Detection of Hemoglobinopathies by HPLC in a Referral Clinical Laboratory in Nepal

2020 ◽  
Vol 3 (1) ◽  
pp. 306-308
Author(s):  
Abha Shrestha ◽  
Vivek Pant ◽  
Keyoor Gautam ◽  
Devish Pyakurel ◽  
Santosh Pradhan

Introduction: Various hemoglobin variants are prevalent in the Nepalese population owing to the ethnic diversity of our population. Detection of asymptomatic carriers by a reliable laboratory method is the cornerstone of prevention of this serious health problem. The simplicity of the automated system with internal sample preparation, superior resolution, rapid assay time, and accurate quantification of hemoglobin fractions makes ion-exchange high-performance liquid chromatography (IEX- HPLC) an ideal methodology for the routine screening for hemoglobinopathies. We report the clinical laboratory-based prevalence of variant hemoglobin and hemoglobinopathies through IEX- HPLC analysis in a cohort of patients referred for hemoglobin electrophoresis to a referral clinical laboratory in Nepal. Materials and Methods: The variant hemoglobin and hemoglobinopathy were diagnosed based on percentage, retention time, and peak characteristics of variant hemoglobin in a chromatogram. Peripheral blood films, reticulocyte count, serum iron profile, and sickling test were done in selected cases along with detailed family history. Results: Hemoglobinopathy was detected in all age group but the vast majority was detected between 20 to 40 years of age. Beta thalassemia trait was the most frequently detected hemoglobinopathy in all age groups. Conclusions: The present study conducted using IEX-HPLC reflects the magnitude of thalassemia and hemoglobinopathies in a laboratory-based population which helps to increase awareness among both health caregivers and the general population. Routine screening for hemoglobinopathy of individuals at the reproductive age group is recommended and this screening can be done through IEX-HPLC.  

2019 ◽  
Vol 1 (Number 2) ◽  
pp. 6-10
Author(s):  
Monowar Ahmad Tarafdar ◽  
Nadia Begum ◽  
Shila Rani Das ◽  
Sultana Begum ◽  
Mehruba Afrin ◽  
...  

This is a cross sectional study conducted among Currently Married Women of Reproductive Age (CMWRA) with a sample size of 476 selected purposively using a semi-structured questionnaire in 2018 at Moulvibazar Sadar to explore the factors affecting fertility. The result shows that 55.26% respondents were within 35 years age whereas only 4.28% from age group 46-49 years age group, 33% of the respondents got married at <16 years of age and 18.70% were illiterate, 47.90% had primary education. It is evident that 76% of the respondents were from rural area; 88% were Muslims, 29.41% from lower middle class followed by upper middle class (25.42%) and poorest comprised only 7.56%. The result explored that 73.91% of the respondents were from age group 41-45 got married before 16 years of age followed by 36-40 years (68.24%), 46-49 years (66%), 20-25 and 26-30 years age groups 52.38% and 52.75% respectively; 73.33% of respondents from rural area got married at <16 years of age, 68.42% of the Muslim at <16 years. The study explored that 96.39% from poorer section and 83.33% from poorest section got married at <16 years of age. Current study revealed that 82.91% of the respondents having secondary education got married before 16 years of age followed by illiterate (82.02%). It is explored that the age at marriage is statistically associated with residence, education, wealth index and religion (p= 0.001, 0.03, 0.001, 0.001 respectively). We conclude that the sociodemographic condition contributes mostly to fertility differentials in Bangladesh.


Author(s):  
Nitin H Shah ◽  
Aditi Vivek Joshi ◽  
Sunita Mourya

An adnexal mass is a common entity in the reproductive age group. Ovarian masses form a majority of this condition. Tuberculosis is a disease commonly encountered in the Tropics and is endemic to India. Abdominopelvic affliction of this disease is common in women especially in the reproductive age groups. It may present with variety of non-specific clinical features and often poses an enormous diagnostic dilemma Author report one such case, presenting with a clinical impression of ovarian malignancy, however, was diagnosed to be a case of extensive pelvic tuberculosis on laparoscopy. Tissue biopsy was consistent with the finding of tuberculosis.


2020 ◽  
Vol 52 (3) ◽  
pp. 139-143
Author(s):  
David Lionardi ◽  
Chrismis Novalinda Ginting ◽  
Linda Chiuman

Type 2 Diabetes mellitus (Type 2 DM) is a metabolic disorder characterized by an increase in blood sugar caused by decreased insulin secretion by pancreatic beta cells and/or impaired insulin function (insulin resistance). This study aimed to determine the specific levels of estradiol hormone in reproductive age women with diabetes mellitus in different age groups. This was an analytical study in September at Royal Prima Hospital, North Sumatra, Indonesia. Twenty women participated in this study after informed consent and were divided into two age groups: 40–45 years old and 46–50 years old. Blood samples were collected after 10-12 hours of fasting to assess blood sugar and estradiol hormone levels. Data were then analyzed using the dependent t-test dependent and compared. No significant difference in blood sugar level was found between the two age groups (p-value=0.113, p-value> 0.05) that there were no significant differences in blood sugar levels between the two age groups. The estradiol hormone level in the age group 40-45 years was lower than in the age group 46–50 years, and the difference was significant (p-value =0.000, p-value<0.05). No significant correlation was seen between type 2 DM and estradiol hormone level in this study. In conclusion, age is not the main contributing factor for the increase and decrease in blood sugar level, and type 2 DM does not correlate with estradiol hormone.


Author(s):  
Madhusmita Choudhury ◽  
Monoj K. Deka ◽  
Shah A. Sheikh

Background: Ovarian malignancy is the second most common cancer of the female reproductive system and the leading cause of death from gynecologic malignancy. With increase in longevity, the incidence of epithelial ovarian cancer is increasing and its etiopathology remains unknown. A female’s risk at birth of having ovarian tumour sometime in her life is 6-7%. Two third of ovarian tumours occur in women of reproductive age group. The aim was to study the distribution of morphological pattern of benign, malignant, and nonneoplastic lesions of the ovary in different age groups and to determine the likelihood of bilateral involvement in different morphologic subtypes.Methods: A retrospective study from January 2018 to December 2020 was undertaken. A total of 210 surgical specimens were obtained. Detailed clinical information and radiological findings were recorded from the case sheets. Grossing of the surgical specimens was done in the pathology department, followed by histological examination.Results: Of 210 cases, benign cases were 140 (66.7%), malignant cases were 70 (33.3%). Surface epithelial tumors were most common (116/55.2%) followed by germ cell tumors (76, 36.1%) followed by others. Serous cystadenoma was commonest benign tumor (58, 41.4%). Serous adenocarinoma was commonest malignant tumor (19, 27.1%). Benign tumours were more common in the younger age group i.e. <40 years of age whereas malignant tumours were supervenes with increase in age. Most benign ovarian tumors (54, 38.6%) were seen between 31-40 years whereas most malignant tumors (24, 34.3%) were seen above 40 years. In 1st two decades, germ cell tumors were more common than other tumours.Conclusions: The prognosis and varying therapeutic strategies of ovarian tumours necessitate an accurate pathological evaluation. Histopathological study is still the gold standard in diagnosing most of these tumours. 


Author(s):  
Yesim Ozarda ◽  
Victoria Higgins ◽  
Khosrow Adeli

Abstract Reference intervals (RIs) are fundamental tools used by healthcare and laboratory professionals to interpret patient laboratory test results, ideally enabling differentiation of healthy and unhealthy individuals. Under optimal conditions, a laboratory should perform its own RI study to establish RIs specific for its method and local population. However, the process of developing RIs is often beyond the capabilities of an individual laboratory due to the complex, expensive and time-consuming process to develop them. Therefore, a laboratory can alternatively verify RIs established by an external source. Common RIs can be established by large, multicenter studies and can subsequently be received by local laboratories using various verification procedures. The standard approach to verify RIs recommended by the Clinical Laboratory Standards Institute (CLSI) EP28-A3c guideline for routine clinical laboratories is to collect and analyze a minimum of 20 samples from healthy subjects from the local population. Alternatively, “data mining” techniques using large amounts of patient test results can be used to verify RIs, considering both the laboratory method and local population. Although procedures for verifying RIs in the literature and guidelines are clear in theory, gaps remain for the implementation of these procedures in routine clinical laboratories. Pediatric and geriatric age-groups also continue to pose additional challenges in respect of acquiring and verifying RIs. In this article, we review the current guidelines/approaches and challenges to RI verification and provide a practical guide for routine implementation in clinical laboratories.


Author(s):  
Muhammet Asena ◽  
ilyas yolbaş ◽  
murat Kanğın

Background: The pandemic of the new coronavirus disease (COVID-19) continues to be a major health problem globally. In this study, clinical findings, radiological findings, laboratory findings and polymerase chain reaction (PCR) test results were evaluated according to age groups in pediatric patients with COVID-19. Methods: In this study, PCR (+) and PCR (-) 278 cases diagnosed with COVID-19 between March 15, 2020 and September 30, 2020 were assessed considering clinical symptoms, radiological and laboratory findings and RT-PCR test results. Results: 43.9% of the cases consisted of RT-PCR (+) and 56.1% of RT-PCR (-) cases. Fever was observed at the rate of 64.7%, cough 53.2%, respiratory distress 12.2%, myalgia 24.5%, diarrhea 12.9%, chest X-ray findings 48.2% and computed tomography findings 43.6%. Diarrhea and cough, alanine aminotransferase, aspartate aminotransferase, leukocyte and lymphocyte elevation were determined as significantly higher in younger age group cases, while high myalgia and neutrophilia was observed in older age group children (p <0.05). Fever, high CRP, leukocytosis frequency, high neutrophil, were significantly higher in PCR(-) cases and the frequency of respiratory distress, high lymphocyte and chest computed tomography findings in PCR(+) cases (p <0.05). Conclusion: COVID-19 infection may indicate different nonspecific clinical, laboratory and radiological findings in children according to both adults and pediatric age groups. In addition, the results of the PCR test may give erroneous results in cases due to conditions such as fever, respiratory distress, high CRP, leukocytosis, high neutrophil and CT finding. Keywords: pediatric, COVID-19, RT-PCR


2020 ◽  
pp. 59-60
Author(s):  
Arti Gupta ◽  
Pankaj Kumar Gupta ◽  
Pushpendra Kumar Gupta ◽  
Abhishree Geda

Introduction: Anaemia is prevalent clinical condition in both developing and developed countries so it needs constant evaluation. As morphological study of red blood cell is initial and cheep tool for approach to causative factors here is an attempt to evaluate morphological distribution of anaemia. Aims and objectives: 1-To study distribution of anaemia in different age and sex category. 2-To determine morphological pattern of anaemia in all age groups. Material and Methods: A total of 752 anaemic samples were studied by peripheral smear examination, Samples were also run in automated cell counter to nd red cell parameters WHO Criteria were used as cut off for haemoglobin concentration Results: Among Seven hundred fty two cases , paediatric age group include 92 cases (12.23%), adult male aged 12 to 65 years include 160 patients (21.27%) , adult female aged 12 to 65 years was 476 ( 63.29%) and elderly patients more than 65 years was 24 (3.19%).Among all 752 cases 311 patients (41.3%) were having microcytic hypochromic anaemia Conclusion: To conclude in our study maximum numbers of cases are observed in adult females in reproductive age group. In both adult females and children maximum number of cases is having microcytic hypochromic anaemia due to iron deciency. So it is important to focus on screening, early dietary modication and supplemental therapy to reduce anaemia prevalence in the developing and developed countries.


Blood ◽  
1990 ◽  
Vol 76 (7) ◽  
pp. 1431-1437 ◽  
Author(s):  
WF Rosse ◽  
D Gallagher ◽  
TR Kinney ◽  
O Castro ◽  
H Dosik ◽  
...  

In 1,814 patients with sickle cell disease who had been transfused, the overall rate of alloimmunization to erythrocyte antigens was 18.6%. The rate of alloimmunization in this group appears to be an explicit function of the number of transfusions received because it increases exponentially with increasing numbers of transfusions. Alloimmunization usually occurred with less than 15 transfusions, although the rate of alloimmunization continued to increase when more transfusions were given. The rate of alloimmunization was less in patients with hemoglobin SC disease and sickle-beta+ thalassemia because these patients had received fewer transfusions. Children less than 10 years old had a slightly lower rate of alloimmunization than patients in other age groups even after correction for the number of transfusions given. Women were more frequently alloimmunized than men; this was largely due to the fact that women received more transfusions than men, but in the age group 16 to 20 years the increase may have been due in part to alloimmunization owing to pregnancy. Forty-five percent of those alloimmunized made antibodies of only one specificity; 17% made four or more antibodies reacting with different antigens. Antibodies to the C and E antigens of the Rh group, the Kell antigen, and the Lewis antigens were most commonly made. These findings may be important in formulating a rational transfusion policy in sickle cell disease.


Author(s):  
Smriti S. Dwivedi ◽  
Malay Bajpai ◽  
Indu Bhushan ◽  
Arunima Satkirti

Background: Abnormal uterine bleeding is one of the common gynecological complaints of women of all age groups. Histopathological study of endometrial biopsy and curettage samples is an effective diagnostic modality that can be used to identify cause of AUB at its earliest. This study was done to investigate the various endometrial causes of AUB that frequently come to our hospital and their incidence in various age groups i.e. reproductive, perimenopausal and postmenopausal.Methods: This study was conducted on 108 patients who clinically presented with AUB and had their endometrial biopsy and curettage specimens sent to the histopathology department of our tertiary care hospital and teaching centre, located in Uttar Pradesh from June 2018 to May 2019. The endometrial patterns were observed, and their frequencies and percentages were computed and classified age group wise.Results: These studies included patients with age range from 19 to 77 years. The predominant age group with AUB was reproductive age group (<40 years). The most common histopathological finding in this study was normal menstrual pattern (48.15 %). The endometrial pathologies observed were hormonal imbalance and pill effect (22.22%), atrophic endometrium (10.19%), chronic endometritis (5.56%), benign endometrial polyp (4.63%), gestation products (3.70%), endometrial hyperplasia (3.70%), and endometrial carcinoma (1.85%). Conclusion: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.Conclusions: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.


2020 ◽  
Vol 1 (1) ◽  
pp. 11-17
Author(s):  
Bhandari Bishwash ◽  
De Tapas Kumar ◽  
Sah Sanjay Kumar ◽  
Sanyam Sandip Das

Background: To determine the normative data and reference value for photostress recovery time (PSRT) following exposure of the macula to light, in various age groups within the Indian population. Methods: Cross-sectional observational study performed from November 2015 to July 2016 in the Bangalore district of Karnataka state in India. We examined a total of 1,282 eyes of 641 participants and included those with corrected distance visual acuity (CDVA) scoes lower than  or equal to 0.4 Logarithm of the Minimum Angle of Resolution (LogMAR). We performed the photostress procedure under standard conditions using the same approach. Results: The mean ± standard deviation (SD) of the participants’ age was 32.04 ± 15.80, with an age range of 8 to 70 years. The PSRT in participants below 16 years and above 45 years of age were significantly different compared to the 16–25-year-old age group (P  <  0.0001 for both). The PSRT values were significantly different between males and females in the reproductive age group (16 to 45 years old) (P  < 0.0001), but not in the other age groups. Conclusions: The PSRT values were significantly different in children and older patients compared to the 16 to 25 years age group. We found that as age increased, PSRT increased significantly.


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