Interdependence of hepatitis B and C virus infection with M2BPGi marker / Эрүүл мэндийн лаборатори

Introduction@#Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice.@*Materials and methods@#From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C.@*Results@#Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.</br> Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.</br> Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection.@*Conclusions@#The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.

Comparison of Sysmex UF-5000 with urine culture for the diagnosis of urinary tract infections / Эрүүл мэндийн лаборатори

Introduction@#Urinary tract infections (UTI) are at the second place in the frequency of all causes of infection after respiratory ones. The UTI requires appropriate antibiotic treatment. 85% of UTI predictive antibiotic treatment without confirmation by bacteriological analysis. This is one of the major causes of drug resistance, especially in K.coli. Urine bacteriological tests do not show bacterial culture in all cases where the number of bacteria in the urine exceeds the reference level. Therefore, there was a need to establish criteria for urine bacteriology test based on the results of urine sediment analysis.</br> In 20I7, a new fully automated Sysmex UF-5000 urine sediment analyzer was installed in the laboratory department of Medipas Hospital. The features of this analyzer include counting the number of bacteria in the urine, distinguishing between gram-positive and negative, homogeneous and mixed forms, and counting the formed elements in the urine. This feature made it possible to compare the number of bacteria and leukocytes in the urine with the results of urine bacteriology tests.@*Goal@#Determine the relationship between the number of white blood cells and bacteria in the urine measured by the Sysmex UF-5000 urine sediment analyzer and the results of the urinary bacteriological test.@*Objectives@#Compare the number of urine bacteriaand leukocyte measured by using the Sysmex UF-5000 urine sediment analyzer with the urine bacterial culture, and calculate the correlation.@*Materials and methods@#The study is analytic cross-sectional study, analyzed the results of a total of 159 people who analyzed a urinalysis and urine bacteriological test at the Medipas Hospital Laboratory in 2017-2019 years.Urine samples were collected in a 100 ml, disposable sterile container in accordance with the instructions for taking urine midstream.Urine analysis was performed within 2 hours of sampling with a fully automatic urine sediment analyzer Sysmex UF-5000 Japan. Urine bacteriological analysis was performed on a lul sterile loop of urine specimens, inoculated into 5% blood agar from Hungary's BioLab, Sabouraud agar, and Chromogen agar from Biomerieux France, and incubated for 24 hours in an incubator at 37°C. Bacterial identification and antibiotic susceptibility tests were analyzed using the "Vitek-2" analyzer from the manufacturer Biomerieux France. Bacterial and leukocyte counts data measured by the Sysmex UF-5000 analyzer and urinary bacteriological analysis data were performed using SPSS23 software.@*Results@#A total of 159 urine samples were tested for bacteriological analysis, of which 81 (50.9%) were bacteria over 105 CFU/ml or urine positive culture UTIs, 78 (49.1%) were nonsignificant bactcruria and urine negative culture.The average number of bacteria measured in the urine of 81 samples with urine positive culture above 105 CFU/ ml was 46491/ul (1168-100000 BACT/ul). </br> The average number of bacteria measured by the urine sediment analyzer of 78 samples with urine negative culture was 2645 BACT/ ul (2-57280 BACT/ul). To calculate more accurately estimate the average number of bacteria in 81 urine specimens with positive culture, the average number of bacteria in 17 (21%) samples was 4753 BACT/ul, measured in relatively low bacteria numbers of 1168-9450BACT/ul. The average leukocyte number in the urine of 81 samples with positive culture was 472.2 WBC/ul, and the average leukocyte number in the urine of 78 samples with negative culture was 87.7 WBC/ul.There is a strong correlation between the number of bacteria measured by the urine sediment analyzer and urine bacterial positive culture, which is 0.8 or statistically significant (p<0.001).The correlation coefficient of the number leukocytes measured by the urine sediment analyzer with in the urine positive cultureof bacteriological tests was 0.6 or moderately of statistically significant (p=0.005).There is a statistically significant relationship (p=0.001) between the number of bacteria in the bacterial positive culture population and the number of leukocytes.@*Discussion@#Of the 81 cases of urine bacterial positive culture, 78 (96%) were female, indicating a high prevalence of UTI among women. According to the results of the Fabio Manon's study, the number of leukocytes in the urine is 160-340 WBC/uL and the number of bacteria is 15000-30000 BACT/u,L in the case of UTI, which is approximate results compared to the our study results.Based on the results of the urine sediment analysis, indications for a urine bacteriological test should be made.</br> Based on the results of urinary bacteriological tests, the choice of antibiotic treatment is the best treatment for urinary tract infections and a way to prevent of antibiotic resistance to UTI.@*Conclusions@#The number of bacteria measured by a Sysmex UF-5000 urine sediment analyzer is directly related to the bacterial culture urine bacteriological test. If the number of bacteria in the urine is measured above 4753 BACT/ul, it can be considered as an indication for urine bacteriological analysis. Although the number of leukocytes in the urine measured by the Sysmex UF-5000 urine analyzer is moderately correlated with bacterial culture in urine bactcriologucal tests, it is a key indicator of the degree of inflammation of the urinary tract.

External Quality Assessment in blood morphology testing in Mongolia / Эрүүл мэндийн лаборатори

Background@#We organized the MEQAS (Mongolian External Quality Assessment Scheme) since 2008, on basis of the Cooperation agreement between Ministry of Health and Sysmex Corporation in the establishment of Hematology external quality control and reference laboratory system.</br> Therefore, since 2017 year we have set up from 1^st to 4^th External Quality Assessment (EQA) for blood morphology testing.@*Method@#This EQA for blood morphology testing included 177 clinical pathologists, 57 technologists, and 36 technicians (270 participants in total). We assessed their ability to distinguish the blood cells on a real-time basis online.@*Result, discussion@#Out of all participants, the clinical pathologists got marks ranging 70.1%, technologists got 59.0%, technicians got 58.2%. Continual trainings should be organized by different programs for laboratory specialists. A real-time online method was adopted in an EQA for the first time. This allowed the participants to know their results immediately after completing the assessment. </br> The overall results of the participants were generated in form of graphs immediately after the completion of the EQA. This allowed for visualization of areas where the percentage of correct answers were low, which were explained extensively during the discussion of answers. </br> As the results directly reflect the knowledge and skills of each participants, this form of EQA is suggested to be an extremely useful mean for determining the future education platform.@*Conclusions@#</br>1. The ability of clinical pathologists to distinguish blood cells and to interpretation are unsatisfactory. </br> 2. The ability of biomedical technologists and technicians to distinguish blood cells are unsatisfactory.

HEPATITIS В, С VIRUS INFECTION AND M2BPGI LIVER CIRRHOSIS MARKER CORRELATION / Шинэ санаа Шинэ нээлт

@#BACKGROUND Mostly of liver cancer in the world is caused by hepatitis B and C virus. Liver cancer occurs within 10-29 years after the virus is infected. If have liver cirrhosis, you can develop cancer after 5-10 years. According to the study in Mongolia 2014, C virus infection is 9.5% and B virus infection is 10.6%, high prevalence of hepatitis B, C and liver cirrhosis. Designed by Sysmex Corporation of Japan, possible analyze from blood, non invasive, sensitive and specific, M2BPGi liver cirrhosis marker. It is necessary to investigate the relationship between hepatitis B and C viruses and M2BPGi liver cirrhosis marker. METHODS M2BPGi liver cirrhosis marker measured total patients number 283. Of this patients 172 cases infected hepatitis B and C viruses, 78 patients with hepatitis B virus infection and 94 patients hepatitis C virus infection. All tests performed by full automatic analyzers Sysmex HISCL-5000, JEOL BM-6010, in the Laboratory department, Medipas Hospital, Orkhon province. RESULT Of the 283 patients who received the M2BPGi screening, 33% had C virus, 28% B virus, 4% had B and C virus co-infected, and 35% had no virus. Of the 172 patients infected with hepatitis B and C virus, man 97 (56%), woman 75 (44%). The majority of patients (72%) have liver function abnormality. Of patients with B and C viruses 115 (67%) were positive for M2BPGi liver cirrhosis marker. M2BPGi positive patients with 68 (59%) had C virus, 47 (41%) had B viruses. CONCLUSION Men are more likely to be infected with hepatic viruses. 67% of patients with hepatitis B and C viruses have M2BPGi liver cirrhosis marker positive. The likelihood of a change M2BPGi liver cirrhosis marker, more likely associated hepatitis C virus infection, than B virus infection. The presence of liver cirrhosis in adults under 45 years of age B virus is relatively high compared to C virus infection.

ТӨМӨР ДУТАГДЛЫГ ЭРТ ИЛРҮҮЛЭХЭД РЕТИКУЛОЦИТЫН ГЕМОГЛОБИНЫГ ТОДОРХОЙЛОХЫН АЧ ХОЛБОГДОЛ / Шинэ санаа Шинэ нээлт

@#BACKGROUND. Regular blood donation can lead to pre-clinical iron deficiency as well as iron deficiency anemia. With Each donation donors lose 220-250 mg of iron. Early detection of iron deficiency is important for the blood donors and even useful for blood and blood product safety and supply. The research work we studied present Ret-HE to be used to detect the occurrence of iron deficiency eritrony level. Purpose: The aim of this study was to determine Ret-He to have sensitivity and specificity for diagnosing iron deficiency than traditional iron measurements. Materials and methods: We performed a cross sectional and case control study of 156 blood donors who served National Center for Transfusion Medicine. Ret-He, hemoglobin, plasma iron and ferritin were measured using XN2000 Sysmex, and CobasE600 Roche. The statistical analysis was done using One way Anova, Rock curve, Kruskal Wallis test. Results: We examined 64(41.02%) male donors, 92(58.9%) female donors by measurements of Ret-He,hemoglobin, serum, iron and ferritin. Survey participants were 8.33%(n=13) with anemia, 91.67% (n=143) without anemia. In donors with anemia the results were: RBC 4.9*106 u/l, HGB 10.8 g/dl (10;11), serum ferritin 5.2 (4.3; 6.3) mmol, serum iron 4.5 (3.7; 5.8) mmol and Ret-He 25.5 (22; 26) pg. Donors were divided into 3 age groups: group I age was up to 25years, group II was between 26-35 years, group III age criteria was above 35. Group I had serum iron 13.5 (10.; 18.), serum ferritin 41.8 (14; 78), Ret-He 32.2 (30; 33.) RBC 5×106 u/l (4.6;5), HGB14.2g/dl (13.3;14. 2). Group II had serum iron 14.6 (11; 19), serum ferritin 54.1 μg/l (29; 138), Ret-He 32.2pg (31; 33), RBC 5.1×106 u/l(4.7;5.1), HGB14.8 g/dl (13.5;14.8),Group III had serum iron 15.1 umol/l (9; 20), serum ferritin 95.7 μg/l (39; 141), Ret-He 32.7pg (31; 34) , RBC4.9×106 u/l(4.6;4.9), HGB 14.5g/dl(13.8;14.5), respectively. According to a curve (Roc) analysis, AUC of serum iron was 0.0963, serum ferritin 0.909, Ret-He 0.975. The mean Ret-He was 32.3pg (31.3;33.4). The optimal cut off value for the Ret-He was 29,25pg by ROC analysis and are presented along with sensitivity 92.3% and specificity 95.1%. Conclusion: 1. Determining the amount of Ret-He has a better sensitivity and specificity for diagnosing iron deficiency compared to traditional iron measurements. 2. Ret-He has diagnostic indicators that are able to detect the depletion of iron reserves, erythron level. And it need to be used in further clinical practices, as well as doctors should be required to use it for diagnosis and treatment.

External Quality Assessment Survey for Hematological Laboratories in Mongolia / Эрүүл мэндийн лаборатори

Backround@#Hematology departments of health laboratories, over capital city and 21 provinces both of governmental and private sectors in this country, have to take responsibilities for providing hematology analysis. A wide range of technology and methods have been implemented among these laboratories. Harmonization of the hematology investigations of different laboratories with standard service all over the country is the major goal to reach. We organized the MEQAS (Mongolian External Quality Assessment Scheme) since 2008 on basis the Cooperation agreement between Ministry of Health and Sysmex Corporation in the establishment of Hematology external quality control and reference laboratory system in Mongolia. This is the report of our 8-year experience of MEQAS as the national project, covering increasing numbers of laboratory members. In 2008-2017 years we set up total 18 MEQAS in Mongolia. @*Materials and Methods@#</br> <i>Survey Materials</i> </br> In each survey, the following three different of survey materials were used; </br> Sample A : Hematology Control Material 1* </br> Sample B : Hematology Control Material 2* </br> Sample C : Fresh Whole Blood Sample** </br> *Hematology Control Material provided by Sysmex Corporation </br> **Under cooperation of National Center for Transfusiology, a fresh whole blood sample was drawn from a healthy donor and prepared on the same day of sample delivery, according to the procedures reported by Kondo H et. all. </br><i>Standard Analyzers</i></br> 3 units of fully-automated standard analyzers (KX-21, pocH-100i, XS-1000i), installed at the Shastin Central Hospital, were used to assign the target values for the survey materials. These standard analyzers have been calibrated with SCS-1000® before the survey, and monitored with hematology controls, e-CHECK(XS) ® and EIGHTCHECK-3WP® on daily basis. </br> <i>Instructions & Sample Distribution</i> </br>On every survey, the workshop was held to give guidance and distribute the survey samples to each participant. </br><i>Categorization of Peer Group</i></br> Participating data were divided into two peer groups, based on methodology; Group 1: laboratories used automated hematology analyzer (in further Auto’s), Group 2: manually examined group. Each laboratory was given ID number and was asked to analyze these samples 3 times and report the all data and average for CBC 8 parameters. </br><i>Statistical Evaluation Method</i></br> For individual reports, the results for each participant were evaluated and expressed according to peer group mean and standard deviation index (SDI), Precision index (PI), Absolute evaluation, Scoring system and Target-value evaluation methods (A B C D evaluation).@*Results@#</br>The Auto’s inter-lab CV% of WBC for fresh whole blood showed decrease from 6.1 to 4.2 comparing with17^th and 18th MEQAS.</br> The Auto’s Inter-lab CV% of RBC for fresh whole blood showed decrease from 3.7 to 3.4 comparing with 17^th and 18^th MEQAS.</br> The Auto’s inter-lab CV% of HGB for fresh whole blood were very stable (2.9%, 3.0%), respectively from 17^th to 18^th MEQAS.</br> The Auto’s inter-lab CV% HCT for the fresh whole blood showed go down from 5.5% to 4.8% comparing with 17^th and 18^th MEQAS. </br>The Auto’s inter-lab CV% PLT for fresh blood showed go down from 10.2% to 8.2% comparing with 17^th and 18^th MEQAS. </br> The Auto’s inter-lab CV% of CBC parameter for fresh blood and control Material (Sample A) showed go down from 1^st to 18^th MEQAS.</br> The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) were big difference comparing with Japan’s CV%.@*Conclusion@#</br>1. The Auto’s inter-lab CV% of WBC, RBC and PLT for fresh whole blood has been decrease respectively 4.2%, 3.4%, 8.2% in the 18^th MEQAS and there was difference in the CV% between manufacturers.</br> 2. The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) showed go down from 1^st to 18^th MEQAS but were big difference comparing with Japan’s CV%. @*Acknowledgements@#We would like to express our appreciation to the Sysmex Corporation (Japan) for providing financial supports investigate this study.

Comparison of CSF analysis by manual counts and automated hematology analyzer Sysmex XN-2000 / Эрүүл мэндийн лаборатори

Introduction:When a central nervous system disorder (meningitis, encephalitis, hemorrhage, leukemia infltration and other neoplasma) is present, cerebrospinal fluid (CSF) shows various changes that reflected the condition. Therefore it is essential to test CSF. Different types of CSF tests include cell count; cell differentiation; chemistry; immunology; microbiology and molecular biology. CSF cell count and cell differentiation in particular, are crucial in differentiating diagnosing various CNS disorder needing immediate care and in evaluating the treatment. The patient’s prognosis largely depends on how accurate diagnosis was done and how early treatment was provided. There for CSF test require high precision and accuracy. In Mongolia until now 2st and 3st level hospital using manual method for CSF cell count and cell differentiation test. In this test has 2 actual problems, which is depends on the analytical techniques, skills and sample stability specific problem. But in Japan in 2011 newly designed Sysmex XN Series hematology analyser with body fluid mode (CSF,pleural effusion, peritoneal and synovial fluid). On The First Central Hospital of Mongolia In 2013 frst timeinstalled Sysmex XN-2000 hematology analyser andpossible use of body fluid automatic testing methods.Materials and methods:We evaluated the basic assay performance of the body fluid mode on the automated hematology analyzer XN-2000, which is used for analysis of CSF fluid. We compared between the manual method and XN-2000 analysis for nucleated (WBC), mononuclear (MN) and polymorphonuclear (PMN) cells was also randomly studied using 10 CSF samples of inpatient section our hospital.Results:In CSF samples the coeffcient correlation(r) for WBC/µl, MN%, PMN% were respectively 0.83, 0.95 ба 0.95.Discussion:The correlation for MN%, PMN% were between automate and manual method was good, that is similar to the other researchers. Whereas the correlation for WBC/µl slightly low, this was probably correlation relatively weak or show discrepancies. In introduction inscriptive in analysis accuracy can to affect analytical techniques skills, sample stability and specifc many problems. Therefore scientifc studied and proven ability specifcity, sensitivity, reproducibility, quality, personnel low cost and spend less time, automatically Sysmex XN series hematology analyzer is desirable to domesticate an appropriate level of medical laboratories.