Trematodes.

Key words: Prevalence, Helminthes, Alimentary tract, Rodents

Effect of pH, Chlorine Residual and Turbidity on the Microbial Bio Indicators of Drinking Water Network

Zafarzadeh, A

Abstract

Background and objective: Bioindicators of drinking water are always influenced by physical and chemical factors such as turbidity and chlorine. Considering the assessment of drinking water quality is based on residual chlorine, E.coli, heterotrophic bacteria and turbidity. We aimed to evaluate the effect of pH, chlorine residual and turbidity on the microbial bioindicators.

Material and methods: In this descriptive-analytic study, 324 and 32 water samples were collected from rural and urban water distribution network of Aq Qala city in 2013, respectively. All steps were performed according to standard methods.

Results: In rural water supply, 5%, 9% and 33% of the samples were contaminated with fecal coliform, fecal streptococcus and the heterotrophic more than 500CFU / ml. In urban network, coliform contamination was not seen and other bioindicators were less than those of rural networks were. Turbidity of above 5 NTU in urban and rural samples was 3 and 9 percent, respectively. Bioindicators had significant relationship with residual chlorine, fecal coliform bacteria with pH and turbidity with heterotrophic bacteria (P ≤0.05).

Conclusion: The presence of fecal streptococcus bacteria in some samples without fecal coliform cannot confirm the safety of drinking water. Microbial contamination in the presence of residual chlorine implies that just chlorination is not enough for having healthy water.

Keywords: Chlorine, Turbidity, Biological Factors, Drinking water

Seroepidemiology of Toxoplasmose in pregnant women in Tabas City

Dabirzadeh, M

Abstract

Keywords: Chlorine, Turbidity, Biological Factors, Drinking water

Occupational Injuries and Knowledge about Standard Precautions related to infectious diseases among clinical laboratories in Kerman

Karvar, M

Abstract

Keywords: Chlorine, Turbidity, Biological Factors, Drinking water

Effect of Silver Nano-Particle on Removing the Enterococcus faecalis Bacterium isolated from Industrial Resid

Habibipour, R

Abstract

Background and Objectives: Due to the unique absorption and antibacterial properties of nanoparticles, their use in water and wastewater treatment to remove bacteria is spreading. This research aimed to study the effect of silver nanoparticles in the removal of Enterococcus faecalis isolated from industrial sewage.

Material and Methods: after preliminary studies, field studies including sampling of industrial wastewater was conducted. First, Fecal Coliform, total coliform and Enterococcus faecalis of industrial Sewage were measured by standard methods of microbiology, then the effect of concentrations of 500, 250, 125, 62.5, 31.25, 15.62, 7.81, and 3. 9 PPM of isolated nanoparticles serial dilution method on Enterococcus faecalis and standard (PTCC 1339) was determined. Next, and the turbidity of tube (OD), which represents growth of bacteria, was read at 600 nm with a spectrophotometer. After that, all tubes were cultured on solid medium and the results were analyzed using SPSS 22.

Results: fecal and total coliform contamination of industrial Sewage from slaughter and textile plant were approved and Enterococcus faecalis was isolated. The growth of isolates and standard bacteria was not controlled by any of these concentrations. None of the concentrations was able to remove the bacteria but the increase of concentration led to higher effect of nanoparticles, and in accordance with the type of bacteria, it was different, but the difference was not statistically significant.

Conclusion: Although silver nanoparticles ,according to the concentration, affect the Streptococcus faecalis, they cannot completely remove bacteria. Therefore, the economic factors and other involved factors need to be considered in the application of nanoparticles.

Keyword: Silver nanoparticles, Enterococcus faecalis, industrial Sewage

microbiological Infection of hamburgers consumed in Arak city

Shariatifar, N.

Abstract

Background and Objective: The presence of microorganisms in food is a paramount importance to public health. This study was carried out to measure the rate of microbial contamination of the hamburgers consumed in Arak.

Material and Methods: The samples of frozen hamburgers ( n= 100) were collected from the selling centers in Arak. The city was divided into five areas and 20 samples were collecte from each area. The experiments of counting staphylococcus aureus with Iranian National No 6806-6, the total counting of bacteria No. 5272 and the counting mould and yeast with No 997 were carried out.

Results: the samples polluted by staphylococcus aureus were 26.6%. , 61.3% of the samples were higher than the required standard and 65% of the samples were higher than the required standard in Iran. The rate of staphylococcus aureus in the samples was 6×10³CFU/gr on average and the total counting of the bacteria was 5×10⁶ CFU/gr on average, and the average rate of being polluted by fungi was 2×10⁴ CFU/gr (820-36300) showing the high microbial contamination in this product. No significant difference was found at the level of different brands.

Conclusion: The results showed that 26.6% of the samples were contaminated with S. aureus, 61.3% with total microbial and 65% with fungal infection.

Keywords: Meat Products, Staphylococcus, Fungi, Food Safety

Prevalence of Oral Candidiasis in Diabetic Patients Referring to Aliasghar Hospital in Zahedan

Mousavi Moh

Abstract

Background and Objective: Oral candidiasis is a common opportunistic infection in diabetic patients. Candida albicans is colonized on different oral surfaces such as tongue, palate, dental caries and plaques. This study aimed to determine the prevalence of Candida albicans in the mouth of diabetic patient.

Material and Methods: This cross - sectional study was conducted on 120 diabetic patients. After completing the questionnaire, the saliva samples were obtained and cultured on sabouraud agar medium containing 0.005% chloramphenicol. For final diagnosis, Germ tube test and Sugar absorption test (with API 120 kit) were used.

Results: Of 120 patients, 61 (50.8%) were positive for Candida. Candida infection rate was relatively higher in older patients and in women. The rate was significant in the patients using dentures (P< 0.001) and the ones keeping on smoking (P <0.038). The infection in the patients with type II diabetes was higher than the cases with Type I.

Conclusion: Given the high prevalence of Candidiasis and Candida colonization in the mouth of diabetic patients, it is a necessity to identify and treat these infections in order to prevent further complications.

Keywords: Candidiasis, Diabetes Mellitus, Fungal Infections

Serum Vitamin D Level in Patients with Iron Deficiency Anemia

M Kosarian

The paper titled“Comparison of the serum vitamin D level in patients with iron deficiency anemia, beta thalassemia with the control subjects” was assesesd and the following needs to be explained(1).

Usually , the rational for the research should be explaied in introduction part. This part is too long and contains unnecessary information which does not help to address the possible association of vitamin D deficiency, neither with a genetic condition such as beta thalassemia a minor, nor with iron deficiency anemia. to address these issues, the writer should refer to some physiologic or pathophysiologic explanation of the research.

Regarding the design method, I should say that; there is not such a method as “descriptive-analytical cross sectional” design. Cross sectional descriptive researche is meant to answer epidemiologic questions and have some obligations such as random sampling, which was not the case in this study (2). On the other hand, analytical studies are designed to find the role of a risk factor in developing an outcome. Case-control studies and cohort studies are the examples of analytical designs. In this case, vitamin D deficiency is not the risk factor for neither iron deficiency nor the beta thalassemia. Thus, there is no reason for selecting such a method. However, an association of two nutritional disorders is well known and is addressed in the discussion of the paper (1). I believe this paper is the result of an irrational sampling.

The sample size should be explained in any research methodology whether the study is cross-sectional or analytic, but in this article the sample size is not rationalized.

Given an important point in analytical researche is the way that confounding variables are being dealt with, this paper does not mentioned these variables such as job, sun exposure, diet and specially using nutritional supplement are not addressed. However, two important variants of age and gender have been matched (1).

There are a large number of researche regarding vitamin D deficiency in Iran that are not addressed in this paper. In some of these, the definition of vitamin D deficiency is on the basis of serum parathyroid hormone (PTH) (3). In a systematic review and meta analysis of Heshmat et al. 77% of Iranian population had vitamin D deficiency (4). This high prevalence could be associated with any, even unrelated condition.

Result should be started with introducing the groups including the matched variables such as age and gender. For showing the results, table is better than the the text. without statistical tests and P values, explaining the difference is not acceptable in scientific writings.

Discussion part of the paper was mostly the repetition of the introduction. I was not convinced by the discussion. It seems that the concept of “association” was confused with " causation" .

Kosarian, M. (MD)

Professor of Pediatrics, Thalasemia Research Center,

Mazandaran University of Medical Sciences, Sari, Iran

The main objective of this study was to compare the lack of vitamin D or association of iron deficiency anemia with healthy individuals.

the case group were the patients with iron deficiency anemia and the two controls were Thalassemia Minor and Healthy people. The Thalassemia Minor Group, in a microcytic anemia, was similar to the control group. the cause of microcytic is genetic rather iron deficiency.

The Sampling was census.The participants were the students who have been enrolled in that year; therefore, the Random sampling is not considered.

The design of a research defines the type of the study.

The printed research was designed in two categories: Cross sectional study (The Nutritional Target) and Analytic (comparison between the three groups)

Sinct all the participants were students, the impact of the job, nutrition and… other factors, were the same.

Considering the prevalence of vitamin D deficiency, less than 50 percent, in control group shows that this deficiency could be varied in different groups.

This study basically was designed just to express the association or lack of association of iron deficiency anemia.

As shown in the results and discussion, The amount of vitamin D deficiency in patients with iron deficiency was more than the control group.

Given that Vitamin D deficiency in patients with iron deficiency brings about Various complications for Growth and health, this study largely emphasizes follow-up of these patients.