Measurement Of Erythrocyte Sedimentation Rate Research Articles

Comparative study of erythrocyte sedimentation rate measurement between Celltac Alpha+ (MEK-1305) ESR Analyzer and standard Westergren method

Background: The Westergren method, a gold standard method for erythrocyte sedimentation rate (ESR) measurement, is one of the screening tests for routine clinical hematology that can be used as an inflammation marker. Since the results can be altered by numerous factors, new methodologies have been established to manage the possible pitfalls. Objective: This study compared erythrocyte sedimentation rate measurements obtained by the Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer with those obtained by the standard Westergren method. Materials and methods: The Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer was used to assess the performance of ESR measurement compared to the standard Westergren method. A total of 220 random EDTA whole blood samples from patients were included and analyzed in parallel using the automated analyzer and the standard Westergren method. Results: Spearman’s rank correlation coefficient (ρ = 0.916) obtained a good correlation between the two methods. In addition, the precision was good and acceptable according to the criteria, with a %CV of less than 10% in both intra-run and inter-run precision. There was no contamination between blood samples from using a single capillary probe. Moreover, Bland-Altman mean difference plot also indicated a good agreement, with a mean bias of -1.4 (95% CI: -0.8 to 2.1), an upper LOA of 7.6 (95% CI: 6.6 to 8.7) and a lower LOA = -10.5 (95% CI: -11.6 to -9.5). Conclusion: This comparative study indicated that the Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer is applicable within clinical routine practice along with proper measurement regulation. Even though the principles between these two methods are completely different, an acceptable interrelation was obtained due to the calibration process by Nihon Kohden corporation.

Pengaruh penundaan pemeriksaan terhadap laju endap darah pada sampel darah EDTA

Introduction: Blood is an essential component of living organisms, ranging from primitive animals to humans. Under physiological conditions, blood always remains within blood vessels to carry out its functions (Bakta, 2020). The Erythrocyte Sedimentation Rate (ESR), also known as blood sedimentation rate, is an examination to determine the rate at which erythrocytes settle in non-coagulated blood (blood containing anticoagulants) in a vertical tube over a specific period. The Westergren method for ESR measurement is the most satisfactory method currently used in hospitals and clinics. This study aims to determine the difference in Erythrocyte Sedimentation Rate values between EDTA blood samples examined immediately and those delayed for 3 hours at room temperature. Method: This analytical descriptive research compares the results of Erythrocyte Sedimentation Rate examinations conducted immediately and those delayed for 3 hours using the Westergren method at room temperature. The study involved 30 samples obtained from outpatient and inpatient patients by venous blood collection. Findings: The statistical analysis using Paired t-Test showed that the P Value was 0.00 (P < 0.05), indicating a significant difference between immediate and delayed examinations for 3 hours at room temperature using the Westergren method. Conclusion: Based on the research findings, it is recommended to conduct Erythrocyte Sedimentation Rate examinations with EDTA blood samples immediately as it is more effective.

ISED, CUBE 30 touch and westergren: Comparison of different methodologies for measuring erythrocyte sedimentation rate (ESR)

ISED, CUBE 30 touch and westergren: Comparison of different methodologies for measuring erythrocyte sedimentation rate (ESR)

Evaluation of Stability and Accuracy Compared to the Westergren Method of ESR Samples Analyzed at VES-MATIC 5.

The Erythrocyte Sedimentation Rate (ESR) is a diagnostic estimator of systemic inflammation as a reflection of acute phase proteins circulating in the blood. The purpose of this manuscript is to evaluate the blood stability at room temperature (RT) and at 4 °C to avoid ESR diagnostic errors, as well as the accuracy of the VES-MATIC 5 analyzer. The ESR stability evaluation at RT for 24 h (4 h "T1", 6 h "T2", 8 h "T3", 10 h "T4", 24 h "T5") and at 4 °C (24 h, 36 h, 48 h) was carried out using 635 total samples, starting with T0 (2 h of venipuncture). For method comparison, 164 patients were analyzed using VES-MATIC 5 and then the Westergren reference method. The sample at RT is established by a significant gradual decrease in correlation R = 0.99 (T0 vs. T1), R = 0.97 (T0 vs. T2), R = 0.92 (T0 vs. T3), R = 0.87 (T0 vs. T4), and R = 0.40 (T0 vs. T5). The stability at 4 °C after 24 h, 36 h, and 48 h showed a regression of R = 0.99, R = 0.97, and R = 0.95, respectively. Therefore, ESR measurements on RT samples beyond 6 h after collection cannot be carried out, but the ESR can be measured until 36 h for samples stored at 4 °C. Moreover, the VES-MATIC 5 accuracy performance compared to the Westergren method (R = 0.96) is confirmed.

Comparison of erythrocyte sedimentation rate measurement between Westergren method and automated method among patients attending Jigjiga University Sheik Hassen Yabare Referral Hospital, Jigjiga, Ethiopia.

Erythrocyte sedimentation rate (ESR) is a widely used screening test in clinical practice as an indicator of inflammatory and degenerative malignant diseases. The Westergren method, renowned as the gold standard, is valued for its accuracy and cost-effectiveness but demands considerable time and blood volume. Emerging automated methods offer quicker and more convenient alternatives, aiming to replace manual techniques. Nonetheless, validating these automated methods against the reference Westergren method is essential to ensure reliability. Therefore, this study aimed to evaluate ESR measurement results obtained from both the reference Westergren method and the automated (SFRI ESR 3000) method. A Hospital-based comparative cross-sectional study was conducted at Jigjiga University Sheik Hassen Yabare Referral Hospital from July 15 to September 16, 2023. Following the acquisition of informed consent, blood samples were obtained from 158 participants, five milliliters of blood from each participant. These samples were then subjected to ESR estimation using both the Westergren (reference) method and the automated (SFRI ESR 3000) method. Subsequently, the collected data were analyzed using SPSS version 20 and MedCalc version 12.3.0.0 statistical Softwares. Statistical analyses such as Paired t-tests, Pearson correlation, linear regression, and the Bland and Altman plot were employed. A p-value of < 0.05 was considered statistically significant. The paired sample t-test analysis revealed no significant difference between the use of the reference Westergren method and the automated method for ESR determination, with a mean difference (MD) of 0.7 ± 9.2 mm/h (P = 0.36). Additionally, a significant correlation was observed between the two methods, with a remarkable correlation coefficient (r = 0.94, p < 0.001). The Bland-Altman data analysis indicated no evidence of systematic bias and demonstrated good agreement of ESR values between the two methods, with a limit of agreement of -17.3 to +18.7. Moreover, within-run imprecision analysis for the automated method across a range of ESR values showed coefficient of variation of 27.08, 12.65, and 10.32% for low, medium, and high ESR levels, respectively. The SFRI ESR 300 automated method demonstrates the potential for interchangeable use with the Westergren method for determining ESR, given the strong correlation and good agreement. Additionally, the same reference range could be applied during interpretation.

Evaluating Different Methods for Determining Erythrocyte Sedimentation Rate in Free-Living Blanding's Turtles (Emydoidea blandingii).

Characterizing host factors affecting individual health can be important in the conservation of many chelonians, including the Blanding's turtle (Emydoidea blandingii). However, many routine clinical pathology tests do not reliably detect differences in health status in reptiles. The erythrocyte sedimentation rate (ESR) has been shown to characterize inflammation in many species, including tortoises, and may be useful in assessing Blanding's turtles. The purpose of our study was to evaluate two methods of ESR measurement in free-ranging Blanding's turtles. Sixty Blanding's turtles captured at two sites in Illinois received a complete physical examination, and blood was collected for determination of packed cell volume, total solids, and ESR with both microhematocrit tubes and commercial kits (Winpette). Method agreement was assessed with Passing-Bablok regression. Associations between ESR and demographic, environmental, and health factors were determined by linear regression. The microhematocrit tube method proportionately overestimated ESR compared with the Winpette. With the use of both measurement methods, ESR was significantly different between study sites, higher in adult Blanding's turtles, and higher in females that were gravid compared with those that were not. ESR was also negatively associated with packed cell volume. ESR values in Blanding's turtles are comparable to other reptiles, and although microhematocrit tube and Winpette results are not interchangeable, their associations with biological predictors are similar, and either method has the potential to be used with separate reference intervals to assess turtles for inflammatory conditions.

Neutrophil-lymphocyte and platelet-lymphocyte ratios for assessing disease activity in patients with rheumatoid arthritis receiving tofacitinib treatment

To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for assessing disease activity in patients with rheumatoid arthritis (RA) treated with tofacitinib. This retrospective study was conducted among 98 RA patients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021. We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and other blood parameters 1 month before and 6 months after tofacitinib treatment. We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients, and analyzed their correlations with RA disease activity. PLR and NLR increased significantly in RA patients as compared with the healthy controls. In the RA patients, PLR and NLR were positively correlated with the levels of hs- CRP, ESR, IL- 6, Disease Activity Score of 28 joints-ESR (DAS28-ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) before and after tofacitinib treatment. Tofacitinib treatment for 6 months significantly decreased hs-CRP, ESR, IL-6, CCP, RF and DAS28-ESR levels in the RA patients. NLR and PLR can be useful biomarkers for assessing disease activity in RA patients treated with tofacitinib.

A-137 Performance Evaluation of an Automatic, Rapid and Non-Westergren Based Method for Erythrocyte Sedimentation Rate Measurement

Abstract The erythrocyte sedimentation rate (ESR) is widely used for the assessment of acute or chronic inflammation, especially for rheumatoid diseases. The gold standard for determining ESR is the Westergren method, which measures the distance in millimeters that red blood cells fall in one hour. However, this method needs to be performed manually, which increases the biohazard risk to laboratory personnel, and the results are often influenced by many preanalytical and analytical factors. Several automated ESR analyzers with different methodologies are now available to provide faster results directly from whole blood anticoagulated with K3EDTA. In this study, we evaluated the performance of an automatic ESR analyzer, Alifax TEST1, and compared it with that of another automatic analyzer, Diesse Cube 30 touch, and also the Westergren method. TEST1 extrapolates the ESR values by measuring the kinetics of red cells aggregation in 20 s, while Cube 30 is a modified Westergren method that could obtain the results in 20 min. A total of 75 clinical samples were analyzed for ESR using the three methods. The hematocrit (Hct) and C-reactive protein (CRP) values were also analyzed. The Spearman correlation coefficient between TEST1 and Westergren methods was 0.90 (P &amp;lt; 0.0001) with a mean difference of -5.45; the correlation between Cube 30 and Westergren methods was 0.80 (P &amp;lt; 0.0001) with a mean difference of 10.74; the correlation between TEST1 and Cube 30 was 0.69 (P &amp;lt; 0.0001) with a mean difference of -15.9. The precision values (CV %) of TEST1 in low-, medium- and high-level controls were 2.71%, 1.21% and 1.05% for inter-assay, and 3.70%, 1.66% and 0.86% for intra-assay. The normal range of TEST1 was also established by analyzing ESR values of 125 healthy individuals where it is 0–15 mm/hr for men ≤50years old, 0–20 mm/hr for men &amp;gt; 50 years old and for women ≤50 years old, and 0–30 mm/hr for women &amp;gt; 50years old. The ESR values obtained from the three methods all significantly correlated with plasma CRP levels. However, the ESR values from Cube 30 and Westergren methods negatively correlated with Hct values, while that from TEST1 did not. The present study demonstrates that 1) TEST1 has a better correlation and a lower difference to the Westergren method compared to Cube 30, suggesting that TEST1, the automatic, rapid and non-Westergren based method is an effective assay for clinical practice; 2) the Westergren based methods are more easily influenced by Hct; 3) the large mean difference between TEST1 and Cube 30 highlights a need for harmonization of the ESR values obtained from different automatic analyzers, especially when it is applied to monitor the disease activity score (DAS28) in rheumatoid arthritis patients.

Performance evaluation of alternate ESR measurement method using BC-780 automated hematology analyzer: a comparison study with the Westergren reference method.

Implementation of alternate erythrocyte sedimentation rate (ESR) measurement method is increasing worldwide due to its various advantages. In this study, we aim to evaluate the analytical performance of the BC-780 automated hematology analyzer in measurement of ESR value. Analyzer performance including precision study, carryover, sample stability and potential interferences are examined. Samples with ESR values spanning the whole analytical ESR range are included for method comparison study. Samples with different hematocrit (Hct) and mean corpuscular volume (MCV) values are also analyzed and compared with the results obtained from the Westergren reference method. Precisions and carryover results are consistent with the manufacturers' claim. ESR values do not change significantly in the samples stored at 2-8 °C for 24 h (h)or at room temperature (RT) for 8 h, but significantly decreased (p<0.001) when stored at RT for 24 h. Significant increase in ESR value is documented in samples that are hemolyzed (hemoglobin concentration ranged from 1.28-6.01 g/L) (p=0.010) or lipemic (triglyceride above 4.75 mmol/L) (p=0.001). Method comparison study yields a proportional difference with a regression equation=3.08+ 0.98x. Bland-Altman analysis shows a mean absolute bias of 3.12 mm. The obtained absolute mean biases are below 5 mm in all analytical categories except for the group where MCV>100 fL. Most tested parameters met the manufacturer's specifications and were comparable to the reference method. Despite the presence of positive bias, it falls within acceptable criteria. Extensive validation against potential interferences such as hemolysis/lipemia is still necessary in future.

A NEW INFLAMMATION MARKER IN RHEUMATOID ARTHRITIS: IMMATURE GRANULOCYTE

Objective: This study aimed to reveal whether immature granulocyte levels can be used for determining the disease activity of rheumatoid arthritis.&#x0D; &#x0D; Material and Methods: The study was conducted in the Kastamonu Rehabilitation Center. The data of 163 patients with rheumatoid arthritis were reviewed retrospectively. Laboratory data of 92 healthy individuals were used for the control group. Complete blood cell counts, measurement of erythrocyte sedimentation rate, and C-reactive protein level were used for the laboratory assessments. The individuals with active infection and any hematological, cardiovascular, metabolic disorder, malignancy, history of trauma, surgery, and hospitalization within the last 15 days were excluded from the study.&#x0D; &#x0D; Results: We found that the number and percentage of immature granulocyte were significantly higher in the patient group (p

Analytical validation of the modified Westergren method on the automated erythrocyte sedimentation rate analyzer CUBE 30 touch.

Analytical validation of automated erythrocyte sedimentation rate (ESR) analyzers is necessary prior to their implementation into routine practice. Our aim was toperform the analytical validation of the modified Westergren method applied on the CUBE 30 touch analyzer (Diesse, Siena, Italy). Validation included determination of within-run and between-run precision following the Clinical and Laboratory Standards Institute EP15-A3 protocol, comparison with the reference Westergren method, sample stability assessment at both room temperature and 4°C, after 4, 8 and24-h storage, and checking the extent of hemolysis and lipemia interference. Coefficients of variation (CVs) for within-run precision were 5.2% for the normal and 2.6% for the abnormal range, while between-run CVs were 9.4 and 2.2%, respectively. Comparison with the Westergren method (n=191) yielded Spearman's correlation coefficient of 0.93, noconstant nor proportional difference [y=0.4 (95% CI:-1.7-1.0)+1.06 (95% CI: 1.00-1.14)x] and a non-significant mean absolute bias of-2.6mm (95% CI:-5.3-0.2). Lower comparability was evidenced with increasing ESR values, with both constant and proportional differences for ESR values between 40 and 80mm, and above 80mm. Sample stability was not compromised up to 8-h storage both at room temperature (p=0.054) and 4°C (p=0.421). Hemolysis did not affect ESR measurement up to 1.0g/L of free hemoglobin (p=0.089), while lipemia index above 5.0g/L affects the ESR result (p=0.004). This study proved that CUBE 30 touch provides reliable ESR measurement and satisfactory comparability with the reference Westergren methods, with minor variation related to methodological differences.

Inflammatory Indices during and after a Randomized Controlled Trial on Exercise in Old Adults: Could Moderate-intensity Exercise be Safe Enough? (Active Elderly and Health – Clinicaltrials.Gov, NCT03858114)

Background: Aging is characterized by a progressive increase in chronic diseases. According to WHO’s guidance, there is a need to develop strategies to monitor, maintain and rehabilitate the health of older people. The present research aims to elucidate whether or not a moderate physical activity intervention in older adults can cause an increase in inflammatory biomarker indices such as C-reactive Protein (CRP) and erythrocyte sedimentation rate (ESR). It is a valuable tool for promoting health that can be considered tolerable in the over-65 population. Methods: 120 males and females over 65 years of age participated in a randomized controlled trial (RCT NCT03858114) in two groups of 60 individuals of similar size and underwent moderate physical activity or cultural and recreational activities. The exclusion criteria were being younger than 65 years old, being unable to participate in physical activity for medical reasons, and a Body Mass Index of greater than 35. Blood samples from participants were collected for the pre-treatment period (t0), at the end of the study of 12 weeks (t1), and 20 weeks after the end of the study (t2) for measurement of inflammatory indices CRP and ESR. Results: The commonly routine tests for inflammatory reactions (ERS and CPR) showed no change at the end of an RCT on mild-to-moderate exercise. Conclusion: The results on inflammatory indices confirm the safety of this type of intervention and encourage its long-term use and testing.

Analytical and Clinical Evaluation of Two Methods for Measuring Erythrocyte Sedimentation Rate in Eastern Indigo Snakes (Drymarchon couperi).

Erythrocyte sedimentation rate (ESR) is a hematological test that can detect inflammatory activity within the body. Although not specific for any particular disease, ESR is often used as a screening "sickness indicator" due to its reliability and low cost. The Westergren method is a manual ESR technique commonly used but requires special graduated pipettes and over 1mL of whole blood, precluding its use in smaller patients where limited sample volumes can be obtained. A modified micro-ESR technique has been described using hematocrit capillary tubes but is used less commonly. ESR has been reported to be a useful inflammatory indicator in gopher tortoises (Gopherus polyphemus) and box turtles (Terrapene spp.) but not in Florida cottonmouth snakes (Agkistrodon conanti). Having an inexpensive screening test for inflammation can help guide medical decisions within conservation efforts of imperiled species. This study evaluated the correlation between these two ESR methodologies in threatened eastern indigo snakes (Drymarchon couperi, EIS) and found a very strong correlation (rs = 0.897), without constant or proportional biases and a reference interval of 0 (90% CI -1-1)-9 mm/h (90% CI 8-11) was defined. Additionally, a significant difference was found between healthy EIS and EIS in mid-ecdysis (p = 0.006) and EIS with gastric cryptosporidiosis (p = 0.006), indicating ESR as a useful inflammatory indicator in EIS.

Red blood cell sedimentation rate measurements in a high aspect ratio microchannel.

The erythrocyte sedimentation rate (ESR) test is commonly used in clinical practice for monitoring, screening and diagnosing pathological conditions and diseases related to the inflammatory response of the immune system. Several ESR techniques have been developed over the years improving the reliability, the precision and the duration of the measurement. In the present study a new low cost micro-ESR technique is described providing the major advantage of reducing the measurement time and the blood sample volume by multiple times compared to the commercial methods. Blood samples were obtained from healthy donors within the age group of 24-28 years and the haematocrit was adjusted to 30%, 40% and 50%. The ESR of the samples was measured utilizing a surface tension driven (STD) microfluidic chip and a monitoring device. The evaluation of the method showed a high correlation (0.94, p < 10-5) at all haematocrit levels with the commercial instrument indicating the feasibility of the technique. This micro-ESR technique provides the potential for a simple, low cost and fast tool for ESR measurement using low blood volume acquired by finger prick.

Evaluation of the ESR fast detector and Improve® ESR analyzer as modified Westergren methods for erythrocyte sedimentation rate

The erythrocyte sedimentation rate (ESR) has been commonly ordered in hematology laboratories and used to screen for monitoring responses to therapy and identifying inflammatory conditions. To overcome the limitations of traditional ESR measurements, various methods have been developed and compared to the established reference method. This study evaluates the analytical performance of ESR fast detector and Improve® ESR analyzer compared to the reference method. Method validation and comparison were performed in 189 volunteer blood samples according to the International Council for Standardization in Hematology recommendations. The analytical efficacy of ESR fast detector and Improve® ESR analyzer was also assessed and compared with the reference method and C-reactive protein (CRP) levels. The results demonstrated that the precision of ESR fast detector and Improve® ESR analyzer was considered as the acceptance criterion for the ESR measurement. The method comparison analysis between the two modified Westergren methods and reference method demonstrated a strong correlation with the Spearman’s rank correlation coefficient of 0.94, with a mean difference of −2.1 and −7.7 mm/h in the ESR fast detector and Improve® ESR analyzer, respectively. Analysis of the area under the receiver operating curve illustrated a high analytical performance compared to the reference method and CRP level. The measurement of ESR level using the ESR fast detector and Improve® ESR analyzer is a reliable method and has a high analytical performance, which can be used instead of the reference method for screening inflammatory conditions.

Perbedaan Nilai Laju Endap Darah (Led) dengan Metode Westergreen Manual dan Automatic Convergys Esr 10s di Puskesmas Pasar Minggu

Examination of the erythrocyte sedimentation rate (LED) can be done by manual or automatic Westergreen methods. LED automatic machine used at the Pasar Minggu Subdistrict Health Center is the Convergys ESR 10s. This study aims to determine the difference in the measurement of the erythrocyte sedimentation rate using the Manual Westergreen for 1 hour and Automatic 30 minutes at the Pasar Minggu Subdistrict Health Center. The study used a comparative descriptive method, namely by comparing the results of the comparison of Westergreen's manual erythrocyte sedimentation rate (ED) measurement with the ICSHS standard and the Automatic method using the Convergent tool using statistical test data analysis of the Paired sample T-test. The results of the LED examination samples were analyzed by Kolmogorov-Smirnov to determine the results of the P-value of 0.20 (P-value &gt; 0.05) the data was normally distributed so that the data could be tested using the Paired Sample T-Test. The results with the paired sample T-Test test obtained a P-value of 0.877 (P-value &gt; 0.05). This result can be interpreted that H­0 is accepted and H1 is rejected, that there is no significant difference between Westergreen's manual erythrocyte sedimentation rate and the Automatic method.

Method Verification of the Caretium XC-A30 Automated Erythrocyte Sedimentation Rate Analyser for Erythrocyte Sedimentation Rate.

The erythrocyte sedimentation rate (ESR) analyser is widely used in haematological testing. In addition to the Westergren method, new automatic methods for ESR measurements have been developed. We aimed to study the reliability, precision, accuracy and stability of the Caretium XC-A30 automated ESR analyser. Ethylenediamine tetraacetic acid (EDTA)-treated blood samples were analysed via the Caretium XC-A30 automated ESR analyser and the Westergren method to compare accuracy. Precision was assessed using control samples and patient samples were classified into three groups-low, medium and high-according to their rates of sedimentation. Moreover, a stability test was performed. The correlation coefficient of the results of the Caretium XC-A30 and Westergren analyses was 0.97. The correlation coefficient of ESR values obtained from the two methods assessed in the low, medium and high groups were r = 0.80, r = 0.68 and r = 0.74, respectively. The coefficient of variation of within-run (%CVw) and between-run (%CVb), with replicates performed with commercial controls samples, were 7.54% and 8.04% for the normal control and 4.68% and 3.50% for abnormal control, respectively. The %CVw obtained with patient samples in the low, medium and high groups were 10.68%, 13.13% and 4.45%, respectively. The Caretium XC-A30 measurements were stable for up to 24 h when samples were stored at 4 °C. The Caretium XC-A30 ESR analyser proved to be a suitable instrument for routine analysis of ESR.

Procalcitonin Role in Musculoskeletal Infection: A Comparative Prospective Study

Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin (PCT) is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in diagnosis of soft tissue, bone and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein and serum Procalcitonin measurements. Healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.

Evaluation of hematological parameters in pulmonary tuberculosis patients.

Tuberculosis (TB) is the most common infectious disease caused by mycobacterium tuberculosis. Apart from the lungs, tuberculosis also affects the bone marrow. There are significant hematological abnormalities that occur in association with tuberculosis. So we can use these hematological parameters as a marker for the diagnosis, prognosis, and response to therapy. To evaluate the hematological parameters in pulmonary tuberculosis patients. A total of 70 diagnosed tuberculosis patients and 70 healthy controls were selected by purposive sampling in this study. About 4 ml of venous blood was collected with proper aseptic precaution. 2 ml ethylenediamine tetra acetic acid (EDTA) tube blood was used for hematological analysis by using Siemens Advia 2120i 5-part hematology analyzer. Rest 2 ml blood was used for measurement of erythrocyte sedimentation rate (ESR) by Wintrobe's method. The hemoglobin, packed cell volume (PCV), and blood indices values were significantly lower compared to healthy controls in both sexes. White blood cell (WBC) count, absolute neutrophil count, platelet count, and ESR values were significantly increased in tuberculosis patients as compared to healthy controls and were found to be statistically significant (P-value < 0.05). To measure hematological parameters in tuberculosis is a simple and cost-effective method to predict the course of the disease and monitor complications in developing countries like India.

Comparison of alternate erythrocyte sedimentation rate measurement by automated Celltac α+ (MEK 1305) and reference Westergren method

Objectives: Manual Westergren method is routinely used for ESR measurement; however, it has many limiting factors which include inherent and technical factors. Alternate/modified Westergren methods have been devised to overcome the limitations of the manual Westergren method. These new methods must be properly evaluated before introducing in clinical laboratories. Material and Methods: A total of 350 randomly collected Ethylene Diamine Tetraacetic Acid (EDTA) samples from hospitalized and ambulatory patients were assayed parallelly in the recently launched Hematology Analyzer Celltac α+ (MEK 1305) and manual Westergren method. Results of these assays were subjected to statistical analysis using a coefficient of correlation, Passing-Bablok regression, and the Bland-Altman statistical methods and the results of the present study were also compared with 16 selected similar studies published in the past 22 years. Intrarun precision using patient samples and inter-run precision using manufacturer’s controls (MEK-3DN and MEK-3DL) were also determined. Results: The present study revealed a Pearson correlation of 0.9058, mean bias of −6.43, and limits of agreements 17.5–−30.4, between Celltac α+ (MEK 1305) and the reference Westergren method. Intrarun precision using patient samples yielded a coefficient of variation ranging from 0% to 14% and inter-run precision using commercial controls yielded a CV of 9.32% for abnormal (MEK-3DL) control and 13.6% for normal level control (MEK-3DN). Conclusion: With good correlation between Celltac α+ (MEK 1305) and the reference Westergren method, acceptable bias, and limits of agreements, automated Celltac α+ (MEK 1305) with its additional advantages is a valid substitute for the reference ESR method in clinical laboratories.