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Background and objectives: Bone-related osteokines play an important role in the response of bone metabolism to physical activity. The purpose of this study was to investigate effects of different intensities of resistance training on serum levels of some osteokines associated with the Wnt signaling pathway and receptor activator of nuclear factor kappa-Β ligand (RANKL) pathway in old male Wistar rats.
Methods: Twenty-four old (23 months) male Wistar rats (mean weight: 437.93±33 g) were randomly divided into three groups of moderate-intensity resistance training (n=8), high-intensity resistance training (n=8) and control (n=8). Moderate- and high-intensity resistance trainings were performed at 60% and 80% maximal voluntary carrying capacity, respectively. The level of wclerostin, osteoprotegerin (OPG) and RANKL was evaluated by enzyme linked immunosorbent assay. Data were analyzed using one-way analysis of variance and at significance level of ≤0.05.
Results: The results showed that sclerostin (p=0.014), OPG (p=0.049) and RANKL (P=0.034) differed significantly between the study groups. The Tukey post-hoc comparison showed that sclerostin decreased significantly in the high-intensity resistance training group  compared to moderate-intensity resistance training group (P=0.048). In addition, OPG decreased significantly in the moderate-intensity resistance training group compared to the control group (P=0.033). Moreover, RANKL decreased significantly in the high-intensity resistance training group compared to the control (P=0.048).
Conclusion: The results showed that resistance training with appropriate repetition and intensity can have positive effects on bone formation signaling pathways.

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Background and objectives:  Safety is a key criterion for assessment of probiotics. The objective of this study was to evaluate safety of a new Iranian Lactobacillus paracasei IBRC-M 11110 strain as a candidate probiotic. 
Methods: Eighteen male and 18 female Wistar rats were divided into two experimental and a control group. The experimental groups received the bacterium at two doses of 6 × 10⁸ CFU/day and 6× 10⁹ CFU/day for 28 days through oral gavage. The control groups received normal saline. On day 29, blood, serum and tissue samples were taken for analysis.
Results: Administration of the bacterium did not affect the general health and body weight of the rats during the study period. No significant change was observed in the blood parameters of rats in the experimental groups except for a significant decrease in mean corpuscular volume and mean corpuscular hemoglobin of male rats. Serum analysis showed a significant increase in the alanine transaminase and a significant decrease in aspartate transaminase in the experimental groups of male and female rats, respectively. In both male and female rats, a significant decrease in urea and a significant increase in creatinine were observed in the experimental groups. However, the above parameters were all within the normal range. Histopathological analysis of liver and kidney tissues also showed no abnormality.
Conclusion: The results confirm that L. paracasei IBRC-M 11110 was safe in the subacute toxicity test in Wistar rats.

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Background and objectives: Differential diagnosis between clonal lymphocytosis (CL) and reactive lymphocytosis (RL) is often established through blood smear examination but with some limitations. We aimed to evaluate ability of clinical data and extended-cells blood count (CBC) parameters to discriminate CL from RL and to establish a decision-making algorithm for moderate lymphocytosis in adults.
Methods: A total of 85 samples were collected from adults with absolute lymphocytescount of >5G/l. The samples were divided into RL group (n=34) and newly diagnosed CL group (n=51).Demographic data, CBC parameters including high fluorescence lymphocytes cells percentage (HFLC%) and abnormal lymphocytes or blasts  (’AbnLym/BL’’) morphological flag were evaluated for each study group. New threshold for discriminating parameters were determined using receiver operating characteristic (ROC) curves and used in an algorithm for moderate lymphocytosis.
Results: Age, high lymphocytes count and the presence of the ’AbnLym/BL’’ flag and low HFLC% were predictor of malignant lymphocytosis. Age threshold of 62.5 years and absolute lymphocytes count of > 10.47 G/l were highly effective in CL detection with area under the ROC curve of 0.9 and 0.99, respectively. In addition, HFLC% showed an area under the ROC curve of 0.71. Considering ALC threshold of 10.47 G/l alone, a sensitivity of 96.7% and a specificity of 100 % were achieved. For moderate lymphocytosis ranging between 5 and 10.47G/l, no false positive or negative result was detected when we considered both the proposed ALC and age cut-offs. 
Conclusion: A combination threshold for ALC and age appears to be helpful for screening CL, especially in moderate lymphocytosis for both laboratory and clinical routine practice.

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Background and objectives: Coronavirus disease 2019 (COVID-19) is a global health problem. Laboratory professionals are at a higher risk of contracting the disease during the COVID-19 pandemic. This study was conducted to examine lab professionals' perceptions and satisfaction with organizational processes during the COVID-19 outbreak.
Methods: This cross-sectional survey was carried out on 53 medical laboratory professionals working at laboratories in Tripoli (Libya) between November 2020 and January 2021. Data were collected via face-to-face questionnaire. Responses to questions were scored based on a five-point Likert scale (1=strongly disagree, 2= disagree, 3=neutral, 4=agree and 5=strongly agree). Data were presented as frequency and percentages using the Microsoft Excel 2016.
Results: Most participants were female (81.2%) and with less than five years of work experience (39.6%). The majority of respondents (79.3%) had a bachelor’s degree. Most healthcare workers (75.5%) were unaware whether the lab would provide medical care if they were tested positive for COVID-19, while 13.2% of them perceived that they will get free medical care. Owing to social distancing, 20 subjects (37.7%) felt that their social activities have been altered during break time.  Only 3.7% of the participants believed that their motivation level decreased due to the COVID-19 outbreak.
Conclusion: The outcomes of this study provide laboratorians’ perspective in the COVID-19 crisis as well as specific lessons for future unpredicted crises.

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Background and objectives: The hoteling quality promotion is part of the health system development plan, based on which the physical appearance of laboratories of public hospitals are improved and renovated. The present study aimed to evaluate the policy-making gap in the hoteling quality promotion of the health system development plan in providing laboratory services in public hospitals in the Golestan Province, Iran.
Methods: This descriptive-analytical and cross-sectional study was performed on 384 medical staff and physicians working in laboratories of public hospitals affiliated with the Golestan University of Medical Sciences, Golestan Province, Iran. Data were collected using a 35-item researcher-made questionnaire that was distributed and collected over a period of six months. We examined the extent of the gap between the current and expected status based on the two components: the alignment of key stakeholders with health system development policies and stakeholders' opposition to health system development policies, as well as the extent of the gap
Results: The hoteling quality promotion was about -0.05 in providing laboratory services in public hospitals of the Golestan Province, indicating a low gap between the current and favorable status in the fifth axis of the health system development plan in terms of supervision.
Conclusion: The implementation of the hoteling quality promotion plan in providing laboratory services in public hospitals of the province is not consistent with the expected goals of the fifth axis of the health system development plan. Therefore, there is a need to examine and eliminate effective factors contributing to this gap.

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The current study aimed to introduce key ethical issues related to laboratory-based diagnostics that any individual may encounter during the provision of healthcare services. In a systematic review, relevant studies published on electronic databases including the PubMed, Scopus, Web of Science, Medline and Cochrane Library were collected for the years 1975 to 2020. The ethical issues related to clinical laboratories diagnosis and patients, colleagues, and society in different phases of laboratory testing were surveyed in this study. Considering ethical issues must be prioritized in each clinical laboratory for better dealing with clients, collaborators, and the community.

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Background and objectives: Lead (Pb) is among the most toxic pollutants that affect health of both humans and animals. Finding a way to prevent Pb accumulation in animals’ bodies seems necessary. Bacterial cellulose nanofiber (BCNF) can remove heavy metals from aqueous solutions. This study investigates effects of oral consumption of BCNF, as a chelator, on Pb concentration in the kidney and liver tissues of rats.
Methods: Sixteen Wistar rats (aged 6-8 weeks) were divided into four groups: 1. control, 2. fed with Pb, 3. fed with Pb (50 μg/g) and BCNF (16 μg/g) simultaneously, and 4. fed with Pb and BCNF with 4 hours interval. The rats were euthanized, and the kidney and liver tissues were separated. After acidic digestion of the tissue samples, Pb concentration was measured by atomic absorption spectrometry.
Results: The mean concentration of Pb in the kidney and liver tissues of rats fed with Pb and BCNF were significantly lower than that of rats fed only with Pb. In addition, the mean Pb concentration in rats of group 3 was lower than that of group 4.
Conclusion: The results of this study showed the favorable effects of BCNF on prevention of Pb accumulation in the kidney and liver tissues of rats. Moreover, removal of Pb may be related to binding of BCNF with Pb in the gut or blood. More studies are necessary to determine the exact mechanisms through which BCNF can reduce Pb accumulation.
 

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Background and objectives: Diabetes mellitus is the most common metabolic disorder in the world. Here, we evaluated effects of resveratrol supplementation alone and combined with exercise on blood glucose, insulin, lipid profile, apoptosis biomarkers, and expression of farnesoid X receptor (Fxr), liver X receptor (Lxr), and sirtuin 1 (Sirt 1) genes in the liver of type 1 diabetic rats.
Methods: Streptozotocin was used to induce type 1 diabetes in Wistar rats. The rats were randomly assigned into seven groups. After treatment with resveratrol alone or combined with exercise training, the animals were sacrificed and lipid profile and levels of blood glucose and insulin were measured. Hepatocyte apoptosis was assessed by measuring the level of Bax and Bcl2 proteins using enzyme-linked immunosorbent assay kits. Expression of Fxr, Lxr, and Sirt1 was evaluated using real-time polymerase chain reaction. Comparison of the mean levels of all variables between different groups was performed using one-way analysis of variance, at statistical significance level of 0.05.
Results: Resveratrol significantly reduced the level of blood glucose and insulin compared with the control groups (p<0.001). It also significantly affected the lipid profile (p<0.001). Diabetes was significantly associated with decreased expression of Sirt1, Lxr, and Fxr and increased hepatocyte apoptosis. Resveratrol significantly improved the expression of all three genes (p<0.01). Overall, resveratrol supplementation combined with exercise was more effective than other methods.
Conclusion: The results indicate that that combination of resveratrol therapy with exercise could be beneficial for diabetic patients. However, more studies are needed to confirm this finding.
 

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Background and objectives: Considering the increasing use of nanochitin for the removal of heavy metals from aqueous solutions, examining the biological effects of this substance on the level of essential metals for humans and animals is crucial. Therefore, this study investigated impact of oral administration of nanochitin on serum levels of iron (Fe) and calcium (Ca) in Wistar rats.
Methods: Twenty male Wistar rats were randomly divided into four treatment groups and one control group. Two groups were fed with nanochitin at doses of 1.6 and 2.6 μg/g for 6 weeks, and the other two groups received the mentioned doses for 10 weeks. Serum concentrations of Fe and Ca were measured using atomic absorption spectroscopy.
Results: Oral administration of 2.6 μg/g nanochitin for 10 weeks caused a significant decrease in serum Ca and Fe concentrations (p<0.05). Oral administration of 1.6 and 2.6 μg/g nanochitin for 6 weeks caused a non-significant reduction in serum Fe and Ca concentrations (p>0.05). However, nanochitin consumption for 10 weeks resulted in a significant decrease in serum Fe concentration but not Ca.
Conclusion: The limited reduction of serum Fe and Ca concentrations after oral consumption of nanochitin at a low dose and for a limited duration indicates that the controlled use of nanochitin could be safe for animals. However, complementary studies are needed to determine the exact effects of nanochitin on the animals’ bodies. On the other hand, it is recommended to use Fe and Ca supplements after consuming high doses of nanochitin for longer periods.

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Background and objectives: Gentamicin is an aminoglycoside antibiotic used in the treatment of Gram-negative bacterial infections. One of the side effects of this antibiotic is nephrotoxicity. In this study, the protective effect of Melissa officinalis L. extract on diabetes- and gentamicin-induced nephrotoxicity was studied.
Methods: Forty male Wistar rats were randomly divided into four groups. The first group received distilled water, and the second group received M. officinalis L. extract (100 mg/kg) for 28 days. The third group received streptozocin (60 mg/kg) for 18 days, and then received gentamicin (80 mg/kg) on day 20 for 8 consecutive days. The fourth group received streptozocin, gentamicin, and M. officinalis L. extract for 28 days. Serum levels of blood urea nitrogen (BUN), creatinine, glucose, and amylases were measured. The right kidney was maintained in 10% formalin for hematoxylin and eosin staining, and oxidative stress markers in the left kidney were assessed.
Results: In the third group, serum BUN, creatinine, glucose, amylase, and malondialdehyde (MDA) increased, while glutathione peroxidase, superoxide dismutase, and catalase activities decreased significantly compared to the other groups (P<0.05). The extract of M. officinalis L. significantly inhibited the enhancement of serum creatinine, BUN, glucose, amylase, and MDA (P<0.05). Histological examinations showed that diabetes and gentamicin could lead to kidney damage by inducing necrosis and inflammation. Finally, the extract of M. officinalis L. could significantly reduce the adverse effects of both gentamicin and diabetes (P<0.05).
Conclusion: The extract of M. officinalis L. improves biochemical parameters and histological lesions in diabetic rats treated with gentamicin.

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Background and objectives: Enterococcus faecium is a normal flora of gut microbiota. This opportunistic pathogen has attracted much attention due to its multidrug resistance and ability to survive in hostile environments. Various molecular typing methods such as pulsed-field gel electrophoresis or ribotyping have been developed for clinical and epidemiological investigation of these bacteria. However, these methods are time-consuming and labor-intensive. The present study was conducted to evaluate the discriminatory power of two common fingerprinting methods i.e. BOX-polymerase chain reaction (PCR) and enterobacterial repetitive intergenic consensus (ERIC)-PCR for E. faecium clinical isolates.
Methods: Fifty multidrug-resistant E. faecium isolates were isolated from 74 clinical specimens. The isolates were identified by specific 16S rRNA PCR. All isolates were fingerprinted using BOX-PCR and ERIC PCR. The discriminatory power and reproducibility of these two methods were also assessed.
Results: According to the dendrogram with >60% similarity, 17 different genotypes were observed using ERIC PCR. In addition, BOX-PCR produced 22 distinct patterns at a genetic distance percentage of 60%, with sizes ranging from 278 bp to 1450 bp. The discrimination index of BOX-PCR was higher than that of ERIC-PCR.
Conclusion: We concluded that a combination of ERIC-PCR and BOX-PCR may be a quicker and more reliable alternative for the discrimination of E. faecium clinical isolates.

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Background and objectives: Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue. It is the most common chronic metabolic bone disease. The purpose of this study was to compare the level of bone metabolic markers including parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, and phosphorus between female basketball players and non-athlete females.
Methods: Twelve female professional basketball players (aged 20-35 years) of the Super League of Golestan Province (Iran) were enrolled as the experimental group. Fifteen age-matched non-athlete females were also selected as the control group. Plasma levels of PTH, ALP, calcium, and phosphorus were compared between the study groups.
Results: The levels of PTH (p=0.004) and ALP (p=0.001) were significantly higher in the experimental group than in the control group. The levels of calcium and phosphorus did not differ significantly between the study groups (p>0.05).
Conclusion: Based on the results, it could be stated that performing weight-bearing sports activities such as basketball can improve the density of bone minerals and the factors stimulating bone formation.

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Marzieh Niakan¹ , Habib Alla Johari ², Mehrdad Shariati¹ , Davood Moghadamnia³ , Ebrahim Talebi⁴
Background: Research has shown that the extract of some plants has an effective protective effect on liver cells against toxins and oxidants. In this research, the effect of hydroalcoholic extract of ginger against hepatotoxicity caused by doxorubicin (Dox) in adult male rats was investigated.
Methods: In this experimental study, 63 adult male rats were divided into 7 groups (n = 9 per group). The experimental treatments included the control and placebo groups without the use of medicines, experimental group I that received Dox at a dose of 20 mg/kg, experimental groups II and III with 300 and 600 mg/kg of ginger hydroalcoholic extract, and experimental groups IV and V that received 20 mg/kg Dox + 300 and 600 mg/kg of ginger hydroalcoholic extract, respectively. After the end of the test period, serum levels of total bilirubin and direct bilirubin were measured. In addition, the histological changes in the liver were examined after hematoxylin and eosin (H&E) staining.
Results: Serum levels of total bilirubin and direct bilirubin in the Dox group showed a significant increase compared to the control group. In contrast, serum levels of total bilirubin and direct bilirubin in Dox + ZIN 600 and Dox + ZIN 300  had a significant reduction compared to the Dox group (P < 0.05). Ginger extract prevented apoptosis and Dox-induced liver tissue damage in dose-dependent designs.
Conclusion: The hydroalcoholic extract of ginger improves the changes of serum bilirubin and liver tissue after receiving Dox due to its antioxidant compounds.

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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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Background: Ulcerative colitis (UC) is a long-term inflammatory bowel disease (IBD) caused by abnormal immune responses, leading to inflammation and scarring in the large intestine. The bacteria Prevotella melaninogenica, found in the intestine and mouth, may contribute to UC. This study focuses on the detection of P. melaninogenica in the saliva of UC patients and compares them with the healthy control (HC) group.
Methods: The present study was a case-control study including 40 UC patients and 40 healthy controls (HCs) with an average age of 43.0 3± 10.3. This study used a real-time PCR test to investigate the frequency and average number of P. melaninogenica from the 16S rRNA gene sequence of P. melaninogenica in both groups.
Results: P. melaninogenica was more frequent in UC patients (77.5%) than HCs (45%) (p = 0.003). The patient group had more bacteria (339.31 ± 1082.29) than HCs (61.29 ± 154.03) (p = 0.005). Women in the UC group had more P. melaninogenica (492.35 ± 1427.61) than the control group (56.98 ± 123.50) (p = 0.0342). Similarly, men in the UC group (262.85 ± 664.97) had more bacteria than the control group (72.62 ± 222.76) (p = 0.015).
Conclusion: The current study showed that dysbiosis in P. melaninogenica, a bacterium in human saliva, could be important in the development of UC. Further investigation is needed to evaluate its use as a potential biomarker in the UC.
 

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 Background: Rampant and irrational use of antibiotics led to antimicrobial resistance in intensive care units, directly influencing the clinical outcome. The prior introduction of antibiotics, especially broad-spectrum antibiotics, has been identified as a leading cause of hospital-acquired pneumonia. The present study aims to examine the existing scenario of antibiotic resistance due to multidrug-resistant organisms that are detected in mechanically ventilated patients.
Methods: This cross-sectional study was conducted in the department of Microbiology of a tertiary care hospital in Central India. A total of 410 endotracheal secretions were collected. The endotracheal aspirate of adult patients admitted to the medicine intensive care unit and on mechanical ventilation was received at the microbiology laboratory for processing by standard bacteriological techniques. Drug susceptibility testing was done using the Kirby-Bauer disc diffusion method according to the indications mentioned in Clinical and Laboratory Standards Institute 2021.
Results: Out of 410 collected endotracheal secretion samples, 332 (81 %) samples demonstrated bacterial growth. A total of 265 (80%) cases fulfilled the inclusion criteria. From 265 samples, 92 (34.7 %) patients were clinically and microbiologically confirmed as cases of ventilator-associated pneumonia. Over eighty percent of gram-negative bacilli were multidrug-resistant strains (Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa).
Conclusion: Real understanding of multidrug-resistant pathogens, early isolation as well as avoiding long-term antibiotic intake can reduce mortality levels currently linked with late-onset ventilator-associated pneumonia.

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