Medical Technology SA - Volume 26, Issue 2, 2012
Volume 26, Issue 2, 2012
Evaluating the success of implementing ISO 15189:2003 in a medical laboratory : peer reviewed original articleSource: Medical Technology SA 26, pp 10 –16 (2012)More Less
The introduction of the ISO standard 15189:2003 in March 2005 implied that South African National Accreditation System would assess medical laboratories against this standard. This study evaluated the success with which the National Institute for Communicable Diseases Laboratories converted to ISO 15189:2003. The research traces the process from the comparison of the existing standard with the ISO 15189:2003 standard, to the adjustment of policies, procedures and practices, and finally the assessment of the effectiveness of the conversion through internal and external audits. Analyses of the internal audits identified what aspects were not yet effectively addressed. A subsequent assessment by the South African National Accreditation System also identified a few non-conformances. These results clearly indicated that aspects of management responsibility, such as monitoring, staff development and maintenance, and safety and health were key aspects that impact on the quality management system of an organization.
Reference ranges for platelet indices using Sysmex XE-2100 blood analyser : peer reviewed original articleSource: Medical Technology SA 26, pp 17 –21 (2012)More Less
Sysmex XE-2100 is a blood cell analyser used to determine full blood counts and platelet counts; it also determines the platelet indices such as the mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW) and immature platelet fraction (IPF). These indices are not reported due to the lack of knowledge about their availability and local laboratory reference ranges. The aim of this study was to determine local reference ranges for platelet indices and to investigate whether a significant gender difference exists. The study population consisted of 30 males and 30 females between 18 and 60 years of age. A full blood count was performed using the Sysmex XE-2100 and the platelet count and indices were recorded. The following reference intervals were obtained for MPV - males 8.80-11.3fl, females 9 .00-12.50fl; PCT - males 0.19-0.39%, females 0.22-0.40%; PDW - males 9.30-14.30fl, females 9.80-16.00fl; IPF - males 0.70-5.50%, females 0.90-5.30%. The results of the study compared well with those of other studies, but differences were also found. A significant difference between the genders was obtained for platelet count and PCT (p < 0.05) while other indices did not show significant differences. This study illustrates the importance of determining local reference ranges, because populations, instruments and reagents may differ from published reference ranges. These reference ranges pave the way for the application of these indices in investigations into other disease states.
Incidence of aerobic spoilage- and psychrotrophic bacteria in non-pasteurised and pasteurised bovine milk from Maseru : peer reviewed original articleAuthor D. OlivierSource: Medical Technology SA 26, pp 22 –27 (2012)More Less
The presence of pathogenic bacteria in milk is a possible source of food-borne diseases. One hundred and sixty non-pasteurised and forty pasteurised milk samples from the Maseru area were analysed for the presence of bacteria. It is recommended by legislation that milk be free from pathogenic bacteria, and microbial counts must be within the ranges as stipulated in Regulation 1555 of 21 November 1997. Eighty seven of the non-pasteurised milk samples had high total aerobic bacterial counts that were not within the stipulated range for microbial counts as outlined in Regulation 1555, whereas twenty seven pasteurised milk samples had unacceptably high aerobic bacterial counts. Unacceptably high counts of E. coli were detected in thirty five of the non-pasteurised samples. Bacterial phosphatase was detected in seven of the pasteurised samples, indicating possible post-processing contamination. Listeria monocytogenes was isolated from five non-pasteurised milk samples and Listeria innocua was isolated from one sample. The presence of psychrotrophic Listeria could contaminate the milk processing plant rendering pasteurised milk unsafe for human consumption. Community members should be informed regarding the dangers of consuming non-pasteurised milk. Small-scale farmers should be educated regarding the dangers of Listeria infection in the herds.
Peroxidase activity and nuclear density analysis (PANDA ) in the diagnosis of acute promyelocytic leukaemia : peer reviewed short communicationAuthor W.J. MauleSource: Medical Technology SA 26, pp 28 –32 (2012)More Less
Acute promyelocytic leukaemia (APL) is a subtype of acute myeloid leukaemia (AML), which has both distinct biological and clinical features and is now highly curable. APL was first described by Hillestad in 1957 when he reported three patients, which he characterised by 'a very rapid fatal course of only a few weeks duration', with a white cell blood picture showing promyelocytes in excess and an allied severe bleeding tendency.
Source: Medical Technology SA 26, pp 33 –38 (2012)More Less
The growth of medical tourism in developing nations has not only helped the local economies but also has assisted patients from the developed world to seek treatment at a lower cost. However, the expansion of the sector has been stigmatized by the growth of organ trafficking that facilitates organ transplantation to those who can afford it. Although developing countries have been taking measures to prohibit the sale of organs, the large gap between demand and supply has fuelled a black market that involves the "brokers", the medical personnel and the poor whose abuse and exploitation is fuelled by the expansion of the sector and the illegitimate opportunities it creates on the side. The problem is exacerbated by the low supply in developed countries, where living potential donors appear to be misinformed about the process and hesitate to register as donors. The need for a nationwide campaign of awareness is urgently needed as the expansion of medical tourism has the potential of encouraging a further rise in organ trafficking.
An optimized method for the analysis of corticosterone in rat plasma by UV-HPLC : peer reviewed original articleSource: Medical Technology SA 26, pp 39 –42 (2012)More Less
Animal models are useful in the study of stress disorders in that they offer the possibility of stimulating a human condition under controlled conditions in a simpler, more readily understandable system. Stress-related activation of the hypothalamic-pituitaryadrenal (HPA) axis characterized by an increase in plasma corticosterone (CT) levels in the rat is an important manifestation of the physiological stress response. Current available methods for the determination of peripheral corticosterone concentrations from trunk blood, is via a commercially available radio immunoassay (RIA) kit. The aim of this study was to optimize and validate a sensitive, specific and cost-effective high performance liquid chromatography (HPLC) method for the determination of CT levels in plasma of rats. A 500 µl plasma sample was extracted with 5 ml dichloromethane and analyzed by HPLC coupled to a diode array detector at 245 nm. The standard curve was linear over a concentration range of 10 - 500 ng/ml (r2=0.996). The percentage recovery was above 85%, the relative standard deviation was less than 7% and the limit of quantification was 10 ng/ml. Results from this method were compared with values obtained from a RIA method and the values were in close proximity of each other. We conclude that the current HPLC method that was optimized and validated is suitable for use in subsequent studies in rats.
Prevalence of obesity and dyslipidaemia in a rural black community in Limpopo Province : peer reviewed original articleSource: Medical Technology SA 26, pp 43 –48 (2012)More Less
Introduction Obesity has reached the proportions of pandemia. About 1,7 million people worldwide have obesity-related problems. The increase in the prevalence of obesity is related to dyslipidaemia, cardiovascular disease and arterial thrombosis. Most of the studies concerning these conditions were conducted among urban residents and less in the low socioeconomic rural populations.
Aim To determine the prevalence of obesity and dyslipidaemia and, their relationship in a rural black population at Ga-Mothapo villages.
Methods Empirical, cross-sectional, prospective and quantitative community-based study. The sample consisted of 382 participants, 286 being females and 96 males aged 18-65 years. Fasting blood samples were analyzed for triglycerides, total cholesterol and high density lipoprotein cholesterol (HDL-C). Low density lipoprotein cholesterol (LDL-C) was calculated from total cholesterol, triglycerides and HDL-C using Friedewald formula. Height and weight were measured using a stadiometer and a weighing scale, respectively. Body mass index (BMI) was calculated from weight and height.
Results in Prevalences Overall prevalence rates were: 10.2% hypertriglyceridaemia, 9.9% hypercholesterolaemia, 6.3% low HDL-C, 13.6% high LDL-C, 23.6% obesity and 30% dyslipidaemia risk. Females prevalence rates were: 11.9% hypertriglyceridaemia, 11.2% hypercholesterolaemia, 6.7% low HDL-C, 15.7% high LDL-C, 29.4% obesity; male prevalence rates were: 5.2%, 6.3%, 4.2%, 7.3% and 6.3%, respectively.
Conclusion The study indicated high prevalence of obesity and dyslipidaemia in the rural population studied. Dyslipidaemia was found to be related to BMI. Dyslipidaemia increased with obesity and age in females but irregularly in males. Obesity and dyslipidaemia were thus, highlighted as health problems with risk for dyslipidaemia indicating a high risk for developing arterial thrombosis, cardiovascular disease and hypertension.
Source: Medical Technology SA 26, pp 49 –55 (2012)More Less
The immune system has evolved to protect the host from a universe of pathogenic microbes and eliminate toxic substances from the body. It is an interactive network of lymphoid organs, cells, humoral factors, and cytokines. The essential function of the immune system in host defence is best illustrated when it goes wrong: decreased activity results in severe infections and tumours of immunodeficiency, and increased activity in allergic and autoimmune disease. Immune cells scan for the occurrence of any molecule that they consider to be foreign to the body, and transformed cells acquire antigenicity, which is recognised as non-self. A specific immune response is generated, and it results in the proliferation of antigen-specific lymphocytes. Immunity is acquired when antibodies and T-cell receptors are expressed and up-regulated through the formation and release of lymphokines, chemokines and cytokines. Both innate and acquired immune systems interact to initiate antigenic responses against carcinomas. There is an increasing body of recent evidence to support the role that the immune system plays in eliminating pre-clinical cancers. Tumour infiltration by immune cells has been shown to have powerful prognostic significance in a host of cancer types. Cytotoxic therapies, including Low Level Laser Therapy (LILI) and chemotherapy, induce potentially immunogenic cell death, releasing tumour-associated antigens in the context of a 'danger' signal to the immune system. An understanding of the interaction between immune cells, tumour cells and treatment modalities will therefore guide the future combination of immunotherapy with conventional therapy to achieve optimal anti-tumour effects.