A study of pre-analytical errors in the clinical biochemistry laboratory at Victoria hospital, BMCRI, Bangalore

To categorize and calculate the percentage error of pre-analytical variables in the clinical biochemistry laboratory. Prospective observational study conducted for two months with documenting the frequency and type of pre-analytical errors occurring in venous samples. The total errors recorded were 1.31%. Insufficient volume followed by haemolysis amounted to a major proportion of errors. Continuous pre-analytical phase evaluation and taking corrective measures to make this phase error-free, have to be done.

Proteomic Analysis of Subchronic Furan Exposure in the Liver of Male Fischer F344 Rats

Furan is a volatile compound formed during the thermal processing of foods. Chronic exposure has been shown to cause cholangiocarcinoma and hepatocellular tumors in rodent models. We conducted a 90 day subchronic study in Fisher 344 rats exposed to various doses by gavage to determine the NOAEL. Previous reports have outlined changes in the liver using gross necropsy examination, histopathology, clinical biochemistry, hematology, immunohistochemistry, and toxicogenomics. The data revealed that males were more sensitive than females. The focus of this study was to evaluate the toxicoproteomic changes by 2-dimensional differential in gel electrophoresis followed by mass spectrometry analysis. To compliment previous studies, protein expression changes were evaluated of male animals after 90 days of exposure to doses of 0, 0.03, 0.5, and 8.0 mg/kg bw/d. Significant statistical treatment-related changes compared to the controls identified 45 protein spots containing 38 unique proteins. Proteins identified are implicated in metabolism, redox regulation, protein folding/proteolysis as well as structural and transport proteins. At lower doses, multiple cytoprotective pathways are activated to maintain a homeostasis but ultimately the loss of protein function and impairment of several pathways could lead to adverse health effects at higher doses of furan administration.

Evaluation of Quality Control Data of Clinical Chemistry Parameters using Six Sigma Metrics Tool in Clinical Laboratory

Background: Physicians rely on laboratory results for treating patients. So it is the duty of laboratories to assure quality of the results released. So laboratory performance should be validated to maintain the quality. Six sigma has now gained recent interest in monitoring the laboratory quality.This study was designed to gauge the clinical chemistry parameters based on six sigma metrics. Materials and Methods: In this retrospective study, both the internal and external quality control data of 26 clinical chemistry parameters were collected for a period of 6 months from June 2020 to November 2020 and the six sigma analysis was done at the Central clinical biochemistry laboratory of Chettinad Hospital and research institute. Results: AST, amylase, lipase, triglyceride, HDL, iron, magnesium, creatine kinase showed sigma values more than 6.Uric acid, total protein, ALT, direct bilirubin, GGT,cholesterol, cholesterol, calcium, TIBC and phosphorus shows sigma values between 3.5 to 6. Glucose, BUN, creatinine, albumin, Na, K, Chloride, showed sigma values less than 3.5. Conclusion: Six sigma metrics can help in improving the quality of laboratory performance and also helps to standardisethe actual amount of QC that is required by the laboratory for maintaining quality.

DIFFERENT TYPES OF PRE ANALYTICAL ERRORS IN CLINICAL BIOCHEMISTRY LAB OF OSMANIA GENERAL HOSPITAL AND HOW TO MINIMIZE THEM.

OBJECTIVES:To study different types of pre-analytical errors in clinical biochemistry lab and how to minimize them. METHODOLOGY: An observational study was done at Department of Biochemistry , Osmania General Hospital for a period of 2 months from Aug 2020-Sep 2020.During this phase different types of errors were monitored. RESULTS: During a period of 2 months ,10000 samples were analyzed and among them 400 were found to be having an error. i.e. 4%. Among them Hemolyzed samples (37.5%), Lipemic samples(25%), Misidentification of samples(15%), Insufficient volume(12.5%) and Sample mixing (10%). CONCLUSION: Proper training to nursing staff and phlebotomist regarding use of vacutainer needles instead of syringes and time of collection of samples reduces the error of hemolysis and lipemia.Use of Barcode labels reduces the error of misidentification. Proper education regarding volume of blood to be collected and use of correct vacutainers reduces the error of insufficient volume and sample mixing.

A UK national audit of the laboratory investigation of phaeochromocytoma and paraganglioma

Background Phaeochromocytomas and paragangliomas (PPGL) are catecholamine secreting tumours associated with significant morbidity and mortality. Timely diagnosis and management are essential. A range of laboratory tests can be utilised in the investigation of PPGL. There is scope for significant variation in practice between centres. We aimed to investigate how the laboratory investigation of PPGL is performed in laboratories across the United Kingdom. Methods A questionnaire consisting of 21 questions was circulated to Clinical Biochemistry laboratories in the United Kingdom via the Association for Clinical Biochemistry and Laboratory Medicine office. The survey was designed to allow audit against Endocrine Society Guidelines on the Investigation and Management of PPGL and to obtain information on other important aspects not included in these guidelines. Results Responses were received from 58 laboratories and the data were compiled. The majority of laboratories use either urine or plasma metanephrines in first-line testing for PPGL, although a number of different combinations of biochemistry tests are utilised in different centres. All laboratories measuring metanephrines or catecholamines in-house use LC or LC-MS/MS methods. There are some marked differences between laboratories in urine metanephrines reference ranges used and sample requirements. Conclusions There is evidence of good practice in UK laboratories (as assessed against Endocrine Society Guidelines) such as widespread use of urine/plasma metanephrines and appropriate analytical methodologies used. However, there is also evidence of variations in practice in some areas that should be addressed.