Cost-effective Laboratory Research Articles

The efficacy of integrated vermifiltration technology for treatment of food analysis laboratory wastewater

The macrophyte-assisted vermifiltration (MAVF) technology was applied for treatment of food analysis laboratory wastewater at Industrial Technology Institute (ITI), Sri Lanka for the first time. Three laboratory-scale sub-surface vertical flow units were established:1) without earthworms and plants (Control unit), 2) with earthworms (Eisenia fetida) (vermi-filtration unit (VF unit), 3) with both earthworms and macrophytes (Canna indica) (MAVF unit). Wastewater was fed batch-wise with a feeding rate of 10 mL/min and seven days hydraulic retention time (HRT) for eight consecutive batches. Physiochemical parameters, Chemical Oxygen Demand (COD), Total Phosphorus (TP), Total Nitrogen (TN), pH, of the influent and effluent of all three units were analyzed to investigate the treatment efficiencies. One-Way ANOVA was performed to evaluate the significant differences in treatment efficiencies. The mean COD removal efficiencies of the control unit, VF unit, and MAVF unit were 60.2 % ± 10.7, 71.6± 8.07 %, and 72.0 % ± 8.86, respectively. Average TN removal efficiencies of the control unit, VF unit, and MAVF unit were 8.05 % ± 5.75, 10.9±6.4 %, and 24.9 % ±12.84, respectively. Average TP removal efficiencies were 35.84 % ± 17.5, 35.84 % ± 17.5 %, and 40.0 % ±16.76, respectively. The COD removal displayed promising results, whereas the means for enhancing TP and TN removal should be further studied. The findings of this study sensitizes the testing laboratories to go green by adopting in-house cost effective laboratory wastewater treatment systems.

Assessing the multidimensional comfort of earplugs in virtual industrial noise environments

Earplugs’ comfort is primarily evaluated through cost-effective laboratory evaluations, yet these evaluations often inadequately capture the multidimensional comfort aspects due to design limitations that do not replicate real-world conditions. This paper introduces a novel laboratory method for comprehensive assessment of the multidimensional comfort aspects of earplugs, combining questionnaire-based evaluations and objective perceptual tests within virtual industrial sound environments replicating in-situ noise exposure. Objective perceptual results confirm that the sound environment affect participants’ ability to detect alarms in a noisy environment and comprehend speech-in-noise while wearing earplugs. Subjective questionnaire results reveal that the earplugs family has an effect on the primary attributes of the acoustical, physical and functional comfort’s dimension. Participants reported the physical dimension as the most important factor they take into account when evaluating earplugs’ comfort. The functional dimension was considered the second most important factor by the participants, followed by the psychological dimension, and the acoustical dimension.

Using Machine Learning for Non-Invasive Detection of Kidney Stones Based on Laboratory Test Results: A Case Study from a Saudi Arabian Hospital.

Kidney stone disease is a widespread urological disorder affecting millions globally. Timely diagnosis is crucial to avoid severe complications. Traditionally, renal stones are detected using computed tomography (CT), which, despite its effectiveness, is costly, resource-intensive, exposes patients to unnecessary radiation, and often results in delays due to radiology report wait times. This study presents a novel approach leveraging machine learning to detect renal stones early using routine laboratory test results. We utilized an extensive dataset comprising 2156 patient records from a Saudi Arabian hospital, featuring 15 attributes with challenges such as missing data and class imbalance. We evaluated various machine learning algorithms and imputation methods, including single and multiple imputations, as well as oversampling and undersampling techniques. Our results demonstrate that ensemble tree-based classifiers, specifically random forest (RF) and extra tree classifiers (ETree), outperform others with remarkable accuracy rates of 99%, recall rates of 98%, and F1 scores of 99% for RF, and 92% for ETree. This study underscores the potential of non-invasive, cost-effective laboratory tests for renal stone detection, promoting prompt and improved medical support.

Precision Non-Alcoholic Fatty Liver Disease (NAFLD) Diagnosis: Leveraging Ensemble Machine Learning and Gender Insights for Cost-Effective Detection.

Non-Alcoholic Fatty Liver Disease (NAFLD) is characterized by the accumulation of excess fat in the liver. If left undiagnosed and untreated during the early stages, NAFLD can progress to more severe conditions such as inflammation, liver fibrosis, cirrhosis, and even liver failure. In this study, machine learning techniques were employed to predict NAFLD using affordable and accessible laboratory test data, while the conventional technique hepatic steatosis index (HSI)was calculated for comparison. Six algorithms (random forest, K-nearest Neighbors, Logistic Regression, Support Vector Machine, extreme gradient boosting, decision tree), along with an ensemble model, were utilized for dataset analysis. The objective was to develop a cost-effective tool for enabling early diagnosis, leading to better management of the condition. The issue of imbalanced data was addressed using the Synthetic Minority Oversampling Technique Edited Nearest Neighbors (SMOTEENN). Various evaluation metrics including the F1 score, precision, accuracy, recall, confusion matrix, the mean absolute error (MAE), receiver operating characteristics (ROC), and area under the curve (AUC) were employed to assess the suitability of each technique for disease prediction. Experimental results using the National Health and Nutrition Examination Survey (NHANES) dataset demonstrated that the ensemble model achieved the highest accuracy (0.99) and AUC (1.00) compared to the machine learning techniques that we used and HSI. These findings indicate that the ensemble model holds potential as a beneficial tool for healthcare professionals to predict NAFLD, leveraging accessible and cost-effective laboratory test data.

Beyond the fractures: A comprehensive Comparative analysis of Affordable and Accessible laboratory parameters and their coefficients for prediction and Swift confirmation of pulmonary embolism in high-risk orthopedic patients

BackgroundPulmonary embolism (PE) poses a significant challenge in diagnosis and treatment, particularly in high-risk patient populations such as those hospitalized for orthopedic reasons. This study explores the predictive and diagnostic potential of laboratory parameters in identifying PE among orthopedic patients. ObjectivesThe purpose of this study was to determine whether selected (inexpensive and readily available) laboratory parameters and their coefficients can be used to diagnose pulmonary embolism and whether they are applicable in predicting its occurrence. Material and methodsSelected laboratory parameters were determined twice in 276 hospitalized orthopedic patients with suspected PE: PLT, MPV, NEU, LYM, D-dimer, troponin I, age-adjusted D-dimer and their coefficients. Depending on the angio-CT results, patients were divided into groups. Selected popular laboratory coefficients were calculated and statistically analyzed. Optimal cutoff points were determined for the above laboratory tests and ROC curves were plotted. ResultsD-dimer/troponin I [p = 0.008], D-dimer [p = 0.001], age-adjusted D-dimer [p = 0.007], NLR/D-dimer [p = 0.005] and PLR [p = 0.021] are statistically significant predictors of PE. D-dimer/troponin I [p < 0.001], troponin I [p = 0.005] and age-adjusted D-dimer [p = 0.001] correlated with the diagnosis of PE after the onset of clinical symptoms. ConclusionsIn the context of orthopedic patients, cost-effective laboratory parameters, particularly the D-dimer/troponin I ratio and age-adjusted D-dimer, exhibit considerable potential in predicting and diagnosing PE. These findings suggest that combining readily available laboratory tests with clinical observation can offer a viable and cost-effective diagnostic alternative, especially in resource-constrained settings. Further studies with larger and diverse patient populations are recommended to validate these results.

Role of C- Reactive Protein (CRP) and Neutrophil Lymphocyte Ratio (NLR) in detecting severity &amp; Predicting outcome of Acute Pancreatitis patients

Acute pancreatitis is an inflammatory disease with varied clinical course. It may vary from mild to severe. Early identification of potentially severe acute pancreatitis is of utmost importance. Acute pancreatitis patients with delayed transfer to intensive care have higher mortality. The severity of the illness can be assessed by some early clinical features, bed side scoring systems, or by the CT severity index. But all these have own disadvantages. So a single and cost effective laboratory test is desired to predict severity of the disease. This study determined the predicting value of C-reactive protein (CRP) and Neutrophil-Lymphocyte ratio (NLR) for the severity of acute pancreatitis of Acute Pancreatitis patients admitted in Chittagong Medical College Hospital. The study followed the observational cross-sectional study design where data has been collected from N=40 patient of department of medicine, Chittagong Medical College Hospital, Chattogram. After obtaining data from clinical examination and laboratory investigations the enrolled patients were grouped into mild and severe pancreatitis using BISAP score. Patients with BISAP score 3 or &gt;3 were grouped as severe and those who scored &lt;3 were grouped as mild pancreatitis. Then quantitative serum CRP and NLR values of each group measured and mean value of each group compared by Chi-square test. After that the values of both CRP and NLR were correlated with severity of acute pancreatitis according to BISAP score by correlation analysis. Finally a cutoff value of CRP and NLR were estimated for predicting severity of acute pancreatitis by receiver operating characteristic (ROC) curve analysis. According to the BISAP score patients of acute pancreatitis were distributed in mild to moderate and severe categories. Among them each categories were distributed according to the CRP level. The result found that most of the severe cases in BISAP score also had CRP level &gt;90 mg/L level (20%), which is statistically significant (P value &lt;0.05). It also found that majority of the mild to moderate cases in BISAP score had CRP level &lt;90 mg/L (72.5%), which is also statistically significant (P value &lt;0.05). The study revealed elevation of CRP and NLR both correlate with the number of BISAP score and thus severity of acute pancreatitis.

Scalable, Cost-Effective, and Decentralized DNA Barcoding with Oxford Nanopore Sequencing.

DNA barcodes are useful in biodiversity research, but sequencing barcodes with dye termination methods ("Sanger sequencing") has been so time-consuming and expensive that DNA barcodes are not as widely used as they should be. Fortunately, MinION sequencers from Oxford Nanopore Technologies have recently emerged as a cost-effective and efficient alternative for barcoding. MinION barcodes are now suitable for large-scale species discovery and enable specimen identification when the target species are represented in barcode databases. With a MinION, it is possible to obtain 10,000 barcodes from a single flow cell at a cost of less than 0.10 USD per specimen. Additionally, a Flongle flow cell can be used for small projects requiring up to 300 barcodes (0.50 USD per specimen). We here describe a cost-effective laboratory workflow for obtaining tagged amplicons, preparing ONT libraries, sequencing amplicon pools, and analyzing the MinION reads with the software ONTbarcoder. This workflow has been shown to yield highly accurate barcodes that are 99.99% identical to Sanger barcodes. Overall, we propose that the use of MinION for DNA barcoding is an attractive option for all researchers in need of a cost-effective and efficient solution for large-scale species discovery and specimen identification.

Protocol for Temperature Toxicity Investigation on Whitefly &lt;i&gt;Bemisia tabaci&lt;/i&gt; (Gennadius)

A cost-effective laboratory protocol was perfected for investigating temperature toxicity against whitefly Bemisia tabaci (Genn.) on tomato. Understanding temperature toxicity relationship will aid in strategization of pest management. The experiments conducted to develop the current protocol used B. tabaci Asia II-1 as test insect. Essentially this protocol consist of three steps which are: (1) Temperature incubation of test insects: includes three hour starvation period and temperature treatment of B. tabaci; (2) Preparatory steps of leaf-dip bioassay: suggests use of agar cube method (reduces agar usage by 70%) to maintain green and turgid test leaves during post-exposure period of bioassay; (3) Release of temperature treated insects and mortality counting: test insect release, securing petri plates, recording observations, etc. all are deliberated in detail. This protocol facilitates economical, convenient and easy-to-handle experimentation to study temperature toxicity relationship in B. tabaci.

Diagnostic Value and Prognostic Significance of Nucleated Red Blood Cells (NRBCs) in Selected Medical Conditions.

Nucleated red blood cells (NRBCs) are premature erythrocyte precursors that reside in the bone marrow of humans of all ages as an element of erythropoiesis. They rarely present in healthy adults' circulatory systems but can be found circulating in fetuses and neonates. An NRBC count is a cost-effective laboratory test that is currently rarely used in everyday clinical practice; it is mostly used in the diagnosis of hematological diseases/disorders relating to erythropoiesis, anemia, or hemolysis. However, according to several studies, it may be used as a biomarker in the diagnosis and clinical outcome prognosis of preterm infants or severely ill adult patients. This would allow for a quick diagnosis of life-threatening conditions and the prediction of a possible change in a patient's condition, especially in relation to patients in the intensive care unit. In this review, we sought to summarize the possible use of NRBCs as a prognostic marker in various disease entities. Research into the evaluation of the NRBCs in the pediatric population most often concerns neonatal hypoxia, the occurrence and consequences of asphyxia, and overall neonatal mortality. Among adults, NRBCs can be used to predict changes in clinical condition and mortality in critically ill patients, including those with sepsis, trauma, ARDS, acute pancreatitis, or severe cardiovascular disease.

An alternative biomimetic tool – Dual hydrophilic/reversed-phase interaction mode

During the early stages of drug discovery, it becomes increasingly important to acquire a basic physico-chemical and pharmacokinetic profile of drug candidates using efficient and cost-effective laboratory and computational models. In this study, the possibility of applying the dual hydrophilic interaction liquid chromatography/reversed-phase mode (HILIC/RP) as a alternative biomimetic tool for the preliminary profiling of imidazoline and piperazine-related compounds was investigated. Their retention behaviour on the mixed-mode HILIC/RP column was described as a dependence of the logarithm of the retention factor (logk) in relation to the volume fraction of the water component in the mobile phase (φ). The retention was quantified by integration of HILIC (logkH), RP (logkR) and the total HILIC/RP (logkA) area under the logk = f(φ) curve. The biomimetic capabilities of HILIC/RP mode were observed through physico-chemical and pharmacokinetic interpretation of chromatographic behaviour. The physico-chemical characteristics of the HILIC/RP mode were defined based on linear solvation energy relationships, genetic algorithm-multiple linear regression and Boruta-XGBoost predictive modeling. The created models showed reliable predictive performances for defining the logkA, logkR, and logkH values. The mixed-mode logkA, logkR, and logkH parameters correlate well with physico-chemical (e.g., lipophilicity indices) and basic pharmacokinetic properties of the examined compounds. The models created have confirmed that the simultaneous contribution of both HILIC/RP mechanisms can be used to accurately evaluate the key properties of newly synthesized imidazoline and piperazine-related compounds while reducing costs and selecting suitable candidates in the early stages of drug development and discovery.

Diagnostic and predictive value of hematological parameters of COVID-19 patients: a retrospective study

Link of Video Abstract: https://youtu.be/K2R3dfdvi20 Background: Simple, cost-effective, and practical laboratory indicators are required to diagnose and evaluate COVID-19 disease severity. This study assessed the diagnostic value and predictor of severity and outcome parameters of NLR, d-NLR, MLR, PLR, and ALC in COVID-19 patients. Methods: A retrospective study used medical record data from 100 COVID-19 patients from November 2020 to March 2021. SPSS version 22 was used to analyze the data. The severity of COVID-19 was predicted using a ROC curve. Kaplan-Meier analysis was employed to evaluate the ability of various inflammatory markers to predict COVID-19 prognosis. A multivariate analysis with logistic regression was conducted to assess the ability of an independent predictor of COVID-19 severity. A p-value of &lt;0.05 was considered significant. Results: ALC values were lower in the severe-critical COVID-19 group, whereas NLR, d-NLR, MLR, and PLR values were higher. The NLR, d-NLR, and ALC parameters had sufficient accuracy, whereas the MLR and PLR parameters had low accuracy. NLR, d-NLR, MLR, PLR, and ALC had optimal cut-off values of 7.865, 4.82, 0.455, 235.000, and 0.895, respectively. The multivariate odds ratio for ALC was 7.348 (95% CI = 1.914-28.214; p = 0.004). Kaplan-Meier analysis revealed differences in survival time based on the optimal NLR, MLR, d-NLR, and ALC cut-offs obtained. Conclusion: NLR, d-NLR, MLR, PLR, and ALC are all potential predictors of COVID-19 severity and prognosis. ALC is a reliable predictor of COVID-19 severity.

SARS-CoV-2 Variants of Concern: Presumptive Identification via Sanger Sequencing Analysis of the Receptor Binding Domain (RBD) Region of the S Gene

Variants of concern (VOCs) of SARS-CoV-2 are viral strains that have mutations associated with increased transmissibility and/or increased virulence, and their main mutations are in the receptor binding domain (RBD) region of the viral spike. This study aimed to characterize SARS-CoV-2 VOCs via Sanger sequencing of the RBD region and compare the results with data obtained via whole genome sequencing (WGS). Clinical samples (oro/nasopharyngeal) with positive RT-qPCR results for SARS-CoV-2 were used in this study. The viral RNA from SARS-CoV-2 was extracted and a PCR fragment of 1006 base pairs was submitted for Sanger sequencing. The results of the Sanger sequencing were compared to the lineage assigned by WGS using next-generation sequencing (NGS) techniques. A total of 37 specimens were sequenced via WGS, and classified as: VOC gamma (8); delta (7); omicron (10), with 3 omicron specimens classified as the BQ.1 subvariant and 12 specimens classified as non-VOC variants. The results of the partial Sanger sequencing presented as 100% in agreement with the WGS. The Sanger protocol made it possible to characterize the main SARS-CoV-2 VOCs currently circulating in Brazil through partial Sanger sequencing of the RBD region of the viral spike. Therefore, the sequencing of the RBD region is a fast and cost-effective laboratory tool for clinical and epidemiological use in the genomic surveillance of SARS-CoV-2.

An improved balanced replicated sampling design for preliminary screening of the tailings ponds aiming at zero-waste valorization. A Romanian case study

The scope of this study consists of setting up of an integrated cost-effective sampling & laboratory analyses procedure which delineates sampling, sub-sampling and analytical uncertainties in case of fine-grained extractive waste deposits. This procedure is designed to support the decision makers towards fine-grained waste deposits upcycling and land reclamation.This procedure consists of a balanced replicated sampling design (BRSD) coupled with a three split levels ANOVA data processing. The paper provides the readership with the mathematical backgrounds of the three split level ANOVA analysis (3L-ANOVA) and an Excel algorithm for its implementation. Also, the paper presents an example of implementation of the developed methods in the case of a Romanian iron ore tailings (IOT) old pond.The findings of the paper consist of:a) argues, based on OM, SEM-EDS, XRFS and XRD observations, that classical TOS is ineffective for fine-grained waste deposits;b) BRSD in conjunction with 3L-ANOVA analysis is the only approach fit for reliable characterization of the fine-grained stockpiles;c) sampling uncertainty is the critical factor of the uncertainty budget of the analyte concentration;d) Lilliefors approach is adequate for the hypothesis testing where or not the measurand is normal distributed;e) The outcomes of the BRDSD&3L-ANOVA investigations carried on Teliuc tailings, estimated at circa 5.5* 106 m3, consist mainly of mineral quantification at lot level i.e. quartz ∼54% (±7%), hematite ∼15% (±3%), calcite ∼11% (±3%), MgO 3% (±1%), Al2O3 9% (±2%). The concentrations of some CRMs like Ti, V, Ba, Y, W were found at ACE limits and their associated relative expanded uncertainties overpass 50%. Thus, the expanded uncertainties clearly depict the reliability of acquired data for the decision makers regarding waste valorization.f) The IOT into Teliuc can be upcycled as minerals for cement and ceramic industries as well as for geopolymer manufacture. Also, IOT can be downcycles as filler in road construction and mine closure. Finally, the Teliuc yard can be rehabilitated with zero-waste left behind.The data exactness provided by this procedure can be increased to any desirable level through increasing the number of collected items, but the cost of sampling and analyses increases proportionally. In such circumstances, the posted approach can be tailored at the stakeholder request as to safely underpin the decision to turn finegrained by-products into valuable secondary resources, facilitating a greater circularity of the mining industry.

Use of a Lean Six Sigma approach to investigate excessive quality control (QC) material use and resulting costs

PurposeThe Eastern Health Clinical Biochemistry Laboratories cater to the province of Newfoundland and Labrador. Over the last ten years, a significant increase in annual expenses on quality control material and calibrator purchases was observed. Two major Clinical Chemistry Laboratories at the Health Sciences Centre (HSC) and St. Clare’s Mercy Hospital (STC), St. John’s, work as referral centers for the province. The study’s design was based on the Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process and involved tests performed on ten automated Abbott Clinical Chemistry (CC) and Immunoassay (IA) analyzers. The cost of purchasing the QC material from Bio-Rad and Randox had increased due to defective QC and analyzer test assignment process design. The processes were modified. An Individualized Quality Control Plan (IQCP) was developed. ResultsModification in quality control processes helped in bringing down the cost and usage of both QC and calibrators. The cost and usage of individual control material were reduced by 25 to 52% depending on the type of quality control. Total annual expenditure on the purchase of different QC materials before modification was estimated as CAD 346,395(2019) which was reduced to CAD 255,267 with annual savings of 91,128 CAD (26%) after modification (2020). The average usage reduction for various calibrators was 40% with the highest reduction in the use of urine calibrators. The annual cost of calibrators was reduced from CAD 30,568.42 (2019-20) to CAD 17,517 (2020-21) with the saving of approximately 13,051 Canadian dollars (43 %) for the laboratory. ConclusionsThere is a constant compulsion in every industry to manage costs. Implementation of Lean and Six Sigma methodology in removing Muda of high costs in a Clinical Chemistry Laboratory is the most warranted strategy in developing a cost-effective laboratory framework.

A simple and versatile strategy for sensitive SIDA-UHPLC-MS/MS analysis of Alternaria toxins in olive oil

Alternaria toxins are naturally occurring contaminants found in natural products. Given the prevalence of Alternaria toxins and the complexity of oil-rich matrices, achieving ultra-trace analysis has become a daunting task. A new sample pretreatment technique, i.e., cold-induced liquid-liquid microextraction combined with serially-coupled-columns for SIDA-UHPLC-MS/MS, was developed and reported for the first time. Theoretical and experimental investigations on the mechanism and key parameters revealed that the proposed method achieved simultaneous purification and enrichment in one-step sample extraction with a superior limit of quantitation (0.15–1.5 μg kg−1), without further sample manipulation, such as fat removal or solvent exchange procedures prior to LC-MS. The method was validated taking into consideration EU guidelines and showed acceptable linearity (r ≥ 0.9991), accuracy with recoveries between 75 and 114% and precision with RSD≤9.7% for all of the analytes studied. It was successfully applied to the analysis of twenty samples sourced from the Mediterranean region in order to gain first insights into Alternaria toxins contaminations in olive oils. This technical approach is well suited for large-scale studies in a high-throughput and cost-effective quality assurance laboratory environments, and it has the potential to detect ultra-trace levels of toxins in complex samples, which may lead to the development of new and sustainable sample preparation procedures.

Shallow shotgun sequencing of the microbiome recapitulates 16S amplicon results and provides functional insights.

Prevailing 16S rRNA gene-amplicon methods for characterizing the bacterial microbiome of wildlife are economical, but result in coarse taxonomic classifications, are subject to primer and 16S copy number biases, and do not allow for direct estimation of microbiome functional potential. While deep shotgun metagenomic sequencing can overcome many of these limitations, it is prohibitively expensive for large sample sets. Here we evaluated the ability of shallow shotgun metagenomic sequencing to characterize taxonomic and functional patterns in the faecal microbiome of a model population of feral horses (Sable Island, Canada). Since 2007, this unmanaged population has been the subject of an individual-based, long-term ecological study. Using deep shotgun metagenomic sequencing, we determined the sequencing depth required to accurately characterize the horse microbiome. In comparing conventional vs. high-throughput shotgun metagenomic library preparation techniques, we validate the use of more cost-effective laboratory methods. Finally, we characterize similarities between 16S amplicon and shallow shotgun characterization of the microbiome, and demonstrate that the latter recapitulates biological patterns first described in a published amplicon data set. Unlike for amplicon data, we further demonstrate how shallow shotgun metagenomic data provide useful insights regarding microbiome functional potential which support previously hypothesized diet effects in this study system.

P300 Importance of direct microscopy in respiratory mold infection: a diagnostic dilemma

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM IntroductionOpportunistic fungal infections are on the rise due to a changing healthcare paradigm worldwide. India is the second most populated country in the world and is experiencing an upward trend in fungal lung diseases.ObjectiveRapid diagnosis of respiratory mold infections by direct microscopy.Material and MethodsWe retrospectively analyzed the mycology of the received respiratory samples; sputum, BAL, or ETT secretion between January 1, 2021 to March 31, 2022. All the samples were processed as per standard mycological procedures. For each sample, two KOH wet mounts were prepared and examined. Samples were inoculated over SDA and blood agar and incubated at 28°0C and 37°C in BOD. Once there was growth, it was processed as per standard protocol.ResultsWe received a total of 109 respiratory samples from suspected respiratory fungal infections of which early morning sputum samples 84 (77%) were the predominant followed by BAL samples 25 (23%). Most of the enrolled patients were male 73(67%) with a mean age of 48 years. Among 109 samples, 83 (76%) were shown to be fungal elements by KOH wet mount while 26 (24%) were KOH negative. A total of 53 (48.6%) samples were culture-positive Aspergillus flavus30(27%), was found to be the most common species isolated followed by A. fumigatus 16 (14.6%), miscellaneous11(10%), Aspergillus. species 5 (4.5%), and A. terreus 2 (1.8%).ConclusionConsidering the findings of KOH mount in our study, we would like to emphasize that this is a very simple, rapid, and cost-effective laboratory method with high diagnostic sensitivity when correlated with clinical findings, radiological findings, and host factors.Further, it has been found to be very dependable for making decisions to start empirical antifungal therapy early by clinicians.

Possible clinical implications and future directions of managing bacterial biofilms in cutaneous leishmaniasis wounds

Cutaneous leishmaniasis (CL) lesions are chronic and result in disfiguring scars. The microbiological aspects of these wounds have not been systematically investigated. We have recently reported that 61.5% of CL wounds in a Sri Lankan cohort harboured bacterial biofilms, mainly composed of bacilli, Enterobacteriaceae, and Pseudomonas, which could delay wound healing. We have additionally reported that biofilms were significantly associated patients over 40 years of age, discharge, pain and/or itching of the wound, and high pus cell counts. Using this as background knowledge and other relevant literature, we highlight the importance of investigating the role of biofilms in CL wound healing, clinical indicators, cost-effective laboratory tests involving less invasive sampling techniques for diagnosing biofilms and potential therapeutic options for biofilm-containing CL wounds, such as adjunctive application of wound debridement and antimicrobial treatment along with anti-parasitic drugs.

Cost of running a full-service receiving office at a centralised testing laboratory in South Africa.

BackgroundThe National Health Laboratory Service operates a platform of 226 laboratories across South Africa, ranging from highly sophisticated central academic hospitals to distant rural hospitals. The core function of the National Health Laboratory Service is to provide cost-effective and efficient health laboratory services in the public healthcare sector.ObjectiveThis study aimed to assess the comprehensive cost of running a full-service receiving office (RO) at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) laboratory.MethodsTop-down costing was conducted, with the cost per registration as the main outcome of interest. The annual equivalent costs (AEC) for the following categories were determined: registration materials, collection materials, staffing, laboratory equipment, building and electricity, and other operating costs. Data for the period from 01 April 2019 to 31 March 2020 were included in the analyses.ResultsThe AEC was $1 657 483.00 United States dollars (USD) and the cost per registration was $0.766 USD. Staff contributed 59.9% of the total cost per registration, while collection materials contributed 21.4%. The RO core staff (data clerks) contributed 50.8% of the total staffing costs, while messengers and drivers contributed 31.2%. The introduction of order entry at the CMJAH and other primary healthcare facilities reduced the total AEC by 20%. A single order entry application would serve both the CMJAH and primary healthcare facilities - hence we would prefer to not refer to order entries.ConclusionProviding a comprehensive RO service costs approximately $1.00 USD per registration. The implementation of order entry at the CMJAH would reduce AECs substantially and improve efficiency.

COVID-19; History, Taxonomy, and Diagnostic Molecular and Immunological Techniques

In recent years, viral epidemics such as the coronavirus disease (COVID-19) have spread, and this outbreak is thought to be the result of animal-to-human transmission. Hence, accurate diagnostic tests to detect COVID-19 and antiviral antibodies in infected individuals are of utmost importance. This report describes the structure, history, taxonomy, and molecular and immunological techniques for diagnosing this disease. Tests for early diagnosis of COVID-19 depend on the reverse transcription-polymerase chain reaction (RT-PCR). However, tests based on isothermal amplification and clustered regularly interspaced short palindromic repeats (CRISPR)-based methods are promising options. Identifying people whose activated antibodies require serological tests, including enzyme-linked immunosorbent assays (ELISA). The search for efficient, cost-effective, and accurate laboratory techniques that can be used on a large scale continues. The RT-PCR technique is a dominant technique for the detection of viral RNA. Other acidic nucleic-based assays such as isothermal amplification, microarray hybridization, amplicon-based metagenomics sequencing, and CRISPER-based techniques have been developed. Along with molecular methods, different efficient serological and immunological methods such as ELISA, rapid antigen test, lateral flow immunoassay, luminescent Immunoassay, and biosensors are also developed.