جستجوی مقالات مرتبط با کلیدواژه « آزمایشگاه » در نشریات گروه « پزشکی »

Medical diagnostic laboratories use ready-to use kits to standardize methods and facilitate tests. In spite of the diversity of the manufacturers, the kits are generally prepared using the same methods and solutions. The International Federation of Clinical Chemistry and Laboratory Medicine acts as one of the authorities for evaluating, setting goals and providing recommendations for choosing test methods, but organizations such as the International Association for Laboratory Accreditation have also published guidelines in the form of the ISO 15189 standard. Familiarity with the molecular basis of kits enables the lab technician to identify possible errors and troubleshooting them. Therefore, in addition to practical skills, it is necessary for the technician to be familiar with the details of the testing method. Common methods can be traced back to the 18th century. The pervious literatures focused on specific analyt and presents their differences in terms of sensitivity and specificity while we reclassified the methods based on mechanism of actions.

We searched PubMed, MEDLINE and the other databases for the most common articles discussing the basis and theory of testing and the technical details of the testing method and reviewed the literature by focusing on current Kit mechanisms.

The review on the methodology of current medical diagnostic kits showed that they are based on several methods but could be categorized into peroxidase-based detection, chemical reaction, complex formation, enzymatic assays, and immune assays.

In general, the method of performing a reaction depends on the type of analyte. Therefore, it is obvious that the method of measuring rare metal elements is different from the method of measuring enzymes. The classification of these methods can promote the laboratory science significantly.

Improving the safety of working environments is one of the duties of any efficient system. Evaluating the risk of hazards is one of the most efficient ways to increase safety issues. Paying attention to the statistics of laboratory accidents and the positive effects of risk assessment to improve safety is of great importance. 

In this cross-sectional study, we evaluated the laboratories of Shahid Sadoqhi University of Medical Sciences, Yazd, using a quantitative three-dimensional cost equation. Based on the regular observation of existing processes and equipment, the evaluation team used a quantitative risk equation as an indication of safety performance at the level of laboratories. The ranking was based on the probability of risk, the frequency of exposure, and the maximum damage potential through a quantitative equation. Finally, the risk score of each laboratory was determined, and the ranking of the risk level of the laboratories was announced. Corrective solutions were suggested, and the evaluation was repeated. The data was entered into the SPSS 20 software and interpreted using descriptive and analytical statistics. 

In general, 52% of the risks identified in laboratories are at a low-risk level. The highest and lowest average evaluation scores were 55.86 ± 30.89 for environmental chemistry and 28.38 ± 13.51 for food safety and health research laboratory, respectively. The highest evaluation score was for the environment laboratory. There was a significant relationship between the risk components before and after providing the suggested solutions. According to the results of the research, the overall safety status of the educational laboratories in the Faculty of Health is at a relatively favorable level. However, chemical hazards and thermal safety are the highest priority to control and perform better regarding improvement.

Laboratories play a crucial role in education and scientific research by providing an environment for various experiments and investigations. However, due to potential hazards such as chemical, biological, and physical agents, laboratories are inherently considered dangerous work environments. Therefore, it is essential to have a reliable and valid tool to evaluate the safety of these environments comprehensively. Therefore, this study was conducted to design and psychometrical evaluation a comprehensive tool for safety evaluation in university laboratory complexes.

In the first stage, a Checklist was developed across various areas through a process that involved using a literature review, field visits, Interviews with laboratory technicians, and creating videos from multiple laboratories. The initially designed questionnaire was sent to 10 safety experts for face validity, and then their comments on the question phrasing were considered. To assess the content validity, two measures were employed: the Content Validity Ratio (CVR) and the Content Validity Index (CVI). Additionally, the reliability of the instrument was evaluated using Cronbach's alpha calculation method.

In the initial stage, a total of 286 questions were designed within 9 different areas. Subsequently, 49 questions were removed by expert members due to overlapping concepts, resulting in a final questionnaire consisting of 237 questions. The content validity index and relative coefficient were found to be above 0.8 in all areas, indicating strong content validity. Furthermore, Cronbach's alpha value exceeded 0.7 in all areas, suggesting a desirable level of reliability for the designed program.

The results of this study demonstrate that the developed questionnaire exhibits acceptable levels of validity and reliability. As such, it can serve as a comprehensive and suitable tool for monitoring safety in University complex laboratories.

Cost management and reduction in healthcare resource utilization while maintaining the quality of laboratory services and making sure of the continued provision of servicesare one of the basic challenges facing hospital managers under COVID-19 pandemic conditions. Hospital managers have to control laboratory performance, identify the bottlenecks, and finally decide which program is necessary for reducing inappropriate utilization of laboratory resources and increasing hospital revenue. Accordingly, study of the workload in clinical laboratories provides them with valuable information to develop and implement policies that improve laboratory performance.

This applied cross-sectional research followed a descriptive-analytical method for analyzing the workload of the clinical laboratory of Amirul Mominin Ali Zabol Hospital in Sistan region in order to investigate the volume of referrals in two years before and after the start of the epidemic. Covid-19 and determining the causes of possible changes has been done.

The research findings indicated that the number of inpatients referring to the hospital laboratory has decreased by 18.7% and outpatients by 49.7%, 2 years into the Covid–19 pandemic in comparison with the same period before it, and the number of tests has decreased by 0.025% in the inpatient ward and by 55.13% in the outpatient ward compared to the pre-epidemic period, on the other hand, the average number of test for each person has increased by 21.09% in the inpatient ward and has decreased by 8.9% in the outpatient ward.

Based on research results, the Covid–19 pandemic affects the workload of clinical laboratories. Cancellation of elective hospitalization cases, decrease of patients' visits to the hospital, closure of non-COVID wards and clinics, reduction in accidents, increases in economic problems, and uncertainty on the quality of services were among the mentioned factors that decreased the number of patients visiting the hospital.

Medical Laboratories have a great impact on patient safety and 80-90% of medical diagnoses are based on the results of laboratory tests. Medical procedures from the initial diagnostic steps such as a test or a simple injection to specialized treatment steps may be erroneous. The aim of this study was to determine the type and rate of human error, equipment, materials and procedures in all stages including before analysis, during analysis and after analysis to analyze the causes and find logical solutions to reduce of them.

This cross-sectional descriptive study was performed in a medical center in Tehran, Iran during the years 1400-1401. Data collection was considered in accordance with the instructions of the Laboratory Affairs Department of the Ministry of Health and Medical Education regarding the type of errors in the field of job description in each of the technical and non-technical sections. Data was analyzed by IBM SPSS software, version 22 (SPSS Inc., Chicago, IL, USA) software.

During the period of study, the number of  referred patients was about 45,000 and the number of tests 594,000. The total number of errors was 837. The ratio of errors to the patients was 1.9% and to the tests 0.15%. The 37 types of errors were identified and reported in this study. Of these, 11 types of errors were in the pre-analysis, 14 types during the analysis and 12 types of errors in the post-analysis stage. The frequency of errors in the three stages was 180(21.5%), 312(37.3%) and 345(41.2%), respectively that the errors rate did not have a normal distribution and a significant difference was observed (P<0.05, df=2).

Due to the variety of reported errors and the importance of their role in other stages of diagnosis and treatment, it is necessary that all human, equipment and process errors in all stages of laboratory analysis be carefully recorded and corrective and preventive measures be taken to minimize them.

Considering the importance and position of the health sector in socio-economic development programs, it is necessary to be aware of the current situation and to recognize its issues and problems. Determining costs and the amount of profit or even loss in the health sector helps in managing costs. The purpose of this study was to evaluate the cost of common laboratory services and compare them with the tariffs approved by the Ministry of Health and Medical Education in the selected hospital of Tehran University of Medical Sciences.

The present study was a cross-sectional and retrospective study. In this study, activity-based costing technique was used. The study population was the laboratory of the selected hospital of Tehran University of Medical Sciences. Data collection tools were information forms, software, interviews and direct observation. The analysis was performed using Excel 2016 software and finally, the cost price was compared with the approved tariff.

The findings indicated that the highest and lowest costs were related to the cost of manpower and energy carriers, respectively. The highest cost was related to the urine analysis test and the lowest was related to the sodium and potassium tests.

The results of this study showed that the cost of conventional laboratory services in the selected hospital of Tehran University of Medical Sciences and the tariffs approved by the Ministry of Health and Medical Education in 2019 were different.

Safety, raising awareness, and preventing the occurrence of hazards are necessary in order to continue to improve the quality of laboratory activities, which have been recently considered by scientific, research, and industrial communities. Therefore, the present study was conducted to determine the risk factor, potential hazards, and provide practical programs in the laboratories of the Shrimp Research Institute.

Safety hazards of eight laboratories of the National Shrimp Research Institute were evaluated during the intervention study with the Failure Mode and Effects Analysis technique. To this end, in the first phase, the team of safety experts (HSE: Health and Safety Executive), by preparing and completing safety questionnaire forms, identified the current status of safety indicators and danger points of laboratories, assessed the distance with safety indicators, and managed danger points. Based on risk severity, probability of occurrence, and probability of risk detection, the risk priority number (RPN) was calculated, prioritized, and corrective measures were proposed. In the second phase, after corrective measures, the safety questionnaire was completed again and the level of risk severity, probability of occurrence, probability of detection, risk priority number, risk number, and percentage reduction of risk priority number of the studied laboratories were calculated and analyzed.

Thirty-five hazard points were identified in the laboratories. The range of risk priority numbers ranged from RPN = 12 for the Plankton Laboratory to RPN = 210 for the Marine Microbiology Laboratories and Marine Pollutants. After control measures, the risk number of marine microbiology laboratory was reduced to 180 and marine pollutants to 120 (P <0.05).

The results showed that FMEA technique is appropriate in identifying the risk points, evaluating, and classifying the risks of the Iran Shrimp Research Institute laboratories and provide control strategies to eliminate or reduce the risk rate of research environments.

Research laboratories are important parts of universities. The risks and variety of laboratory activities have made the issue of fire protection one of the major safety challenges in the laboratory, and fire prevention is important to ensure the safety of people and equipment. Therefore, the present study was performed to evaluate the efficacy of active and passive fire protection in scientific laboratories of Hamadan university of medical sciences.

In this descriptive-analytical study, the FRAME fire risk assessment method was used to assess the fire risk. Data were collected using a checklist and the resulting data was entered into the FRAME calculation program. First, the fire risk of buildings, people and laboratory activity were calculated and ranked according to the level of risk. The efficiency of active and passive protections available in laboratories was also evaluated.

The results showed that 63% of laboratories had inadequate protective equipment, and the calculated level of risk for staff in all laboratories is higher than 1. So, the existing protection facilities were not suitable to protect staff in all laboratories. The results related to fire risk of activity showed that only in 18 laboratories (39.13%), the existing protection facilities had good performance.

Simultaneous use of active and passive protection is more effective in reducing risk. Due to the high risk of fire for people in all laboratories, it is recommended taking appropriate management measures to be prioritized by safety programs to reduce the risk to an acceptable level.

The aim of this study was to assess financial performance of 260 clinic’s laboratories affiliated to Social Security Organization (SSO) from 2012 to 2019.

Step-down cost accounting was used. At first, the proportion of laboratory cost separated from the total clinic cost for each clinic, then four groups of indicators were measured including: ratio of laboratory cost to total clinic current cost, ratio of direct, overhead and support cost to total laboratory cost, the average cost and revenue per laboratory prescription and total revenue to total cost ratio.

Ratio of laboratory cost to total clinic cost has been 11% on average from 2012 to 2019 and its trend has not changed significantly. Ratio of direct, support and overhead costs to the total laboratory cost was 61%, 33% and 6% respectively. The average annual growth of cost and revenue per laboratory prescription was 28% and 26% respectively. In studied years, the revenue of laboratories covered an average of 48% of their costs with a declining trend.

There is a significant gap between the costs and revenues of the SSO clinic’s laboratories and a wide variation in financial performance of laboratories even in similar environment as well. To conclude, the results of this study demonstrate opportunities to optimize financial performance of laboratories.

In order to timely identify and treat the patients with coronavirus disease 2019 (COVID-19), the use of rapid and accurate laboratory diagnostic methods is important, and tests such as erythrocyte sedimentation rate (ESR), complete blood count (CBC), C-reactive protein (CRP), arterial blood gas (ABG), and real time-polymerase chain reaction (RT-PCR) are helpful in assessing patient's condition and diagnosing the disease. This was a comparative study of the physician specialty and laboratory services requested for patients with COVID-19 based on the evidence from a large hospital."

This was a descriptive-analytical cross-sectional study in Mashhad City, Iran, on 307 patients with COVID-19 hospitalized under the management of internal and infectious therapist groups, selected using random stratified sampling method. Data were entered into SPSS version 22 statistical software.

A statistically significant relationship was reported between the two groups of internal and infectious therapists in the capitation and cost of K, Na, alkaline phosphatase (ALP), aspartate aminotransferase (AST), blood albumin (Alb), bilirubin (Bili), blood sugar (BS), fasting blood sugar (FBS), Ca, Mg, phosphorus (Pho), treponema pallidum immobilization (TPI), CBC, CBC differential (CBC/Diff), and ABG tests, and tracheal tube culture and antibiogram. Patients were discharged with 89.7% recovery and 10.3% death in the first group, and with 95.5% recovery and 4.5% death in the second group.

Different behavioral patterns in prescribing and performing laboratory services by physicians with different specialties, especially in times of epidemic outbreaks, may indicate the lack of national laboratory protocol and also limited access to reliable diagnostic tests, while wasting resources, impose direct and indirect costs to patients and medical centers.

The existence of different types of laboratory equipment, as well as chemical and biological materials necessitate a careful planning to prevent possible accidents in the laboratories of medical sciences universities. This study set out to assess the safety and environmental status in educational-research laboratories and its compliance with regulatory criteria.

In this descriptive study, a standardized checklist under the auspicious of the ministry of health was used to assess the situation of 17 laboratories of Golestan University of Medical Sciences in terms of building conditions, physical, chemical and biological hazards, as well as safety and ergonomic. Data were collected via interviews and observations during April to September 2019. SPSS 20 was used to describe obtained information. Ethical principles were observed in all steps of study.

The results showed that more than 62% of safety regulations and environmental requirements were compatible in the laboratories of Golestan University of Medical Sciences. Compliance rates were 61%, 70%, 71%, 59%, 56% and 59% in the sectors of building, physical, chemical and biological hazards, safety and ergonomic, respectively. Lack of proper locating of the laboratory building and allocated limited space were the main problems of these units.

Safety and environmental status of studied laboratories was in the limit of recommended requirements by ministry of health. Nonetheless, the existence of some defects regarding the hazards related to gas cylinders or chemical and biological substances may threaten employee’s health and environment. Hence, an appropriate plan and safe management implementation is needed to prevent accident incidents in the educational-research laboratories.

Universities research laboratories play an important role in promoting higher education. Factors such as the presence of various types of flammable chemicals, and a variety of laboratory activities have turned the issue of fire safety into one of the main safety challenges in the lab. Fire prevention is important to protect the safety of people in laboratories and adjacent units. This study was conducted to evaluate the risk of fire at the University of Medical Sciences Laboratories. In this descriptive-analytical study, risk assessment method of FRAME was used. The data was collected using a checklist and the data from the checklist was entered into the FRAME computational program. After calculating the fire risk of the building and the contents, individuals and activities, then the labs were ranked according to the level of risk. In addition to determining the efficiency of existing facilities and protection for high risk labs and lacking adequate protection system was proposed a suitable fire system. In according to the level of risk are gained, the effectiveness of existing protective measures provides only adequate protection for 35% of activities and 37% buildings. However, considering the calculated risk for individuals, no adequate protection for individuals is provided in any laboratory. Fire safety training is mandatory for employees. Considering the high risk of fire risk for individuals in all laboratories and the importance of the safety of individuals, it is recommended that appropriate management measures be taken to reduce safety risks to safety priorities.

One of the common problems in the medical parasitology laboratory is the differentiation of parasites from other elements in the stool and body fluids so-called "artifacts". Artifacts generally referred to living or abiotic agents that embedded in the clinical sample and may misleading the lab because of their similarity to parasitic organisms. Artifacts are an integral part of the diagnosis process and they are cause of common misdiagnosis in the laboratory.
Their differentiation from pathogenic parasitic agents is done by proper diagnosis, which leads to proper treatment of parasitic infections. As usually an inexperienced technician often misdiagnosed a yeast or other plant cell as amoeba or considers a platelet as a malaria parasite, it may be unsuccessful to identify parasitic organisms that really exist in the stool sample.
The major forms that cause confusion and misdiagnosis in parasitology laboratory are spores, fat droplets, yeast, red blood cells, and macrophages.Compared with other parts of the medical laboratory, in parasitology lab less attention observe  to this problem. The consequence is the reporting of false positive results, incorrect treatment, and patient injury.
 Identifying, introducing, and differentiating artifacts for laboratory personnel, especially inexperienced, are an important factor in accurate diagnosis. In the present study, key diagnostic points of parasitic organisms and artifacts have been categories.

Clinics, laboratories and health care centers are considered as one of the main waste generating sources in solid waste management. The problems associated with the generated health-care waste in clinics, laboratories and health care centers have been rarely investigated in Iran. Therefore, the present study was developed to investigate the status of health care waste in clinics, laboratories and health care centers of Mahmoudabad, Mazandaran in 2017.
Methods and Materials: This cross-sectional study was conducted to determine the status of solid waste management in 117 medical centers in Mahmoudabad, Mazandaran, 2017. The solid waste data in terms of waste generation rate, storage, collection, and disposal were surveyed through interview and questionnaire that were validated by Iran’s ministry of health. The average health-care waste generation in medical centers in Mahmoudabad was found to be 248 g/day. The mean and standard deviation for environmental health criteria in all medical centers were 248.3 and 41.1, respectively. In addition, there was a statistically significant difference between the amount of waste generation in private and governmental medical centers (p=0.111). The results obtained from the present research indicated that the medical waste management in Mahmoudabad, particularly in private centers, face serious problems. Improper waste collection technology, mixing municipal and medical waste, requirement for training the personnel in medical waste management and surveillance can be considered as important concerns in health-care waste management in Mahmoudabad.

Outsourcing, as one of the most recently used tools in the field of healthcare management, has an important role in improving the efficiency and quality of health services. The objective of the present study was to design a tool for evaluation of the process of outsourcing in laboratories of non-educational hospitals.   This applied study was conducted as mixed methods and in two qualitative and quantitative steps. In the first step, through reviewing the existing literature and documents published abroad and in Iran relating to the research subject, a check list for evaluation of the process of laboratories’ outsourcing was prepared. In the second step, using a close questionnaire, 46 selected experts were asked to give their opinions about the content and face validity of the proposed check list. Finally, Lawshe's Content Validity Ratio and Excel software were used to analyze data.   The final check list about evaluating the process of out sourcing laboratories at non-educational hospitals included the following 5 dimensions: proving the necessity of laboratories outsourcing (9 questions), selecting the undertakers (13 questions), negotiating and finalizing the contract (10 questions), implementing the contract (5 questions) and evaluating the undertakers’ performance (8 questions).   Given the importance of outsourcing laboratories, providing education related to the implementation and evaluation of this process form its beginning until end, in periodic training courses for university’s managers and staff is highly recommended.

Observation of the safety principles in educational and research laboratories is very important to protect the researchers and students. This study was conducted to investigate the safety and health status of the educational and research laboratories in Shiraz University of Medical Sciences. This cross-sectional study was conducted in 34 educational and research laboratories of Shiraz University of Medical Sciences in 2013. In this regard, the safety and health status of the studied laboratories was studied based on the ELMERI Indicator. This indicator consists of 59 items in nine dimensions including electrical safety, fire safety, building safety, emergency response management, chemical safety, individual safety, device and equipment safety, waste management, and safety management. Finally, the Laboratory Safety Index (LSI) was calculated in percentage using the mean and standard deviation by SPSS 16 in each laboratory. The mean of LSI was 77.62 ± 10.35 percent in all the studied laboratories. The highest and the lowest percentages of LSI score were in individual safety (89.46 ± 12.86%) and emergency response management (53.72 ± 35.46%) dimensions, respectively. The other dimensions were classified to have good status. According to the results, the overall status of safety and health was good in the studied laboratories. However, in the dimension of emergency response management, the status of laboratories was unacceptable. So, required measures should be taken in this regard. For example, all the emergency exit systems should be investigated, instructions should be issued, staffs should be trained with regard to the emergency conditions, emergency exit doors should be designed, and the requirements for the exit emergency routes should be observed appropriate to the laboratory conditions.

  Reference laboratory values undergo major changes during pregnancy and if they were defined according to non-pregnant women laboratory reference values, can lead to inappropriate decisions and have adverse effects on pregnancy. Because of the physiological changes in the body of pregnant women, the reference values are not standardized in the medical diagnostic labs. Therefore, the present study was conducted to determine the reference values of biochemical, hematological and hormonal tests during pregnancy. In the present study, the articles were extracted from SID, Google Scholar, ISI, MedLib, and PubMed databases. Our research was performed without any time or language limitation. In our study, 46 diagnostic laboratory values differentiated in pregnant women were extracted from 21 reports. These changes were found in complete blood count, coagulation proteins, alkaline phosphatase, albumin, urea-creatinine, and hormones, such as aldosterone, cortisol, estradiol, progesterone, testosterone prolactin, and human chorionic gonadotropin. Examination of laboratory values in pregnant woman showed that there were significant differences in the laboratory values between the pregnant and non-pregnant women. So the recognition of these differences could be useful in the prevention of making incorrect decisions by physicians and pregnant women.

Despite continuous efforts to reduce risk in different systems, accidents are occurring. The safety of laboratories is important because a variety of chemicals and electrical equipment are normally used, high numbers of students, professors, and staff visit it daily, and there are expensive equipment in such places. For this reason, it is necessary to identify, assess and control the hazards in laboratories by appropriate methods. In this study, the ACHiL method was used. The ACHiL approach is based on a structure in which 28 risks are classified and each of them has its own allowable limits which is categorized in three levels. The results of this study showed that chemical agents were the most important risk factor in the studied laboratories. Environmental agents were the second most influential factor in occurrence of accidents. Biological agents and physical agents had the least role in the occurrence of accidents in the studied laboratories. Moreover, the level of hazard and their location were determined according to the severity of each one. The ACHiL structure is a simple yet highly efficient and effective tool for occupational health and safety professionals to get a full and deep view of the hazards present in the lab and manipulated samples. The method can be used for selecting appropriate safety measures.

The scientific and research laboratories at universities of medical sciences use a variety of chemical and biological materials. Various people, including the laboratory staff, students, and faculty members, are exposed to these materials, and various respiratory and dermatological symptoms may occur in these people. The purpose of this study is to evaluate the use and control of such chemicals in the laboratories of medical university. In this study, we investigated 43 chemical hoods in laboratories at universities of medical sciences. The technical specifications of the hoods and their compliance with the standards were investigated. The amount of hood suction was measured by using Flow visualization and the face velocity of the hoods using a thermal anemometer. The results were analyzed by SPSS software, version 19. 51.2 percentage of the hoods in terms of hardware and 44.2 percentage in terms of locations had inappropriate conditions. Maximum of face velocity was 96.16 ft/min. The results showed that 50.2% of the hoods had visible leakage. The mean face velocities were not suitable in any of the hoods when they were fully open or 50% open. These velocities were appropriate only when the hoods were 25% open. Most hoods had inappropriate conditions, and their face velocities were low, mainly due to inadequate fans. Further investigation and correction of technical problems are needed. Also, the performance of the hoods should be evaluated annually

Every year, we witness hazardous and even fatal accidents in laboratories. Therefore, identification of the risks in laboratories and creating safe conditions are of paramount importance in these settings. The present study aimed to evaluate the potential risks in the laboratories of the Persian Gulf and Oman Sea Ecological Research Center.
In order to assess and classify the risks associated with working in research centers, the failure mode and effects analysis (FMEA) and relevant statistical tests were used.
Potential risk levels were evaluated as moderate or high in all the laboratories, with the exception of the benthic laboratory. Therefore, appropriate corrective measures must be taken in this regard. Based on the results of the Kruskal-Wallis test, there were significant differences between the studied laboratories in terms of the risk priority number (RPN) before and after the corrective measures. In addition, posthoc tests indicated the lowest risk levels in the benthic and histology laboratories, while the highest risk was identified in the instrumental analysis laboratory. Results of laboratory classification using cluster analysis were noticeably similar to the post-hoc test results. According to Mann-Whitney U test, there were significant differences between the RPN values before and after the corrective measures only in the case of the sample preparation laboratory (P>0.05).
It could be concluded that FMEA is an effective method for risk assessment in research laboratories, while appropriate statistical approaches could also be used for the complementary analysis in this regard.