Deepak M Nayak

Discrepancy in Optical & Mechanical Method in Coagulation Tests in a Turbid Sample

Automated coagulation analyzers have replaced manual methods to meet the ever-increasing test load in many laboratories. Of the different methods, two distinct methods exist based on optical and mechanical clot detection (magnetic steel ball method). In optical method the detection of clot formation is measured by a change in optical density (OD) of a test sample. Mechanical clot detection technology, involves monitoring the movement of a steel ball within the test solution using a magnetic sensor. There are limited studies comparing both these methods and they have conflicting results regarding the effect of plasma turbidity on the final result. We report a case where a plasma factor (lipemia) caused prolongation of both PT and APTT, as measured by the photo optical method.

Primary biliary cirrhosis presenting as immune hemolytic anemia: A case report

The association between primary biliary cirrhosis (PBC) and autoimmune hemolytic anemia (AIHA) has rarely been reported in the literature. To this date, less than twenty five cases have been described. We came across a case of immune hemolytic anemia manifesting in a 21 year old female presenting with jaundice and lethargy. On examination besides pallor and icterus, no significant findings were elicited on clinical examination. The peripheral smear showed features consistent with hemolysis. The patient was placed on corticosteroids but the 6 week follow up did not show a rise in hemoglobin level. The bone marrow examination showed erythroid hyperplasia with few “Tart” cells. We advised a work-up for autoantibodies, which revealed positivity for anti-mitochondrial antibody (AMA). The patient was placed on immunemodulators and supportive therapy and has showed clinical and hematologic recovery.

Comparison of Photo–Optical and Mechanical Methods for Prothrombin Time Test

Background: The PT measures the activity of the so-called extrinsic and common pathways of coagulation. Automated coagulation analyzers have replaced the manual methods to meet the increasing test load in many laboratories. Two distinct automated or semi-automated methods exist based on optical and mechanical clot detection. Aim: To compare the reliability of prothrombin time test using mechanical and photo-optical methods in a semi-automated coagulation analyzer. Materials and methods: Prothrombin time data was collected retrospectively conducted on 100 samples run on mechanical & optical modes on Amax Destiny Plus™ analyzer (Trinity Biotech) in the month of November 2012. The standard deviation (SD), Coefficient of Variance (C.V.) & R² value were calculated. Results: The instrument results showed good precision and coefficient of variation. Statistical analysis demonstrated an excellent correlation between the photo-optical and mechanical methods for PT (R² 0.995). Conclusion: The results for the prothrombin time test obtained by the photo-optical detection method is reliable and is statistically equivalent as those obtained by the mechanical detection method.

Role of papanicolaou smear in the diagnosis of pathologic flora in asymptomatic patients in rural health care set-up

Introduction: The infections of female genital tract, especially the cervix are asymptomatic in presentation and pose a diagnostic challenge. Vaginal infections can lead to cytoplasmic and nuclear abnormalities in the epithelial cells. Additionally, these infections could augur an inflammatory response of varying nature. The most common flora include Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, Human Papilloma Virus (HPV), Human Herpes Virus (HHV) and Actinomyces sp.Aim: This study seeks to measure the role of Papanicolaou smear in detection of pathologic flora: Candida albicans, Gardnerella vaginalis, Trichomonas vaginalis, HPV, HHV and Actinomyces; in a rural health care set up amongst women in the reproductive and menopausal age group.Materials and Methods: A retrospective study of cervical smears by Papanicolaou method, over a 14 month period was carried out in a tertiary care centre including a total number of 150 patients.Results: Of the total of 150 samples examined, Candida species was the most frequently detected (8.7%) followed by Trichomonas vaginalis (5.3%) and Gardnerella vaginalis species (4.7%). HPV-induced changes were noted in a mere 2% of cases. Actinomyces species was noted in less than 1% of cases.Conclusion: The Papanicolaou test for examining cervical smear has definite uses in detecting vaginal microorganisms. Apart from detection of the usual pathogenic flora, the test has utility in defining the degree of inflammation and additional reparative changes