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Background: A recent cluster of pneumonia cases all over the world including India, is caused by a novel beta coronavirus, the 2019 novel coronavirus (2019-nCoV). The objective of this study was to observe the effect on renal profiles at admission of these COVID-19 infected patients.Methods: All the patients were admitted to Dr. S. N. Medical College and Hospital, Jodhpur, a tertiary care hospital of Western Rajasthan and were tested for COVID-19 by real time reverse transcription polymerase chain reaction assay of 2019-nCoVRNA. All data in relation to patients including blood renal profile were collected from data collection form from electronic medical records and history given by COVID-19 infected patients admitted.Results: Out of total 300 COVID-19 patients, majority of patient were male i.e. 210 (70%) and majority of the patients 70% were below 60 years of age. The underlying diseases were present in 98 (32.67%) patients. Cough was the most common symptom (80%) followed by fever (72%) in out of 180 (60%) symptomatic patients. 64 (21.3%) patients had deranged renal function tests with abnormal blood urea nitrogen and serum creatinine. Overall, 56 patients (18.6%) without chronic kidney disease showed mild increase of BUN or serum creatinine. 35 patients (11.6%) had high blood urea nitrogen and 18 patients (6%) had raised creatinine.Conclusions: In setting of COVID-19 infected patient’s presentation, renal profile remained essentially normal with deranged RFT seen in patients with comorbidities. Nevertheless, the renal function of patients with COVID-19 needs to be monitored regularly, especially in patients with elevated plasma creatinine.
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@#Introduction: Laboratory turnaround time (LTAT) is considered a reliable indicator of the quality and efficiency of a laboratory’s service. LTAT achievement, particularly of urgent tests, remains unsatisfactory and challenging in many clinical laboratories especially in tertiary health care centres with high workload and restricted resources. The unresolved issue of unsatisfactory urgent renal profile (RP) LTAT below the standard performance goal prompted our interest to improve laboratory’s handling of urgent test request. We thus implemented the Lean principle in the management of urgent test requests using urgent RP as the test model. Methods: The implementation of laboratory Lean involved 4 steps process; (1) Development of burning platform for change (2) Identification of waste (3) Planning and implementation of control measures (4) Measuring, monitoring, and sustaining the improvement. Urgent RP LTAT and the percentage of the request met the time requirement determined based on the data extracted from laboratory information system (LIS) before and after the implementation of Lean was compared to assess the effectiveness. Results: Urgent RP LTAT after the implementation of Lean was reduced i.e 35 min (before) vs 31 min (after), with the percentage of LTAT met the time requirement was significantly increased above the set target i.e 82.8% (before) to 93.5% (after) with P-value = 0.001. Conclusion: Implementation of innovation using Lean management has significantly improved urgent RP LTAT achievement, thus optimised urgent test management in our Chemical Pathology laboratory. Lean is a strongly recommended strategy to improve urgent test LTAT especially in laboratories with restricted resources.
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Introduction: CD34 Immunohistochemical antigen serves as a tool in differentiating between benign and malignant conditions. Hence, the study was conducted to determine the stromal expression of CD34 antigen by immunohistochemical method in proliferative lesions of the breast and to evaluate the loss of CD34 antigen expression in stromal cells is specific for malignant lesions. Materials and methods: 108 cases of proliferative lesions of the breast were studied from January 2016 to December 2017 for some time of 2 years. Paraffin-embedded blocks were retrieved for all the cases and underwent routine processing followed by Hematoxylin and Eosin staining. 84 cases of the benign lesion, one case of the borderline lesion and 23 cases of the malignant lesion were studied for CD34 immunohistochemical staining, and semi-quantitative assessment was done. Results: On Hematoxylin and Eosin staining, we have found benign lesions includes 63 cases of fibroadenoma, 7, 4, and 3 cases of the fibrocystic disease, fibro adenosis and fibroadenoma respectively with apocrine metaplasia. Malignant lesions include 22 cases of infiltrating ductal carcinoma, one case of infiltrating lobular carcinoma. One case of borderline phyllodes tumor was also included in this study. In normal breast tissue, stroma was positive for CD34 IHC stain. All the malignant cases are showing loss of CD34 staining. Only one case of borderline phyllodes tumor shows grade 2 staining with CD 34 Antigen. Conclusion: We can concluded that the use of CD34 Immunohistochemical marker positivity as an adjuvant tool in differentiating between benign and malignant conditions where the morphology is equivocal.
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Background: Myocardial infarction which is an outcome measure in clinical trials, observational studies and quality assurance program have several conventional risk factors which include older age, hypertension, diabetes, decreased physical activity, alcohol intake, smoking, abdominal obesity, highrisk diet, psychological stress. Hypomagnesemia and means platelet volume is now recognized as a significant risk factor for atherogenesis, and thus for hypertension, ischemic heart disease, cardiac arrhythmias, coronary vasospasm, sudden cardiac death, cerebrovascular accident, and myocardial infarction. The aim of the study: To determining the relationship between serum Magnesium levels on platelet reactivity in Acute Myocardial infarction. Therefore in this study, we attempted to find the impact of serum Magnesium level on the Mean Platelet Volume and the use of these parameters as novel biomarkers to predict AMI. Materials and methods: A case-control study was carried out in the Department of Cardiology, Govt. Royapettah Hospital/ Kilpauk Medical College. Totally 88 Acute Myocardial Infarction patients (for the estimated prevalence of 30.36% in urban Indian population) admitted in the Intensive Coronary Care Unit between July to October 2015 and 88 age and sex-matched apparently normal individuals were included. Fasting venous peripheral blood samples were drawn within 48 hours of admission. Blood samples were taken into standardized trisodium citrate tubes (stored at room N. Jayaprakash, V. Madhavan, Aswanaa Kamanuru Govindarajulu. Serum magnesium levels and mean platelet volume (MPV) as biomarkers in acute myocardial infarction. IAIM, 2019; 6(4): 1-8. Page 2 temperature) and a sterile vacutainer which was serum separated, aliquoted into 2 Eppendorf’s and stored at minus 20 º C until further analysis. Results: Both the Systolic and Diastolic Blood pressure was significantly elevated in the cases (p= 0.000) which was statistically significant. The Fasting Blood Glucose levels were raised in AMI patients (p=0.001) although only 38.6% were known Diabetics. Urea levels were increased in cases (p=0.007) which was significant. The serum magnesium values were significantly lower in AMI patients in comparison to the normal individuals (p= 0.000) and the Mean Platelet Volume was significantly elevated in the cases than the control (p=0.004). Conclusion: Our study demonstrated that Magnesium levels were reduced in AMI patients and that Mean platelet Volume was elevated in AMI patients however a cause-effect relationship between the two parameters was not established. However, we propose that MPV and Magnesium may be useful biomarkers in identifying patients with increased risk for AMI. Further, a cohort study design including all the confounding variables can better address their relationship and role as adjuvant biomarkers in the diagnosis of AMI.
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The aim of this study is to investigate the effectiveness of intravenous administration of Berberis vulgaris root bark aqueous extract (BRBD) on the cardiovascular and renal functions of healthy normotensive rats. The different doses of BRBD 1, 10 and 20 mg/kg were administered intravenously (i.v) in normal rats. Blood pressure, diuretic activity and serum renal profile were analyzed. Intravenous injection of BRBD at the different doses of 1, 10 and 20 mg/kg showed a dose-dependent reduction in mean arterial blood pressure (P<0.001). At different doses of 1, 10 and 20 mg/kg, the hypotensive effect remained for more than one hour. Single dose administration of BRBD at doses of 10 and 20 mg/kg caused a significant increase in urine output (P<0.001) as compared to the control rats. Serum renal profile test (albumin, Urea, Uric Acid, creatinine and BUN) did not show any significant alteration. The authors conclude that the BRBD is a potent hypotensive and possesses diuretic potential