مقالات رزومه مسعود حاجیا

Today, molecular diagnostic methods have an unignorably position in diagnostic laboratories. It is estimated that 60-70% of all decisions depend on molecular detection methods. However, many Iranian physicians still do not fully trust the newly developed protocols in particular. If necessary, they request some confirmatory tests available to ensure a final decision.The purpose of this short study is to investigate the causes of uncertainty in these tests and current challenges in Iranian clinical centers. Therefore, all the effective cases from receiving the samples to publishing the patient reports are looked up. Significant parameters including pre-analytical, analytical and post-analytical parameters are studied in this study. The reason for some of the current limitations is discussed based on released documents and reported periodic inspections according to published standard criteria. Based on the results, the need for fundamental revisions in some parts of the relevant bodies is clearly identified.

Clinical databases have been developed in recent years especially during the course of all medical concerns including laboratory results. The information produced by the diagnostic laboratories have great impact on health care system with various secondary uses. These uses are sometimes as publishing new extracted information of laboratory reports which have been widely applied in the scientific journals. Nowadays, some large scale or national databases are also formed from the integration of these data from smaller centers in the field of human health in many countries. These databases are beneficial for different stakeholders who may need these information. Unfortunately, reviewing some of these uses has indicated lots of errors in quality control, test validity, uniformity and so on. More importantly, some of the diagnostic procedures have been applied in the clinical diagnostic laboratories without even preliminary clinical evaluation studies. Therefore, any taken conclusion from these analyzed data may not be reliable.  This use requires checking the several specifications that have been notified in this study. Current review also intends to show how the correct information should be to extract for the scientific reports, or integrated in large scale databases.

The prevalence of brucellosis has increased in recent years in some regions in Iran, particularly in the western, northeastern, and some central areas. Undoubtedly, the main causes of brucellosis are the lack of vaccination coverage in livestock and distribution of dairy products. In addition, attention must be paid to the diagnostic difficulties associated with slow growth specificity and use of inefficient methods, which lead to the delayed diagnosis of the disease. All the available diagnostic procedures are currently used for the diagnosis of brucellosis, including isolation on culture media, serological procedures, and molecular techniques. Among these methods, isolation on culture media has shown the minimum efficiency, especially in blood specimens, which are the most commonly requested specimens in disease diagnosis. The influential factors could be the use of unapproved commercial kits, applying outdated diagnostic procedures, and using unqualified specimens in hospitalized patients. The present study aimed to enhance the current status of the isolation method, especially in the endemic areas for brucellosis. Several parameters were assessed in this regard, including the role of laboratory conditions, sampling quality, type of culture media, and various isolation methods, in order to review the studies aiming to increase the efficiency of this method.

Human brucellosis and its prevalence are directly correlated with the presence of animal infections in various regions. The infections associated with Brucella species have been reported in numerous animals. The incidence of these infections has recently increased in the endemic regions in Iran, including Zagros areas and the northeast of the country. Therefore, there have been difficulties in the diagnosis of the infectious cases since there is the possibility of encountering resistant strains. Furthermore, the spread of immerging strains is among the challenges that rapidly affect animals, even vaccinated livestock. Antibiotic-resistant strains are important in livestock since drug resistance may rapidly spread to humans. Therefore, continuous investigation is required in the case of drug resistance or immerging strains. Conventional typing procedures are no longer used due to several difficulties. Identifying the type of Brucella could provide adequate data on epidemiological surveillance, investigation of the infection outbreaks, tracking the diseases, identifying the immerging types, reviewing the success rate of eradicating the infections, and examining the outbreaks in the endemic areas. The reports regarding the application of molecular typing methods are still under development. Extensive research has been focused on the typing of brucellosis, proposing controversial results and aiming to improve the applied procedures. This review aimed to assess the ability of the introduced molecular methods and their status for identification and typing procedures. In addition, the frequency and distribution of Brucella species and subspecies have been investigated.

The food-borne pathogens appear to be a reemerging and endless problem in the human community all over the world. Hence, all the outbreaks should be constantly monitored for pandemic strains and new mutant genotypes. The main purpose behind the molecular typing is the comparison of bacterial isolates to obtain genomic relatedness regarding epidemiological aspects. One of these methods that have been recently reported in several Iranian studies is pulse field gel electrophoresis (PFGE). The aim of this study was to review and discuss the current situation and difficulties, and also the necessity of planning for tracking new and re-emerging food-borne pathogens investigating PFGE future status in Iran as a molecular epidemiology tool. According to the results, it was found that this technique requires high investments in both fields of required equipment and software some of which are now available in many research centers. In addition, investigations on various medical search engines revealed that hundreds of studies have been published after 2010 in Iran. These reports indicated that most of these studies were not able to provide an efficient epidemiological analysis of the outbreaks and prevention of future events, except for a few exceptions. A review of the capabilities available in the country in this respect led the researchers to infer that it may be the best time to make a plan on the existence of a general network of collecting and analyzing the results, as well as integrating them into the international databases. It is expected that these responsible institutions to make the required design in this field.

Currently, different highly sensitive nucleic acid detection-based protocols used in medical diagnostic laboratories need specific working conditions, and if no optimization is performed, misleading results can be obtained. Limitations of each protocol is different in obtaining an appropriate result. Awareness of these limitations plays an important role in providing a reliable result for physicians and patients. The present study aims to investigate these limitations

Cholera is considered a key indicator of social development but still is reported in various cities of Iran. The present study aimed to analyze the available information regarding cholera outbreaks since 2010 in Iran.
All cases reported to the Center for Disease Control and Prevention of Ministry of Health and Education who had been confirmed as cholera cases by the Health Reference Laboratory, were entered into this study since 2010. A specific spreadsheet was designed to ensure the safe keeping of the patient records.
A total of 1522 patients were clinically diagnosed as cholera with laboratory confirmation over the study period. Cholera was detected in 26 Provinces and 115 cities during this period. Mean age of the patients was 35.1±17, both the Inaba and Ogawa strains were isolated. The highest mortality and the morbidity rate was 1.98% in 2013. The most cholera prevalent provinces in order of frequency were Baluchistan, Alborz, Gilan, Golestan and Qom, as well as Tehran. Inaba serotype was the most common cause of mortality and morbidity in 2013.
These findings indicate significant outbreaks of cholera in some of the provinces of Iran and warrant appropriate treatment and preventive measures.

Cholera is a potentially life-threatening acute diarrheal disease caused by the toxigenic bacteria, Vibrio cholerae. Antibiotics should be selected using local antibiotic susceptibility testing patterns. This study was performed to identify the patterns of antimicrobial resistance in isolates collected from laboratory-confirmed cases of cholera during three years, from 2011 to 2013. All isolates at the Health Reference Laboratory were tested by the Minimum Inhibitory Concentration (MIC) Test using Liofilchem against ciprofloxacin, nalidixic acid, cefixime, ampicillin, tetracycline, trimethoprim-sulfamethoxazole, and erythromycin. The following organisms were used as quality control strains for MIC E-testing; Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 29213), and Pseudomonas aeruginosa (ATCC 27853). Results of susceptibility testing showed complete sensitivity to ciprofloxacin, cefixime and amplicillin for both isolated Inaba and Ogawa serotypes except all isolated Inaba serotypes from year 2011, which were resistant to cefixime. These resistant Inaba serotypes were not isolated in the next year. Inaba serotypes showed an increased resistance rate of up to 100% to nalidixic acid, tetracycline and trimethoprim-sulfamethaxazone, while Ogawa serotypes were 100% sensitive at the end of year 2013. The susceptibility pattern of erytromycine was similar in these two types. Sensitivity to erythromycin was decreased in both Inaba and Ogawa serotypes. The analyzed results indicate that tetracycline should not be considered as a first line antibiotic therapy for patients infected with Ogawa serotypes. Also, national guidelines for confirmation of cholera should be improved by responsible authorities to cover new resistance during outbreaks.