Chemical Pathology Laboratory Research Articles

Reliability Model of Medical Equipment in University of Port Teaching Hospital

In this research, on medical equipment maintainability and reliability we conducted basic statistics analysis using University of Port Harcourt Teaching Hospital as the case study; the data collected covered 18 departments, namely; Anatomical Pathology, Micro Biology, Chemical Pathology Laboratory, Radiography Department, Pediatrics, Hemodialialysis, Hematology and Blood Transfusion, Physiotherapy, Dental Department, MDR-TB unit, Pharmacy, ICU, Assisted Conception Unit, Orthopedic Ward, Care for Elderly Laboratory, Family Planning Unit, Community Medicine and Labour Ward. The results of the parametric Weibull distribution percentile suggested that the reliability of the devices tends to fail every 21 days. The reliability plot of the model indicated that the devices tend to decrease its life span with age, the Weibull model was adequately fitted following the results of Anderson adjust test of goodness of fit and the probability plot. In comparison, the Probability value of goodness of fit P(0.0000) of Weibull distribution model was compared with that of exponential distribution model P(0.034), the outcome showed that Weibull distribution is better to model the data of medical equipment in University of Port Harcourt Teaching Hospital.

SERUM ACTIVIN A & INHIBIN A: POSSIBLE BIOCHEMICAL MARKERS OF PREECLAMPSIA & PREGNANCY INDUCED HYPERTENSION

Objective: The objective of this study was to compare the levels of Serum Activin A and Inhibin A in Pregnancy induced hypertension, Preeclampsia & Normal Pregnancy Material and Methods: An analytical, cross-sectional study conducted at Chemical Pathology Laboratory Collaborating with Gynae/Obstetric Department of Pakistan Railway Teaching Hospital, Rawalpindi over the period of one year (18 Sep 2019 to 18 March 2020). The study started after the approval of Ethical Review Committee, Riphah International University Islamabad. The sample size was calculated using WHO sample size calculator. Taking Prevalence of PIH and PE is 8%.3 Non probability convenient sampling technique was used. An overall 100 pregnant women with gestation of 20 – 25 weeks, were included. Patients of UTI, Carcinomas, Diabetes Mellitus and other chronic disorders were not included. The subjects were divided into three groups. Group I PIH: This group included 30 pregnant women of PIH; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions without proteinuria. Group II PE: This group included 20 pregnant women of preeclampsia; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions with proteinuria (>0.3 g protein/24 hours Urine). Group III Control Group: This group included 50 pregnant women with gestational age of 20 – 25 weeks without any complication as healthy controls. Results: It was determined that Serum Activin A and Serum Inhibin A levels were significantly increased in PIH and PE groups as compared to healthy group. Mean of Serum Activin A in PIH, PE and Control group was (251.53+200.23 pg/ml), (466.95 + 237.40 pg/ml) and (43.35 + 85.22 pg/ml) respectively. Similarly Mean and Standard Deviation of Serum Inhibin A levels in PIH, PE and Control group was (194.78 + 173.00 pg/ml), (349.20 + 190.30 pg/ml) and (17.27 + 44.33 pg/ml) respectively. One-way ANOVA and post-hoc Tukey analysis was conducted to compare the mean of Serum Activin A and Serum Inhibin A levels among three different groups i.e Group 1(PIH and PE), Group 2(PIH and Control) and Group 3 (PE and Control). p-value< 0.05 was considered as statistically significant. Conclusion: It can be concluded that Serum Activin A and Serum Inhibin A can be used as biochemical markers of PIH and PE. Estimation of Serum Activin A and Inhibin A at an early stage can detect PIH and PE early and further prevents their complications such as Eclampsia and HELLP syndrome. Keywords: Pregnancy induced hypertension (PIH), Pre-eclampsia (PE), HELLP syndrome (H – Hemolysis, EL- Elevated Liver Enzymes, LP – Low platelets count), Serum activin A, Serum inhibin A.

Identification and Association of Polymorphism rs2073618 of the Osteoprotegerin Gene in Type 2 Diabetics with and without Retinopathy.

To identify and determine the association of SNP (rs2073618) of OPG gene in diabetics with and without retinopathy and in healthy controls. Descriptive study. Place and Duration of the Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi in collaboration with Chemical Pathology Laboratory, Pak Emirates Military Hospital, Rawalpindi and Armed Forces Institute of Ophthalmology, Rawalpindi, from June 2021 to May 2022. Participants aged 25-70 years were inducted and divided into three equal groups. Group I consisted of diabetics with retinopathy (n = 50), group II was diabetics without retinopathy (n = 50), and group III was healthy individuals (n = 50). DNA was extracted and allele specific PCR technique was adopted using specifically designed primers. Results were analysed using the software Statistical Package for Social Sciences (SPSS) version 22.0 and online bio-informatics tool SNPstats. CC, CG, and GG genotypes were found to be present in 94%, 4%, and 2% in diabetics without retinopathy, 92%, 4%, and 4% in diabetics with retinopathy, respectively, and 100% presence of CC genotype only in healthy controls. C and G alleles were present in 96% and 4%, respectively, in diabetics without retinopathy, with 100% presence of only C allele in healthy subjects. The genotypic assessment using the models showed no significant association. SNP rs2073618 of OPG gene was identified in all study groups without any significant distribution or association with the development of diabetic retinopathy. The major genotype C/C was found in the majority of subjects in all groups. Allele specific PCR, Diabetic retinopathy, Single nucleotide polymorphism, Type 2 Diabetes mellitus.

THE STRUCTURES, PROPERTIES, SYNTHESIS, AND INNOVATIVE APPLICATIONS OF GOLD NANOPARTICLES IN LABORATORY MEDICINE: A REVIEW

Nanoparticles technology has gained a great deal of interest in medical and non-medical fields. Gold nanoparticles (AuNPs) which are one of the most attractive metal nanoparticles are widely used in many biomedical fields either for therapeutic or diagnostic purposes. The properties of AuNPs, such as their stability, high biocompatibility, large surface area, relatively inert element, and tunable chemical and physical characteristics have enabled a wide range of applications and discoveries. The AuNPs can be synthesised chemical, physical, or biological synthesis. It is prepared through top-down or bottom-up methods depending on the starting material preparation. AuNPs are used in assays to detect diagnostic markers and specific nucleic acid sequence. Additionally, it is also used in assays to improve bacterial species identification. This review article provides a general overview of the structures, properties, synthesis, and various innovative applications of AuNPs in laboratory medicine such as in chemical pathology, immunology, haematology, molecular, cytogenetics, and transfusion medicine laboratories.

PS-P16-4: VALIDATION OF CHO ET AL FORMULA FOR APOLIPOPROTEIN B100 CALCULATION; A POTENTIAL ATHEROSCLEROTIC RISK TOOL IN LIMITED RESOURCES SETTINGS

Objectives: Increased atherogenic lipid molecules such as low-density lipoprotein cholesterol (LDL) concentration is associated with increased risk of atherosclerotic, but a substantial risk of cardiovascular disease often remains after LDL and other lipid parameters concentrations have been extensively treated to healthy level. Owning to the lack of assay procedure in the current research geographical area, this study aims to determine the sensitivity and specificity of Apolipoprotein B100 derived from Cho's formula in conjunction with existing routine lipid profile parameters. Method: The lipid profile parameters (TC, LDLC, HDLC, Apo B100, TG and non-HDL-C) in the fasting samples of 301 adult patients in the Chemical Pathology Laboratories of the Federal Medical Centre; Birnin Kudu Jigawa State, and Birnin Kebbi, Kebbi State Nigeria. The Apo B100 was calculated using Cho equation (Cho et al., 2012). Receiver Operating Curve (ROC) was employed to determine the sensitivity and reliability of lipid parameters in the assessment of atherosclerotic risk. Cho^’ s Equation: ApoB100 = -33.12 + 0.675*LDLc + 11.95*ln(Trig) Results: From the table 1, the areas under the curves represent the probability that the lipid assay for a randomly chosen atherosclerotic risk case (sensitivity) will exceed the result for a randomly chosen no risk case (specificity). The asymptotic significance for HDL-C, TC, LDL-C Apo B100 and non-HDL-C were less than 0.05, and AUC greater than 0.7. Furthermore, LDL-C, Apo B100, non-HDL-C, and TC have AUC of 1.00, 0.990, 0.976, and 0.885 respectively. In addition to their high AUC, the specificity of TC, HDL-C, LDL-C Apo B100 and non-HDL-C for ASCVD risk were 74.4, 37.2, 100.0, 94.8 and 88.4 percent respectfully, whereas TG has no significant influence (AUC) on risk of ASCVD. It is worthy to mention that the AUC of HDL-C was statistically significant, but lower than 0.70 (0.429). The serum TC, LDL-C, Apo B100, and non-HDL-C level of greater than 172.1mmg/dl, 106.3 mg/dl, 95.6 mg/dl, and 135.3 mg/dl respectively were associated with a high risk of atherosclerotic as indicated by their specificities and sensitivities. Conclusion: It can be concluded that using the TC, LDL-C, Apo B100 and non-HDL-C for atherosclerotic risk estimation guaranteed significant reliability. It can be concluded that Apo B100 derived using Cho formula showed a high sensitivity and specificity in predicting atherosclerotic risk at a serum level of approximately 96 mg/dl. Therefore, Apo B100 derived from Cho formula may be a useful tool in the management of atherosclerotic cardiovascular disease in limited resources settings.

A Comparative Study on the Haematological and Biochemical Alterations in Catfish (Clarias gariepinus) under Natural and Artificial Environments in Sokoto Metropolis, Nigeria

Aims: The study was conducted to compare the alteration in haematological and biochemical parameters in African catfish (Clarias gariepinus) under natural (river) and artificial (ponds) habitats in Sokoto metropolis, Nigeria.
 Study Design: Whole blood and serum samples harvested from each group of the catfish were used for assessment of the haematological and biochemical parameters, respectively. Data were analyzed to compare changes between the two groups of African catfishes using T-test and P < 0.05 was considered statistically significant.
 Place and Duration of Study: Catfish samples were collected over a period of four weeks from Kwalkwalawa river and commercial fish farms in Sokoto metropolis. Samples for haematological parameters were determined at the Clinical Pathology Laboratory, Veterinary Teaching Hospital, Usmanu Danfodiyo University Sokoto. The serum analyses were performed at the Chemical Pathology Laboratory, Usmanu Danfodiyo University Teaching Hospital Sokoto.
 Methodology: A total of fifty (50) whole blood samples were obtained from live African catfishes representing twenty-five (25) samples each from natural and artificial environments.
 Results: The results showed significant changes in some haematological parameters, packed cell volume (P = 0.039), haemoglobin concentration (P = 0.001), white blood cell count (P = 0.012), and differential neutrophils (P = 0.001) and lymphocytes (P = 0.001) counts between the two groups of African catfishes studied. Significant biochemical alterations in the total protein (P = 0.001), total bilirubin (P = 0.028) and direct bilirubin (P = 0.019) were observed in catfishes under natural and artificial environments.
 Conclusion: This study shows that aquaculture environment has great influence on the haematological and biochemical parameters in African catfish. These changes were more evident in catfish reared under the natural environment. Hence, the alterations in haemato-biochemical parameters were suggestive of unhealthy state or chronic stressful condition in catfish perhaps due to natural and human caused stresses.

Clinical value of urine nuclear matrix protein 22 (NMP22) quantitative test in the diagnosis of bladder cancer in a schistosoma endemic region

Background: Bladder cancer is the ninth commonest cancer and the 13th most common cause of mortality worldwide. Its early diagnosis poses a great challenge therefore the need to identify biomarkers which may improve the current diagnostic practice.Methods: This is a prospective study of patients managed for bladder cancer at the urology unit, department of surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria between April 2019 to June 2020. Urine cytology, urine nuclear matrix protein 22 (NMP22) quantitative test and histology of the bladder biopsy specimens were done at the Histopathology and Chemical Pathology laboratory respectively of the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Data was collected using a structured proforma and analyzed using statistical package for social sciences (SPSS) version 20.0.Results: Eighty-three patients enrolled in the study however 46 of them with features of bladder carcinoma participating in the study group and 37 in the control group. The study and control groups' mean age and age range are (49.70±11.45,18-69) and (51.84±13.75,18-78) years, respectively. The sensitivity, specificity, PPV, NPV and AUC of urine NMP22 and urine cytology in the study were (78.3% vs. 58.7%), (32.4% vs. 100.0%), (59.0% vs. 100.0%), (54.6% vs. 66.1%), (0.207 vs. 0.538) respectively for the diagnosis of bladder cancer.Conclusions: Urine NMP22 quantitative test shows high sensitivity, low specificity and a low AUC compared to urine cytology and thus of poor clinical value in the diagnosis of bladder cancer in our region.

W109 Prevalence of hepatitis B virus and hepatitis C virus co-infection in both apparently healthy adults and suspected viral hepatitis patients of the chemical pathology laboratory, University College Hospital, Ibadan

W109 Prevalence of hepatitis B virus and hepatitis C virus co-infection in both apparently healthy adults and suspected viral hepatitis patients of the chemical pathology laboratory, University College Hospital, Ibadan

M118 Contingency plan for potential vibration impact on a large-scale chemical pathology laboratory during hospital redevelopment construction period

M118 Contingency plan for potential vibration impact on a large-scale chemical pathology laboratory during hospital redevelopment construction period

Appropriate use of plasma glucose tests for diagnosis of diabetes mellitus in Ibadan, Nigeria.

BackgroundDiabetes mellitus is a growing epidemic in Africa. Its diagnosis relies exclusively on laboratory evidence, which differs based on clinical circumstances.ObjectiveThe study described the appropriateness of plasma glucose test requests per the American Diabetes Association criteria.MethodsWe reviewed the plasma glucose test requests received by the chemical pathology laboratory of the University College Hospital, Ibadan, Nigeria between June 2018 and November 2018. The American Diabetes Association diabetes diagnostic criteria were used to define the appropriateness of test requests and determine the potential for ill-informed clinical decisions.ResultsFour hundred and twenty-three requisition forms were included, with the majority from the medical wards/clinics (72.3%); the most frequent reason for a plasma glucose test was systemic hypertension (28.6%). Fasting plasma glucose was most requested (254; 60.0%). One hundred and sixteen (27.4%) requests were potentially inappropriate, with the 2-h postprandial plasma glucose (2hPPG) test requests (83; 71.6%) being the most inappropriate. The difference in the proportion of inappropriate requests was not statistically significantly between medical or surgical wards/clinics (Odds ratio 1.131, 95% confidence interval 0.709–1.803, p = 0.605). Inappropriate requests in six cases may have triggered inappropriate action.ConclusionA third of the glucose tests requested for querying diabetes mellitus may have been inappropriate. Results of such testing may trigger inappropriate clinical action. To improve the quality of care and for economic reasons, laboratories should have programmes to improve the appropriate use of their services.

Assessment of laboratory test request forms for completeness

Background: Laboratory test request forms usually accompany patient’s samples to the laboratory, providing biodata and clinical details of the patient. This information is for purposes of identification and guiding pathologists to accurately interpret patient’s result. Clinicians however do not usually provide all the required information, thus making interpretation difficult. The frequency of such incompleteness is assessed in this study.Methods: Laboratory request forms received at the Chemical Pathology laboratory between July and September 2020 were assessed for completeness of all the required parameters. Parameters analyzed in this study included age, gender, hospital number, location, clinical information, name of requesting physician and the date of request. Frequency of missing parameters were expressed as proportions (%) of the total omissions.Results: There were 1906 request forms received during the course of this study and 789 (41.4%) of them had at least one missing parameter. Apart from patients’ names, nature of sample and the requested investigation, all other parameters were omitted at one time or the other making a total of 1117 omissions. Age (287; 25.7%) hospital number (264; 23.6%) and clinical information (246; 22%) were the most commonly omitted parameters. Majority of the omissions (69%) were from the outpatient clinics, 20% were from the wards while 10% of the forms had no ward or clinic indicated.Conclusion: Incomplete filling of laboratory test request forms is a regular occurrence among clinicians. Effort must be made to continually sensitize them of the importance of each of the required parameters to ensure a visible improvement. Â

Synergistic Effect of Coconut Water and Garlic Tincture on Lipids and Oxidative Profile of Albino Rats Treated with High Fat Diet and Alcohol

Aim: This study evaluated the combined effect of coconut water and garlic tincture on lipid and antioxidants profile of albino rats fed with high fat diet and alcohol.
 Study Design: This study is a non-randomized experimental study design.
 Place and Duration of Study: Rivers State University Chemical Pathology Laboratory, Department of Medical Laboratory Science, the study was done between 20th November, 2018-30th June 2019.
 Methodology: A total number of 45 Wister albino rats were used with the weight ranged from 120-200 grams. The animals were grouped into two major groups, the control Group A and the test Group B. Blood samples were collected via cardiac puncture into heparinized bottle for standard laboratory investigation of lipid profile, and Superoxide dismutase (SOD), Total antioxidant capacity (TAC) and Malondialdehide (MDA). Plasma SOD and MDA were determined using ELISA methods, TAC was determined using FRAP Colorimetric method while lipid profile were determined using enzymatic method.
 Results: The results revealed that, alcohol induced oxidative stress group exhibited significant differences in MDA levels amongst the groups, and no significance differences in SOD and TAC levels as compared with negative control groups. There were significant differences in the Total Cholesterol and low density lipoprotein levels, amongst the groups. However, these changes appear to improve with coconut water and garlic tincture treatment. Treatment with coconut water alone following 30% alcohol treatment, showed a significant decrease in MDA level, no significant increase in SOD and TAC. Similar observation was recorded for the garlic tincture treatment alone. Treatment with low dose of combined coconut water with garlic tincture following 30% alcohol treatment, shows significant decrease in MDA level, significant increase in SOD, no significant increase in TAC. Treatment with low and higher doses of combined coconut water with garlic tincture following HFD treatment showed similar results, no significant decrease in TG levels, a significant decrease in MDA, TC and LDL levels, a significant increase in TAC and HDL levels and no significant increase in SOD. However, no difference was observed at higher dose. Histological findings revealed changes in hepatocellular architecture, such as inflammatory cell aggregates, dilation of sinosidal space, fatty droplet after treatment with alcohol and high fat diet. However, upon garlic tincture and coconut water treatment, there was amelioration of these abnormalities.
 Conclusion: The mixture of coconut water and garlic tincture seem to exerted an antioxidant and antiatherogenic effect on alcohol-induced oxidative stress and HFD-induced dyslipidaemia in rats.

The impact of COVID-19 on routine patient care from a laboratory perspective.

Globally, few studies have examined the effect of the COVID-19 pandemic on routine patient care and follow-up. To evaluate the effect of the COVID-19 response on biochemical test requests received from outpatient departments (OPDs) and peripheral clinics serviced by the National Health Laboratory Service Chemical Pathology Laboratory at Tygerberg Hospital, Cape Town, South Africa (SA). Request volumes were used as a measure of the routine care of patients, as clinical information was not readily available. A retrospective audit was conducted. The numbers of requests received from OPDs and peripheral clinics for creatinine, glycated haemoglobin (HbA1c), lipid profiles, thyroid-stimulating hormone (TSH), free thyroxine, free tri-iodothyronine (fT3), serum and urine protein electrophoresis, serum free light chains and neonatal total serum bilirubin were obtained from 1 March to 30 June for 2017, 2018, 2019 and 2020. The biggest impact was seen on lipids, creatinine, HbA1c, TSH and fT3. The percentage reduction between 1 March and 30 June 2019 and between 1 March and 30 June 2020 was 59% for lipids, 64% for creatinine and HbA1c, 80% for TSH and 81% for fT3. There was a noteworthy decrease in overall analyte testing from March to April 2020, coinciding with initiation of level 5 lockdown. Although an increase in testing was observed during June 2020, the number of requests was still lower than in June 2019. This study, focusing on the short-term consequences of the SA response to the COVID-19 pandemic, found that routine follow-up of patients with communicable and non-communicable diseases was affected. Future studies are necessary to evaluate the long-term consequences of the pandemic for these patient groups.

Determination of cerebrospinal fluid adenosine deaminase activity cut-off for the diagnosis of tuberculous meningitis in Hong Kong

AimsTuberculous meningitis (TBM) is a severe infection which may lead to serious complication and mortality. Prompt diagnosis and treatment are essential. There is a need for a simple and fast...

Quality Assurance in Medical Laboratories in Developing Countries: Assessment of Pre-Analytical Errors in a Chemical Pathology Laboratory in a Tertiary Hospital in Nigeria

Quality Assurance in Medical Laboratories in Developing Countries: Assessment of Pre-Analytical Errors in a Chemical Pathology Laboratory in a Tertiary Hospital in Nigeria

Evaluation of Zinc, Vitamin C and Vitamin E Levels in Male Subjects with Type 2 Diabetes Mellitus

Aim: The aim of this study was to determine the serum/plasma levels of zinc, vitamin C and E in male subjects with type 2 diabetes mellitus to establish their concentration pattern.
 Place and Duration of Study: Medical outpatient clinic, Chemical Pathology Laboratory of Enugu State University of Science and Technology Teaching Hospital, between January and December 2016.
 Methodology: This prospective cohort study enrolled 40 male individuals with type 2 diabetes mellitus and 40 apparently healthy control, within the age range of 45-75 years. Zinc, vitamin C, vitamin E, and fasting blood glucose levels were determined at pre-treatment, six months and 12 months into treatment.
 Results: The mean values of zinc, vitamin E and fasting blood glucose were significantly higher at pre-treatment compared to apparently healthy control values (147. 76 +/- 32.95 vs 114.31+/- 15.58 µg/dl, 11.88 +/- 3.13 vs 3.42 +/- 0.21 mg/dl and 8.08 +/- 3.22 vs 5.25+/- 0.35 mmol/l respectively) (p=<0.001, <0.001, and <0.001 respectively). At 6 month into treatment in comparison to pre-treatment values, there were significant decreases in vitamin C (3.90+/-0.97 vs 5.15+/-1.43 mg/dl) (p= 0.04). At 12 month into treatment in comparison to pre-treatment values, there were significant decreases in vitamin C (3.25+/-0.16 vs 5.15+/-1.43 mg/dl) (p= <0.001). At pre-treatment, vitamin C significantly decrease from 6.49 +/- 0.96 mg/dl in age group 45-64 years to 4.10 +/- 0.76 mg/dl in age >65 years (p=0.01).
 Conclusion: The levels of vitamin C were lower at six months, but lowest at 12 month into treatment. Also vitamin C levels were found to be lower in age >65 years.

Copper, Magnesium and Selenium Levels in Serum Samples of Male Patients with Type 2 Diabetes Mellitus

Background: Trace elements are known to enhance the complete function of the immune system; avert uncontrolled expression and synthesis of inflammatory cytokines. The aim of this study was to determine the levels of Copper, magnesium, selenium in male individuals with type 2 diabetes mellitus.
 Study Design: Prospective cohort study.
 Place and Duration of Study: Medical outpatient clinic and Chemical Pathology Laboratory both of Enugu State University of Science and Technology Teaching Hospital, between January and December 2016.
 Methodology: Forty male individuals with type 2 diabetes mellitus and forty apparently healthy male individuals within the age range of 45 - 75 years were recruited for this study. Glycated haemoglobin (HbA1c), fasting blood glucose (FBG), trace elements (copper, magnesium and selenium) was measured at six months interval.
 Results: The mean values of Cu, Mg, Se were significantly lower at pre-treatment compared to apparently healthy control values (18.40 +/- 5.25 vs 95.16 +/- 30.32 µg/dl, 1.23+/- 0.16 vs 1.51+/- 0.09 mg/dl and 268.47+/-54.32 vs 349.63+/- 32.95 µg/l respectively) (p= <0.001, <0.001 and <0.001 respectively). At 6 month into treatment in comparison to pre-treatment values, there were significant decreases in HbA1c and Mg (5.76+/-0.50 vs 9.74+/-1.25 %, 0.26+/-0.02 vs 1.23+/-0.16 mg/dl respectively) (p= <0.001, <0.001 respectively).
 Conclusion: The levels of copper and magnesium were lower at pre-treatment, while magnesium was lowest at 6 month into treatment. In this study there is continuous increase in serum selenium levels during the treatment period.

Effect of dietary status on plasma-fractionated metanephrines in healthy individuals measured by Elisa

ABSTRACT Pheochromocytoma is a rare tumor that typically originates in the adrenal glands, often causing the over-production of catecholamines. The aim of this study was to determine whether dietary status could affect the concentration of plasma-fractionated metanephrines. This study was conducted at the Chemical Pathology Laboratory, Royal Hospital, Oman. Three plasma samples were collected from each participant (16 male and 16 female) over three consecutive days (day one: dietary restriction,day two: excess intake of restricted foods, day three: random sample following the typical diet for each participant). Samples were collected and centrifuged to obtain the plasma, which was then stored at −20°C prior to analysis. Metanephrine and normetanephrine concentrations were measured by comparative ELISA. Plasma metanephrine and normetanephrine measured under the three different dietary conditions for each individual were not significantly different and within normal range. Pearson correlation coefficient analysis of plasma concentration of metanephrines within individual patients under the three dietary conditions revealed positive correlation. We found no significant effect of dietary status on plasma metanephrine or normetanephrine concentration. Therefore, samples taken under any dietary condition may be used to determine plasma MN and NMN concentration. However, dietary restrictions in the diagnosis of Pheochromocytoma need further investigations.

Reference interval of fasting plasma glucose in apparently healthy adults in Port Harcourt, Nigeria

Background: Reference values of most assays in use in many chemical pathology laboratories in Nigeria are usually those of the manufacturer of diagnostic kit using non-indigenous reference populations. This is professionally unacceptable, so this study was aimed at determining a reference value for fasting plasma glucose (FPG) in adults living in Port Harcourt, Nigeria, using our indigenous population. Methods: A total of 332 non-diabetic subjects who met the inclusion criteria for this study were recruited after they had signed the consent forms. After an overnight fast, about 2 ml of blood was collected into the fluoride oxalate bottles and was assayed the same day using the glucose oxidase method. Each sample was measured in duplicate and an average was calculated. The data were statistically analysed using the SPSS version 20 and the significance level was set at P ≤ 0.05. Results: The reference interval of FPG was calculated by the non-parametric method after data had been screened for outliers and ranked. This was done using the 2.5th and 97.5th percentile due to the skewed nature of the data, and the reference interval of FPG obtained was 3.1–5.8 mmol/l. Conclusion: The reference interval obtained from this study was different but close to that obtained in 2008 in Port Harcourt and more importantly different from those provided by manufacturers of the diagnostic kit (4.2–6.4 mmol/l). The use of this new reference interval is recommended to be necessary for better management of patients in Port Harcourt, Nigeria. The need to use locally determined reference intervals is emphasised.

Incomplete patient data on chemical pathology laboratory forms in a Tertiary Hospital in Nigeria

Background: Correct and complete filling of information on the laboratory request forms is necessary if preanalytical errors are to be minimized. It also gives the laboratory opportunity to compare results with the clinical details of the patient, which can point out the possibility of errors in either laboratory test or clinical diagnosis. Appropriately, filled laboratory forms allow for timely communication of critical results to physicians providing early intervention and improved patient care. We, therefore, evaluated the extent of incomplete laboratory forms in our center. Methodology: The study was a cross-sectional where assessment of forms received over 3 months from February 17, 2014, to May 28, 2014, in the Chemical Pathology Department of Federal Teaching Hospital, Gombe, during working hours were analyzed for the frequency of incomplete data. The forms were scrutinized for the presence of name, gender, age, clinical details, ward/clinic, consultant, hospital number, and doctor's signature. Results: Only 8% of a total of 4638 forms provided all the required data. Only patient's name appeared in all the forms. Time of sample collection (58%) was the most omitted parameter. Age and gender did not appear in 39% and 38%, respectively. No clinical details or location of the patient was provided in 25% and 24% of the cases. Consultant in charge was missing in 38% of forms. Date of request, doctor's signature, and hospital number were missing on 18%, 18%, and 13%, respectively. Conclusion: The study has demonstrated high frequency of incomplete information needed on the laboratory request forms. This may be responsible for many preanalytical errors. Increased interaction between clinicians and pathologist with a view to reducing the frequency of preanalytical errors should be encouraged.