Laboratory diagnosis of infectious endophthalmitis

AIM:To analyze the lab diagnosis and etiology of infectious endophthalmitis.METHODS:The medical and microbial records of 36 patients diagnosed with infectious endophthalmitis and 8 patients diagnosed with intraocular lens(IOL)-related inflammation between Nov.1999 and Dec.2009 were retrospectively reviewed for lab diagnosis and etiology.RESULTS:The inflammatory cell counts in all aqueous humor specimens from infectious endophthalmitis patients were more than in all aqueous humor specimens from patients with IOL-related inflammation.Sixteen of the 36 aqueous humor samples(44.4%) and 11 of the 24 vitreous humor samples(45.8%) from infectious endophthalmitis patients showed positive results in smears;while 17 aqueous humor samples(47.2%) and 15 vitreous humor samples(62.5%) from infectious endophthalmitis patients showed positive results in culture.CONCLUSION:The inflammatory cell count may be an important index for infectious endophthalmitis;while,smears can show etiological information earlier.

Laboratory diagnosis for malaria in the elimination phase in China:efforts and challenges

Malaria remains a global health challenge,although an increasing number of countries will enter pre-elimination and elimination stages.The prompt and precise diagnosis of symptomatic and asymptomatic carriers of Plasmodium parasites is the key aspect of malaria elimination.Since the launch of the China Malaria Elimination Action Plan in 2010,China has formulated clear goals for malaria diagnosis and has established a network of malaria diagnostic laboratories within medical and health institutions at all levels.Various external quality assessments were implemented,and a national malaria diagnosis reference laboratory network was established to strengthen the quality assurance in malaria diagnosis.Notably,no indigenous malaria cases have been reported since 2017,but the risk of re-establishment of malaria transmission cannot be ignored.This review summarizes the lessons about malaria diagnosis in the elimination phase,primarily including the establishments of laboratory networks and quality control in China,to better improve malaria diagnosis and maintain a malaria-free status.A reference is also provided for countries experiencing malaria elimination.

A Comprehensive Overview of the Paradigm of Laboratory Findings in the Diagnosis of the Pandemic Coronavirus Disease 2019 (COVID-19) in India

COVID-19 is a pandemic disease caused by 2019 Novel Coronavirus or SARS-CoV-2. As this disease is highly contagious and rapidly spreading, so all countries have to increase their level of preparedness, alert, and response to identify, manage, and care for new cases of COVID-19;laboratory testing is an integral part of this strategy. Accurate results by laboratory diagnosis are beneficial for public health.

Frequency of Rotavirus among under 5 Children Admitted to Wad Madani Pediatric Teaching Hospital with Diarrhea, Gezira State, Sudan (2021-2022)

Rotavirus is the leading cause of acute gastroenteritis and responsible for 20% of death in children under 5 years of age approximately 111 million episodes of gastroenteritis due to Rotavirus in under 5 children, which result in 25 million visits to clinic, 2 million hospitalization and 352,000 - 592,000 deaths. Children in the poorest countries account 82% of rotaviruses death. Diarrhea disease are major cause of death and disease among children under five years, a child on average suffers 2 to 3 attacks of diarrhea every year. Stools samples were collected from 196 children suffering from diarrhea and were tested for rotaviruses by immune chromatography test antigen (ICT-Ag), ELISA and RT PCR The data were analyzed using statistical package for the Social Sciences (SPSS). The results showed that prevalence of rotavirus was 26/196 (13.3%) by ICT Ag and ELISA and confirmed by RT-PC R. 87.8% of the children were vaccinated by Rota vaccine, 70% of their mothers not using soap for cleaning the children and thought diarrhea not infectious disease and believed it was caused by teething. In conclusion there was a decrease in prevalence of diarrhea by Rotavirus due to insertion of Rota vaccine in routine vaccination, rotavirus infection mostly occurs in poor family that not able to provide safe water and due to poor sanitation and low education of mother beside that some children suffered from malnutrition, so it recommended to incorporate ELISA as a diagnostic tool in routine diagnosis of rotavirus among children suffered from gastroenteritis.

Alterations in the Results of Biochemical Laboratory Tests Due to the Administration of Antihypertensive Drugs

Objective:Perform a literary review of the interference in the results of biochemical laboratory tests caused by antihypertensive drugs.Methods:This is a review of the scientific literature with descriptive research performed according to the PRISMA model using the databases PUBMED,SCIELO,MEDLINE,LILACS,and searches of Brazilian Ministry of Health and Federal Pharmacy Council publications,reagent kits and package inserts approved by ANVISA.Literature and papers in Portuguese and English were selected,prioritizing the years 2010 to 2020.Results:The diuretic class of antihypertensive drugs causes decreases glucose tolerance,thus resulting in an increase in triglycerides.In long-term use,the drug captopril can increase serum levels of potassium,creatine kinase and decreases blood sodium.Methyldopa causes an increase in AST levels.Propranolol is associated with an increase in triglyceride levels and a decrease in HDL and glucose levels.The constant use of losartan results in an increase in HDL,a decrease in uric acid levels and a slight and transient increase in transaminases.In the Gold Analisa,Bioclin and Labtest reagent kits,most of the alterations occur due to the increase in levels of serum biomarkers according to the class of the antihypertensive drug.Conclusions:Biochemical alterations in serum can result in false-positive or false-negative reports,since it can be observed that most of the dosages caused increases due to the physiological effect of the drugs.The antihypertensive drugs that showed the highest incidence of interference were captopril,atenolol,losartan and propranolol.

Isolation and Identification of Salmonella pullorum

[Objective] The paper was to explore the cause of disease with symptoms of swelling joint, blanc-loose stool and few deaths, so as to provide suggestions and effective measures for diagnosis and control of the disease in chicken farm. [Method] The diseased chick samples were collected for bacteriological examination. Through bacterial isolation culture, PCR identification, biochemical test and animal test, 5 strains of S. pullorum were identified. [Result] When the isolates were inoculated into SPF chicks, the same disease cases with natural infection could be reproduced. [Conclusion] S. pullorum is the major cause of the disease in chicken farm.

Knowledge of Covid-19 among Medical Scientists in Nigeria

Background: The impacts of the ongoing COVID-19 pandemic have created a need for constant improvement in the effectiveness and efficiency of laboratory diagnosis to contain the spread, aid the treatment and management of positive cases. Inadequate knowledge of COVD-19 and its laboratory diagnosis among medical scientists is detrimental to the reliability of laboratory results, which are critical in the control, and management of the COVID-19 pandemic. The purposes of this study are to determine the knowledge of COVD-19 and to assess the knowledge of laboratory diagnosis of SARS-CoV-2 among medical scientists. Methodology: An internet-broadcasted and validated questionnaire was used to obtain data from 131 medical scientists in Nigeria. The generated data were analyzed using IBM SPSS Statistics version 25. Results: More than half of respondents had good general knowledge and causes (52%), mode of transmission (52.7%), and symptoms (54.2%) of COVID-19. However, only a few (<40%) knew the hallmark of laboratory diagnosis of COVID-19 and Coronavirus detection steps in the right order (45%). Surprisingly, age (F-ratio = 2.729 p = 0.032), gender (χ2 = 4.173;p = 0.041) and level at work (F-ratio = 3.552, p = 0.016) have significant effects on the knowledge of COVID-19 and knowledge of laboratory diagnosis of SARS-CoV-2 among the study participants. Conclusion: There is a need for improvement in the knowledge of COVID-19 diagnosis through relevant work level (work experience) and gender-based training as well as continuous professional development programs for medical scientists in Nigeria.

Investigation on detection of Haemophilus ducreyi by Polymerase Chain Reaction

Objective:To investigate the application of polymerase chain reaction (PCR) detection of Haemophilus ducreyi in clinical diagnosis of chancroid. Methods: Nucleotide sequences of 16srRNA gene specific for H. dureyi were used to develop primer sets for amplification of two strains. The amplified products were tested via PCR and sequenced by electrophoresis in a 1.5% gel.These products were compared with those of heterogeneous species or related bacteria to test the specificity of the PCR assay. PCR amplification with different concentrations of H.ducreyi was performed to test its sensitivity. Results: PCR amplification of two strains of H. ducreyi produced a single band of expected 438bp length. The sequence was identified with genomic DNA. None of the other 19 reference species amplified under the same conditions gave this result. The highest sensitivity of PCR assay in the present test was 10ng/L. Conclusions: PCR assay for detection of H. ducreyi is a rapid, specific, and sensitive detection method. If laboratory conditions are strictly controlled, PCR assay is a potentially useful laboratory test for H. ducreyi infection diagnosis.

Laboratory response to an infant with suspected measles vaccine associated fever and rash in Sri Lanka

Background:Measles is a highly contagious illness.Sri Lanka(SL)has eliminated the measles in 2019.The coun-try is at risk of importation of measles and there could be vaccine-associated measles like illnesses.Therefore,it is important to investigate patients with fever,rash to differentiate the wild-type from vaccine-type exclud-ing other suspected pathogens to direct infection prevention and control strategies.The objective is to describe the laboratory investigation procedure in an immunocompetent child,developed fever,rash following measles containing vaccine in post-measles eliminated period,SL.Methods:This laboratory based investigation was carried out in National Measles Laboratory,SL.Blood and throat swab were received from a patient with fever,rash,cough and coryza developed at tenth day of receiving the measles containing live-attenuated vaccine.Samples were tested for measles,rubella,and other relevant pathogens according to the laboratory testing algorithm for an immunocompetent child with fever,rash and flu like symptoms.Results:Measles vaccine type A,Edmonston-strain virus was detected after sequencing in throat swab and measles IgM and IgG were positive at sixth-week of illness-onset.In addition,influenza A RNA was detected in throat swab at day-three with detectable parvoB19 IgM in blood sample received at sixth-week of post-onset symptoms.Conclusions:Measles like illness of this immunocompetent child who received measles containing vaccine could be due to measles vaccine-type A or influenza infection.In a measles eliminated,resource-limited setting in SL,there should be a well-defined,testing algorithm to exclude prevalent possible pathogens according to epidemiological and clinical information.

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Laboratory Characterizations on 2007 Cases of Monoclonal Gammopathies in East China

Monoclonal gammopathies are characterized by the presence of monoclonal immunoglobulin in patients with or without evidence of multiple myeloma （MM）, macroglobulinemia, amyloidosis （AL）, or a related plasma cell proliferative disorder. This study aims to evaluate laboratory diagnostic characters of monoclonal gammopathies and investigates the correlation between monoclonal gammopathies and transforming growth factor β1 （TGFβ1）. Immunofixation electrophoresis （IFE）, serum protein electrophoresis （SPE）, nephelometry and urine light chain ELISA were used for laboratory identification of monoclonal immunoglobulins. Plasma TGFβ1 was detected with double-antibodies ELISA. Lightcycler was used for single nucleotide polymorphism （SNP） analysis. Totally 2,007 cases of monoclonal immunoglobulin （M protein） were identified in 10,682 samples. The isotypes of M protein were IgG type 47.1%, IgA 23.0%, IgM 8.7%, IgD 5.3%, free light chain κ 6.1%, λ 9.8%. In reference to IFE, the coherency of diagnosis was serum light chain ratio （κ/λ） 94.4%, quantitation of Igs 83%, light chain quantitation 80.9%, and urine light chain ratio （κ/λ） 58.0%. Plasma TGFβ1 was elevated significantly compared to normal control. The allelic frequency of codon 10 （C 〉 T） was neither associated with the existence of the M protein nor with the M protein isotype. Monoclonal gammopathies can be identified with the combination of IFE, SPE, Igs quantitaion and urine light chain determination. Although TGFβ1, an important cytokine in immune regulation, was elevated in monoclonal gammopathies, the SNPs in coding region of TGFβ1 gene did not confer susceptibility to the development of monoclonal gammopathies in this study. Cellular ＆ Molecular Immunology. 2008;5（4）： 293-298.

Clinical and laboratory features of preleukemia patients

Objective To explore prospective diagnostic criteria for preleukemia.Methods A case control study was done comparing the discrepancies on clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH).Results There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in the bone marrow; (2) immature granulocytes in the peripheral blood; (3) ≥2.0% myeloblasts in the bone marrow; (4) positive periodic acid schiff (PAS) stained nucleated erythrocytes; (5) myeloid differentiation index ≥1.8; (6) typical colonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM)】4.0. The following criteria were assigned: A: to meet variable one and at least two of the other seven variables and B: to meet at least four of the eight variables. All of the patients with preleukemia met either A or B and none of the patients with CAA or a-PNH did. Conclusions Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for its prospective diagnosis.

Bites from the same dog,different outcomes for two patients:a case report

Background:Rabies is a serious reemerging zoonosis in China.At present human rabies cases are primarily diagnosed based on clinical presentation.Case presentation:In August 2012,a woman and her son were attacked by a stray dog in Henan,China.The son received rabies postexposure prophylaxis(wound treatment followed by vaccine,no immunoglobulin),however,the mother did not.Rabies infection was subsequently laboratory confirmed in the mother and she died in December;her son is alive and healthy after 2 years of follow-up.Conclusion:This report documents that the timely utilization of postexposure prophylaxis is a required measure in preventing rabies after exposure to an animal bite.