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Publications (52)
Original Research Articles Brief Communication: More Chat about Chatbots Assisting with Routine Clinical Biochemistry Queries Rucita Severaj, Nareshni Moodley and Verena Gounden* Department of Chemical Pathology, Inkosi Albert Luthuli Central Hospital, University of KwaZulu Natal and National Health Laboratory Service, 800 Vusi Mzimela Road, Cator...
Introduction
Exposure to Bisphenol A (BPA) during early development particularly in-utero has been linked to a wide range of pathology. Over the last two decades the importance of vitamin D in maternal and child health has been highlighted. The aim of this pilot study was to examine the relationship of BPA and its naturally occurring metabolite BPA...
Background:
Inappropriate testing remains a high healthcare cost driver. Tumour marker tests are more expensive than routine chemistry testing. Implementing test demand management systems like electronic gatekeeping (EGK) has reportedly decreased test requests.
Objective:
This study aimed to describe the appropriateness of tumour marker tests, c...
Background:
Sigma metrics is a quantitative management tool. This study assessed the Six Sigma score for 26 chemistry analytes, compared scores with different total allowable errors (TEa) and use of scores for internal quality control (IQC) rules in 4 Laboratories in Kwa-Zulu Natal, South Africa.
Methods:
Utilizing 6 months of IQC SD, CV, and bi...
Background: The International Myeloma Working Group and College of American Pathologists recommend a 24-h urine collection to determine the Bence Jones protein (BJP) excretion level for monitoring treatment response in patients with multiple myeloma (MM). There are several issues related to sample collection and the method is prone to inaccuracy....
Exposure to Bisphenol A (BPA) during early development particularly in- utero has been linked to a wide range of pathology. The aim of this study was to examine the relationship of BPA and its naturally occurring metabolite BPA-glucuronide (BPA-g) with sex steroid hormone levels in South African mother-child pairs.
Third-trimester serum maternal sa...
Globally, there are an estimated 37.9 million people living with HIV and of these approximately 23.3 million are receiving anti-retroviral therapy. Thus, HIV infection, its sequelae and the complications related to treatment remain a significant cause of morbidity worldwide. Disorders of the endocrine system may present across the spectrum of HIV i...
This chapter provides an overview of the clinical presentation, pathophysiology, and laboratory testing required for diagnosing endocrine disorders of the anterior and posterior pituitary. The major focus of the chapter is to review the work up of hypopituitarism and secretory tumors of the Pituitary gland. Detailed information is provided with reg...
Objectives
Rejections of clinical chemistry specimens delays the availability of results, which may impact patient management. The study aims to measure sample rejection rate, identify reasons for sample rejection, evaluate the effect of a campaign to reduce rejection rates and discover which clinical units produced the most insufficient specimen....
Exposure to Bisphenol A (BPA) during early development particularly in- utero has been linked to a wide range of pathology. The aim of this study was to determine serum levels of BPA and its naturally occurring metabolite BPA-glucuronide (BPA-g) in South African mother-child pairs.
Method:
Third-trimester serum maternal samples and matching cord...
Background
Peritoneal dialysis (PD) is an easily implementable dialysis modality in end-stage renal disease (ESRD). PD may improve access to renal replacement therapy in low- and middle-income countries; however, these countries have a higher prevalence of protein-energy wasting in patients and poorer socioeconomic conditions. We evaluated the effe...
The pituitary gland is responsible for the production and/or secretion of various hormones that play a vital role in regulating endocrine function within the body. Secretory tumors of the anterior pituitary predominantly, pituitary adenomas, collectively account for 10%–25% of central nervous system tumors requiring surgical treatment. The most com...
Background
In a phase 2 short‐term (6 months) study of patients with congenital adrenal hyperplasia (CAH), continuous subcutaneous hydrocortisone infusion (CSHI) was found to be a safe, effective, and well‐tolerated method of replacing cortisol with improved disease and patient related outcomes.
Objective
Evaluate the safety and efficacy of long‐t...
Hypertension in childhood leads to hypertension in adult life, the strongest risk factor being obesity. This study determined the prevalence of primary hypertension and its risk factors in Grade XII learners in KwaZulu-Natal, South Africa, from March 2016 to June 2017. Weight, height, body mass index (BMI), random finger prick cholesterol and gluco...
Background:
The estimation of glomerular filtration rate (GFR) plays a vital role in assessment of the renal function. This study evaluated the performance of the CKD-EPIcreat and MDRD equations in the South African Kwa-Zulu Natal population.
Objectives:
The objectives if the study were to compare the of CKD-EPIcreat and MDRD equations in the se...
Chronic kidney disease is currently assessed by estimated glomerular filtration rate, a mathematical construct based on creatinine or creatinine and cystatin concentration. Creatinine-based equations have improved with standardization efforts and the Modification of Diet in Renal Disease Study (MDRD) and CKD-Epidemiology Collaboration Study (CKD-EP...
Background
The use of serum creatinine equations for estimating glomerular filtration rate is well known in adults and children. We evaluated the revised Schwartz creatinine-based estimated glomerular filtration rate prediction equation in Black African children in KwaZulu-Natal, South Africa.
Methods
Review of medical records of all Black African...
Context:
Classic congenital adrenal hyperplasia (CAH) management remains challenging, as supraphysiologic glucocorticoid doses are often needed to optimally suppress the ACTH-driven adrenal androgen overproduction.
Objective:
To approximate physiologic cortisol secretion via continuous subcutaneous hydrocortisone infusion (CSHI) and evaluate the...
Background:
Serum creatinine (SCr) levels are decreased following traumatic amputation, leading to the overestimation of glomerular filtration rate (GFR). β-Trace protein (BTP) and β2-microglobulin (B2M) strongly correlate with measured GFR and have not been studied following amputation. We hypothesized that BTP and B2M would be unaffected by trau...
Objective:
The main drawback of the periodic analysis of quality control (QC) material is that test performance is not monitored in time periods between QC analyses, potentially leading to the reporting of faulty test results. The objective of this study was to develop a patient based QC procedure for the more timely detection of test errors.
Met...
Background:
High doses of Eltrombopag have been previously reported to cause bilirubin interference. Following receipt of a sample from a patient receiving high-dose Eltrombopag therapy, the laboratory decided to investigate the effect of this drug on routine chemistry testing.
Methods:
Interference studies were performed by spiking Eltrombopag...
A turbid-appearing pleural fluid sample from a 15-year-old boy was received by our laboratory for biochemical analysis (Fig. 1). Clinical history revealed that the patient was receiving antiretroviral therapy and presented with bilateral pleural effusions. Biochemical results for the pleural fluid yielded an albumin 14 g/L and LDH 245 …
The treatment goal in congenital adrenal hyperplasia (CAH) is to replace glucocorticoids while avoiding androgen excess and iatrogenic Cushing's syndrome. However, there is no consensus on how to monitor disease control. Our main objectives were to evaluate hormonal circadian rhythms and use these profiles to identify optimal monitoring times and n...
Carfilzomib-lenalidomide-dexamethasone therapy yields deep responses in patients with newly diagnosed multiple myeloma (NDMM). It is important to gain an understanding of this combination's tolerability and impact on minimal residual disease (MRD) negativity because this end point has been associated with improved survival.
To assess the safety and...
We evaluated the accuracy and precision of creatinine- and cystatin C-based prediction equations for estimating glomerular filtration rate (eGFR) compared to measured GFR (mGFR) in an antiretroviral-naive human immunodeficiency virus (HIV) population.
The study population consisted of 100 treatment-naive HIV patients. GFR was estimated using the Co...
There is an unmet need for identifying new clinical biomarkers in chronic Graft-versus-Host-disease (cGVHD) suitable for diagnosis and disease monitoring. Circulating autoantibodies represent an ongoing immune response and suggest a pathogenic role for B cells in cGVHD. Autoantibodies could be useful markers of cGVHD disease activity, severity or o...
Metabolic acidosis is a clinical disturbance characterized by a decreased blood pH. The condition is commonly recognized using laboratory investigations that include blood gas analysis and bicarbonate determination. Apart from detecting and confirming the presence of metabolic acidosis, laboratory investigations are important to assist in identifyi...
Background: We evaluated the clinical validity of serum FT4 measurements by assessing its correlation with log TSH. To provide pediatric reference intervals (representative ranges) for FT4, and TSH on the Architect ci8200 integrated system. Methods: This population-based study encompassed 6023 children (3369 females and 2654 males). The percentile...
BACKGROUND: Early treatment with lenalidomide and dexamethasone delays progression and increases overall survival in patients with high-risk smoldering multiple myeloma. The addition of the selective proteasome inhibitor carfilzomib to a lenalidomide and dexamethasone backbone has proven effective in patients with newly-diagnosed multiple myeloma;...
A falsely high cerebrospinal fluid (CSF) total protein (TP) result measured by pyrogallol red (PGR) method was suspected to be caused by preparation of the collection site with povidone-iodine (PVP-iodine) solution.
CSF TP was evaluated for interference in samples with different final concentrations of PVP-iodine (up to 0.25% PVP and 0.025% iodine)...
Background
It is common practice in most chemical pathology laboratories for reflective immunofixation electrophoresis (IFE) to occur following the detection or suspicion of a paraprotein on serum protein electrophoresis (SPEP). The chemical pathology laboratory at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, South Africa, is currently...
The diagnosis of subclinical hypothyroidism is defined as the presence of an elevated thyroid stimulating hormone (TSH) with a normal free thyroxine (FT4) level. The commonly used direct analogue immunoassays for the measurement of FT4 have been shown to have poor performance at the upper and lower limits of the FT4 reference interval.
The purpose...
To the Editor:
The availability of accurate and appropriate reference intervals is imperative for proper screening, diagnosis, and monitoring of disease. It is therefore with great interest that we read the recent reports (1, 2) by the CALIPER (Canadian Laboratory Initiative for Pediatric Reference Intervals)1 group. The efforts of the CALIPER pro...
Several previous studies have described the effects of interfering substances on clinical assay results; however, the effects of exogenous substances, particularly additives from blood collection tubes on quality control (QC) specimens and serum specimens have not been well examined. This study examines the effects of blood-collection tube additive...
South Africa has the largest prevalence of HIV infected individuals in the world. The introduction of point of care testing to anti-retroviral (ARV) clinic sites is hoped to fast track initiation of patients on ARVs and to allow for earlier recognition of adverse effects such as dyslipidaemia, renal and hepatic dysfunction.
We evaluated six instrum...
The 516G > T polymorphism in exon 4 of the CYP2B6 gene has been associated with increased plasma Efavirenz (EFV) concentrations. EFV concentrations greater than the recommended therapeutic range have been associated with the increased likelihood of developing adverse CNS effects. The aims of this study were to a) determine the presence of the 516G...
Side effect questionnaire. A copy of the questionnaire used to assess the presence of neuropsychiatric side effects post EFV initiation in study participants
