Effects of Storage Conditions on Complete Blood Cell Count Parameters / Эрүүл мэндийн лаборатори

Introduction@#The complete blood count (CBC) is a frequently performed laboratory test today. This study evaluated the effects of temperature and sample storage time on parameters of CBC which could produce misleading results of clinical significance. @*Methods@#In a cross-sectional study, CBC was checked in 20 randomly selected out-patients and baseline measurements were analyzed using the XN-2000 (Sysmex, Kobe, Japan) fully automated hematology analyzer. CBC was done all samples of storage at room temperature. Values were checked at time intervals of 0, 6, and 24 hr.@*Results@#Among CBC parameters, white blood cell, red blood cell, hemoglobin, mean cell hemoglobin (MCH), neutrophils and lymphocytes were stable at time up to 6 h. Hematocrit increased between 0 and 24 hours, averaging 41.5% and 45.2%, respectively. MCV, RDW-SD, and RDW-CV increased between 0 and 24 hours. The mean value was statistically significant. There were 85.6fL/ 93.4fL (p<0.001), 40.7fL /48.2fL (p<0.001), 13.1% and 14.2% (p<0.05), respectively. </br> However, the MCHC was affected by time differences. (p <0.001 at 0 and 24 hours, p <0.001 at 3 and 24 hours). Platelet PDW, MPV, and P-LCR values increased between 0 and 24 h, respectively.@*Conclusion@#Whole blood samples were stored at room temperature for 24 hours for CBC tests, there were statistically significant differences in the size of red blood cells and platelets.

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.

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.

Results revealing renal complication in patients with type 2 diabetes / Эрүүл мэндийн лаборатори

Abstract: Type 2 diabetes is one of the non communicable diseases which are cause of mobility and mortality of world population. By the study of other researchers in our country early diagnosis of type 2 diabetes is more than 10%, in total of 84.3% of all diagnosed patients, vascular complication has been revealed. In this study we involved 64 people to reveal renal complication which is one of the microvascular of diabetes mellitus and did statistical analyses. We estimated renal complication according to the classification of 5 phases of clinical and laboratory indices. We defined amount of creatinine by fully automatic analyzer CHEMIX-180, amount of urine protein microalbumin and creatinine by CABOY 720 analyzer and proportion was accounted according to terminology. From all participants, 53.1% was male, 46.9% was female, average age was 54.2 years. 29,7% of the all participants had the first and second phase of nephropathy, 14.1% had the third phase, 12.5% had the fourth stage or clinical nephropathy. There wasn’t any participant whom chronic renal failure was revealed. Microalbuminuria analyze is important to reveal renal complication of type 2 diabetes and determine the phase in detail.