Frequency and types of pre-analytical errors in a clinical laboratory of a specialized healthcare hospital.

Background & Objective: The pre-analytical phase, encompassing all preparatory steps leading to the analytical process, represents a critical stage prone to laboratory errors. An assessment of the occurrence and categories of laboratory errors, specifically within the pre-analytical phase of laboratory procedures, can guide in taking timely actions for rectifying errors responsible for damage and loss of samples. This study aimed to assess the frequency and types of pre-analytical errors within a clinical laboratory at the Multan Institute of Kidney Diseases over two years. Methods: This research took place at the Multan Institute of Kidney Diseases. Data was extracted from the hospital laboratory records of the period from 1st January 2021 to 31st December 2022. After data compilation, a retrospective cross-sectional methodology was adopted to assess frequency and types of pre-analytical errors within a clinical laboratory. The records underwent a thorough examination to identify pre-analytical errors, which were classified according to their type and occurrence rate. Results: Among the 254810 specimens received during the data collection period, a total of 1,722 specimens (0.67% of all collected samples) were found unsuitable for further processing. Amongst the rejected specimens, 718 (41.6%) displayed indications of hemolysis, 388 (22.5%) exhibited clotting, 217 (12.6%) had an insufficient volume and the remaining specimens fell into other miscellaneous categories such as insufficient quantity, unlabeled samples etc. Conclusion: The overall percentage of sample rejections in the laboratory was 0.67%. This study provided valuable insights into various reasons, and causes that require improvements to enhance the efficiency and quality of laboratory processes.

Primary pulmonary plasmacytoma presenting with rare IgG lambda monoclonal gammopathy.

Extramedullaryplasmacytoma (EMP) represents a peculiar and typically progressive malignancy that can originate outside the bone marrow. Primary pulmonary plasmacytoma (PPP) is a rare subset of EMP, confined to the lung. A 55-year-old man, diabetic, non-smoker presented to our clinic with a right chest wall swelling. A routine chest radiograph showed a well-circumscribed opacity in the right upper lung zone. A CT of the chest revealed a large right upper lobe mass with extensive local infiltration. Biopsy and immunohistochemical evaluation led to a diagnosis of PPP. Screening for multiple myeloma was negative. Serum immunofixation showed an IgG lambda monoclonal gammopathy, found in a minority of PPP patients. In view of disease extent, treatment with chemotherapy and radiotherapy was initiated. The patient is currently in out patient follow-up and has shown a favourable response to the treatment with a considerable decrease in serum IgG levels.

A source of strength and empowerment? An exploration of the influence of disabled children on the lives of their mothers in Karachi, Pakistan.

PURPOSE: Previous literature has highlighted marginalisation and stigma of children with disabilities in developing countries, but few studies have explored the central care-giving environment and the relationship of the mother and her child with disabilities in this context. A group of women caring for children with disabilities in a low income community in Karachi, Pakistan was identified for the study. The aims were: (1) to explore the influence children with disabilities have on the daily lives of their mothers, (2) to describe the factors which influence the care-giving capacity of mothers. METHOD: A participatory qualitative research design was implemented. A women's group of caregivers of children with disabilities was formed. Several different tools were used during the course of the group meetings to facilitate discussion including social mapping. A thematic analysis of issues around care-giving and the relationship between the mother and her child with disabilities was conducted. RESULTS: In a society where women may experience restrictions in freedom of movement and decision making, caring for a child with disabilities enabled women to move beyond traditional boundaries in seeking health and education services for their children. However, the gain in empowerment was counter-acted by a lack of care-giving support, a lack of appropriate services for health, rehabilitation and education of children with disabilities and stigma creating anxiety and stress for women. CONCLUSION: While children with disabilities do have some positive effects on the lives of their mothers, there are many more factors which create anxiety for this group of mothers (including a lack of care-giving support and stigma). Community-based rehabilitation strategies should consider the care-giving environment of children with disabilities and shift from a child only to family focus. Interventions which support, empower and strengthen the capacity of mothers are essential for the well being of their children with disabilities.