Private Laboratories Research Articles

Increased measles and rubella seroprevalence in children using residual blood samples from health facilities and household serosurveys after supplementary immunization activities in two districts in India

Abstract Residual blood specimens provide a sample repository that could be analyzed to estimate and track changes in seroprevalence with fewer resources than household-based surveys. We conducted parallel facility and community-based cross-sectional serological surveys in two districts in India, Kanpur Nagar District, Uttar Pradesh, and Palghar District, Maharashtra, before and after a measles-rubella supplemental immunization activity (MR-SIA) from 2018 to 2019. Anonymized residual specimens from children 9 months to younger than 15 years of age were collected from public and private diagnostic laboratories and public hospitals and tested for IgG antibodies to measles and rubella viruses. Significant increases in seroprevalence were observed following the MR SIA using the facility-based specimens. Younger children whose specimens were tested at a public facility in Kanpur Nagar District had significantly lower rubella seroprevalence prior to the SIA compared to those attending a private hospital, but this difference was not observed following the SIA. Similar increases in rubella seroprevalence were observed in facility-based and community-based serosurveys following the MR SIA, but trends in measles seroprevalence were inconsistent between the two specimen sources. Despite challenges with representativeness and limited metadata, residual specimens can be useful in estimating seroprevalence and assessing trends through facility-based sentinel surveillance.

Towards harmonized laboratory methodologies in veterinary clinical bacteriology: outcomes of a European survey.

Veterinary clinical microbiology laboratories play a key role in antimicrobial stewardship, surveillance of antimicrobial resistance and prevention of healthcare associated-infections. However, there is a shortage of international harmonized guidelines covering all steps of veterinary bacterial culture from sample receipt to reporting. In order to gain insights, the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) designed an online survey focused on the practices and interpretive criteria used for bacterial culture and identification (C&ID), and antimicrobial susceptibility testing (AST) of animal bacterial pathogens. A total of 241 microbiology laboratories in 34 European countries completed the survey, representing a mixture of academic (37.6%), governmental (27.4%), and private (26.5%) laboratories. The C&ID turnaround varied from 1 to 2 days (77.8%) to 3-5 days (20%), and 6- 8 days (1.6%), with similar timeframes for AST. Individual biochemical tests and analytical profile index (API) biochemical test kits or similar were the most frequent tools used for bacterial identification (77% and 56.2%, respectively), followed by PCR (46.6%) and MALDI-TOF MS (43.3%). For AST, Kirby-Bauer disk diffusion (DD) and minimum inhibitory concentration (MIC) determination were conducted by 43.8% and 32.6% of laboratories, respectively, with a combination of EUCAST and CLSI clinical breakpoints (CBPs) preferred for interpretation of the DD (41.2%) and MIC (47.6%) results. In the absence of specific CBPs, laboratories used human CBPs (53.3%) or veterinary CBPs representing another body site, organism or animal species (51.5%). Importantly, most laboratories (47.9%) only report the qualitative interpretation of the result (S, R, and I). As regards testing for AMR mechanisms, 48.5% and 46.7% of laboratories routinely screened isolates for methicillin resistance and ESBL production, respectively. Notably, selective reporting of AST results (i.e. excluding highest priority critically important antimicrobials from AST reports) was adopted by 39.5% of laboratories despite a similar proportion not taking any approach (37.6%) to guide clinicians towards narrower-spectrum or first-line antibiotics. In conclusion, we identified a broad variety of methodologies and interpretative criteria used for C&ID and AST in European veterinary microbiological diagnostic laboratories. The observed gaps in veterinary microbiology practices emphasize a need to improve and harmonize professional training, innovation, bacterial culture methods and interpretation, AMR surveillance and reporting strategies.

Role of Human Cytomegalo virus and High Risk Human Papilloma Virus in Breast Cancer

Background: In Iraq, breast tumor is the greatest prevalent form of female malignancy. Increasing research in the past ten years shows that many human malignancies, including breast tumors, are associated with Human Cytomegalovirus and high-risk Human Papilloma Virus. Objectives: The aim of this research was to determine the role of HPV and HCMV in benign and malignant breast tumors. Methods: This retrospective research used 140 chosen formalin-fixed, paraffin-embedded pieces of breast specimen taken from 100 patients of breast tumor (70 cases of ductal mammary, 15 patients of lobular cancer, five persons mixed from ductal and lobular cancer and ten persons of medullary cancer) and 20 patients infected with benign epithelial lesion As well as 20 pieces of normal breast tissue as control groups. The range of age was 16-72 years. The study was conducted in hospitals and private laboratories in Kirkuk and Tikrit city from 15th January 2022 to 15th December 2022 using the in situ hybridization (ISH) technique. Results: The archival samples collected were related to breast cancer patients ranging from 16 years to 70 years of age, with a maximum age of 73 years in breast cancer and 60 years in healthy women. ISH found that CMV was positive in (25 percent) breast cancer tissues (25 / 100) according to the control group were negative. While in HPV demonstrated (45%) 45/ 100 breast cancer tissues compared to the control group were negative. Of these, The findings revealed that the spreading of HPV-DNA genotypes in malignant and benign cancer groups were as follows: HPV16 10 (20.8%), HPV 18 10 (20.8%), and HPV 31 28 (58.33%). These results suggest that HPV genotype 31 appeared at a greater rate than other genotypes (16 and 18). In 25 (55.6 percent) cases, the largest ratio of co-infection with several high-risk genotypes of HPV 16 + 18 + 31 was observed. Co-infection in the malignant group with other high-danger HPV genotypes was as follows: HPV 16 +18 6(13.33%), HPV 16 + 31 6(13.33), and HPV 18+31 8(17.8%). Positive signs suggesting high-risk HPV infection were detected for 1/1 (100 percent) of benign breast tumor tissues; 30(66.7 percent) mixed HPV infection was found in 45 cases of malignant breast tumors. Conclusion: The results of this study showed a connection between HCMV and high-oncogenic genotypes of HPV in breast cancer patients.

HEPATITIS B AND C: PREVALENCE AND EVALUATION OF ITS ASSOCIATED RISK FACTORS IN GENERAL POPULATION OF OKARA DISTRICT

Viral Hepatitis B and C are common blood –borne infections and lead to chronic liver diseases and causes economic burden on country. Blood samples (N=13295) were collected from individuals who attending public and private sector labs and subjected for Hepatitis B surface antigen and anti- HCV. A structured questionnaire was also filled to assess the risk factors for disease transmission. An overall prevalence of HBV 2.5% and HCV 14.5% was observed. The prevalence of HBV and HCV was higher in Males, 3.6%, 16.8% respectively than Females (2% for HBV; 13.5% for HCV). Results of Bivariate analysis showed that age group >70 years was more susceptible for HBV (4.6%) and for HCV (29.7%) 51 to 60 years age group Multivariate analysis showed that blood transfusion (5.3%, 43.3 %), dental extraction (3.4%, 22.5%), ear and nose piercing (3.9%, 17.8%) were significantly associated with HBV and HCV respectively. To the best of our knowledge, this is the first study conducted in Okara district and the results indicate that there is a dire need to educate the population regarding disease and to initiate effective control strategies.

Detection of Some Virulence Genes in Diarrheagenic Escherichia Coli Pathotypes in Children Under Five Years in Aleppo City

Diarrheagenic Escherichia coli (DEC) strains can be classified into six main pathotypes based on their specific virulence properties. These pathotypes are associated with certain serotypes and exhibit distinct epidemiological and clinical features. The identification of DEC cannot be based solely on cultural and biochemical criteria, as they are indistinguishable from the non-pathogenic E. coli. However, the presence of virulence genes and DNA sequences specific to DEC can be used to determine its identity. The aim of this study is to investigate the prevalence of Diarrheagenic Escherichia coli (DEC) pathotypes among infected children under 5 years living in the city of Aleppo Syria. From June 2020 to September 2021, one hundred samples of diarrheal were collected from children under five years suffering from diarrhea admitted at Aleppo University Hospital and from some private laboratories in Aleppo city. Escherichia coli pathotypes were detected by using multiplex polymerase chain reaction and Phylogenetic genes were detected by Triplex PCR. The frequency of diarrheagenic E. coli was (48%), the most frequently isolated pathotypes were atypical enteropathogenic E. coli. (42%), followed by enterotoxigenic E. coli (4%), and enteroinvasive E. coli (2%). Enterohemorrhagic E. coli, enteroaggregative E. coli and Diffusely Adherent E. coli were not detected in any sample (0%). The most prevalent phylogenetic group of E. coli was "Phylogenetic group B2" which represented (62%), followed by "Phylogenetic group D" that comprised 33%, followed by "Phylogenetic group A" strains (3%). Strains of the "Phylogenetic group B1" were rare (2%). This study revealed that DEC strains contribute to cause diarrheal diseases in children, EPEC is the most commonly identified DEC strain. B2 and D groups are the most prevalent phylogenetic groups. In addition, they are virulent because these groups are associated with the presence of several virulence factors.

Epidemiological and diagnosis study of Entamoeba histolytica in diabetic patients at Kut city

The current study was conducted on patients with diabetes mellitus and those infected with Entamoeba histolytica who were attended to Al-karamah Teaching Hospital and some private laboratories in the city of Kut-Iraq for the period from August to September, 2023 at the ages ranging from 20-70 years. A total of 50 feces samples were collected; 30 male and 20 female. Only 15 samples (30%) were given positive results to E.histolytica; male 9 (18%) and female 6(12%). Samples were examined microscopically by direct smear then stained with iodine. The prevalence of E.histolytica infection in patients from urban areas was more than rural areas and in male more than female.

Prevalence of Entamoeba histolytica and Giardia lamblia infection among patients attending Heet Hospital in Al-Anbar, Iraq

This study was designed to estimate the spread of Entamoeba histolytica and Giardia lamblia and study the age, sex and months effect in the infection rate. 398 stool samples (215 males and 183 females) were collected from both children and adults attending to Heet General Hospital, and some of private laboratories affiliated to Heet. The total infection rate was 64.3%. Entamoeba histolytica infection rate was higher (56.7%) than Giardia lamblia infection (7.5%). Regarding the seasonal effect on the infection rate, E. histolytica highest rate was observed in August (14.6%) and the lower rate was in September (9%). And the age related infections appear to be mostly in ages older than 35 years significantly (26.63%) followed by ages younger than 15 years (16.83%). In comparison, the infection could be considered non gender specific with a shallow elevation in males (29.4%) over the rate in females (27.3%). Regarding Giardia lamblia, the prevalence was considered significantly lower. The seasonal related infection considered much greater in May and June (2%) compared to July, August, September (125%,1.25%,1%) respectively. With convergent rate of infection retention among different ages or between females (3.2%) and males (4.3%).

PEMERIKSAAN TEKANAN DARAH DAN TES BUTA WARNA PADA MAHASISWA BARU DI SALAH SATU PTS KOTA PALEMBANG TAHUN 2023

Background: Health examinations can be carried out at government or private laboratories or free health education institutions. A person's blood pressure is influenced by several factors, such as changes in body position and physical activity. However, color often causes problems for sufferers both in daily activities and when sufferers want to pursue higher education or apply for certain types of work. The aim is to provide blood pressure checks and color blindness tests for new students at PTS X Palembang City in 2023. Method: research using quantitative methods with a Cross Sectional research design, carried out at the PTS X Laboratory, Palembang City on September 7 2023. The research population was 96 students and the research sample was 96 students using total sampling technique, data collection using checklist sheets and data analysis using univariate and bivariate analysis. Results: Based on the results obtained from 96 students at PTS Blood pressure examination results were abnormal 51.0%, normal 49.0%. The color blindness test results, which were 1.0% color blind, were 99.0% normal. From the majors, the Public Health major got 57.3%, ATLM 42.7%. There is a significant relationship between the color blindness test and gender (p value 0.003 and OR 0.900). There was no relationship between gender, PTS major and blood pressure. There is no relationship between major and color blindness test. Conclusion: Blood pressure checks and especially color blindness should be given early so as not to affect learning achievement, educational paths and future career development. Keywords : Health Checkup, Blood pressure, Color blindness

EMERGENCE OF MULTIDRUG RESISTANT BACTERIA AMONG PATIENTS WITH RESPIRATORY TRACT INFECTIONS

In this study, 25 Pseudomonas aeruginosa isolates were diagnosed in 160 clinical samples collected from patients attending the Tuberculosis Institute/ Medical city and Al-Muhmodia Public Hospital, in addition to a number of private laboratories in Baghdad during the period from September 2020 to February 2021. The bacterial isolates from clinical samples were biochemically diagnosed by API® 20E system then further identified by VITEK 2 system. P. aeruginosa represented the most prevalent bacteria in lower respiratory tract specimens. These isolates showed moderate to high susceptibility towards 11 antimicrobial agents tested in this study except that of ceftazidime and ceftriaxone. Extra-chromosomal resistance of the top three of the most resistant P. aeruginosa isolates were subjected for molecular investigation. Bacterial transformation of E. coli S1 cells with plasmid DNA extracted from the selected P. aeruginosa isolates exhibited increased resistance to ceftazidime and penicillin G. The data clearly suggest that the plasmid DNA content is implicated in enhancement of P. aeruginosa resistance through horizontal transfer of extra- chromosomal beta lactam resistance associated genes.

Identify The Urinary Bladder Cancer Patterns In Nasiriyah city / Thi-Qar Province – Iraq

This study aims to shed light on the generality types of urinary bladder cancer in the city of Nasiriyah / Thi-Qar Province – Iraq. The study includes cases that were registered in the Department of Pathology in Al-Hussein Teaching Hospital and Private Laboratories. Patient records were analyzed for information regarding age, sex, residence, and cancer type. A total of 114 sufferers of bladder cancer were obtained. The data taking period was from January 1, 2021 to April 30, 2022. Tumors were diagnosed mainly in the private laboratories of two consultant pathologists in Nasiriyah. The results showed 107 (93.86%) transitional cell carcinomas with a mean age of 47 years, in addition to 6 (5.26%) squamous cell carcinomas with a mean age of 69 years and 1 adenocarcinoma (0.88%) at the age of 51 years. Out of all cancer cases, males accounted for 74.56% whilst females accounted for 25.44%, indicating a male to female ratio of 4:1. Additionally, males showed a clear dominance in the totality of the histological grades. The age range with the highest number of cancer cases was between 70-79 years old (n = 37; 32.45%), while the age range with the lowest number of cases was between 23-39 years old (n = 3; 2.63%). The current study concluded that the majority types of bladder cancer in the city of Nasiriyah / Thi-Qar Province - Iraq are transitional cell carcinomas with an average age of 47 years. Among all cancers, males had the highest incidence.

Terminology Issues in the Field of Genetic Research

Due to the intensive development of genetic research, the availability of genetic testing is increasing, including those based on genome-wide sequencing offered by private and public laboratories. Genetic testing can be used to identify the cause of the disease in patients with suspected hereditary (orphan) diseases and as a screening tool for healthy people, for example, if expectant parents planning to have children are carriers of hereditary diseases, to identify the risks of hereditary oncological diseases and multifactorial diseases, for pharmacogenetic testing, as well as for non-medical purposes, for example to determine the «ethnic origin». In addition, genetic research can be used to identify individuals, including in criminology and for genomic registration, determination of paternity and other kinship. This review paper analyzes some issues of terminology in the field of genetic research, including their results, as well as the legal basis for the genetic certification of the population of the Russian Federation, the use of the terms «genetic passport», «genetic profile» and «genomic passport», «genomic profile» and provides recommendations for improving the use of relevant terms such as standardizing the requirements for the preparation of a report/conclusion on the results of a genetic study and resolving the issue of the medical nature of the full-genome sequencing process. In addition, the practice of using the term «genetic passport» in federal acts, as well as domestic and foreign literature and media publications, is analyzed. Not only does the paper reveal the concept of complete genome sequencing, but also provides cases of mandatory medical and biological examination, including complete genome sequencing.

Antimicrobial Resistance Surveillance Methods in Bangladesh: Present and Way Forward.

The Institute of Epidemiology, Disease Control and Research (IEDCR) conducts active, case-based national antimicrobial resistance (AMR) surveillance in Bangladesh. The Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia (CAPTURA) project accessed aggregated retrospective data from non-IEDCR study sites and 9 IEDCR sites to understand the pattern and extent of AMR and to use analyzed data to guide ongoing and future national AMR surveillance in both public and private laboratories. Record-keeping practices, data completeness, quality control, and antimicrobial susceptibility test practices were investigated in all laboratories participating in case-based IEDCR surveillance and laboratory-based CAPTURA sites. All 9 IEDCR laboratories recorded detailed case-based data (n = 16 816) in electronic format for a priority subset of processed laboratory samples. In contrast, most CAPTURA sites (n = 18/33 [54.5%]) used handwritten registers to store data. The CAPTURA sites were characterized by fewer recorded variables (such as patient demographics, clinical history, and laboratory findings) with 1 020 197 individual data, less integration of patient records with the laboratory information system, and nonuniform practice of data recording; however, data were collected from all available clinical samples. The analyses conducted on AMR data collected by IEDCR and CAPTURA in Bangladesh provide current data collection status and highlight opportunities to improve ongoing data collection to strengthen current AMR surveillance system initiatives. We recommend a tailored approach to conduct AMR surveillance in high-burden, resource-limited settings.

Relation between Epstein-Barr virus (EBV) with some biochemical variables in high-risk aborted women in Mosul city, Iraq

Epstein-Barr Virus (EBV), or Kissing Virus, is a member of the Herpes virus that can be a contributory factor for compromised pregnant, high-risk aborted women worldwide. The present study aimed to detect high-risk EBV by the Monospot test for pregnant, high-risk aborted women, to detect immunoglobulin IgM and IgG for EBV using Enzyme-linked immunosorbent assay (ELISA) technique, to distinguish the infections as acute, chronic, or reactivated, and to determination of Enzymes as Aspartate Transaminase (AST), Alkaline phosphatase (ALP), and Alanine Transaminase (ALT).A cohort of 91 serum samples were collected from high-risk aborted women (ages 15-45 years) who attended Al-Medina Private Laboratory from February to December 2022.Sera were tested for heterophile antibodies(HA) associated with Infectious Mononucleosis (IM) caused by EBV by Latex Agglutination slide test (IM Quick test) and were tested for IgM and IgG antibodies against EBV-CA in serum using the ELISA kit.Sera from the patients and healthy controls were analyzed for Glutamate-Pyruvate Transaminase (GPT), Glutamic Oxaloacetic Transaminase (GOT), Lactate Dehydrogenase (LDH), and Alkaline phosphatase. Compared to healthy controls, the data showed that the late phase with loss and reactivated infection was responsible for 25% of cases and that the acute and late infection cases had a high of 64%. There were significant differences in the level of these hormones;aborted women showed increased levels of serum ALP (70.83) while having a reverse effect with serum ALT (11.7) and AST (25.43). EBV activation was higher in the aborted women. The study would help to determine the role of EBV in the pathogenesis of abortion.

The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis

A critical and persistent challenge to global health and modern health care is the threat of antimicrobial resistance (AMR). Previous studies have reported a disproportionate burden of AMR in low-income and middle-income countries, but there remains an urgent need for more in-depth analyses across Africa. This study presents one of the most comprehensive sets of regional and country-level estimates of bacterial AMR burden in the WHO African region to date. We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for countries in the WHO African region in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). We obtained data from research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. In the WHO African region in 2019, there were an estimated 1·05 million deaths (95% UI 829 000-1 316 000) associated with bacterial AMR and 250 000 deaths (192 000-325 000) attributable to bacterial AMR. The largest fatal AMR burden was attributed to lower respiratory and thorax infections (119 000 deaths [92 000-151 000], or 48% of all estimated bacterial pathogen AMR deaths), bloodstream infections (56 000 deaths [37 000-82 000], or 22%), intra-abdominal infections (26 000 deaths [17 000-39 000], or 10%), and tuberculosis (18 000 deaths [3850-39 000], or 7%). Seven leading pathogens were collectively responsible for 821 000 deaths (636 000-1 051 000) associated with resistance in this region, with four pathogens exceeding 100 000 deaths each: Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus. Third-generation cephalosporin-resistant K pneumoniae and meticillin-resistant S aureus were shown to be the leading pathogen-drug combinations in 25 and 16 countries, respectively (53% and 34% of the whole region, comprising 47 countries) for deaths attributable to AMR. This study reveals a high level of AMR burden for several bacterial pathogens and pathogen-drug combinations in the WHO African region. The high mortality rates associated with these pathogens demonstrate an urgent need to address the burden of AMR in Africa. These estimates also show that quality and access to health care and safe water and sanitation are correlated with AMR mortality, with a higher fatal burden found in lower resource settings. Our cross-country analyses within this region can help local governments to leverage domestic and global funding to create stewardship policies that target the leading pathogen-drug combinations. Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.

Legalization of medical cannabis in Ukraine: issues of criminal law protection

The article discusses the legalization of medical cannabis in Ukraine. The main draft laws on the regulation of the circulation of hemp plants (Cannabis) for medical, industrial purposes, scientific and scientific and technical activities, the state of their consideration and the main conclusions of the specialized committees of the Verkhovna Rada were analyzed.
 It has been established that the process of legalizing medical cannabis involves a special mechanism of organizational and legal regulation of activities related to the cultivation of cannabis for medical purposes, transportation, processing of plants and extracts of cannabis, the manufacture of appropriate medical devices using them as raw materials, as well as the conduct of scientific research. Such a mechanism establishes the procedure for obtaining permits, restrictions and rules for cultivation, transportation, processing, production and sale in terms of organizational, administrative and legal aspects.
 The article notes that the current regulations do not cover social relations in the field of the production of medicinal products based on cultivated medical cannabis, and such activity itself may be associated with a corruption component in terms of permit procedures, the activities of control and inspection bodies and institutions, dishonesty of private laboratories, etc. It is proposed to conclude that the process of regulating sowing, cultivation, production of medical cannabis, etc. is in the realm of civil, economic, and administrative procedures, but ensuring legality and compliance with the rules and mechanisms established by these industries requires the participation of criminal-legal means. Such measures include the establishment of new and revisions of existing criminal prohibitions in order to ensure the criminal protection of social relations that may occur in connection with the legalization of medical cannabis.
 Key words: medical cannabis, cannabis, license, criminal law protection, criminal liability, narcotic substances, medicinal products.

Critical values notification: A nationwide survey of practices among clinical laboratories across Nigeria.

Critical value notification (CVN) entails notifying doctors or other laboratory users of aberrant laboratory results that threaten the patient's life and of any values for which reporting delays could negatively impact the patient's health. Critical value notification practices in clinical laboratories in Nigeria and sub-Saharan Africa are largely unknown. We conducted a nationwide survey to obtain baseline information on CVN practice by Nigeria's laboratories. This cross-sectional study was conducted among purposively selected secondary- and tertiary-tier, public and private clinical laboratories across northern and southern Nigeria between October 2015 and December 2015. Consenting senior laboratory staff completed and returned a structured questionnaire, that gathered data on respondents' demographics, designations, and institutional characteristics and practices regarding CVN. One hundred and thirty-four laboratories responded to the questionnaires. Only 69 (51.5 %) laboratories practised CVN; only 23 (33.3%) had existing written policies guiding the practice. Most (43; 62.3%) laboratories use similar critical values (CVs) for adult and paediatric populations. Most laboratories (27; 39.1%) obtained their CVs by combining published literature and local opinions from stakeholders. Physical dispatch (42; 60.9%) followed by telephone calls (38; 55.1%) were the most common means of notification. Private laboratories, compared with public hospital laboratories, were likelier to have separate paediatric CV lists (p = 0.019) and practise telephone notifications (p < 0.001). Critical value notification practices vary and are often suboptimal in many clinical laboratories in Nigeria, which is exacerbated by the absence of guiding policies and national recommendations for post-analytical procedures. This study provides baseline information on CVN practice by Nigeria's laboratories. The study explores the causes of practice variations that can serve as a foundation for enhancing critical reporting and post-analytical services, particularly in clinical laboratories in sub-Saharan Africa.

STABILITAS PLASMA LIOFILISAT BUATAN SENDIRI SEBAGAI BAHAN KONTROL KUALITAS PADA LABORATORIUM KIMIA KLINIK TERHADAP PEMERIKSAAN TOTAL PROTEIN DAN ALBUMIN

The stability test of the control material is very important because the stability indicates the control material does not change significantly during storage. The use of commercial control is not economically feasible in many countries because of the unavailability or high cost. Therefore, the manufacture of lyophilized human plasma will be great use to several small and private laboratories, including puskesmas laboratories. This study aims to determine the stability of homemade lyophilized plasma as a quality control agent in a clinical chemistry laboratory on total protein and albumin parameters. This type of research is an experimental research with a time series group design. This research was conducted at the campus laboratory and Pramita Laboratory. Samples were taken from 1 respondent in April - May 2022, stored at a temperature of 2-8°C and checked every week for 8 weeks. The results of the examination of total protein levels mean weeks 1 to 8 were 6,42 mg/dL, 6,65 mg/dL, 6,73 mg/dL, 6,50 mg/dL, 6,25 mg/dL, 6,47 mg/dL, 6,28 mg/dL, 6,28 mg/dL. The results of the examination of albumin levels on average 1 to 8 were 3,99 mg/dL, 3,91 mg/dL, 3,63 mg/dL, 3,80 mg/dL, 3,97 mg/dL, 3,43 mg/dL, 3,60 mg/dL, 3,72 mg/dL. The results Leavy Jenning's chart analysis showed plasma lyophilized test results for total protein and albumin levels were still within the limit of ± 2SD. And in regression test the KD value for Total protein 40.32% and the KD value for Albumin 32.54%, showed that the storage time for total protein and albumin had effect on stability of plasma lyophillized. So it can be concluded the examination of total protein and albumin levels stored at a temperature of 2-8°C was stable for 8 weeks

Analysis of the association between lipid panel and hypothyroidism in patients at a private laboratory in Jacutinga – MG

Introduction: The thyroid gland produces the thyroid hormones triiodothyronine (T3) and thyroxine (T4), which regulate metabolism through the transcription of certain genes. Hypothyroidism is characterized by a decrease in the body's metabolic activity due to the low production of important agents for this process, which can cause dyslipidemia. Objective: To analyze the association between hypothyroidism and lipid panel in biological samples from patients treated in a private laboratory in the city of Jacutinga – MG during the year 2022. Material and Method: Data from laboratory reports were collected from patients over 18 years of age who simultaneously carried out TSH, free T4, total cholesterol, HDL-c, LDL-c, VLDL-c and triglycerides tests, and after collected, the data were separated according to the presence or absence of hypothyroidism, based on the reference values for this purpose. The lipid panel of patients with hypothyroidism was also analyzed following reference values. The study variables were age and gender. Results: The study included 470 laboratory reports, where 17.66% were characterized with hypothyroidism and of these, 61.45% were female with a mean age of 51 years and 38.55% were male with a mean age 55 years old. The Total Cholesterol test and the LDL-c test showed an increase in 55,42% and 40,96% patients with hypothyroidism, respectively. Conclusion: it is concluded that females have a higher incidence of cases of hypothyroidism, especially after the age of 50. The incidence of elevated lipid tests was also higher among females.

Establishing a One Health AMR Community of Practice in Nigeria

Abstract To support the objectives set out in Nigeria’s national action plan for Antimicrobial Resistance (AMR), we established a One Health AMR Community of Practice comprised of Fleming Fund Fellows and their mentors. This community is a multi-disciplinary team dedicated to addressing AMR in human and animal health sectors, with members from Nigeria, Denmark, and the United Kingdom. We undertook gap analyses of the systems in Fleming Fellows’ laboratories and institutions to identify areas for support. Tailor-made capacity support programmes were developed for each Fellow. Fellows visited their mentors’ institutes for in-person coaching, and subsequently implemented strengthened processes at their home institutes. The community has trained 178 Nigerian scientists from Government, academic, and private laboratories, by delivering courses comprising classroom teaching and hands-on laboratory sessions. This up-skilling of Nigerian laboratory staff, through the ‘train-the-trainer’ approach, has enhanced capacity to produce high-quality microbiological data. The community has completed One Health collaborative projects investigating AMR in livestock, in-contact humans, the farm environment, and hospital submissions. We have held feedback sessions with stakeholders to raise awareness of AMR and provided advice on measures such as biosecurity, which can help to prevent disease and therefore reduce the need for antimicrobial use. The establishment of this community has helped to strengthen personal and institutional capacities in Nigeria, Denmark, and the United Kingdom and created a network of scientists working together to tackle AMR. This community has contributed to One Health AMR surveillance systems and supported the implementation of Nigeria’s national action plan for AMR. Information © The Authors 2023

Comparative Evaluation of Serological, ELISA and Molecular Tests in Diagnosis of Brucella abortus in Human Serum

Background: Brucellosis is one of the most prevalent and common diseases between humans and animals.Prompt diagnosis and timely treatment of this disease can prevent many complications. In this regard, this study aims to comparatively evaluate ELISA, PCR and serological methods to identify Brucella abortus. Methods: In this study, the serum of 100 patients referred to Tonekabon private laboratory from July 2020 to January 2021 was examined by PCR, ELISA and Wright, Coombs Wright, and 2ME methods for the detection of Brucella abortus. Results: In this study, the mean age of the sample was 43.3 ± 18.2 of which 21% were infected with Brucella abortus according to the above serological methods. According to ELISA test, 22% of the samples were IgM, 6% of the samples were IgG and 16% were PCR positive. Kappa agreement coefficient in Wright and Coombs Wright test and 2me were significant (P &lt;0.001). Serological diagnostic indices and ELISA sensitivity were 68.75% and 68.75%, respectively. The lowest prediction rate of Brucella abortus among diagnostic methods was related to Elisa (IgM). Based on Fisher's exact test, there was no significant relationship between the percentage of Brucella abortus positive PCR cases and age, sex, previous history of infection with Brucella, fever, body aches and dairy consumption. Conclusion: Based on the results of our study, the accuracy of all methods is comparative and the lowest accuracy is related to Elisa (IgM) which has a lower level of predictability than other methods. The highest level of prediction belonged to Wright and 2me tests.