CONTENTS
Original Articles
Published 【PDF】
CONTENTS
Original Articles
Published 【PDF】
Abstract
Assessing iron status during pregnancy is fraught with difficulties because the profound hemodynamic changes associated with pregnancy affect several indexes of iron status. Current markers of iron deficiency tend to be less reliable in pregnancy especially ferritin which is an acute phase reactant and as such will not be reliable in the diagnosis of iron deficiency anaemia among pregnant women with infections. Soluble transferrin receptor assay may be useful in these situations because
it reflects the degree of iron requirement in relation to supply and it is not an acute phase reactant. Our aim was to evaluate the usefulness of soluble serum transferrin receptor (sTfR) in relation to serum ferritn in the diagnosis of iron deficiency and iron deficiency anaemia during pregnancy. Serum iron and soluble transferrin receptor concentration were determined using ELISA technique while haemoglobin concentration was determined using automatic cell counter PCE-210 version 5.10 by ERMA INC. Tokyo. One hundred and fifty consenting pregnant women within the age range of 15-45 years were recruited for the study. In 81.81% of the samples analysed serum ferritin and soluble transferrin receptor agreed on the presence/absence of iron deficiency anaemia.18.18% of the pregnant women that were shown to be without iron deficiency anaemia with serum ferritin (serum iron < 12ng/ml) were shown to have iron deficiency anaemia with soluble transferrin receptor (sTfR> 2.4 ug/ml). The specificity of sTfR was 100%. The sensitivity of sTfRin relation to both
anaemia and depleted iron stores was 67.99%, but this figure may not be a true reflection of sensitivity because of small sample size. sTfR during the first trimester was low (1.34±0.48) but increased significantly (p < 0.05) in second (2.98±0.72) and third trimester (2.59±0.73). The prevalence of iron deficiency anaemia was shown to be 18.0% when using serum ferritin and haemoglobin as markers (SI < 12ng/ml and Hb< 11g/dl) and 22.0% when soluble transferrin receptor and haemoglobin were used as markers (sTfR> 2.4ug/ml and Hb< 11g/dl) and the difference was statistically significant (p < 0.5).Conclusions: sTfR seems to be a more specific and sensitive marker of iron deficiency anaemia in pregnancy when compared to serum ferritin especially in the presence of infection.
Key words: Anaemia, Soluble Transferrin Receptor, Ferritin, Pregnancy
Abstract
Background: The incidence of diabetes mellitus round the globe is escalating remarkably. Diabetes mellitus has some deleterious effects on the genitourinary system and render diabetic patients more vulnerable to UTI. Objective: This study was undertaken to determine the prevalence of UTI among diabetic patients, the causative pathogens & their antimicrobial susceptibility pattern. Materials and Methods: Urine culture & sensitivity test reports data of 462 diabetic patients who had visited the B.P.Koirala institute of health sciences during a five year period, from February 2008 to January 2012, were retrospectively reviewed from log & register book and also from laboratory software( Q-Lab). These data were analyzed statistically using Microsoft Excel 2007.Results: The overall prevalence of UTI was 54.76% with female preponderance of 67.98 % and in case of male it was 32.02%. The UTI was common in age group between 31-40 yrs. The most predominant bacterial isolates were Escherichia coli, Klebsiella pneumonia, Proteus mirabilis and Enterococcus. In-vitro antimicrobial susceptibility tests revealed that Amikacin was more effective against Gram negative pathogens where as Nitrofurantion was sensitive to Gram positive pathogens. Ampicillin, nalidixic acid and ciprofloxacin were poorly effective against isolated uropathogens. Conclusions: This study highlights that the prevalence of UTI among diabetics is considerably high and the responsible pathogens have developed resistance to several potent antibiotics which if not looked into timely, there is every chance that we will be left with no choice in near future. Therefore, it is highly recommended that periodic screening of diabetic patients should be done for optimal therapy and
management.
Key words: UTI, diabetes, bacteria, antimicrobial susceptibility
Abstract
Public health laboratories are critical for diagnosing and supporting control of infectious diseases. Concern about Kenyan provincial laboratories’ ability to detect and respond to outbreaks and other emergencies has increased in recent times, with cholera and Rift Valley fever outbreaks as examples. These situations have raised questions regarding readiness of laboratories for outbreaks and emergency response, particularly to serious threats such as Ebola. We assessed provincial
laboratories to determine their level of preparedness. We selected eight out of ten core functional areas of the World Health Organization’s Laboratory Assessment Tool / Facilities (WHO LAT) that are critical for responding to public health emergencies. Managers of the eight provincial laboratories completed the checklist, which assesses preparedness and emergency responses in eight components: equipment; reagents and supply; analysis and test performed biosafety, hygiene and security; total quality; laboratory staffing and working time; reporting, analysis and communication; and outbreak participation. Percentage scores relative to the World Health Organization benchmark were calculated for each of the eight components. Median overall scores across the eight laboratories for five out of eight components were 41-49% of the benchmark level set by the WHO; reagents and supply exceeded the minimum optimal WHO of 50% threshold, attaining median score of 67% (55-85). Lab 6 scored was rated optimal scores of 75% and above on 23 of 32 specific indicators. All of the other provincial laboratories achieved at least 75% on 11 to 16 indicators out of 32 indicators. Provincial laboratories in Kenya are therefore inadequately prepared for public health emergencies. The result of this evaluation illustrated a need to improve the ability of provincial laboratories to respond to public health emergencies.
Key words: Kenya, laboratories, public health, emergencies
CONTENTS
Original Articles
Published 【PDF】