Total leucocyte count and platelet indices: novel, early diagnostic markers of acute appendicitis

Background: Among the plethora of causes for patients presenting with an acute abdomen, appendicitis is the most common conclusive diagnosis. Known being controversial for its etiology and pathogenesis, diagnosis of acute appendicitis has been challenging despite the development of various clinical and laboratory studies. Inflammatory markers of hematological origin-total leucocyte count (TLC), platelet indices viz. mean platelet count (MPV), plateletcrit (PCT), and platelet distribution width (PDW), have long been preferred as rudimentary diagnostic parameters for acute appendicitis despite being contentious. Methods: An analytical and cross-sectional study among 100 individuals. Statistical evaluation of TLC, MPV, PCT and PDW of 21 appendicitis cases and 70 healthy individuals were complied. Results: Compared to the control group, cases showed significantly higher values of TLC and MPV while the PCT and PDW were normally distributed and showed no significant statistics. The sensitivity of TLC and MPV was determined to be 95.2%, 71.4%, and specificity 100%, 73.8% respectively. Conclusions: With equitable results, the routine and cost-effective TLC and MPV play a novel role in the early diagnosis of acute appendicitis.

Biomedical waste in laboratory medicine: audit and management.

Pathology, microbiology, blood bank and other diagnostic laboratories generate sizable amount of biomedical waste (BMW). The audit of the BMW is required for planning proper strategies. The audit in our laboratory revealed 8 kgs anatomical waste, 600 kgs microbiology waste, 220 kgs waste sharps, 15 kgs soiled waste, 111 kgs solid waste, 480 litres liquid waste along with 33,000 litres per month liquid waste generated from labware washing and laboratory cleaning and 162 litres of chemical waste per month. Section wise details are described in the text. Needle sharps are collected in puncture proof containers and the needles autoclaved before sending to needle pit. The glass forms the major sharp category and is disinfected with hypochlorite before washing/recycling. All microbiology waste along with containers/plates/tubes are autoclaved before recycling/disposal. The problem of formalin fixed anatomical waste as histology specimens is pointed out. The formalin containing tissues cannot be sent for incineration for the fear of toxic gas release and the guidelines by the Biomedical waste rule makers need to be amended for the issue. The discarded/infected blood units in blood bank need to be autoclaved before disposal since chemical treatments are difficult or inefficient. The liquid waste management needs more attention and effluent treatment facility needs to be viewed seriously for hospital in general. The segregation of waste at source is the key step and reduction, reuse and recycling should be considered in proper perspectives.