Razi Journal of Medical Sciences

    Background & Aim: Cyclospora cayetanensis is a new-emerging pathogenic protozoan parasite. It is a rare coccidian associated with gastrointestinal disorders. Cyclosporiasis occurs in persons of all age groups and either in immunocompetent or immunocompromised hosts. The most characteristic feature of this infection is a syndrome of acute or chronic diarrhea. This parasite is worldwide in distribution. Cyclospora can be transmitted by ingestion of water or food contaminated with oocysts. The present study was undertaken to assess the prevalence of cyclospora cayetanensis in children with diarrhea. Material & Method: During twelve months(from June 2002 to June 2003) 420 stool samples from children under 10 years of age with diarrhea, admitted into Tehran Children Medical Center were screened. To detect and identify the organism, direct smear, formalin-ether concentration, and staining(modified acid fast) techniques were used. Results: In this cross-sectional study, 31 out of 420 specimens(7.3%) showed parasite infection, but cyclospora cayetanensis was not detected in any of the stool samples. Conclusion: According to our study, it seems that cyclospora infection in Tehran is very rare and further studies with larger volume size of stool are necessary for cyclospora identification. We also suggest that medical practitioners and laboratories should be more aware of this infection and its diagnosis.

    Background & Aim: Nowadays one of the problems in developing countries is pediatric diseases and their mortalities. In this respect diarrhea plays a significant role. Cryptosporidium is recognized as an important widespread cause of severe and prolonged diarrhea mainly in immunocompromised or malnourished children, but there is no attention to identifying the parasite. The present study was designed and undertaken to assess the prevalence rate of agents causing diarrhea and determine the role of cryptosporidium and its relationship to some potential risk factors. Material & Method: In this cross-sectional study carried out during twelve months(from June 2002 to June 2003), stool samples from 420 children under 10 years of age with diarrhea who were admitted to Tehran Children Medical Center were screened. To identify parasites, direct smear, formalin-ether and modified acid fast staining techniques were applied. In addition, in order to distinguish pathogenic bacteria, differential media and polyvalent standard antisera were used. The obtained data was analyzed using descriptive and analytical statistics, i.e. Chi-square, t-test and Fisher exact test. Results: This study showed that after bacteria, parasites were important causes of diarrhea, and cryptosporidium(2.4%) following giardia(2.9%) was the second parasite isolated in children with diarrhea. Statistical analysis of our results indicated that existence of cryptosporidium was significantly related to the presence of mucus in stool(P<0.003), immune deficiency(P<0.01), and age(P<0.017). Conclusion: This study emphasized that laboratories include appropriate diagnostic techniques for cryptosporidium in the routine examination of watery or mucoid diarrheal stool specimens, particularly for immunosuppressed patients.

  Background: Laboratory tests are used to diagnose diseases, monitor its progress and response to treatment. So the goal of the laboratory medicine is reporting accurate and on time test results. The aim of this study was to evaluate rate and causes of post-analytical errors in the Clinical Laboratory of Children’s Medical Center. We especially focused on 1) delay in reporting test results and 2) inaccuracy of test results.

  Methods: This descriptive study was conducted in Children’s Medical Center in 2008. Any complaint related to accurate reporting and on time test results from inpatients and outpatients, physicians and wards during 3 months period were registered. The reasons were investigated then recorded in predesigned forms data were analysed with SPSS version 15, Chi square and Fischer’s tests.

  Results : A total of 375 of 425 complaints were related to delay in reporting test results. We also recorded 50 cases of erroneous result complaints. Also 72% of delayed reports and 34% of complaints of unaccepted results were caused in post-analytical phase (i.e. after test was performed). “Failure to input the results in computer” was the main reason (37%). “Lost results “(25%) and transcription error (22.6%), “absence of laboratory request form” (9.8%) and “wrong method of filing” (4.2%) were the other observed causes. Microbiology, hematology and clinical chemistry were departments with the highest rate of complaints whereas urine culture, CBC and biochemistry tests were the most frequent problematic tests. The rate of complaints was 1:108 patients or 1:541 tests, and 4.8% of results were not reported in timely manner.

  Conclusion: Our findings revealed that the source of most of the errors related to reporting test results were in post-analytical phases. Therefore along with continuing the educational programme, and improvement of automation, it seems necessary to add periodic evaluation and investigation of errors to benchmarks programmes, especially in reporting test result processes, in order to provide error free service to physician and their patients. Cooperation with the clinicians and the other personnel outside the laboratory is also important for error reduction.