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COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.
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Introduction : Quality control of the laboratory has gained increased importance in the present years. 70 % of the errors in the clinical laboratory occur in the pre-analytical phase. With various guidelines to gauge the quality of the laboratory, Six Sigma Metrics remains by far the most difficult benchmark that a laboratory can achieve. We aimed to quantify the performance of the quality indicators of the routine clinical Biochemistry laboratory in the pre-analytical phase in the form of sigma metrics and devise measures and identify steps to decrease the percentage of errors by defining the DMAIC approach. Materials and Methods : One year retrospective data was collected from January, 2020 to December, 2020 from the data entry register and pre-analytical variables were quantified. Defects Per Million and sigma metric were calculated for each pre-analytical indicator. DMAIC approach was applied and post intervention sigma scores for the month of Jananuary, 2021, February, 2021 and March, 2021 were calculated. Results : Postinterventional analysis was done on a month-to-month basis to monitor the trend and also to ensure corrective action can be taken without delay. Out of 5 quality indicators which were quantified, the pre versus post sigma scores (March’21) are as follows: missing location of the patient (Sigma 4 versus 3.6), missing registration number (Sigma 3.7 versus 4.3) and both registration number and location missing (Sigma 3.6 versus 4.0), Homolysed sample (4.2 versus 4.6), insufficient sample volume (sigma 3.9 versus 4.7). Encouraging results in the form of improved Sigma scores were seen in four of the quality indicators except for the fact that the patient location were still missing in the forms and hence warrants continuous monitoring.
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Introduction: Gestational Diabetes Mellitus is thedevelopment of carbohydrate intolerance of variable severitywith onset or first recognition during pregnancy. Many studieshad suggested that an elevated serum ferritin level in maternalblood in early as well as mid-pregnancy is an independent riskfactor for development of GDM. In the present study we aimto find the association of serum ferritin levels with serum ironand Hb% in the GDM patients at the time of delivery and alsocorrelate it with cord blood Hb% and iron levels of the newborn.Material and Methods: The study group was composed of50 diagnosed cases of GDM and the control group comprisedof age matched 50 cases of normal pregnancy. Maternal bloodwas used to measure mother’s hemoglobin, iron levels, serumferritin and hsCRP. Cord blood sample was used to estimatehemoglobin and iron levels of the newborns.Results: Our study shows that in the GDM cases the levelof serum ferritin was significantly higher (p <0.001) than inthe non GDM controls at the time of delivery. Cord bloodhemoglobin is negatively correlated with maternal serumferritin levels in GDM.Conclusion: Elevated serum ferritin level in GDM is a markerof inflammation due to increased ROS production caused byiron overload. This oxidative stress might affect the placentaliron transfer to the fetus and fetal Hb synthesis.
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Background: Pulmonary hypertension in chronic obstructive pulmonary disease (COPD) due to chronic alveolar hypoxia is probably the main contributor to the pathogenesis of pulmonary hypertension in COPD. Angiotensin II is a potent vasoconstrictor in renin angiotensin aldosterone system (RAAS), it has been shown to promote growth response in vascular smooth muscle cell contributing towards pulmonary hypertension. So, the Echocardiographicaliy measured MPAP and its correlation with RAAS in patients of COPD was evaluated.Methods: A prospective observational study was done in 32 patients with COPD and 10 age matched healthy, non-smoker subject included as controls. Stable patients requiring no change in their medication in the previous four weeks and not having had an acute exacerbation in that period were included. MPAP was calculated. Measurement of Ang II and aldosterone was done.Results: Thirty-two cases of COPD, meeting inclusion criteria were enrolled comprising of 32 males and the mean age of patients �d was (55.6 �.8), while mean age of controls � 2sd was 49.60 �56. Arterial blood gas analysis, PaO2 was ranged from (mean�d 75.44�.1), PaCo2 ranged from (mean �d 41.36�79) and SpO2 ranged from (mean�d 94.03 2�.74). Mean �d of plasma Ang II in COPD cases was (4.9�8) ng/dl, significantly higher in comparison with controls (p < 0.001). Mean �d of plasma ACE activity was (51.12�.9) in COPD. Mean �d of plasma aldosterone was (182.35�4.2) in COPD cases with significant (p<0.01). The MPAP in COPD cases was (mean�d 34.53�70).Conclusions: Use of Doppler has the advantage of being noninvasive and has been shown to be extremely reproducible in evaluation of MPAP and CO. The increased level of Ang II with increase MPAP in the present study would suggest that this may be a suitable model for investigating effects of novel vasodilator drugs for the treatment of pulmonary hypertension developed due to COPD.