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Introduction:Iron is a component of a number of proteins including haemoglobin, myoglobin, cytochromes and enzymes deficiency of which leads to iron deficiency anemia and excess in iron overload. There is a panel of tests to assess iron status in the body. A low serum iron & ferritin with an elevated TIBC are diagnostic of iron deficiency. While a low serum ferritin is virtually diagnostic of iron deficiency.AS ferritin is an acute phase reactant, it may not be a good marker for iron overload.The objective of the study was to find out whether UIBC is an alternative lab parameter of iron storage/ overload compared to ferritin.Methodology:In a retrospective study conducted, data of 118 patients were collected, who were categorized as iron deficient and those with iron overload. Ferritin, UIBC and serum iron were assayed and remaining parameters were calculated.ROC curves were constructed using SPSS version 16 software.Results:Area under the curve (AUC) for ferritin as a marker of iron storage, AUC for UIBC, serum iron, TIBC and transferrin were 0.108,0.607,0.098,0.098 respectively. In patients with iron depletion, it was observed that AUC was 0.371 and 0.566 respectivelyfor ferritin and UIBC respectively.
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Background: Six sigma is a process of quality measurement and improvement program used in industries. Sigma metrics can be used effectively in laboratory services as total testing process has multiple steps and error can occur anywhere. The present study was undertaken to evaluate the quality of the analytical performance of clinical chemistry laboratory by calculating sigma metrics. Methods: The study was conducted in the clinical biochemistry laboratory of Karwar Institute of Medical Sciences, Karwar. Sigma metrics of 15 parameters with automated chemistry analyzer, transasia XL 640, electrolytes with Roche electrolyte analyzer and thyroid hormones with Maglumi were analyzed. Results: Sigma values <3 for Urea, ALT, BD, BT, Ca, creatinine (L1) and urea, AST, BD (L2), sodium, potassium and T4 were observed. Sigma lies between 3-6 for Glucose, AST, cholesterol, uric acid, total protein (L1) and ALT, cholesterol, BT, calcium, creatinine and glucose (L2), chloride, T3,TSH.Sigma was more than 6 for Triglyceride, ALP, HDL, albumin (L1) and TG, uric acid, ALP, HDL, albumin, total protein (L2). Conclusion: Sigma metrics helps to assess analytical methodologies and augment laboratory performance. It acts as a guide for planning quality control strategy. It can be a self assessment tool regarding the functioning of clinical laboratory.
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Introduction: Clinical laboratories have focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. But studies in recent years demonstrates that quality in clinical laboratories cannot be assured by merely focusing on analytical aspects. But mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Objective of our study is to analyze the causes of errors occurring in our Clinical Biochemistry Laboratory and categorize them, find the frequency and percentage of errors. Methodology: This study was carried out in a newly established Clinical biochemistry laboratory. Causes of errors were noted down and were categorized in to pre analytical, analytical and post analytical errors. Data has been noted down from April 2015 to December 2015. Results: Pre analytical errors were contributing significantly to laboratory errors (59.8%) as compared to analytical (30.84%) and post-analytical errors (9.35%). Hemolyzed and clotted samples were the main causes of pre analytical errors (37.5% and 21.87% respectively). Calibration drifts were contributing mainly to analytical errors (39.39%).Transcription error (60%) was the main contributor to the post analytical error. Conclusion: Errors can be minimized by training the laboratory personnel regarding phlebotomy techniques, storage, transport of specimen, instrument handling .Computerization of entire process will help to minimize the errors. The success of any efforts to reduce errors must be monitored in order to assess the efficacy of the measures taken. In the testing process areas involving non-laboratory personnel, interdepartmental communication and cooperation are crucial to avoid errors.
ABSTRACT
According to the World Health Organization, snakebites cause more death and disability and are more notorious than some tropical diseases. Snakebite is a leading medical emergency in Asia/Pacific. It is one of the major causes of mortality in India. The objective of the study was to gather epidemiological information on snakebite that will help to guide/design a snakebite prevention and treatment intervention in Karwar. A retrospective study was conducted, in which we have collected data of snakebite cases admitted to the district hospital from October 2010 to October 2014. Epidemiological and demographic profiles of three hundred victims were noted. Data was analyzed by using descriptive statistics. Three hundred snakebite cases were admitted to district hospital, Karwar over the period of four years. Incidence was highest in post monsoon (n=97). Victims affected were mainly in third decade. Male preponderance was clearly seen. Farmers or people involved in farming related activities accounted for more than half of the victims (n=196). Eighty seven percent (87%) (n=261) occurred on the lower limb. Snake bite is an important neglected health problem in Karwar and surrounding rural areas . Using this study as a guiding tool, awareness and education programs on prevention of snakebite can be planned. It is important to educate people regarding first aid treatment, dos and don’ts in case of snakebite. Medical personnel should be trained; facility should be improved in Karwar district hospital so as to manage even complicated cases.