General Hospital Laboratory Research Articles

Hospital surveillance of respiratory viruses during the COVID-19 pandemic and beyond: contribution to the WHO mosaic framework, Israel, 2020 to 2023.

BackgroundA new respiratory virus surveillance platform, based on nationwide hospital laboratory data, was established in Israel during the COVID-19 pandemic.AimWe aimed to evaluate the performance of this platform with respect to the detection of influenza and respiratory syncytial virus (RSV) from week 36 in 2020 to week 15 in 2023, and how it fits with the World Health Organization (WHO) mosaic surveillance framework.MethodsData of respiratory samples from hospitalised patients sent for laboratory confirmation of influenza virus or RSV from 25 general hospital laboratories nationwide were collected. We analysed the weekly number and percentage of samples positive for influenza virus or RSV vis-à-vis SARS-CoV-2 activity and compared data from the new surveillance platform with existing surveillance platforms. Using data in the new surveillance platform, we analysed early stages of a 2021 out-of-season RSV outbreak and evaluated the capabilities of the new surveillance system with respect to objectives and domains of the WHO mosaic framework.ResultsThe new hospital-laboratory surveillance platform captured the activity of influenza virus and RSV, provided crucial data when outpatient sentinel surveillance was not operational and supported an out-of-season RSV outbreak investigation. The new surveillance platform fulfilled important objectives in all three domains of the mosaic framework and could serve for gathering additional information to fulfil more domain objectives.ConclusionThe new hospital laboratory surveillance platform provided essential data during the COVID-19 pandemic and beyond, fulfilled important domain objectives of the mosaic framework and could be adapted for the surveillance of other viruses.

GAMBARAN PEMERIKSAAN TES CEPAT MOLEKULER (TCM) GENEXPERT PADA PASIEN DI RUMAH SAKIT UMUM DAERAH PALEMBANG BARI

Background: Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis. The diagnosis of pulmonary TB is made based on the clinical picture, physical examination, radiological picture, laboratory examination, and tuberculin test. The pulmonary TB diagnosis currently used routinely in laboratories including hospitals and health centers is bacteriological diagnosis using the rapid molecular test (TCM) technique, while microscopic examination is used as a follow-up examination (monitoring) in patients receiving treatment. TCM examination is a molecular detection method based on nested real-time PCR. The use of TCM is a priority for TB testing because it has several advantages, including: it can diagnose TB and resistance to rifampicin quickly, accurately with high sensitivity, and results can be known in approximately 2 hours.
 Objectives: The aim of this study is to see the description of TCM examinations in patients at Palembang BARI Regional Hospital based on gender and age groups. Method: This research was conducted at the Palembang BARI Regional General Hospital Laboratory Installation. The samples taken were from patients at the Palembang BARI Regional General Hospital and not referrals from other health service facilities. 50 samples were taken and grouped based on TCM results, gender and age. Result: In grouping based on TCM results, the highest result was negative. In gender grouping, more male patients underwent TCM examinations. In the age grouping, the elderly are more likely to undergo TCM examinations. Conclusion: There are several factors that cause a person to become infected with TB, namely social status, smoking, and having the habit of drinking alcohol.

Evaluation of the CKD-EPI 2021 creatinine equation using laboratory data: Considerations for practice changes among clinical laboratories in British Columbia, Canada

IntroductionClinical laboratories in British Columbia, Canada implemented the CKD-EPI 2009 equation without the race variable for estimated glomerular filtration rate (eGFR) reporting since 2014. As more clinical laboratories adopt the new CKD-EPI 2021 equation, the study aims to compare these two race-free CKD-EPI eGFR equations using the laboratory data from a large tertiary hospital in BC and evaluate the impact on reclassification of eGFR category. MethodsSerum/plasma creatinine results and demographic data were collected from Vancouver General Hospital laboratory. The CKD-EPI 2009 without the race variable and CKD-EPI 2021 equations were computed. eGFR and its distributions were compared and reclassification of eGFR category was assessed across the full cohort and in specific patient populations. ResultsThe analysis included 58,763 patients. The median age was 57 years, with women comprising 51 % of the population. The median of eGFR changed from 85 to 90 mL/min/1.73 m2 using the CKD-EPI 2009 equation without the race variable and the CKD-EPI 2021 equation, respectively. The CKD-EPI 2021 equation reclassified 11.86 % of patients, mainly from G3a (45–59 mL/min/1.73 m2) to G2 (60–89 mL/min/1.73 m2). There was statistical significance between the non-renal and the renal population reclassified from G5 (<15 mL/min/1.73 m2) to G4 (15–29 mL/min/1.73 m2). ConclusionsUsing laboratory data representative of local populations, we observed an overall positive shift to higher eGFR, with 11.86 % of individuals having improved eGFR categories based on the CKD-EPI 2021 equation. This study provides insights into clinical implications at both the individual and population levels. The data-based approach is the first step towards adopting the CKD-EPI 2021 equation within the province.

DETERMINATION OF HEPCIDIN CONCINTRATION AND MANY HEMATOLOGICAL AND BIOCHEMICAL VARIATIONS IN PATIENTS WITH DIABETESTYPE 2 IN BALAD CITY

Introduction: Diabetes is a group of metabolic diseases characterized by excessive blood sugar caused by a defect in insulin secretion or function, there are two main types of diabetes: namely, insulin-dependent diabetes mellitus (Type I) known as childhood diabetes, The second type is non-insulin-dependent diabetes mellitus, and usually affects adults after the age of forty. Hepcidin is the main organizer of the iron metabolism inHuman and in the rest of mammals.&#x0D; The aim of the study:&#x0D; &#x0D; Examine the relationship between the concentrations of each of the hepcidin, glycated hemoglobin HBA1C and ferritin and iron in patients with type II diabetes as well as healthy control.&#x0D; Examine the relationship between these virables with each other and with other virables.&#x0D; &#x0D; Materials and Methods: The concentration of hepcidin hormone and other biochemical variables was examined in (80) patients with diabetes type II, divided into two groups (39) males and (41) females. Age ranged between (34-75) years. Samples have been collected from patients who visited Balad General hospital laboratory and Dijla Private Laboratory in Balad District. At the same time , blood of (25) healthy volunteers was collected. Sample was divided into 2.5 ml in EDTA tube for hematological tests like complete blood count and HbA1C and 2.5 ml in heparin anticoagulated tube for chemical tests like blood sugar, Iron, Total iron binding capacity and Hepcidin.&#x0D; Results and Discussion: The results study showed a significant relationship (P&lt;0.05) between the concentration of Hepcidinin patients with type 2 diabetes and healthy persons for both sexes . Also hepcidin concentration tend to increase in female patients as compared with male patients.&#x0D; It was also noted that there was a statistically significant relationship between hepcidin and ferritin concentration (p&lt;0.05), as well as between iron and Hepcidin concentration (p &lt; 0.05), with no statistical relationship between iron binding capacity (TIBC) and the concentration of hepcidin.&#x0D; The study showed a Positive correlation between the concentration of Hepcidinand count of red blood cells in people with type 2 diabetes when compared with healthy people.&#x0D; Conclusion: The average concentration of hepcidin was found to be higher among females than that among males. Also, there was an increase in the concentration of Hepcidin compared with healthy people.&#x0D;

Cost analysis of 25-hydroxy vitamin D tests in Turkiye with big data: A cross-sectional study.

The high prevalence of vitamin D deficiency in the population causes physicians to request more vitamin D tests and increases laboratory costs. It is aimed at investigating the demanded numbers and cost analyzes of 25-hydroxyvitamin D (25(OH)D) tests with the big data obtained from the national information health system of the Turkish Ministry of Health. Between 2017 and 2018, all inpatient and outpatient tests and 25(OH)D tests in all medical biochemistry laboratories in Turkiye were determined based on department and institution type. The cost amount, distribution among health institutions, and test request rates were calculated. In both years, the top ten most expensive tests, according to health institutions, were evaluated. The total number of medical biochemistry tests performed in 2017 and 2018 was 1.424.948.155 and 1.713.134.326, respectively. The number of 25 (OH)D tests analyzed in the same years was 8.698.393 and 13.919.127, respectively. When the data of the 2 years are compared, the consumption of 25 (OH)D tests increased by 37% in General hospital laboratories, whereas it increased by 115.09% in primary health laboratories. When all health institutions were evaluated, the increase rate in 25 (OH)D test demand was 60%, while the cost increase rate was 23%. This report showed that the demands for 25(OH)D testing are increasing steeply, especially in primary health-care facilities. In this direction, laboratory information system test demand restrictions in accordance with national and international guidelines are important issues for policymakers.

ANALYSIS OF WIDAL SLIDE TEST ON TIFOID FEVER PATIENTS IN SUNDARI MEDAN GENERAL HOSPITAL

Typhoid fever is an acute systemic disease caused by Salmonella typhi and Salmonella paratyphi A, B and C are characterized by prolonged fever, bacteremia without changes in the endothelial system. Salmonella is a genus of gram-negative enterobacteria bacteria in the form of rods, flagellated, without spores, capsules, and anaerobes that cause typhoid and paratyphoid. Salmonella is the leading cause of foodborne illness. In general, Salmonella causes diseases of the digestive organs. Salmonella antigen structure consists of flagellar antigen (H antigen), somatic antigen (O antigen). Widal test is a serological test procedure to detect Salmonella typhi bacteria infection that causes typhoid fever. This test will show the Salmonella antibody reaction to O- somatic, H-flagellar and Vi (bacterial hoops) antigens in the blood. Culture is the gold standard in examining typhoid fever cases to date because in culture we can determine the morphology of Salmonella. This type of research is a descriptive study that aims to analyze the results of the Widal Slide Test with the agglutination method in the Sundari General Hospital Laboratory, Medan. Of the 15 samples analyzed, the results of the Widal Slide Test were obtained for 33% of typhoid fever patients with agglutination and 67% of those without agglutination. The results were Salmonella typhi O = 4 samples, Salmonella typhi H = 1 sample, Salmonella paratyphi AO = 1 sample, Salmonella paratyphi BO = 2 samples, and Salmonella paratyphi CO = 3 samples. This type of research is a descriptive study that aims to analyze the results of the Widal Slide Test with the agglutination method in the Sundari General Hospital Laboratory, Medan. Of the 15 samples analyzed, the results of the Widal Slide Test were obtained for 33% of typhoid fever patients with agglutination and 67% of those without agglutination. The results were Salmonella typhi O = 4 samples, Salmonella typhi H = 1 sample, Salmonella paratyphi AO = 1 sample, Salmonella paratyphi BO = 2 samples, and Salmonella paratyphi CO = 3 samples. This type of research is a descriptive study that aims to analyze the results of the Widal Slide Test with the agglutination method in the Sundari General Hospital Laboratory, Medan. Of the 15 samples analyzed, the results of the Widal Slide Test were obtained for 33% of typhoid fever patients with agglutination and 67% of those without agglutination. The results were Salmonella typhi O = 4 samples, Salmonella typhi H = 1 sample, Salmonella paratyphi AO = 1 sample, Salmonella paratyphi BO = 2 samples, and Salmonella paratyphi CO = 3 samples.

Biomechanical Exposure to Upper Extremity Musculoskeletal Disorder Risk Factors in Hospital Laboratories.

Exposure to ergonomic risk factors has been reported for laboratory workers over decades. However, these exposures are not well characterized with respect to the type of laboratory or work organization. This study compared biomechanical exposure to upper extremity (UE) postures and hand activity levels (HALs) in general hospital laboratories by job, work, and laboratory type. The study used observational data gathered using a revised version of the Posture, Activity, Tools, and Handling (PATH) method, generating frequencies of categorized exposures. Eighteen workers were observed in 11 job titles (seven laboratories) in a single hospital by two investigators over a 7 month period. A taxonomy was constructed to categorize the extent to which the laboratory operations were automated. Overall, there were markedly high exposures to postural strain for the distal UE, especially wrist/forearm deviation (73% of observations), gross grasp (71%), and pinch grip (49%). For the HAL categories, 61% of the observations were in the moderate range (3.3–<6.7). Shoulders and elbows tended to remain in the neutral postural range. Posture frequencies were similar among the job categories studied and laboratory types. HAL was higher when the hand was in a pinch grip. Manual operations represented a higher proportion of work time than semi-automated or automated operations. Biomechanical exposure can be documented more extensively and diversely when using the revised PATH approach along with the taxonomy, with respect to exposure variables, such as the type of job, work, or organization in the industry including the hospital laboratories.

The Association of Anemia with Vitamin D Deficiency among Patients Visiting King Khalid General Hospital in Majmaah, Saudi Arabia

Aims: To assess the association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.&#x0D; Methodology: We reviewed the medical records of 120 patients (median age, male 37.44 [±17.86] and female 43.22 [±16.23] years; range 1–96 years) who attended the King Khalid General Hospital laboratory in Majmaah city, Saudi Arabia, between January 2019 and January 2020. The laboratory data included the following parameters: complete blood count (Hb, MCV, MCHC, MCH, Hct, WBC, RBC, and Plt) and vitamin D (25(OH)D) levels.&#x0D; Results: The chi-squared analysis showed that moderate anemia was highest among the participants who had vitamin D levels &gt;30 ng/ml and less than 20 ng/ml, with a prevalence rate of 5% (n=6) for each category. Mild anemia was prevalent among 4.12% (n=5) of the participants with vitamin D levels &lt;20 ng/ml. Finally, there were significant associations between parameters including age, RBC count, WBC count, platelet count, MCV, MCH, MCHC, hematocrit, vitamin D, and anemia. In addition, the odds ratio results indicated that mild vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.63 to 1.92). Moderate vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.76 to 1.97). The results confirmed a negative association between normal vitamin D values and the degree of anemia.&#x0D; Conclusion: There is a significant association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.

The Active Surveillance of Staphylococcus aureus using Polymerase Chain Reaction-based Identification Method among Hospitalized-patient of Haji Adam Malik General Hospital, Medan, Indonesia

BACKGROUND: Active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) carriers is associated with the lower incidence of bacteremia and lower mortality rates throughout literature; yet, this important step still remains problematic for developing countries, particularly Indonesia. AIM: The study aimed to demonstrate MRSA colonization rate in Haji Adam Malik Hospital, Medan, Indonesia. MATERIALS AND METHODS: The study enrolled 200 mucocutaneous isolates obtained from hospitalized patients during a 1-year period of study (2018). VITEK-2 system in addition to standard bacterial identification, such as gram staining, latex agglutination test, and hemolysis pattern, was performed to select S. aureus colonies in two different laboratories, Microbiology laboratory of Haji Adam Malik General Hospital and Multidisciplinary Laboratory, Faculty of Medicine, Universitas Sumatera Utara, for polymerase chain reaction (PCR) examination. RESULTS: Based on the VITEK-2 system preliminary identification, there were 80 S. aureus colonies which then underwent PCR examination. Through standard PCR assay, there were 32 bacterial isolates contained the mecA gene and it can be determined MRSA colonization rate of the hospital was 16% with consistent results of standard bacterial identification. CONCLUSIONS: Active surveillance of MRSA carriers is mandatory and urged it as a regular program in a hospital setting to decrease MRSA transmission rate.

A20 DIAGNOSTIC ACCURACY OF A LOW COST, WIDELY AVAILABLE TEST STRIP FOR PREDICTING A POSITIVE FECAL CALPROTECTIN TEST

Abstract Background Fecal calprotectin is a non-invasive test of colonic inflammation used for monitoring inflammatory bowel disease activity and for risk stratifying non-specific colonic symptoms. Calprotectin is a leukocyte specific enzyme. A similar test, leukocyte esterase is used to detect leukocytes in urine and is widely available as a low-cost point-of-care test strip. We hypothesize that an unmodified version of the urine test strip would be highly accurate in predicting a positive fecal calprotectin test in a real world sample of patients. Aims To explore a low cost, rapid alternative to the fecal calprotectin test Methods All inpatient and outpatient stool samples tested for calprotectin by the Vancouver General Hospital laboratory from February 2020 to November 2020 were included prospectively. Samples were simultaneously tested for fecal leukocyte esterase using an unmodified Roche Cobas Chemstrip urinalysis test strip by central lab personnel. An identical aliquot was sent to LifeLabs for calprotectin as per standard protocol. All samples were suspended in buffer using established laboratory protocols prior to testing. Fecal leukocyte esterase results were reported as 0–4+ based on visual interpretation, calprotectin results were reported as mcg/g of stool. REB review and approval was obtained prior to data collection. Sensitivity, Specificity and AUROC were calculated using Microsoft Excel and JROCFIT. Results 26 samples were collected. Using a fecal calprotectin greater than 120 mcg/g as a gold standard an AUROC of 0.89 (SE= .06) was calculated. A leukocyte esterase reading of 2+ or greater had the best test characteristics based on ROC curve analysis. Using this cutoff, 21/26 samples were concordant, giving an accuracy of 80.8%, sensitivity of 90.9% and specificity of 73.3%. Positive likelihood ratio was 8.07 and negative likelihood ratio was 0.29. Assuming an AUROC of 0.8, the sample size N=26 is 90% powered (β=0.9) to predict the true AUROC within 0.1 with a type I error rate of .05 (α&amp;lt;.05). Conclusions This study suggests application of a prepared stool sample to a urinalysis test strip gives a result highly predictive of a positive fecal calprotectin test. Further results are being collected prospectively to improve the robustness of these preliminary data. Secondary outcomes including comparison to endoscopy and biopsy results where available are planned if an adequate sample size can be accrued. Future studies justifying independent clinical use of leukocyte esterase would require a common gold standard comparator such as endoscopy. Fecal calprotectin testing is not universally insured and is not available as a rapid test strip. Use of fecal leukocyte esterase may reduce costs and shorten time to results if proven to be independently reliable. Funding Agencies None

Impact of zinc: Early prevention of obesity and fatty in children

Abstract Objective Get the effect of zinc supplementation on the fat profile consisting of blood glucose levels, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides in obese and fatty children. Methods Primary data are anthropometric, nutritional intake and blood sugar levels at the time, total cholesterol, glycerides, HDL and LDL collected before and after intervention, namely in March to April 2018. Zinc supplements in the form of 1 teaspoon (20 mg) syrup used one day. The researcher got a sample, namely by criteria of obese and fatty children age 6–12 years, Bugis-Makassar tribes, physically healthy, received parental approval. Finally, there were 12 samples based on sample size calculations. Blood serum was examined using Roche Cobas C111 to in the Tajuddin Chalik General Hospital Laboratory Makassar, Indonesia. Anthropometric data consists of weight and 24-h intake. Results Latest, obese and fatty students who received zinc supplements caused blood sugar levels, total cholesterol and HDL to decrease significantly while triglyceride and LDL levels dropped not significantly. Conclusions Zinc supplements can be used as substances that can maintain the balance of blood fats and blood sugar levels for obese and fatty students.

Efficacy of Acacia nilotica aqueous extract in treating biofilm-forming and multidrug resistant uropathogens isolated from patients with UTI syndrome

Escherichia coli is the dominant bacterial cause of UTI among the uropathogens in both developed and developing countries. This study is to investigate the effect of Acacia nilotica aqueous extract on the survival and biofilm of isolated pathogens to reduce UTIs diseases. A total of 170 urine samples were collected from Luxor general hospital and private medical analysis laboratories in Luxor providence, Egypt. Samples were screened for the incidence of uropathogens by biochemical tests, antibiotics susceptibility, detection of virulence, and antibiotic-resistant genes by multiplex PCR, biofilm formation, and time-killing assay. Escherichia coli is by far the most prevalent causative agent with the percentage of 73.7% followed by Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeuroginosa, and Acinetobacter baumanii. Isolates were multidrug-resistant containing blaTEM, blaSHV, blaCTX, qnrs, and aac(3)-Ia resistant genes. All isolates were sensitive to 15–16.7 mg ml−1 of Acacia nilotica aqueous extract. Time killing assay confirmed the bactericidal effect of the extract over time (20–24 h). A high percentage of 3-Cyclohexane-1-Carboxaldehyde, 2,6,6-trimethyl (23.5%); á-Selinene (15.12%); Oleic Acid (14.52%); Globulol (11.35%) were detected among 19 bioactive phytochemical compounds in the aqueous extract of A. nilotica over the GC-mass spectra analysis. The plant extract reduced significantly the biofilm activity of E. coli, K. pneumoniae, P. mirabilis, and P. aeuroginosa by 62.6, 59. 03, 48.9 and 39.2%, respectively. The challenge to improve the production of A. nilotica phytochemicals is considered a very low price for the return.

Clinical evaluation of the quidel solana flu a + b assay in a uk district general hospital laboratory

Clinical evaluation of the quidel solana flu a + b assay in a uk district general hospital laboratory

Low expression of collagen type-1 in sacrouterine ligament as risk factor of stage III–IV uterine prolapse

BackgroundDespite being non-life threatening, uterine prolapse is a reproductive health problem that interferes psychosocial life, economical and sexual function. Uterine prolapse can be caused by direct trauma resulting in damaged and weakened levator ani muscle which in turn causing sacrouterine ligament to stretch in order to maintain uterus normal position. The main component of sacrouterine ligament is collagen. Types of collagen that was involved in the occurrence of uterine prolapse are which plays a role of risk of occurrence uterine prolapse is collagen type-1 and type-3. Collagen type-1 has a good resistance and flexible to strain. If there is a disruption in the expression of collagen in sacrouterine ligament, it will result in cause uterine prolapse. ObjectiveThe aim of this study is to prove low expression of collagen type-1 in sacrouterine ligament is a risk factor for the occurrence of stage III–IV uterine prolapse. Study designThis study was an observational study using case-control approach. A total of 22 cases of stage III–IV uterine prolapse and 22 cases of non-uterine prolapse as control group were selected by consecutive sampling. This study was carried out in Sanglah General Hospital and Pathobiology Laboratory of Veterinary Faculty of Udayana. Samples were taken from sacrouterine ligament of individual with stage III–IV uterine prolapse compared to non-prolapse uterine who had undergone total hysterectomy. ResultsChi-square analysis with 95 % confidence interval indicated that low expression of collagen type-1 was 6 times more likely to be the risk factor of stage III–IV uterine prolapse (OR = 5.95; 95 %CI = 1.59–22.33; p = 0.006). ConclusionLow collagen type-1 in sacrouterine ligament is a risk factor of stage III–IV uterine prolapse.

Comparing a compact hematology analyzer based on direct optical measurements using blue LED with the VCS reference technology for neutrophil differential count

Technologies for the automated blood cell count have been evolving over the last decades. Hematology analyzers enable identifying blood elements, including leukocytes differential. In the bloodstream, the most abundant leukocyte, the neutrophil, presents multi-lobed nuclei, requiring, therefore, combined measurement principles for their detection and classification. Due to the lack of white blood cells’ certified reference materials or reference measurement method, it has been customary to evaluate the performance of new hematology analyzers by comparing them with traditionally available and well-consolidated systems. In 2015, a technology based on axial light loss using a blue LED, the Beckman Coulter DxH500, was launched. This hematology analyzer presents reduced cost, fewer chemical reagents, and a compact design. This work compares the performance of the DxH500 with an analyzer frequently employed in large-scale laboratory routine, the Beckman Coulter LH750, based on the well-established combination of volume (impedance), conductivity and light scatter principles. The study examined 310 paired samples taken out randomly from the routine of a general hospital laboratory. The analyses evaluated the correlation coefficient, p-value, and the linear regression equation. The equivalence of results provided by both analyzers for the characterization of neutrophils in the leukocyte population points to the performance adequacy of the new low-cost and portable technology, suitable for small-sized clinical laboratory’s routines.

The effect of L-Arginine of treatment for infertile men on semen parameters

The aim of the study is to determine the effect of oral supplement of L-Arginine on semen parameters as a treatment for infertile men. Patients and methods: The study conducted on 15 infertile men at infertility clinic in SalahadDin general hospital and private clinics and laboratories in Tikrit city from beginning of March to the end of July 2018. Infertility is a common clinical problem affecting 13-15% of couples worldwide. The prevalence varies throughout developed and undeveloped countries, being higher in the latter in which limited resources for diagnosis and treatment exist. L-arginine was given daily and orally at a dose 1000 mg one capsule per day morning after breakfast.&#x0D; Results: There was a significant increase in total sperm count after treatment with L- Arginine as compare with that before treatment. Also there was significant elevation active motility and Ejaculate volume after treatment with L- Arginine, as compare with that before treatment. However, there are significant reductions in Sluggish motility, abnormal sperm shape and non-motile sperms after treatment with L-Arginine as compare with that before treatment. &#x0D; &#x0D; http://dx.doi.org/10.25130/tjps.24.2019.08

The effect of L-Arginine of treatment for infertile men on semen parameters

The aim of the study is to determine the effect of oral supplement of L-Arginine on semen parameters as a treatment for infertile men. Patients and methods: The study conducted on 15 infertile men at infertility clinic in SalahadDin general hospital and private clinics and laboratories in Tikrit city from beginning of March to the end of July 2018. Infertility is a common clinical problem affecting 13-15% of couples worldwide. The prevalence varies throughout developed and undeveloped countries, being higher in the latter in which limited resources for diagnosis and treatment exist. L-arginine was given daily and orally at a dose 1000 mg one capsule per day morning after breakfast.&#x0D; Results: There was a significant increase in total sperm count after treatment with L- Arginine as compare with that before treatment. Also there was significant elevation active motility and Ejaculate volume after treatment with L- Arginine, as compare with that before treatment. However, there are significant reductions in Sluggish motility, abnormal sperm shape and non-motile sperms after treatment with L-Arginine as compare with that before treatment.

Respiratory syncytial virus testing capabilities and practices among National Respiratory and Enteric Virus Surveillance System laboratories, United States, 2016

BackgroundLaboratory tests to detect respiratory syncytial virus (RSV) vary in sensitivity and specificity. Diagnostic testing practices can impact RSV disease diagnosis and burden estimates. ObjectivesWe surveyed a sample of laboratories that participated in the National Respiratory and Enteric Virus Surveillance System (NREVSS) in 2015–2016 to understand RSV testing, diagnostic capabilities, and practices. Study designWe distributed surveys in fall 2016 to NREVSS laboratories using an internet survey platform. We conducted a descriptive analysis of survey responses and stratified results by self-identified children’s hospital laboratories (CHL, i.e. laboratories affiliated with or in a children’s hospital) or general hospital laboratories (GHL, i.e. laboratories that performed analysis on specimens from only adults or adults and children). ResultsWe sampled 367 (82.5%) of 445 eligible NREVSS laboratories with a 35.7% response rate; 11.5% (n = 15) were CHLs. All CHLs had PCR-based assay capability to test for RSV compared to 48.7% of GHLs (p < 0.001), and it was the most frequent method used by CHLs (n = 9, 75.0%). GHLs used rapid antigen detection tests most frequently (n = 65, 60.2%) to detect RSV compared to CHLs (p = 0.02, n = 3, 25.0%). Almost half (n = 41, 48.2%) of GHLs reported specimen submission from adults ≥50 years for RADTs. ConclusionsLaboratory testing and diagnostic capabilities differed by whether laboratories self-identified as a CHL or GHL. Many GHLs reported use of RADTs in adults ≥50 years, a less sensitive diagnostic method for this population compared to PCR-based assays. RADT use in adults might miss RSV cases and affect diagnoses and disease burden estimates.

Morphological and Molecular Identification of Trichophyton mentagrophytes Isolated from Dermatophytes Patients in Garmian Area

Conventional and molecular diagnosis considered as a complementary approach for making a final decision about causative agent of all microbial population, the present study was conducted in Kalar General Hospital, Dermatology unit and research laboratory center in Garmian University. Out of thirty clinically collected specimens only five samples displayed positive dermatophytic characters against microscopic and macroscopic as well as biochemical tests, such appearances of isolated colonies as white and brown color for both surface and reverse respectively, as well as, the colonies showed with a cottony texture which changed to powdery-granular colonies after two weeks incubation. Microscopic examination appeared numerous single-celled, spherical shaped microconidia were seen as clustered on both sides of hyphae, furthermore, multiseptate cigar shaped macroconidia and spiral hyphae were seen during the formation of granular colonies, biochemically analysis showed positive for urease and hair perforation testes. Molecular identification carried out via conventional PCR protocol by using the primers set ITS1 and ITS4 which result in 700bp in agarose gel electrophoresis for all isolates. PCR-RFLP carried out by means of using BstN1 digestion enzyme revealed four separated pattern bands 250,180,150 and 120bp. Sequencing of the ITS region in one of the isolated species revealed that similarity about 86% with Trichophyton mentagrophytes ATCC11481

Optimization of an Anti-NMDA Receptor Autoantibody Diagnostic Bioassay

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is one of the most frequently encountered autoimmune encephalitis. The pathogenesis of both anti-NMDAR encephalitis and schizophrenia involve down-regulation of NMDA receptors. Whether autoantibody-mediated destruction of neuronal NMDA receptors is associated with schizophrenia or first-episode psychosis (FEP) remains unclear, as the current findings from different groups are inconsistent. The main culprits are likely due to heterogeneity of autoantibodies (autoAbs) in a patient's blood or cerebrospinal fluid (CSF), as well as due to limitation of the current detection methods for anti-NMDAR autoAbs. Here, we optimized the current diagnostic method based on the only commercially-available anti-NMDAR test kit. We first increased detection sensitivity by replacing reporter fluorophore fluorescein isothiocyanate (FITC) in the kit with Alexa Fluor 488, which is superior in resisting photobleaching. We also found that using an advanced imaging system could increase the detection limit, compared to using a simple fluorescence microscope. To improve test accuracy, we implemented secondary labeling with a well-characterized mouse anti-NR1 monoclonal antibody (mAb) after immunostaining with a patient's sample. The degree of colocalization between mouse and human antisera in NMDAR-expressing cells served to validate test results to be truly anti-NMDAR positive or false-positive. We also incorporated DNA-specific DAPI to simultaneously differentiate autoAbs targeting the plasma membrane from those targeting cell nuclei or perinuclear compartments. All the technical implementation could be integrated in a general hospital laboratory setting, without the need of specialized expertise or equipment. By sharing our experience, we hope this may help improve sensitivity and accuracy of the mainstream method for anti-NMDAR detection.