Showing 10 results for Kumar
Puja Kumari Jha, Rachna Agarwal, Rafat Sultana Ahmed,
Volume 15, Issue 6 (Special issue (Nov-Dec) 2021)
Abstract
Background and objectives: Turnaround time (TAT) is an important quality indicator for benchmarking laboratory performance. Delay in TAT may affect patient safety; thus, continuous monitoring and analysis of laboratory workflow is mandatory. This study was designed to improve the TAT of two biochemistry laboratories serving in tertiary care teaching hospitals (multispecialty and super-specialty) through the application of quality tools namely quality failure reporting, the Fishbone model, and process mapping.
Methods: First, TAT was defined for routine (four hours) and urgent samples (two hours). Then, TAT failureincidents in 2018-2019 were analyzed using the Fishbone model. The process map of TAT was studied and made more value streamed and lean after removal of waste steps.Corrective action plans were prioritized and implemented for potential causes with more adverse outcomes. Pilot solutions were implemented for six months and TAT failures incidents were reanalyzed.
Results: The quality failure in TAT reporting was reduced by 22% (from 34% to 12%) for urgent samples and by 19% (from 27% to 8%) for routine samples after the implementation of quality tools in multispecialty hospital laboratory. In the super-specialty hospital laboratory, the improvement was more profound and the TAT percentage achieved after the corrective actions was 96.57% and 98% for urgent and routine samples, respectively.
Conclusion: Implementation of quality failure reporting culture along with quality tools led to significant improvement in TAT and higher quality laboratory performance in terms of efficiency, reliability, and increased patient safety.
Iffat Jamal, Shuchi Smita, Ravi Bhushan Raman, Vijayanand Choudhary, Satyadeo Choubey, Kaushal Kumar,
Volume 16, Issue 6 (Special issue (Nov-Dec) 2022)
Abstract
Background and objectives: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, a newly emergent coronavirus, first recognized in Wuhan, China in December 2019. Early identification of laboratory indicators helps in distinguishing severe patients from mild to moderate counterparts and can facilitate medical interventions, thereby lowering the mortality rate. The present study was done to evaluate the role of hematological parameters and basic coagulation parameters in the assessment of the severity of COVID-19.
Methods: This retrospective observational study was done at a tertiary care institute from May 2020 to May 2021. Hematological and coagulation profile was studied in 200 confirmed COVID-19 cases. Data related to age, gender, and clinical features were retrieved from patients’ records. Laboratory findings such as complete blood count neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and coagulation parameters in different categories were compared.
Results: The majority of patients were males (59.5%) and with mild illness (52.5%). Moderate and severe illness was present in 30% and 17.5% of cases, respectively. The frequency of anemia, leucopenia, and thrombocytopenia was 62.5%, 6%, and 5.5%, respectively. Overall neutrophilia was seen in 40.5% of cases, whereas lymphopenia was seen in 39% of cases. Coagulation parameters were also much deranged in moderate and severe cases as compared to mild cases.
Conclusion: The hematopoietic and hemostatic systems are significantly affected by COVID-19. Careful evaluation of laboratory parameters assists clinicians in formulating a tailored treatment approach and in predicting disease severity.
Fatemeh Ahamdi, Elham Siasi Torbati, Kumarss Amini,
Volume 17, Issue 1 (Jan-Feb 2023)
Abstract
Background and objectives: Enterococcus faecium is a normal flora of gut microbiota. This opportunistic pathogen has attracted much attention due to its multidrug resistance and ability to survive in hostile environments. Various molecular typing methods such as pulsed-field gel electrophoresis or ribotyping have been developed for clinical and epidemiological investigation of these bacteria. However, these methods are time-consuming and labor-intensive. The present study was conducted to evaluate the discriminatory power of two common fingerprinting methods i.e. BOX-polymerase chain reaction (PCR) and enterobacterial repetitive intergenic consensus (ERIC)-PCR for E. faecium clinical isolates.
Methods: Fifty multidrug-resistant E. faecium isolates were isolated from 74 clinical specimens. The isolates were identified by specific 16S rRNA PCR. All isolates were fingerprinted using BOX-PCR and ERIC PCR. The discriminatory power and reproducibility of these two methods were also assessed.
Results: According to the dendrogram with >60% similarity, 17 different genotypes were observed using ERIC PCR. In addition, BOX-PCR produced 22 distinct patterns at a genetic distance percentage of 60%, with sizes ranging from 278 bp to 1450 bp. The discrimination index of BOX-PCR was higher than that of ERIC-PCR.
Conclusion: We concluded that a combination of ERIC-PCR and BOX-PCR may be a quicker and more reliable alternative for the discrimination of E. faecium clinical isolates.
Aneesha Asok Kumar, Deepak Panasseril Jayapradeep, Gayathri Gangadharan Nair , Sebina Asmi, Ashid Salim,
Volume 17, Issue 5 (Sep-Oct 2023)
Abstract
Background: Blood transfusion is a potentially life-saving procedure that has many consequences and complications. Most of the complications are due to clerical and technical problems. Hence, the proper knowledge and skills of the personnel involved in blood transfusion are critical. Nurses are an integral part of blood transfusion procedures. Our study aimed to evaluate nurses' knowledge about safe blood transfusion practices in a tertiary care center in North Kerala.
Methods: This was a descriptive, cross-sectional study of 113 registered nurses involved in a blood transfusion procedure in a tertiary care center in North Kerala. The knowledge of the nurses was evaluated by using a questionnaire comprising 20 questions, of which 10 questions were about theoretical knowledge and 10 were about practical knowledge. Scores>75%, between 50% and 75%, and <50% were considered as good, fair, and poor knowledge, respectively.
Results: In our study, 44.25% of the nurses showed fair knowledge, and 32.7% had poor knowledge of knowledgebased questions. Moreover, 48.6 % had fair knowledge, and 14.16% had poor knowledge of practice-based questions. No statistically significant association was found between nurses' years of experience and theoretical and practical knowledge. A statistically significant association was found between the place of work and theoretical and practical knowledge. Many of the nurses lacked proper knowledge regarding the key aspects of blood transfusion.
Conclusion: We recommend more training programs to improve the knowledge and skills of the nurses to ensure the quality and safety of blood transfusion.
Udhaya Kumar, Anirudh Mutalik, Jeevithan Shanmugam, Mohan Kumar,
Volume 18, Issue 1 (Jan-Feb 2024)
Abstract
Background: Viral hepatitis is increasingly being recognized as a public health problem, requiring special attention. The World Health Organization (WHO) estimated that in 2019, 296 million people globally (3.8%) had chronic hepatitis B virus (HBV) infection, and 58 million people (0.8%) were living with hepatitis C virus (HCV). To add to this, every year, about 1.5 million people are newly infected with either hepatitis B or C viruses. The Global Health Sector Strategy (GHSS) has aimed to eliminate viral hepatitis as a major public health problem by 2030.
Methods: We conducted a desk review to identify strategies for preventing viral hepatitis and develop a roadmap to attain the sustainable development goals (SDG) target by 2030 (particularly in low- and middle-income countries). A search was done in PubMed via Medline on 1 December 2022.
Results: The focus has to be on key interventions, including hepatitis B vaccination (part of the routine child immunization along with rescheduling the birth dose to up to 7 days post-term, adult vaccination, for targeted groups like health care providers, rag pickers, waste handlers, and sanitation workers), ensuring safe injection practices and blood transfusion, harm reduction interventions for people who inject drugs (PWID), adequate testing for early diagnosis, and ensuring appropriate treatment.
Conclusion: It is the need of the hour to prioritize key interventions identified in the review for preventing viral hepatitis.
Imran Ahmed Siddiqui, Sowmya Gayatri C, Swati Suravaram, Bharat Kumar Reddy, Dhanalakshmi A,
Volume 18, Issue 2 (Mar-Apr 2024)
Abstract
Background: ‘M’ proteins or paraproteins refer to immunoglobulins that are produced by clonal plasma cells and are a characteristic feature of monoclonal gammopathies. Routine electrophoresis on agarose gel and immunofixation can be used to detect immunoglobulin paraprotein (M-protein). We aimed to evaluate the performance of agarose gel electrophoresis alone and in combination with immunofixation for detecting serum M-proteins.
Methods: One hundred and twenty-three patients suspected of paraproteinemia were evaluated. Routine serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) protocols were performed. Data from SPE, and SPE-IFE (gel images and electrophoretograms) were collected and reviewed.
Results: 21% cases were confirmed using the SPE-IFE combination, and among them, 33% had positive light chain (λ) only on IFE. Similarly, nine cases with biclonal gammopathy on SPE were characterized by IFE.
Conclusion: IFE can be a confirmatory test in cases where SPE results are not reliable and it can be a complementary test when characterization of the M protein detected on SPE is required.
Piyushkumar Mansinh Pargi , Manish Barvaliya , Bhargav Purohit,
Volume 18, Issue 4 (Jul-Aug 2024)
Abstract
Background: Although the anti-diabetic effects of various Ficus species have been investigated in animal models, research on the blood glucose-lowering potentials of Ficus lacor Buch Ham bark remains sparse. This study evaluated the blood glucose-lowering potentials of an aqueous extract derived from Ficus labor bark in a diabetic rabbit model.
Methods: Diabetes was induced in rabbits through intravenous administration of alloxan monohydrate (120 mg/kg). 36 rabbits were divided into six groups, each consisting of six animals. Control groups included a non-diabetic control (Distilled water) and a diabetic control (Distilled water). Two experimental groups received Ficus lacor extract at doses of 100 mg/kg (Low-dose) and 200 mg/kg (High-dose) orally for six weeks. Metformin was used as an active control. A non-diabetic group (Extract control) was also administered Ficus lacor extract at 200 mg/kg. Fasting blood sugar (FBS) and post-prandial blood sugar (PP2BS) levels were measured weekly over the 6 weeks. The percentage reduction in blood glucose levels was calculated and compared for each group.
Results: The administration of both low-dose and high-dose Ficus lacor extracts resulted in significant reductions in FBS and PP2BS levels in diabetic rabbits. After six weeks, the low-dose extract group exhibited an average reduction of 38.3% in FBS and 40.5% in PP2BS, whereas the high-dose extract group showed average reductions of 35.3% in FBS and 36.3% in PP2BS.
Conclusion: The aqueous extract of Ficus lacor bark demonstrates substantial glucose-lowering activity, indicating its potential utility as a therapeutic agent in diabetes management.
Mohammed Fabin, Jayakrishnan Jayakumar, Swathy Shanker,
Volume 18, Issue 4 (Jul-Aug 2024)
Abstract
Background: Diabetes Mellitus (DM) is a metabolic disorder whose pathophysiology has been linked to various genetic and environmental factors. The main mechanism of the development of complications has been implicated as inflammation-mediated. Various blood cell parameters are being used as early indicators of inflammation-mediated endothelial dysfunction; thereby predicting the severity or prognosis of DM. In this study, we aimed to evaluate the role of platelet-to-lymphocyte ratio (PLR) in predicting glycemic control in patients with DM.
Methods: This is a retrospective, hospital-based study conducted from August 2023 to December 2023. A total of 134 patients were included in the study. The hematological and biochemical reports of the study population were retrieved, and the data obtained was analyzed using SPSS software version 16.0.
Results: In this study, it has been found that PLR is significantly increased in patients suffering from DM with poor glycemic control compared to those patients with good glycemic control (P<0.001). In concordance with other studies, a positive association was observed between PLR and disease severity.
Conclusion: Based on the findings of the study, PLR may be used as a predictive marker in assessing the severity and prognosis of DM; however, the exact cut-off value is yet to be determined.
Joseph Ki , Mohan Kumar , Kanagasabapathy Sivagami , Jeevithan Shanmugam , Periasamy Aparnavi ,
Volume 18, Issue 6 (Nov-Dec 2024)
Abstract
Background: The ABO and Rh blood group systems have been associated with variations in disease susceptibility. This study aimed to assess the variability in blood parameters, including red cell parameters and metabolic parameters (Renal function, hepatic function, blood glucose, lipid profile, and thyroid function), by ABO and Rh blood grouping systems.
Methods: A secondary data analysis was conducted among patients who underwent a preventive health check-up at a private tertiary care hospital in Coimbatore, India. The laboratory database contained records of 62,808 adult participants who reported for master health check-ups between January 2017 and February 2024. Among these patients, those who reported for the first time were included.
Results: Blood grouping and typing data were available for 50,368 and 56,155 participants, respectively, with a mean age range of 52.6 to 53.0 years across all blood groups. The most prevalent blood group was O, followed by B, A, and AB, with a similar distribution across genders. The mean hemoglobin level was highest in the B group (13.7 ± 13.9 g/dl). MCH and MCV values were elevated in the A and O groups, while MCHC and ESR were higher in the B and AB groups. Renal and liver parameters mostly did not vary by blood group or Rh type, except for elevated urea levels in the A group and higher ALP levels in the O and Rh-positive groups. LDL and total cholesterol were highest in the A group, while HDL was highest in the AB group.
Conclusion: The results underscore the importance of considering blood group variations when interpreting blood parameters in clinical practice.
Mohit Kumar, Jayaprakash C S, Athira K P,
Volume 19, Issue 1 (4-2025)
Abstract
Background and objectives: Non-Hodgkin lymphoma represents a heterogenous group of lympho-proliferative malignancies with unique presentation and treatment response. This study was intended to assess the histomorphology of non-Hodgkin lymphoma subtypes and correlate with clinicopathological and immunohistochemical findings.
Methods: A retrospective study was conducted on all samples, diagnosed as non-Hodgkin lymphoma by histopathological analysis, with available immunohistochemical findings. Study was conducted in the department of pathology, for 24 months, during the period of March 2018 to February 2020. The specimens were fixed in 10 % formalin and representative sections were obtained.
Clinical details such as age, gender, location and presentation were recorded. Histopathological and immunohistochemical findings were correlated. Statistical analysis based on p value was performed.
Results: The study includes a total of 48 cases with a male predominance (56.3%). Cervical lymph node (35.4%) was the most common site. Extra nodal presentation was noted in 39.6% of the cases including stomach, testis, hard palate, para-sacral area and para-vertebral area. Diffuse large B-cell lymphoma (43.8%), followed by follicular lymphoma and mantle cell lymphoma were the most common subtypes. A statistically significant p value of 0.05 was obtained.
Conclusion: In our study, we found diffuse large B cell lymphoma (DLBCL) as the most common type of Non Hodgkin’s Lymphoma. Cervical lymph nodes were most common site of involvement. But involvement of sites like the testis and palate were also found, hence the probability of NHL in these rare sites should always to be considered.
