ABSTRACT
Laboratory tests are used to diagnose diseases, monitor its progress and response to treatment. So the goal of the laboratory medicine is reporting accurate and on time test results. The aim of this study was to evaluate rate and causes of post-analytical errors in the Clinical Laboratory of Children's Medical Center. We especially focused on 1] delay in reporting test results and 2] inaccuracy of test results. This descriptive study was conducted in Children's Medical Center in 2008. Any complaint related to accurate reporting and on time test results from inpatients and outpatients, physicians and wards during 3 months period were registered. The reasons were investigated then recorded in pre-designed forms; data were analyzed with SPSS version 15, Chi square and Fischer's tests. A total of 375 of 425 complaints were related to delay in reporting test results. We also recorded 50 cases of erroneous result complaints. Also 72% of delayed reports and 34% of complaints of unaccepted results were caused in post-analytical phase [i.e. after test was performed]. "Failure to input the results in computer" was the main reason [37%]. "Lost results "[25%] and transcription error [22.6%], "absence of laboratory request form" [9.8%] and "wrong method of filing" [4.2%] were the other observed causes. Microbiology, hematology and clinical chemistry were departments with the highest rate of complaints; whereas urine culture, CBC and biochemistry tests were the most frequent problematic tests. The rate of complaints was 1:108 patients or 1:541 tests, and 4.8% of results were not reported in timely manner. Our findings revealed that the source of most of the errors related to reporting test results were in post-analytical phases. Therefore along with continuing the educational programme, and improvement of automation, it seems necessary to add periodic evaluation and investigation of errors to benchmarks programmes, especially in reporting test result processes, in order to provide error free service to physician and their patients. Cooperation with the clinicians and the other personnel outside the laboratory is also important for error reduction
ABSTRACT
To cease the increasing damage to the brain neurons following epileptic seizures, natural anti-oxidative systems play the main role. One of the most important detoxifying systems is composed of the trace element selenium and its dependent detoxifying enzyme, glutathione peroxidase. The object of this study was to evaluate serum selenium and red blood cell glutathione peroxidase activity in pediatric epileptics and compare it with that of healthy children. Patients suffering from various types of epilepsy were studied during a 15-month period. Control group consisted of healthy children with no history of any neurologic disease. Serum selenium level and RBC Glutathione peroxidase activity was evaluated and the results compared. Fifty three epileptic patients with a mean age of 5.5 years and 57 healthy children with a mean age of 5.6 years were enrolled in this study. Statistically significant differences in the mean values for serum selenium level [72.9 vs. 86.0 ng/ml, P=0.017] and also RBC glutathione peroxidase activity [440.6 vs. 801.0 nmol/min/ml, P=0.000] between the two groups were observed. On the other hand, after analyzing the study results, trying to introduce a value for GPx activity, which could be accepted as a reliable indicator for serum selenium deficiency in patients, was not successful. Findings of the present study strongly support the proposed crucial role for the trace element selenium and deficiency of its dependent enzyme, glutathione peroxidase, in epilepsy pathogenesis