Stress and job satisfaction among medical laboratory professionals in Oman: A cross-sectional study.

Background: Job satisfaction leads to employees being more productive. However, when the job requirements do not meet the capabilities it will cause stress. Therefore, it is important to define the cause of dissatisfaction to reduce work-induced stress as this has a negative impact on the quality of healthcare services. The literature on stress and satisfaction studying medical laboratory professionals (MLPs) is still limited.The aim of this study was to assess the relationships between stress and job satisfaction factors among MLPs in Omani hospitals, and to quantify a possible correlation between job stress and job satisfaction. Methods: A cross sectional study involved all medical laboratory professionals in eight hospitals in Oman from different geographical areas. A survey instrument measuring job satisfaction was developed from the result of earlier qualitative studies done by the authors in the population of 101 participants. In addition, job stress was assessed using a survey based on the Nurse Stress Index (NSI). Results: The results show a significant statistical association between stress and job satisfaction. Omanis have significantly higher stress scores compared to non-Omani citizens. The youngest MLPs at Omani Hospitals were less satisfied at work and more stressed than their older colleagues. Job satisfaction was lower and job stress higher in the Sultan Qaboos University Hospital than in all the other hospitals. The most important dissatisfaction factors, leading to job stress, are insufficient support for professional development, poor relations with supervisors and co-workers, as well as heavy workload. Conclusion: This study emphasizes the importance of investing in measures to meet the expectations of laboratory staff, to strengthen factors that increase satisfaction and eliminate dissatisfaction factors. It gives concrete advice on what those measures should be and, consequently, guides actions on improving the work environment in medical laboratories. When implemented those would reduce job stress among medical laboratory professionals in Oman, and, possibly, more widely.

The role and effect of companions during childbirth in Oman.

BACKGROUND: There is increasing evidence that a companionship is an important tool for improving the quality of care provided to pregnant women during the labour and delivery process. The literature review shows very limited studies assessing the role of companions during childbirth from the companion's point of view. Many published papers studied the role and satisfaction of pregnant women but not their companions. Therefore, this study aimed to assess the role and effect of companions during childbirth in Oman. METHODS: This cross-sectional observational study was conducted at Sultan Qaboos University Hospital, Oman, between June 2022 and April 2023. Companions were interviewed face-to-face at a time convenient to them. A telephone interview was conducted with those who left the hospital early. The questionnaire comprised sociodemographic data and other sections, including the nature of the help provided by the supportive companion, their effects on the women who gave birth, and the timing of their presence during companionship. RESULTS: A total of 214 companions were included in this study with the mean age of 42.54 years. The most common relationship to the pregnant women was mothers (35.7%), followed by husbands (30.5%). The majority of companions provided support during admission (62.6%), in the immediate post-partum ward (56.5%) and during delivery (54.2%), while a minority helped from admission to discharge (22.4%). The most common type of support provided was encouraging words (89.7%) followed by transferring things (43.9%), massage (37.4%) and touch (33.6%). The majority of companions (96.7%) reported that their support helped very much, and the pregnant women felt better and calmer. CONCLUSIONS: Labouring women felt better and calmer because of the presence of companions. Companions preferred to be present in the postpartum and during labour and delivery. The majority of companions support their labouring women by encouraging wards. Companions love and encourage others to support their labouring women during their critical times.

Knowledge and attitude about organ donation and transplantation among Omani university students.

Background: Despite the importance of organ donation and transplantation in improving the quality of life, still, there is a shortage of organ donations, worldwide. Lack of knowledge among the public could be the reason. In previous studies, the focus was predominantly on medical students at universities. The aim of this study was to assess university students' knowledge and attitude about organ donation and transplantation among different colleges at the university. Method: A cross-sectional study was conducted among university students between August 2021 and February 2022 using a validated self-designed questionnaire. The questionnaire consisted of five sections. The first section was about the research information. The second section was informed consent. The third section was about sociodemographic information. The fourth section was about the knowledge of organ donation. The last section was about the attitude toward organ donation. The data were analyzed by descriptive statistics and chi-square tests. Results: The study included 2,125 students. 68.1% were females, and 93.1% were in the age group 17-24 years old. Only 34.1% had good knowledge about organ donation, 70.2% had a low attitude, and 7.53% had adequate information about brain death. The most common reason for supporting donating organs among university students was to save a life (76.8%) and the most common reason for refusing organs, was I am still unaware. In addition, only 25.66% of the participants had a high attitude toward people with poor knowledge about organ donation. The majority of the students (84.13%) used online sources and social networks as the primary sources of information about organ donation. Conclusion: The knowledge and attitudes of university students toward organ donation and transplantation were low. Saving a life was the most common reason for supporting organ donation, and knowledge was the biggest obstacle. Online sources and social networks were the primary sources of knowledge. The attitude was greatly influenced by knowledge. Organizing campaigns, and events, and incorporating organ donation and transplantation into university curricula will increase university students' knowledge and attitudes.

Prevalence of laboratory-related musculoskeletal disorders among biomedical scientists.

BACKGROUND: Laboratory- related musculoskeletal disorders (LMSDs) are injuries resulting from working in the laboratory. Biomedical scientists (BMSs) play an important role in any health care system. However, they are at high risk of exposure to the LMSDs. OBJECTIVE: This study aimed to estimate the prevalence and the associated risk factors of LMSDs among this group of healthcare professionals. METHODS: We conducted a cross-sectional survey using the Nordic Musculoskeletal Questionnaire to estimate the prevalence of the LMSDs among the BMSs. BMSs with occupational or non-occupational accidents that affected their musculoskeletal system were excluded from the study. A Chi-square test was performed to measure the significant association between different risk factors (age, gender, weight, height, nationality, specialty, educational level, nature of the job, and the number of experience years) and the prevalence of the LMSDs among the BMSs. RESULTS: The study included 83 BMSs. Females represented 63.9% and 36.1% were in the age group of 35- 44. The overall prevalence of the LMSDs was 77.1%. The most prevalent LMSDs were neck, shoulders, and lower back with 50.6%, 49.4%, and 43.4%, respectively. A total of 65.57% of BMSs had irregular symptoms of LMSDs. CONCLUSION: The study found that the prevalence of LMSDs among the BMSs was high. Good practice and training in ergonomics may minimize the prevalence of LMSDs among the BMSs.

COVID-19 in the Arab countries: Three-year study.

Background: Twenty-two Arab countries share a common language, history, and culture. Nevertheless, governmental policies, healthcare systems, and resources differ from one Arab country to another. We have been following Coronavirus (COVID-19) from the beginning in each Arab country. In the present study, we aimed to assess the prevalence of COVID-19 in the Arab world and to compare these findings with other significantly affected countries. Methods: Websites of the World Health Organization, World COVID-vaccinations tracker, Worldometer, and Ministries of Health were used to extract COVID-19 data in all Arab countries between the period January 2020 to December 2022. Results: All Arab countries had 14,218,042 total confirmed COVID-19 cases, 13,384,924 total recovered cases and 173,544 total related deaths. The trend demonstrated that the third quarter of 2021 recorded the highest death toll and the first quarter of 2022 recorded the highest number of confirmed and recovered cases. Compared to the top 15 affected countries, the Arab world ranked last as it had the lowest overall incidence per million population (PMP) of 31,609. The data on total deaths PMP showed that India had the lowest number of deaths with only 377 cases followed by the Arab world with 386 cases. Conclusions: Although the number of confirmed, death, and recovered cases of COVID-19 have greatly reduced in the last quarter of 2022 in most Arab countries, many Arab countries still need to re-campaign about COVID-19 vaccines and raise awareness programs about boosters. COVID-19 has had a relatively smaller impact on Arab countries than on other countries that have been significantly affected.

Histopathological Spectrum of Glomerular Diseases in Oman: A Five-year Study.

Glomerular diseases are numerous and difficult to diagnose without a renal biopsy. Despite the development of many radiological and laboratory tests and the use of up-to-date equipment, renal biopsies are the best method for diagnosing renal diseases. This study aimed to analyze the histopathological patterns of glomerular diseases in Oman. Light microscopy and immunofluorescence markers such as immunoglobulin (Ig) G, IgA, IgM, C3, and C1q, which are routinely used to evaluate the presence of immune deposits, were analyzed. In total, 596 renal biopsies were retrospectively analyzed at the Sultan Qaboos University Hospital for a 5-year period (2011-2015). Males represented 45.8%, and the median age was 29.7 years. Primary glomerular diseases were more common in males (54%); secondary glomerular diseases were more prevalent among females (76.7%). The prevalence of primary glomerular diseases (65.6%) was more dominant than secondary glomerular diseases (34.4%). Lupus nephritis (LN) was the most common secondary glomerular disease and was the most prevalent among all biopsies (29.9%). Focal segmental glomerulosclerosis (FSGS), membranous glomerulopathy, IgA nephropathy, minimal change disease, and diffuse global glomerulosclerosis were the most common primary glomerular diseases, accounting for 21.5%, 9.1%, 8.6%, 6.4%, and 6.2%, respectively. The level of the fluorescein isothiocyanate C1q marker in the top five renal diseases was low compared with other markers. In conclusion, in Oman, LN was the most common glomerular disease encountered and FSGS was the most common primary glomerular disease. The findings suggest that the localization of glomerular C1q in renal diseases needs to be investigated further.

Effectiveness of neutral honey as a tissue fixative in histopathology.

Background: In routine histopathology, 10% neutral buffered formalin (NBF) is the choice fixative. However, formalin is a human carcinogen, so there is a necessity for a safer alternative. To the best of our knowledge, neutral honey, not natural or artificial honey, has not been tested to fix histological samples. This study determined the effectiveness of neutral buffered honey and other types of fixatives to fix histological tissues. Methods: The study was conducted between July 2019 and August 2020 at Sultan Qaboos University, Oman. Sections from three rat livers, kidneys, and stomach tissues were fixed with 10% NBF, neutral buffered Sumer honey, neutral buffered date honey, formalin, Sumer honey, date honey, alcoholic formalin, alcoholic Sumer honey, and alcoholic date honey for 24 hours. Samples were stained with hematoxylin and eosin (H&E), special stains, and vimentin methods. Three expert biomedical scientists then evaluated the fixed and stained samples for the quality of all sections. The fixation ability of the different honey solutions was then compared to 10% NBF and the utility was determined using nuclear and cytoplasmic criteria, specificity, and intensity. Results: H&E showed adequate staining in all groups compared to 10% NBF. The specificity and intensity of all groups for the Periodic acid-Schiff method were identical to 10% NBF except for Sumer honey and alcoholic date honey. Vimentin showed comparable findings with 10% NBF as there were no significant differences. Conclusions: The findings of this study encourage the use of honey, including neutral, as a possible safe substitute fixative for formalin, however, further experiments on larger specimens should be conducted.

One-year Review of COVID-19 in the Arab World.

The coronavirus disease 2019 (COVID-19) has affected almost every country worldwide, including all 22 Arab countries. To the best of our knowledge, this is the first study to follow the prevalence of COVID-19 in all Arab countries. In this review, we aimed to assess the 12-month prevalence of COVID-19 in Arab countries and to compare these findings with other significantly affected countries. World Health Organization, Worldometer, and Ministries of Health websites were used to search for COVID-19 data in all Arab countries. The period covered started from February 2020 to February 2021. In all Arab countries, the median age of the population was 26.25 years. As of March 01, 2021, the total number of confirmed COVID-19 cases in all Arab countries was 4,259,756. Bahrain, Qatar, Lebanon, Kuwait, and United Arab Emirates had the highest reported number of confirmed COVID-19 cases per million population. The total number of COVID-19 deaths was 72,950, with predominance in Lebanon, followed by Tunisia, Jordan, Palestine, and Iraq. In comparison with the topmost affected countries, and based on both the highest number of confirmed and deaths per million population, Arab countries ranked second last before India, with 9,646 and 165 cases, respectively. Among the Arab countries, Qatar, Bahrain, and Lebanon showed the highest number of recovered, confirmed, and death cases per million populations, respectively. The number of confirmed and death cases among all Arab countries triggered significant worries about morbidity and mortality of COVID-19, respectively. However, the younger population in Arab countries may have contributed to fewer COVID-19 deaths in comparison with the topmost affected countries.

A review of the prevalence of COVID-19 in the Arab world.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a rapidly spreading disease worldwide. It is a real test for all health authorities including Arab countries. In this review, we aimed to assess the prevalence of COVID-19 in the Arab world. In addition, to compare the findings of this study with other top affected countries. METHODOLOGY: We searched for official websites from the Ministries of Health and other official sources in all 22 Arab countries. Medline, Science Direct and Google Scholar websites were also used to search for COVID-19, 2019 novel coronavirus, SARS-CoV-2 and coronavirus. The time period was from 1 January 2020 to 31 May 2020. RESULTS: As of May 31, 2020, COVID-19 has caused 290,428 confirmed cases, 3,696 deaths and 157,886 cured cases in all Arab countries. In terms of confirmed cases, Saudi Arabia followed by Qatar, UAE, Kuwait and Egypt have the highest reported cases. However, the total number of deaths was dominant in Egypt, followed by Algeria, Saudi Arabia, Sudan and UAE. In comparison to other non-Arab countries and confirmed cases, Arab countries come fourth after USA, Brazil and Russia. In terms of death, the Arab world is not listed as the top ten affected countries as only scored eight deaths per million have been recorded. CONCLUSIONS: Most Arab countries took some serious early steps to minimize the outbreak of COVID-19. At the moment, controlling the source of infection, the route of transmission and taking care of infected patients are the main challenges for health authorities in all Arab countries.

The application of Herzberg's two-factor theory of motivation to job satisfaction in clinical laboratories in Omani hospitals.

BACKGROUND: Job satisfaction is an important condition for staff retention in most healthcare Organizations. As a concept, job satisfaction is linked to motivation theory. Herzberg's two factor theory of motivation is used in this study to explore what motivational elements are associated with job satisfaction among medical laboratory professionals (MLPs) in Oman. METHODS: A mixed-method approach was adopted, and focus group discussions (FGDs) were used for data collection. The FGDs were conducted in the main hospitals in Oman. Data were analyzed by directed content analysis, and frequencies of statements related to factors were calculated for a comparison with the Herzberg theory. RESULTS: The following job dissatisfaction factors (hygiene) were identified: health and safety, heavy workload, salary, promotion, recognition and organizational policies. The satisfaction (motivators) were: relationships with co-workers, relationship with leaders, and professional development. CONCLUSIONS: The job dissatisfaction reported was resulted from the absence of hygiene factors and some of the motivators in accordance with Hertzberg's theory. Hospital managers need to address these factors, defined by Hertzberg, in order to improve motivation and job satisfaction.

Immunoperoxidase and Immunofluorescence on Formalin-Fixed, Paraffin-Embedded Tissue Sections versus Immunofluorescence on Frozen Sections in the Assessment of Renal Biopsies.

INTRODUCTION: There are few published studies comparing immunofluorescence on formalin-fixed, paraffin-embedded (FFPE) tissue sections (IF-P) and immunoperoxidase on FFPE tissue sections (IP-P) with immunofluorescence on frozen sections (IF-F) for evaluation of renal diseases. Also, the accuracy for each method differs greatly. The aim of this study was to evaluate IF-P and IP-P as an alternative to IF-F (gold standard method) in the diagnosis of renal biopsies specimens. METHODS: In all, 101 renal biopsies were subjected to IF-P, IP-P, and IF-F staining to demonstrate immunoglobulin IgA, IgG, and IgM immune deposits. Sensitivity, specificity, false-positive, and false-negative values were calculated. RESULTS: IP-P showed sensitivity of 61.8%, 74.2%, and 64.2%, and specificity of 84.8%, 69.2%, and 66.7% for IgA, IgG, and IgM, respectively. IF-P showed a sensitivity of 45.6%, 69.4% and 52.8%, and specificity of 87.9%, 87.2% and 77.1% for IgA, IgG and IgM, respectively. False-positive cases of IF-P and IP-P were 4, 5, and 11 and 5, 12, and 16 for IgA, IgG, and IgM, respectively. CONCLUSION: Where IF-F lacks glomeruli or fresh renal biopsies are not available, IP-P is a sensitive method, whereas IF-P is a specific method for the evaluation of immune deposits in the renal tissue biopsies. The presence of false-positive cases in both methods deserves further research.

Decoy Cells versus Plasma Real-Time Polymerase Chain Reaction for the Detection of Polyomaviruses in Renal Transplant Patients: A Single Institutional Experience.

BACKGROUND AND AIMS: Microscopic detection of decoy cells is routinely performed in urine samples from renal transplant patients for the evaluation of polyomaviruses. However, they are scanty papers evaluated the diagnostic accuracy of decoy cells in urine samples. The aim of this study is to evaluate the diagnostic accuracy of decoy cells in urine samples and compare with plasma real-time polymerase chain reaction (RT-PCR) as a gold standard method. In addition, to compare the findings of this study with other similar studies. METHODS: A retrospective study over a period of four years from January 2014 to December 2017 was performed. A total of 89 urine samples from renal transplant patients were assessed for the presence of polyomaviruses and compared with plasma RT-PCR. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were measured. RESULTS: There were 29 males and 18 females. The mean patient age was 40.3 years. The sensitivity, specificity, accuracy, PPV and NPV were 86.6%, 67.5%, 70.7%, 35.1% and 96.1%, respectively. Other similar studies reported a sensitivity of 41.9-84.6%, specificity of 65.8-100% and accuracy of 69.9-82%. CONCLUSION: The findings of this study show that the detection of decoy cells in urine samples is a sensitive screening method for polyomaviruses. The findings of this study are compatible with other similar studies.

A substitute to xylene in deparaffinization and clearing prior to coverslipping in histopathology.

INTRODUCTION: Deparaffinization and clearing prior to coverslipping are important steps in all staining methods in histopathology. Xylene is the most commonly used agent worldwide. However, xylene is toxic. We evaluated safer alternative dewaxing and clearing agents prior to coverslipping in a histopathology laboratory. MATERIALS AND METHODS: Thirteen different fresh surgical tissues were cut into two halves. One half processed using xylene and the other half processed using UltraClear™. Five groups were designed. For each Group of A, B, C, and D, 100 slides were cut from xylene-processed blocks. For Group E, 100 slides were cut from UltraClear™-processed blocks. Group A is the standard method. Group B evaluates UltraClear™ as a dewaxing agent only. Group C evaluates UltraClear™ as a clearing agent prior to coverslipping only. Group D evaluates UltraClear™ as both dewaxing and clearing agents prior to coverslipping. Group E evaluates UltraClear™ as both dewaxing and clearing agents prior to coverslipping. Six parameters were evaluated: nuclear staining, cytoplasmic staining, cell morphology, clarity of staining, uniformity of staining, and cost. RESULTS: Groups B, C, and D showed 79% (P = 0.054), 83% (P = 0.221), and 80% (P = 0.079) adequacy when compared with Group A (89%), respectively. However, Group E showed only 76% (P = 0.016) adequacy. UltraClear™ is more expensive than xylene. CONCLUSION: UltraClear™ is a promising dewaxing agent. It is also a good clearing agent for use prior to coverslipping in histopathology laboratory. Cost-benefit balance between safety of laboratory workers, good quality staining, and cost-effective strategy needs to be further studied.

Incidence of pediatric glomerular diseases in Arab world: A systematic review.

Despite the high number of Arab children, there are a scanty available data about different types of pediatric glomerular diseases in all Arab countries. Very few Arab countries have a national renal biopsy registry. In this review, we performed a systematic review analyzing the incidence of pediatric glomerular disease in all Arab countries. Relevant manuscripts in all 22 Arab countries found through searches of Medline, Science Direct, Embase and Google Scholar were evaluated. The period was from January 1990 to March 2018. A total of 17 manuscripts containing 3083 renal biopsies from seven countries were analyzed. Male-to-female ratio was 1.3:1. Saudi Arabia revealed the most published studies with seven papers. The average period of the study was 8.63 years. Retrospective studies represent 94.12%. Minimal change disease (MCD) (29.25%), focal and segmental glomerulosclerosis (FSGS) (22.34%), mesangioproliferative glomerulonephritis (14.78%), membranoproliferative glomerulonephritis (6.9%), IgA nephropathy (3.98%), and membranous glomerulopathy (2.65%) were the top types of primary glomerular diseases. The most common types of secondary glomerular diseases were lupus nephritis (36.1%), postinfectious glomerulonephritis (17.62%), congenital nephrotic syndrome (6.08%), Alport syndrome (4.71%), Henoch-Schönlein purpura (1.49%), and amyloidosis (1.36%). In conclusion, MCD and lupus nephritis are, respectively, the most common types of primary and secondary glomerular diseases in children of all evaluated Arab countries. FSGS is the predominant pattern of primary glomerular diseases in Asian Arab countries. The trend of all types of glomerular diseases has not changed in the past 28 years except a noted significant reduction in FSGS. Arab countries are strongly recommended to establish a renal biopsy registry.

Factors affecting job satisfaction among medical laboratory technologists in University Hospital, Oman: An exploratory study.

BACKGROUND: The worldwide shortage of health care professionals has prompted Oman to recruit such professionals from other countries. Among such professionals, medical laboratory technologists are key in effective health care delivery, and it is therefore important to discover what influences the job satisfaction enjoyed by them. However, little research has been undertaken in this area; consequently, this study explores the factors that impact upon job satisfaction among medical laboratory technologists in University Hospital, Oman. METHOD: Twelve groups of professionals were involved in Focus Group Discussions. The participants comprised senior and junior medical laboratory technologists. The study was undertaken during the end of 2015 and the beginning of 2016. One general question was presented: Can you please describe your situation at work in this hospital? RESULTS: Factors that caused major dissatisfaction at work were identified as follows: workload, promotion, health and safety in the laboratory, relationship with the leaders, professional status (recognition and appreciation), and hospital policies such as appraisal. Stress was the outcome of the presence/absence/quality of these factors. Other factors that emerged as important were autonomy and professional development. The satisfaction factors were identified as salary, the co-worker relationship, and job security for non-Omanis. CONCLUSIONS: These findings call for a reevaluation of the promotion system, improved health and safety within the laboratories, appraisal that relates to the technologists careers within their laboratories, and improved professional training programmes for career enhancement.

Factors Influencing Knowledge and Practice Regarding Cervical Cancer and Pap smear Testing among Omani Women

Background: Knowledge of cervical cancer and performance of Pap smear testing are influenced by several sociodemographic factors. This study aimed to describe the effect of relevant variables on knowledge and compliance with guidelines in Oman. Methods: In this cross-sectional survey, participants were divided into three groups: patients who attended Outpatient Gynecology Department, female medical staff and university graduate students. Results: There were 204 outpatients, 133 staff, and 157 students. Adequate knowledge among was seen in 38.7%, 35.3%, and 7.6%, respectively. Knowledge of cervical cancer and Pap smear was significantly lower among outpatients with secondary education, while those with high level of income were more likely to have adequate cancer knowledge. Uptake of Pap smear was significantly greater among outpatients aged ≥ 30 years, with high income and a positive history of cancer. Conclusion: Culturally tailored interventions that focus on improving cancer risk knowledge are needed to maximize screening uptake for cervical cancer.

Spectrum of glomerular diseases in Arab countries: A systematic review.

According to the best of our knowledge, there is no review compiling incidence of glomerular disease in all Arab countries. Most of the Arab countries do not have a national renal biopsy registry. In addition, there is scanty data available on the epidemiology of glomerular diseases in Arab countries. In this review, we performed a systematic review analyzing the incidence of glomerular disease in all Arab countries. Relevant manuscripts in all 22 Arab countries found through searches of Medline, Science Direct, Embase, and Google Scholar were evaluated. The time was from January 1990 to March 2018. A total of 36 manuscripts containing 10,727 biopsies from 11 countries were analyzed. The male-to-female ratio was 1.2:1. Saudi Arabia had the largest number of published studies with 14 papers followed equally by Iraq, Jordan, and Sudan with three papers each. The average period of study was 8.17 years. Retrospective studies represented 86.11%. Focal and segmental glomerulosclerosis (FSGS) (27%), minimal change disease (14%), membranoproliferative glomerulonephritis (13%), mesangioproliferative glomerulonephritis (13%), and membranous glomerulopathy (11%) were the main types of primary glomerular diseases. The most common types of secondary glomerular diseases were lupus nephritis (LN) (58%), amyloidosis (10.19%), diabetic nephropathy (9.89%), hypertension (4.84%) and poststreptococcal glomerulonephritis (2.72%). In conclusion, FSGS and LN are the most common types of primary and secondary glomerular diseases, respectively, in all evaluated Arab countries. The trend of all types of glomerular diseases has not changed in the last three decades. We strongly recommend that each Arab country should have its own renal biopsy registry.

Correlation and discrepancy of phospholipase A2 receptor staining in membranous nephropathy in paraffin-embedded kidney biopsies.

Distinguishing primary from secondary forms of membranous nephropathy (MN) in paraffin-embedded kidney biopsies is challenging. Previous studies have measured the accuracy, sensitivity, and specificity of phospholipase A2 receptor (PLA2R) on MN. However, due to the absence of a gold standard method for diagnosis, further studies are necessary. Here, we measure the correlation and discrepancy of PLA2R on MN in paraffin-embedded kidney biopsies by correlating PLA2R findings with immunofluorescence (IF), light microscopy (LM), and electron microscopy (EM) results. A total of 116 kidney biopsies were investigated including 87 MN and 29 nonmembranous kidney diseases. PLA2R was examined by indirect IF assay. A total of 79 MN cases were subjected to PLA2R staining and histopathological analyses. The remaining eight cases were excluded due to the lack of the glomeruli in the sections. The correlation and discrepancy between PLA2R and IF findings were seen in 65.45% and 34.55%, respectively. PLA2R and EM findings showed a 65.52% correlation and 34.48% discrepancy. LM features and PLA2R findings showed a correlation of 58.44% and discrepancy of 41.56%. Overall correlation between histopathology and PLA2R was seen in 65.82% and 34.18% showed discordant cases. All 29 non-membranous MN cases were negative for PLA2R. Staining for PLA2R could be a useful adjunctive tool in the stratification of cases of MN. The findings of this study strongly recommend the use of PLA2R IF staining method as a routine test for all MN cases.

Alternative to xylene as a clearing agent in histopathology.

INTRODUCTION: Clearing is an essential step in processing tissue for light microscopy. Xylene is the clearing agent used most commonly worldwide. Xylene is toxic and therefore a threat to personnel working in histopathology laboratories. We evaluated a safer alternative clearing agent for use in the histopathology laboratory. MATERIALS AND METHODS: We used 230 formalin-fixed, paraffin-embedded tissue blocks from 19 different tissues. Half of the specimens were processed using xylene and half were processed using UltraClear™. Tissues were evaluated for eight parameters: sectioning, nuclear staining, cytoplasmic staining, overall cell morphology, clarity of staining, uniformity of staining, quality of immunohistochemistry (IHC), and cost. RESULTS: Both UltraClear™ and xylene processed sections scored 100% for IHC. Sections processed using UltraClear™ were easy to cut (81.7%) as were xylene processed sections (96.5%). UltraClear™ processed sections showed 67%, 60.9%, 52.2%, 63.5%, and 67% for nuclear staining, cytoplasmic staining, cell morphology, clarity of staining, and uniformity of staining, respectively. UltraClear™ is twice as expensive as xylene. We found that tissues processed using UltraClear™ were easy to cut and worked well for both hematoxylin and eosin and IHC staining. CONCLUSION: UltraClear™ is less toxic, less flammable, friendlier to the environment, and easy to handle, but it is two times expensive than xylene. The findings of this study recommend the use of UltraClear™ solution as a routine clearing agent in histopathology laboratories. However, further studies are required.