Journal of Laboratory Physicians最新文献

{"title":"Burkholderia vietnamiensis Causing Bacteremia in Patients Suffering from B-Cell Acute Lymphocytic Leukemia: A Case Series and Review of Literature","authors":"Mitra Kar, Akanksha Dubey, Chinmoy Sahu, Sangram Singh Patel","doi":"10.1055/s-0043-1774722","DOIUrl":"https://doi.org/10.1055/s-0043-1774722","url":null,"abstract":"Abstract Burkholderia cepacia complex consists of 24 species of microorganisms that include B. cepacia, B. multivorans, B. cenocepacia, B. vietnamiensis, B. ambifaria, and many more. It is a ubiquitous microorganism found in the soil and aquatic milieu. The probability of infections in immunocompetent individuals is rare, but an increase in the population of immunocompromised patients in the past decade has attributed to increasing incidence of infections caused by these microorganisms. The most common infections caused by these isolates include bacteremia, pneumonia, genital tract infections, and surgical wound infections. Their potential to cause nosocomial outbreaks in wards of immunocompromised patients is well known. In this case series, we describe three cases of community-acquired Burkholderia vietnamiensis bacteremia in patients suffering from B-cell acute lymphocytic leukemia and their antibiotic sensitivity pattern to guide the treatment of these individuals.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135689373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Outcome in Organophosphorus Poisoning Using RBC Cholinesterase and Serum Cholinesterase Values: A Hospital-based Longitudinal Study","authors":"Saswati Kar, Nihar Ranjan Mohanty, Bhagyashree Panda, Roma Rattan, Anurag Choudhury, Suchismita Panda, Pramod Kumar Rout, Bhaktabandhu Das, Biswaranjan Prusty, Pravat Kumar Thatoi","doi":"10.1055/s-0043-1775734","DOIUrl":"https://doi.org/10.1055/s-0043-1775734","url":null,"abstract":"Abstract Background Organophosphorus (OP) poisoning is a leading cause of mortality due to self-harm in Asian countries, including India. Red blood cell cholinesterase (RBC-ChE) and serum cholinesterase (serum-ChE) levels are used for predicting outcomes. There is a paucity of literature studying the RBC-ChE levels in OP poisoning and comparing it with the serum-ChE levels. Methods This is a longitudinal study assessing the outcome in OP poisoning patients using the RBC-ChE and serum-ChE levels. Both enzyme levels are compared and correlated for adult patients presenting within 24 hours of consumption of the OP compound. Sensitivity and specificity are measured. Results Of the 99 OP poisoning patients included, 20 patients did not survive, and 23 patients required ventilatory support. At admission, RBC-ChE (median, interquartile range [IQR]) was significantly different between survivors (45.2 [30.5–60] U/g Hb) and nonsurvivors (6.3 [4.2–13.4] U/g Hb), while serum-ChE (median, IQR) was not statistically different (p = 0.061) between survivors (350 [247–670]) and nonsurvivors (290 [182–415.8]). Similarly, RBC-ChE was significantly different between patients requiring a ventilator and those not requiring a ventilator (6.8 vs. 44.2 U/g Hb), whereas the serum-ChE values measured on admission were not significantly different for patients requiring a ventilator versus those not requiring a ventilator (290 vs. 348 U/L; p = 0.119). At the cutoff of 20 U/g Hb, RBC-ChE had 90.5% sensitivity and 91% specificity in predicting mortality. Kaplan–Meier survival showed the probability of survival decreased to nearly 50% if the time to reach the hospital was ≥4 hours. Conclusion RBC-ChE was superior in predicting outcomes in OP poisoning patients compared with serum-ChE measured on the day of admission.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135385209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effectiveness of Critical Result Notification Protocol of Biochemistry Laboratory at a Tertiary Care Hospital","authors":"Silpa Thota, Aparna R. Bitla","doi":"10.1055/s-0043-1775573","DOIUrl":"https://doi.org/10.1055/s-0043-1775573","url":null,"abstract":"Abstract Background Critical value reporting is an essential aspect of laboratory medicine, ensuring prompt communication of life-threatening results to clinicians for immediate action. Existing guidelines emphasize the importance of timely notification, but protocols may vary. This study evaluated the effectiveness of the protocol for reporting critical results in the biochemistry laboratory of a tertiary care hospital and proposed alternative protocols for improvement. Materials and Methods Data were collected over a 6-month period, including the total number of investigations, critical values detected, parameters analyzed, and clinical departments involved. Quality indicators such as turnaround time (TAT), unsuccessful reporting rates, and clinical actions taken were assessed. Statistical analysis was performed using Microsoft Excel. Results Out of 390,000 investigations, 0.5% had critical values. Serum potassium (55.9%) had the highest frequency of critical values, followed by sodium, calcium, and glucose. The emergency department received the highest number of critical alerts. The success rate of critical result reporting within 1 hour was 86.8%, while unsuccessful reporting accounted for 10.7%. The causes of unsuccessful reporting included outpatient requests and delayed intimation due to patient transfers. Corrective action was taken in 91% of cases, with documentation primarily in nurse charts. Conclusion Evaluation of the protocol for reporting critical results identified areas for improvement. Recommendations included revising the critical value list, reducing TAT through process optimization and automation, enhancing staff training and awareness, fostering interdisciplinary collaboration, and maintaining incident records. Implementing these changes can enhance compliance, reduce errors, and improve patient care.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135478334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In response to the article; “Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer. J Lab Physicians. 2023;15(2):264-268”","authors":"Erkan Topkan, Efsun Somay, Uğur Selek","doi":"10.1055/s-0043-1775763","DOIUrl":"https://doi.org/10.1055/s-0043-1775763","url":null,"abstract":"We congratulate Chavan et al for their study that explored the significance of salivary immunoglobulin A (IgA)s levels in predicting microbial infections in patients with head and neck cancer (HNC) who underwent adjuvant chemoradiotherapy (CRT).[1] Their findings demonstrated a considerable rise in the prevalence of bacterial infections, mostly Klebsiella pneumoniae and Pseudomonas aeruginosa, in post-CRT patients. Furthermore, individuals with oral mucositis who acquired bacterial and fungal infections had significantly higher levels of salivary IgA (p = 0.003) than those who did not. The results of this study provide valuable insights into the relationship between radiation-induced toxicities and the mucosal immune response, specifically in the context of oral mucositis and concomitant infections. However, two issues need further discussion, which may contribute to the existing body of knowledge on this hot topic.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135771018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Human Epididymis Protein 4, Risk of Ovarian Malignancy Algorithm, and Risk of Malignancy Index Efficiency for Ameliorating Sensitivity and Specificity for Differentiating Benign from Malignant Adnexal Masses","authors":"Sonia Chawla, Gitanjali Goyal, Seema Grover, Sarita Nibhoria, Jaswant Kaur","doi":"10.1055/s-0043-1775590","DOIUrl":"https://doi.org/10.1055/s-0043-1775590","url":null,"abstract":"Abstract Background Inadequacy of effective sensitive and specific screening modalities results in late-stage diagnosis of ovarian cancer. Cancer Antigen-125 (CA-125) individually possesses limited specificity for differentiating adnexal masses. The present study aimed to evaluate the Human Epididymis Protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA), and Risk of Malignancy Index (RMI) for ameliorating sensitivity and specificity for differentiating benign from malignant adnexal masses. Materials and Methods This study was conducted on 96 preoperative women with suspected adnexal mass (patients) and 48 healthy females without adnexal mass (controls) for the duration of 2 years. Both study participants were divided into two groups, pre- and postmenopausal. CA-125 and HE4 were done using commercially available kits. ROMA% and RMI were calculated. We validated their performances using histopathology as the gold standard. The statistical analysis was done using SPSS 21, Kruskal–Wallis, and Tukey's tests. The best cutoff points to best values of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were also evaluated. Results For differentiating benign from malignant masses in the premenopausal group, the sensitivity, specificity, PPV, NPV, and area under the curve (AUC) were 93.7%, 78.3%, 65.2%, 96.6%, 0.892 for CA-125; 87.5%, 83.7%, 70%, 93.9%, 0.926 for HE4; 93.7%, 70.2%, 57.6%, 96.2%, 0.927 for ROMA; and 68.7%, 86.4%, 68.7%, 86.5%, 0.916 for RMI. While in the postmenopausal group, the sensitivity, specificity, PPV, NPV, and AUC were 92.3%, 76.4%, 85.7%, 86.6%, 0.907 for CA-125; 78.5%, 94%, 95.6%, 80%, 0.955 for HE4; 92.3%, 94.1%, 96%, 88.8%, 0.968 for ROMA; and 88.4%, 88.2%, 92%, 83.3%, 0.943 for RMI. Conclusion For differentiating benign from malignant masses more specifically in women with a suspected adnexal mass, ROMA and HE4 appear to be more effective than CA-125.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Cyclooxygenase-2, P53, Vascular Endothelial Growth Factor, and Nitric Oxide Synthase-2 in Angiogenesis and Growth of Tobacco-Related Malignancies","authors":"Shruti Gautam, Manisha Sangma, Safia Rana, Shaan Khetrapal, Sujala Kapur, Zeeba S. Jairajpuri","doi":"10.1055/s-0043-1772680","DOIUrl":"https://doi.org/10.1055/s-0043-1772680","url":null,"abstract":"Abstract Introduction In India, tobacco consumption is responsible for half of all the cancers in men and a quarter in women. The present study focuses on the expression of cyclooxygenase-2 (COX-2), P53, vascular endothelial growth factor (VEGF), and nitric oxide synthase (NOS) and their relationship with the growth and angiogenesis of tobacco-related malignancies of the oral cavity, esophagus, lungs, and stomach. It further evaluates the carcinogenic action of nicotine and examines whether COX-2 and NOS-2 overexpression is responsible for tumor growth and associated angiogenic VEGF expression via its receptor. Material and Methods A cross-sectional study on 140 biopsies, resected specimens of cancer of oral cavity, esophagus, stomach, and lungs, was done. Immunohistochemical evaluation for p53, COX-2, VEGF, and inducible NOS was done. Relevant statistical analysis was applied for the significance of the findings. Results Immunohistochemical evaluation of pattern of expression of COX-2, NOS-2, VEGF, and p53 was done in both tobacco- and nontobacco-associated cases. The results of the present study revealed an upregulation of COX-2, NOS-2, VEGF, and p53 in all the malignancies. Conclusion The present results indicated that p53 protein accumulation and increased expression of COX-2, NOS-2, and VEGF might be responsible for carcinogenesis and tumor aggressiveness by enhancing angiogenesis. A possible significant effect of nicotine on COX-2 and P53 expression in tumorigenesis is revealed. These data might have important implications for the therapeutic use of COX-2, NOS-2, and VEGF inhibitors as well as of p53 gene therapy in future anticancer therapeutic strategies in tobacco-related malignancies.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136015309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet and Erythrocyte Parameters in Type 2 Diabetic Moroccan Patients: A Cross-Sectional Study","authors":"Ibtissam Mhirig, Sara Harrar, Leila Habibi, Sanae Sayagh, Siham Aboulmakarim","doi":"10.1055/s-0043-1774811","DOIUrl":"https://doi.org/10.1055/s-0043-1774811","url":null,"abstract":"Abstract Introduction Complete blood count parameters have gained renewed interest as predictors of endothelial dysfunction in type 2 diabetes mellitus (T2DM). Thus, the aim of this study was to observe the changes in platelet and erythrocyte parameters between diabetics and nondiabetics and to evaluate these changes in relation to glycemic control. Materials and Methods This cross-sectional study was performed in Mohammed VI University Hospital, Marrakech, Morocco, from January 2020 to July 2021. A total of 307 Moroccan patients were enrolled in this study, which included 222 diabetic patients and 85 nondiabetics. The diabetic patients were divided into two groups A (hemoglobin A1c [HbA1c] ≥ 6.5%) and B (HbA1c < 6.5%) according to their glycated hemoglobin levels (HbA1c). Biological parameters were processed as per the standard technique. Data analysis was performed using SPSS statistical software. Results A significant difference was mentioned regarding mean corpuscular volume (MCV) (p < 0.001), red blood cell distribution width (RDW) (p < 0.001), and volume/platelet count (p = 0.023) between diabetics and nondiabetics. MCV and RDW were lower in group B than group A (p = 0.004; p = 0.04), while MPV was higher (p = 0.342). RDW significantly and negatively correlated with HbA1c in diabetic population (r = –0.182; p = 0.006). On the other hand, a significant and positive correlation between MPV and HbA1c was mentioned (r = +0.184; p = 0.006). Conclusion Our study showed that RDW and MPV correlate with HbA1c in T2DM and can be used as a reproducible and inexpensive means to ensure proper control of glycemic status. Further studies are warranted to define specific RDW and MPV values predictive of complication risk in the diabetic population.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135149176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyponatremia: A Marker of Inflammation for COVID-19","authors":"Jesús Salvador Sánchez-Díaz, Karla Gabriela Peniche-Moguel","doi":"10.1055/s-0043-1773808","DOIUrl":"https://doi.org/10.1055/s-0043-1773808","url":null,"abstract":"We have read with great interest the article by Nair et al[1] in which they explain the presence of two subphenotypes of acute respiratory distress syndrome (ARDS) secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through serum markers of systemic inflammation such as ferritin (ferritin), serum lactate dehydrogenase (LDH) and C-reactive protein (CRP), which are associated with worse results in terms of days of stay in the intensive care unit (ICU), days of mechanical ventilation, and higher mortality; interleukin-6 (IL-6) is the proinflammatory cytokine involved in the cascade of systemic damage. Therefore we share our experience and research on the other side of the world: under the premise that elevated serum levels of IL-6[2] favor non-osmotic secretion of antidiuretic hormone (ADH) with the consequent presence of hyponatremia this electrolyte disturbance could be another marker of severity and poor prognosis; therefore, SARS-CoV-2 would be the etiological agent in which the IL-6 released is recognized as the main inflammatory mediator of the acute phase with hematological, immunological, endocrinological, and metabolic effects.[3]","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135150385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Ancillary Investigations in Medicolegal Autopsy to Establish the Cause of Death and Legal Implications","authors":"Arneet Arora, Sangita Moirangthem, Jayanthi Yadav, Suhail Alikkal, Aniket Gour, Navinchandra M. Kaore","doi":"10.1055/s-0043-1774411","DOIUrl":"https://doi.org/10.1055/s-0043-1774411","url":null,"abstract":"Abstract Sudden death in young females can have various causes and it is important to investigate the cause thoroughly. In cases with a vague history, postmortem ancillary investigation can also help to establish or rule out potential causes of death, such as underlying medical conditions or environmental factors. These investigations may include various laboratory tests, such as toxicology, histology, microbiology, and genetic analysis, as well as radiological imaging studies. This information not only helps in ascertaining the cause and manner of death but also helps in establishing the legal connotations in any medicolegal case. This is a case of a young woman allegedly 18 years brought for a medicolegal autopsy. She had been feeling unwell for a few days before her death, experiencing vomiting, weakness, and fatigue. Although no underlying disease was diagnosed, she was advised to take a pregnancy test. Fifteen days later, she died at home continuing to feel unwell. Upon autopsy, the young woman was found to be emaciated, and revealed a male fetus, of 4 to 5 months of gestational age, in her uterus. A radiological examination of bones conducted postmortem revealed that the age of woman was approximately 15 years old. Postmortem microbiology analysis revealed the presence of the bacteria Leuconostoc mesenteroides in a blood sample collected from the subclavian vein. The pathogenicity of this bacteria in the cause of death along with the role of ancillary investigation in the light of Indian criminal law and its challenges are being discussed.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135734386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver and Mesenteric Hydatid Cyst in a Child—A Brief Report with Review of Literature","authors":"Sravanthi Vutukuru, Nitin James Peters, Abhishek Mewara, Simran Kaur, Ram Samujh","doi":"10.1055/s-0043-1774379","DOIUrl":"https://doi.org/10.1055/s-0043-1774379","url":null,"abstract":"Abstract Hydatid disease, though endemic in the sub-Himalayan region of the subcontinent, is relatively rare in the pediatric age group. The simultaneous existence of hydatid in two or more organs is very rare, seen only in 5 to 13% of patients. We report an 11-year-old patient, who presented with painless progressive abdomen distension over 6 months. Imaging studies revealed a large cystic lesion occupying majority of the abdomen. The patient was diagnosed to have a hydatid cyst of the liver and mesentery, with multiple daughter cysts intraoperatively. Excision of the cyst was done and the patient is doing well on postoperative follow-up of 1 year.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135734388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}