Search results for: clinical laboratory results

Authors: Ayman M. Mansour, Bilal Hawashin, Hesham Alsalem

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Faster delivery of laboratory test results is one of the most noticeable signs of good laboratory service and is often used as a key performance indicator of laboratory performance. Despite the availability of technology, the delivery time of clinical laboratory test results continues to be a cause of customer dissatisfaction which makes patients feel frustrated and they became careless to get their laboratory test results. The Medical Clinical Laboratory test results are highly sensitive and could harm patients especially with the severe case if they deliver in wrong time. Such results affect the treatment done by physicians if arrived at correct time efforts should, therefore, be made to ensure faster delivery of lab test results by utilizing new trusted, Robust and fast system. In this paper, we proposed a distributed Multi-Agent System to enhance and faster the process of laboratory test results delivery using SMS. The developed system relies on SMS messages because of the wide availability of GSM network comparing to the other network. The software provides the capability of knowledge sharing between different units and different laboratory medical centers. The system was built using java programming. To implement the proposed system we had many possible techniques. One of these is to use the peer-to-peer (P2P) model, where all the peers are treated equally and the service is distributed among all the peers of the network. However, for the pure P2P model, it is difficult to maintain the coherence of the network, discover new peers and ensure security. Also, security is a quite important issue since each node is allowed to join the network without any control mechanism. We thus take the hybrid P2P model, a model between the Client/Server model and the pure P2P model using GSM technology through SMS messages. This model satisfies our need. A GUI has been developed to provide the laboratory staff with the simple and easy way to interact with the system. This system provides quick response rate and the decision is faster than the manual methods. This will save patients life.

Keywords: multi-agent system, delivery process, GSM technology, clinical laboratory results

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Authors: Getachew Belay Kassahun

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Background: Locally established clinical laboratory reference intervals (RIs) are required to interpret laboratory test results for screening, diagnosis, and prognosis. The objective of this study was to establish a reference interval of clinical chemistry parameters among apparently healthy adolescents aged between 12 and 17 years in Mekelle, Tigrai, in the northern part of Ethiopia. Methods: Community-based cross-sectional study was employed from December 2018 to March 2019 in Mekelle City among 172 males and 172 females based on a Multi-stage sampling technique. Blood samples were tested for Fasting blood sugar (FBS), alanine amino transferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), Creatinine, urea, total protein, albumin (ALB), direct and indirect bilirubin (BIL.D and BIL.T) using 25 Bio system clinical chemistry analyzer. Results were analyzed using SPSS version 23 software and based on the Clinical Laboratory Standard Institute (CLSI)/ International Federation of Clinical Chemistry (IFCC) C 28-A3 Guideline which defines the reference interval as the 95% central range of 2.5th and 97.5th percentiles. Mann Whitney U test, descriptive statistics and box and whisker were statistical tools used for analysis. Results: This study observed statistically significant differences between males and females in ALP, ALT, AST, Urea and Creatinine Reference intervals. The established reference intervals for males and females, respectively, were: ALP (U/L) 79.48-492.12 versus 63.56-253.34, ALT (U/L) 4.54-23.69 versus 5.1-20.03, AST 15.7- 39.1 versus 13.3- 28.5, Urea (mg/dL) 9.33-24.99 versus 7.43-23.11, and Creatinine (mg/dL) 0.393-0.957 versus 0.301-0.846. The combined RIs for Total Protein (g/dL) were 6.08-7.85, ALB (g/dL) 4.42-5.46, FBS(mg/dL) 65-110, BIL.D (mg/dL) 0.033-0.532, and BIL.T (mg/dL) 0.106-0.812. Conclusions: The result showed a marked difference between sex and company-derived values for selected clinical chemistry parameters. Thus, the use of age and sex-specific locally established reference intervals for clinical chemistry parameters is recommended.

Keywords: reference interval, adolescent, clinical chemistry, Ethiopia

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Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

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A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

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Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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Authors: M. Patterson, R. Bond, K. Cowan, M. Mulvenna, C. Reid, F. McMahon, P. McGowan, H. Cormican

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This paper outlines the design of a simulator to allow for the optimisation of clinical workflows through a pathology laboratory and to improve the laboratory’s efficiency in the processing, testing, and analysis of specimens. Often pathologists have difficulty in pinpointing and anticipating issues in the clinical workflow until tests are running late or in error. It can be difficult to pinpoint the cause and even more difficult to predict any issues which may arise. For example, they often have no indication of how many samples are going to be delivered to the laboratory that day or at a given hour. If we could model scenarios using past information and known variables, it would be possible for pathology laboratories to initiate resource preparations, e.g. the printing of specimen labels or to activate a sufficient number of technicians. This would expedite the clinical workload, clinical processes and improve the overall efficiency of the laboratory. The simulator design visualises the workflow of the laboratory, i.e. the clinical tests being ordered, the specimens arriving, current tests being performed, results being validated and reports being issued. The simulator depicts the movement of specimens through this process, as well as the number of specimens at each stage. This movement is visualised using an animated flow diagram that is updated in real time. A traffic light colour-coding system will be used to indicate the level of flow through each stage (green for normal flow, orange for slow flow, and red for critical flow). This would allow pathologists to clearly see where there are issues and bottlenecks in the process. Graphs would also be used to indicate the status of specimens at each stage of the process. For example, a graph could show the percentage of specimen tests that are on time, potentially late, running late and in error. Clicking on potentially late samples will display more detailed information about those samples, the tests that still need to be performed on them and their urgency level. This would allow any issues to be resolved quickly. In the case of potentially late samples, this could help to ensure that critically needed results are delivered on time. The simulator will be created as a single-page web application. Various web technologies will be used to create the flow diagram showing the workflow of the laboratory. JavaScript will be used to program the logic, animate the movement of samples through each of the stages and to generate the status graphs in real time. This live information will be extracted from an Oracle database. As well as being used in a real laboratory situation, the simulator could also be used for training purposes. ‘Bots’ would be used to control the flow of specimens through each step of the process. Like existing software agents technology, these bots would be configurable in order to simulate different situations, which may arise in a laboratory such as an emerging epidemic. The bots could then be turned on and off to allow trainees to complete the tasks required at that step of the process, for example validating test results.

Keywords: laboratory-process, optimization, pathology, computer simulation, workflow

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Authors: Yoon Kyung Song, Seung Won Han, Sang Hyun Hwang, Do Hoon Lee

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Laboratory tests is a significant part for the diagnosis, prognosis, treatment of diseases. Blood collection is a simple process, but can be a potential cause of pre-analytical errors. Vacuum blood collection tubes used to collect and store the blood specimens is necessary for accurate test results. The purpose of this study was to validate Improve serum separator tube(SST) (Guanzhou Improve Medical Instruments Co., Ltd, China) for routine clinical chemistry laboratory testing. Blood specimens were collected from 100 volunteers in three different serum vacuum tubes (Greiner SST , Becton Dickinson SST , Improve SST). The specimens were evaluated for 16 routine chemistry tests using TBA-200FR NEO (Toshiba Medical Co. JAPAN). The results were statistically analyzed by paired t-test and Bland-Altman plot. For stability test, the initial results for each tube were compared with results of 72 hours preserved specimens. Their clinical availability was evaluated by biological Variation of Ricos data bank. Paired t-test analysis revealed that AST, ALT, K, Cl showed statistically same results but calcium (CA), phosphorus(PHOS), glucose(GLU), BUN, uric acid(UA), cholesterol(CHOL), total protein(TP), albumin(ALB), total bilirubin(TB), ALP, creatinine(CRE), sodium(NA) were different(P < 0.05) between Improve SST and Greiner SST. Also, CA, PHOS, TP, TB, AST, ALT, NA, K, Cl showed statistically the same results but GLU, BUN, UA, CHOL, ALB, ALP, CRE were different between Improve SST and Becton Dickinson SST. All statistically different cases were clinically acceptable by biological Variation of Ricos data bank. Improve SST tubes showed satisfactory results compared with Greiner SST and Becton Dickinson SST. We concluded that the tubes are acceptable for routine clinical chemistry laboratory testing.

Keywords: blood collection, Guanzhou Improve, SST, vacuum tube

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Authors: Olgha Giorgishvili

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The work is mainly concerned with the determination of modulus of deformation by laboratory method. It is known that a modulus of deformation is defining by laboratory and field methods. By laboratory method the modulus of deformation is defined in the compressive devices. Our goal is to conduct experiments by both methods and finally make to interpret the obtained results. In this article is considered the definition by new offered laboratory method of deformation modulus that is closer to the real deformation modulus. Finally, the obtained results gives the possibility to us to raise the issue of change the state norms for determining ground by laboratory method.

Keywords: building, soil mechanic, deformation moulus, compression methods

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Authors: N. G. Vepkhvadze, T. Enukidze

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Anthrax is a fatal disease caused by strains of Bacillus anthracis, a spore-forming gram-positive bacillus that causes the disease anthrax in animals and humans. Anthrax is a zoonotic disease that is also well-recognized as a potential agent of bioterrorism. Infection in humans is extremely rare in the developed world and is generally due to contact with infected animals or contaminated animal products. Testing of this zoonotic disease began in 1907 in Georgia and is still being tested routinely to provide accurate information and efficient testing results at the State Laboratory of Agriculture of Georgia. Each clinical sample is analyzed by RT-PCR and bacteriology methods; this study used Real-Time PCR assays for the detection of B. anthracis that rely on plasmid-encoded targets with a chromosomal marker to correctly differentiate pathogenic strains from non-anthracis Bacillus species. During the period of 2015-2022, the State Laboratory of Agriculture (SLA) tested 250 clinical and environmental (soil) samples from several different regions in Georgia. In total, 61 out of the 250 samples were positive during this period. Based on the results, Anthrax cases are mostly present in Eastern Georgia, with a high density of the population of livestock, specifically in the regions of Kakheti and Kvemo Kartli. All laboratory activities are being performed in accordance with International Quality standards, adhering to biosafety and biosecurity rules by qualified and experienced personnel handling pathogenic agents. Laboratory testing plays the largest role in diagnosing animals with anthrax, which helps pertinent institutions to quickly confirm a diagnosis of anthrax and evaluate the epidemiological situation that generates important data for further responses.

Keywords: animal disease, baccilus anthracis, edp, laboratory molecular diagnostics

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Authors: Isa Usman Balan, Umar Aliyu, Ahmad Tijjani Muhammed

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The laboratory scale experiment was conducted to determine the phytochemical constituents and antibacterial activities of epiphytic neem leaves (Tapinanthusdodoneifolius) extracts on some selected clinical isolates. The samples were collected using polythene bags to avoid unnecessary contamination of the plants, and they were collected from the old site garden of the BUK. The phytochemical screening and antibacterial test were carried out in the Chemistry and Biology laboratory, respectively at Bayero University Kano (BUK). The result obtained showed that carbohydrates, glycosides, steroids, alkaloids, phenol, saponins and flavonoids are present in the ethanolic extract. However, chloroform extract showed only glycosides, phenols, and carbohydrates. Furthermore, there was no significant difference between the ethanolic extracts and bacterial isolates (p<0.05).

Keywords: phytochemical screening, antibacterial, clinical isolates, epiphytic neem leaves, Tapinanthus dodoneifolius

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Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

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Authors: Kaisa M. Herne, Hanna E. Björkstedt

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Comparisons of online and laboratory environments are important for assessing whether the environment influences behavioral results. Trust game behavior was examined in three environments: 1) The standard laboratory setting with physically present participants (laboratory), 2) An online environment with an online meeting before playing the trust game (online plus a meeting); and 3) An online environment without a meeting (online without a meeting). In laboratory, participants were present in a classroom and played the trust game anonymously via computers. Online plus a meeting mimicked the laboratory in that participants could see each other in an online meeting before sessions started, whereas online without a meeting was a standard online experiment in which participants did not see each other at any stages of the experiment. Participants were recruited through pools of student subjects at two universities. The trust game was identical in all conditions; it was played with the same software, anonymously, and with stranger matching. There were no statistically significant differences between the treatment conditions regarding trust or trustworthiness. Results suggest that conducting trust game experiments online will yield similar results to experiments implemented in a laboratory.

Keywords: laboratory vs. online experiment, trust behavior, trust game, trustworthiness behavior

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Authors: Ergin Toros, Manar Aslan

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This study was planned as a descriptive study in order to learn the opinions of the students who are studying in nursing undergraduate program about their theoretical/practical lessons and departments. The education in the undergraduate nursing programs has great importance because it contains the knowledge and skills to prepare student nurses to the clinic in the future. In order to provide quality-nursing services in the future, the quality of nursing education should be measured, and opinions of student nurses about education should be taken. The research population was composed of students educated in a university with 1-4 years of theoretical and clinical education (N=550), and the sample was composed of 460 students that accepted to take part in the study. It was reached to 83.6% of target population. Data collected through a survey developed by the researchers. Survey consists of 48 questions about sociodemographic characteristics (9 questions), theoretical courses (9 questions), laboratory applications (7 questions), clinical education (14 questions) and services provided by the faculty (9 questions). It was determined that 83.3% of the nursing students found the nursing profession to be suitable for them, 53% of them selected nursing because of easy job opportunity, and 48.9% of them stayed in state dormitory. Regarding the theoretical courses, 84.6% of the students were determined to agree that the question ‘Course schedule is prepared before the course and published on the university web page.’ 28.7% of them were determined to do not agree that the question ‘Feedback is given to students about the assignments they prepare.’. It has been determined that 41,5% of the students agreed that ‘The time allocated to laboratory applications is sufficient.’ Students said that physical conditions in laboratory (41,5%), and the materials used are insufficient (44.6%), and ‘The number of students in the group is not appropriate for laboratory applications.’ (45.2%). 71.3% of the students think that the nurses view in the clinics the students as a tool to remove the workload, 40.7% of them reported that nurses in the clinic area did not help through the purposes of the course, 39.6% of them said that nurses' communication with students is not good. 37.8% of students stated that nurses did not provide orientation to students, 37.2% of them think that nurses are not role models for students. 53.7% of the students stated that the incentive and support for the student exchange program were insufficient., %48 of the students think that career planning services, %47.2 security services,%45.4 the advisor spent time with students are not enough. It has been determined that nursing students are most disturbed by the approach of the nurses in the clinical area within the undergraduate education program. The clinical area education which is considered as an integral part of nursing education is important and affect to student satisfaction.

Keywords: nursing education, student, clinical area, opinion

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Authors: Ji-Chan Jang

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Tuberculosis is still major health problem because there is an increase of multidrug-resistant and extensively drug-resistant forms of the disease. Therefore, the most urgent clinical need is to discover potent agents and develop novel drug combination capable of reducing the duration of MDR and XDR tuberculosis therapy. Three reference strains H37Rv, CDC1551, W-Beijing GC1237 and six clinical isolates of MDRTB were tested to daptomycin in the range of 0.013 to 256 mg/L. Daptomycin is resistant to all tested M. tuberculosis strains not only laboratory strains but also clinical MDR strains that were isolated at different source. Daptomycin will not be an antibiotic of choice for treating infection of Gram positive atypical slowly growing M. tuberculosis.

Keywords: tuberculosis, daptomycin, resistance, Mycobacterium tuberculosis

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Authors: Ari S. Prabowo, Nia Febriyanti, Haryono B. Santosa

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Security function that is called as Physical Protection Systems (PPS) has functions to detect, delay and response. Physical Protection Systems (PPS) in Detection and Radiation Measurement Laboratory needs to be improved continually by using internal resources. The nuclear security culture provides some potentials to support this research. The study starts by identifying the security function’s weaknesses and its strengths of security culture as a purpose. Secondly, the strengths of security culture are implemented in the laboratory management. Finally, a simulation was done to measure its effectiveness. Some changes were happened in laboratory personnel behaviors and procedures. All became more prudent. The results showed a good influence of nuclear security culture in laboratory security functions.

Keywords: laboratory, physical protection system, security culture, security function

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Authors: Noorulaine Maqsood, Saeed Khan

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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.

Keywords: biosafety practices, clinical laboratory, Pakistan, survey

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Authors: Saowaluck Ukrisdawithid

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The thermal conductivity of thermal insulation materials are measured by Heat Flow Meter (HFM) apparatus. The components of uncertainty are complex and difficult on routine measurement by modelling approach. In this study, uncertainty of thermal conductivity measurement was estimated by single laboratory validation approach. The within-laboratory reproducibility was 1.1%. The standard uncertainty of method and laboratory bias by using SRM1453 expanded polystyrene board was dominant at 1.4%. However, it was assessed that there was no significant bias. For sample measurement, the sources of uncertainty were repeatability, density of sample and thermal conductivity resolution of HFM. From this approach to sample measurements, the combined uncertainty was calculated. In summary, the thermal conductivity of sample, polystyrene foam, was reported as 0.03367 W/m·K ± 3.5% (k = 2) at mean temperature 23.5 °C. The single laboratory validation approach is simple key of routine testing laboratory for estimation uncertainty of thermal conductivity measurement by using HFM, according to ISO/IEC 17025-2017 requirements. These are meaningful for laboratory competent improvement, quality control on products, and conformity assessment.

Keywords: single laboratory validation approach, within-laboratory reproducibility, method and laboratory bias, certified reference material

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Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

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A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT behavior, clinical laboratory persons, Sub-Saharan Africa, Uganda

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Authors: El Miloudi Djelloul

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Technology nowadays enables the remote access to laboratory equipment and instruments via Internet. This is especially useful in engineering education, where students can conduct laboratory experiment remotely. Such remote laboratory access can enable student to use expensive laboratory equipment, which is not usually available to students. In this paper, we present a method of creating a Web-based Remote Laboratory Experimentation in the master degree course “Wireless Communications Systems” which is part of “ICS (Information and Communication Systems)” and “Investment Management in Telecommunications” curriculums. This is done within the RIPLECS Project and the NI2011 FF005 Research Project “Implementation of Project-Based Learning in an Interdisciplinary Master Program”.

Keywords: remote access, remote laboratory, wireless telecommunications, external antenna-switching controller board (EASCB)

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Authors: Ayubova Nargiza Mirzabixulaevna, Kiryakov Dmitriy Andreyevich

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Relevance: According to experts from the World Health Organization, in 80% of cases, the causes of skin cancer are external factors: polluted air, radioactive substances, solar flares, and free radicals. In dermatology, one of the most common related to obligate diseases is actinic keratosis. Actinic keratosis (AC) is an area of abnormal proliferation and differentiation of keratinocytes, which carry the risk of progression into invasive squamous cell carcinoma of the skin. The purpose of the study is to study the prevalence of various forms of actinic keratosis among the population of Uzbekistan. Materials and methods of research: The study is based on the observation and clinical laboratory examination of 96 patients who were divided by gender and age. Women made up 45% and men made up 55%. The youngest patient was 43 years old, and the oldest was 92 years old. The control group consisted of 40 patients. The following clinical signs were evaluated: peeling, hyperkeratosis, erythema, pigmentation, atrophy. Results: Studies have shown that of all forms of actinic keratosis, erythematous (36%), hyperkeratotic (27%), pigmented (12%), cutaneous horn (7.0%), atrophic (7.0%), Actinic cheilitis (6%), lichenoid (5%) are common. Conclusion: Thus, the data we have obtained indicate that the main and pronounced clinical sign in the erythematous form is erythema and the hyperkeratic form is often found. With cutaneous horn, there is a sharp hyperkeratosis of the epidermis.

Keywords: actinic keratosis, patient, skin cancer, obligate diseases

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Authors: Salih Uzun

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The laboratory activities are seen an indispensable part of science, teaching, and learning. In this study, the aim was to identify pre-service science teachers’ perceptions related to the concept of laboratory through metaphors. It is expressed that metaphors can be used as a powerful research tool in order to understand personal perceptions. Therefore, metaphors were used with the aim of revealing a picture regarding how pre-service science teachers perceive laboratory. Within the scope of this aim, phenomenographic research design was adopted for this study and an answer was sought to the question; ‘What are pre-service science teachers’ perceptions about the concept of laboratory?’. The sample of this study was a total of 80 pre-service science teachers at various grade levels in Turkey. Participants were asked to complete the sentence; ‘Laboratory is like…; because…’. Documents including pre-service science teachers’ answers to the open-ended questions were used as data sources and the data were analysed with content analysis.

Keywords: laboratory, metaphor, phenomenology, pre-service science teachers

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Authors: Manas Kotepui, Chatree Ratcha, Kwuntida Uthaisar

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Malaria infection is still to be considered a major public health problem in Thailand. This study, a retrospective data of patients in Surat Thani Province, Southern Thailand during 2012-2015 was retrieved and analyzed. These data include demographic data, clinical characteristics and laboratory diagnosis. Statistical analyses were performed to demonstrate the frequency, proportion, data tendency, and group comparisons. Total of 395 malaria patients were found. Most of patients were male (253 cases, 64.1%). Most of patients (262 cases, 66.3%) were admitted at 6 am-11.59 am of the day. Three hundred and fifty-five patients (97.5%) were positive with P. falciparum. Hemoglobin, hematocrit, and MCHC between P. falciparum and P. vivax were significant different (P value<0.05).During 2012-2015, prevalence of malaria was highest in 2013. Neutrophils, lymphocytes, and monocytes were significantly changed among patients with fever ≤ 3 days compared with patients with fever >3 days. This information will guide to understanding pathogenesis and characteristic of malaria infection in Sothern Thailand.

Keywords: prevalence, malaria, Surat Thani, Thailand

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Authors: Omonov Jahongir Mahmatkulovic

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Purpose: To study the significance of D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen coagulation parameters (Fg) in predicting the course, severity and prognosis of COVID-19. Source and method of research: From September 15, 2021, to November 5, 2021, 93 patients aged 25 to 60 with suspected COVID-19, who are under inpatient treatment at the multidisciplinary clinic of the Tashkent Medical Academy, were retrospectively examined. DD, PT, APTT, and Fg were studied in dynamics and studied changes. Results: Coagulation disorders occurred in the early stages of COVID-19 infection with an increase in DD in 54 (58%) patients and an increase in Fg in 93 (100%) patients. DD and Fg levels are associated with the clinical classification. Of the 33 patients who died, 21 had an increase in DD in the first laboratory study, 27 had an increase in DD in the second and third laboratory studies, and 15 had an increase in PT in the third test. The results of the ROC analysis of mortality showed that the AUC DD was three times 0.721, 0.801, and 0.844, respectively; PT was 0.703, 0.845, and 0.972. (P<0:01). Conclusion”: Coagulation dysfunction is more common in patients with severe and critical conditions. DD and PT can be used as important predictors of mortality from COVID-19.

Keywords: Covid19, DD, PT, Coagulogram analysis, APTT

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Authors: Fatemeh Keshavarz

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Background: Rheumatoid arthritis (RA) is one of the most common autoimmune diseases, often leading to joint damage and physical disability. This study aimed to investigate the relationship of serum levels of interleukin 17 and anti-CCP factor with disease severity in RA patients. Materials and Methods: Fifty-four patients with RA confirmed by clinical and laboratory criteria were recruited. A 5 ml venous blood sample was taken from every patient, its serum was separated. Based on clinical data and severity of symptoms, patients were classified into three groups of those with mild, moderate, and severe symptoms. Serum levels of IL-17 and anti-CCP in all samples were measured using ELISA. Results: Analysis of IL-17 serum levels in different groups showed that its amount was higher in the group with mild clinical symptoms than in other groups. Comparison of IL-17 serum levels between mild and moderate disease severity groups showed a statistically significant relationship. There was also a positive linear relationship between anti-CCP and serum IL-17 levels in different groups of the disease, and serum IL-17 levels were inversely related to the duration of exposure to the disease. Conclusion: Higher IL-17 serum levels in patients with mild symptom severity confirm that this highly specific marker is involved in the pathogenesis of RA and may be effective in initiating patients’ clinical symptoms.

Keywords: IL-17, anti-CCP, rheumatoid arthritis, autoimmune

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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Authors: Dale Daniel G. Bodo

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This study investigated the status of the Laboratory Tools and Equipment of the BSHRT Program of Eastern Visayas State University, Tacloban City Campus. Descriptive-correlation method was used which Variables include profile age, gender, acquired NC II, competencies in HRT and the status of the laboratory facilities, tools, and equipment of the BSHRT program. The study also identified significant correlation between the profile of the respondents and the implementation of the BSHRT Program in terms of laboratory tools and equipment. A self-structured survey questionnaire was used to gather relevant data among eighty-seven (87) BSHRT-OJT students. To test the correlations of variables, Pearson Product Moment Coefficient Correlation or Pearson r was used. As a result, the study revealed very interesting results and various significant correlations among the paired variables and as to the implementation of the BSHRT Program. Hence, this study was done to update the status of laboratory tools and equipment of the program.

Keywords: status, BSHRT Program, laboratory tools and equipment, descriptive-correlation

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Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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Authors: Babina Aryal

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Background: The diagnosis of pancreatitis is generally based on clinical and laboratory findings; however, Computed Tomography (CT) is an imaging technique of choice specially Contrast Enhanced Computed Tomography (CECT) shows morphological characteristic findings that allow for establishing the diagnosis of pancreatitis and determining the extent of disease severity which is done along with the administration of appropriate contrast medium. The purpose of this study was to compare Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) among male and female patients from Contrast Enhanced Computed Tomography (CECT) Pancreatitis Protocol. Methods: This retrospective study involved data collection based on clinical/laboratory/ultrasonography diagnosis of Pancreatitis and has undergone CECT Abdomen pancreatitis protocol. data collection involved detailed information about a patient's Age and Gender, Clinical history, Individual Computed Tomography Dose Index and Dose Length Product and effective dose. Results: We have retrospectively collected dose data from 150 among which 127 were males and 23 were females. The values obtained from the display of the CT screen were measured, calculated and compared to determine whether the CTDI, DLP and ED values were similar or not. CTDI for females was more as compared to males. The differences in CTDI values for females and males were 32.2087 and 37.1609 respectively. DLP values and Effective dose for both the genders did not show significant differences. Conclusion: This study concluded that there were no more significant changes in the DLP and ED values among both the genders however we noticed that female patients had more CTDI than males.

Keywords: computed tomography, contrast enhanced computed tomography, computed tomography dose index, dose length product, effective dose

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Authors: Mari A. Virtanen, Elina Haavisto, Eeva Liikanen, Maria Kääriäinen

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Rapid technological development and digitalization has affected also on higher education. During last twenty years multiple of electronic and mobile learning (e-learning, m-learning) platforms have been developed and have become prevalent in many universities and in the all fields of education. Ubiquitous learning (u-learning) is not that widely known or used. Ubiquitous learning environments (ULE) are the new era of computer-assisted learning. They are based on ubiquitous technology and computing that fuses the learner seamlessly into learning process by using sensing technology as tags, badges or barcodes and smart devices like smartphones and tablets. ULE combines real-life learning situations into virtual aspects and can be flexible used in anytime and anyplace. The aim of this study was to assess the effects of ubiquitous 360 o learning environment on higher education students’ clinical histotechnology competence. A quasi-experimental study design was used. 57 students in biomedical laboratory science degree program was assigned voluntarily to experiment (n=29) and to control group (n=28). Experimental group studied via ubiquitous 360o learning environment and control group via traditional web-based learning environment (WLE) in a 8-week educational intervention. Ubiquitous 360o learning environment (ULE) combined authentic learning environment (histotechnology laboratory), digital environment (virtual laboratory), virtual microscope, multimedia learning content, interactive communication tools, electronic library and quick response barcodes placed into authentic laboratory. Web-based learning environment contained equal content and components with the exception of the use of mobile device, interactive communication tools and quick response barcodes. Competence of clinical histotechnology was assessed by using knowledge test and self-report developed for this study. Data was collected electronically before and after clinical histotechnology course and analysed by using descriptive statistics. Differences among groups were identified by using Wilcoxon test and differences between groups by using Mann-Whitney U-test. Statistically significant differences among groups were identified in both groups (p<0.001). Competence scores in post-test were higher in both groups, than in pre-test. Differences between groups were very small and not statistically significant. In this study the learning environment have developed based on 360o technology and successfully implemented into higher education context. And students’ competence increases when ubiquitous learning environment were used. In the future, ULE can be used as a learning management system for any learning situation in health sciences. More studies are needed to show differences between ULE and WLE.

Keywords: competence, higher education, histotechnology, ubiquitous learning, u-learning, 360o

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