Quantitative Proteomics of COVID-19 Recovered Patients Identifies Long-Term Changes in Sperm Proteins Leading to Cellular Stress in Spermatozoa.

Following an initial recovery, COVID-19 survivors struggle with a spectrum of persistent medical complications, including fatigue, breathlessness, weight loss, hair loss, and attention deficits. Additionally, there is growing evidence of adverse effects of COVID-19 on the male reproductive system. This investigation seeks to understand the long-term ramifications on male fertility by examining hormonal profiles, semen parameters, and sperm proteome of recovered COVID-19 patients compared to controls. The serum hormone profiles between the two groups showed minimal variations except for prolactin, cortisol, and testosterone levels. Testosterone levels were slightly lower, while prolactin and cortisol were elevated in COVID-19 cases compared to controls. Though semen parameters exhibited no significant disparities between the COVID-19 and control groups, quantitative proteomics analysis revealed changes in sperm proteins. It identified 190 differentially expressed proteins, of which 161 were upregulated and 29 downregulated in COVID-19 cases. Western blotting analysis validated the differential expression of serpin B4 and calpain 2. Bioinformatics analysis signifies cellular stress in the spermatozoa of COVID-19 recovered patients and thus, SOD and MDA levels in semen were measured. MDA levels were found to be significantly elevated, indicating lipid peroxidation in COVID-19 samples. While the effects of COVID-19 on semen parameters may exhibit a potential for reversal within a short duration, the alterations it inflicts on sperm proteome are persisting consequences on male fertility. This study paves the path for further research and emphasizes the significance of comprehending the complex molecular processes underlying the long-term consequences of COVID-19 on male reproductive health.

A Combination of Inflammatory and Hematological Markers is Strongly Associated with the Risk of Death in Both Mild and Severe Initial Disease in Unvaccinated Individuals with COVID-19 Infection.

Background: Inflammatory and hematological markers are used extensively for early prognostication and monitoring in COVID-19.We aimed to determine whether routinely prescribed laboratory markers can predict adverse outcome at presentation in COVID-19. Methods: This retrospective observational study was performed on 401 samples collected between July to December 2020 from COVID-19 positive subjects, admitted at All India Institute of Medical Sciences, Delhi, India. Clinical details and laboratory investigations within 3 days of COVID-19 positivity were obtained. Clinical outcomes were noted from patient medical records, till discharge or death. Laboratory parameters, with individually defined cut-offs, were used, either singly or in combination to distinguish survival and death for those having severe and non-severe disease at initial presentation. Findings: Total Leukocyte count, Absolute neutrophil count, Neutrophil to Lymphocyte ratio, C-Reactive Protein (CRP), Interleukin-6 (IL-6), Lactate Dehydrogenase, Ferritin and Lymphocyte to CRP ratio (LCR) were significantly altered at presentation in severe COVID-19 as compared to non-severe cases; and, also in those who died due to COVID-19 compared to those who survived. A combination of four markers, CRP (≥3.9mg/dL); IL-6 (≥45.37pg/ml); Ferritin (≥373ng/mL); 1/LCR ≥0.405 was found to strongly predict mortality in cases with non-severe presentation as also in severe cases. Conclusion and Interpretation: The combination of routinely used markers, CRP, IL-6, Ferritin and 1/LCR can be used to predict adverse outcomes, even in those presenting with mild to moderate disease. This would identify subset of patients who would benefit from closer monitoring than usual for non-severe disease.

Prevalence and Risk Factors of Soil-Transmitted Helminthic Infections in the Pediatric Population in India: A Systematic Review and Meta-Analysis.

Soil-transmitted helminths (STH) is a major healthcare challenge in the pediatric age group affecting poor and deprived parts of our community. The main species that infect people are roundworm (AL, Ascaris lumbricoides ), whipworm (TT, Trichuris trichiura ), and hookworms (HW, Ancylostoma duodenale and Necator americanus ). We aimed to estimate the pooled prevalence of STH infections in India in the pediatric age group (< 18 years) and assess the risk factors associated with STH in this age group. Three databases were searched (PubMed, Scopus, and Embase) up to February 16, 2021 with deliberate and inclusive search terms for original research articles estimating the prevalence of either of the three STH in India. Data extracted included individual prevalence of the three STH, prevalence of double or triple infections, and associated risk factors. We identified systematically 1,408 publications, of which 44 were included for the final analysis, including studies from 20 states covering 34,590 children. In our study, the prevalence of AL ranged from 0.8 to 91% with a pooled prevalence of 25%, prevalence of TT ranged from 0.3 to 72% with a pooled prevalence of 13%, and for HW prevalence ranged from 0.2 to 80% with pooled prevalence of 10%. Two most important risk factors with higher odds ratio were open defecation practices or open latrine (odds ratio: 5.2) and washing hands without soap using water only (odds ratio: 2.49). Knowledge of areas with high prevalence of STH and associated risk factors would help in designing effective control strategies in the high-risk groups to prevent infection and aid in a drastic reduction of morbidity in children.

Evaluation of Erythrocytes Magnetized Technology for Measurement of ABO Isoagglutinin Titers.

Background A variation in the measurement of ABO antibody titer has been seen among different laboratories due to lack of standardization. In our study, we aim to evaluate automated ABO isoagglutinin titer measurements by erythrocytes magnetized technology (EMT) and compare with conventional tube technique (TT). Methods We performed ABO isoagglutinin titration on samples received in a reference laboratory during a period of 2 months. A total of 134 tests for immunoglobulin G (IgG) titer and 116 for immunoglobulin M (IgM) for anti-A or anti-B were included in the study. Samples were processed for ABO isoagglutination titers by both TT and EMT by QWALYS-3 (DIAGAST, France). Microsoft Excel was used to compile data, for all calculations, and to draw graphs and plots. The number and percentage of cases within ±1, ±2, or ±3 titer difference (TT-EMT) were calculated. Results Median titers and their ranges obtained by EMT were higher or equal to those by TT for all IgM and IgG ABO-antibodies in all blood group (BGs), except anti-A IgM in (BG) O that was lower by EMT (32 [4:128]) than TT (48 [8:256]). One twenty one (121/134, 90.3%) cases of IgG titer showed an agreement by both methods (within ± one titer difference). One hundred seven cases (107/116, 92.2%) for IgM titer were within one titer difference by both the methods. Conclusion Results of titration by EMT-based automated instrument QWALYS-3 and conventional TT may vary by one titer dilution in the majority of cases. Use of consistent method for patient management is, therefore, advised.

Medical postgraduate (MD) program in Laboratory Medicine in India: The Past, Present and Future.

A medical postgraduate course in the field of Laboratory Medicine for the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree holders has existed for more than two decades in India, initiated and offered by the All India Institute of Medical Sciences, New Delhi, which was created under the special Act of Parliament of India 1956. This course has recently been included in the draft of National Medical Commission's Post Graduate Regulation 2021 list of medical courses, and the foundation guidelines have been laid for other medical colleges and teaching hospitals across the country to start this course. This article, written purely in academic interest, describes the past, present and future of this postgraduate training program in India with an aim to answer several doubts regarding this unique and holistic course with a view to providing a direction to those who are willing to become a laboratory physician through this post-graduation.

Interference in Ion-Selective Electrodes Due to Proteins and Lipids.

BACKGROUND: Ion-selective electrodes (ISE) have become the mainstay of electrolyte measurements in the clinical laboratory. In most automated analyzers used in large diagnostic laboratories, indirect ISE (iISE) -based electrolyte estimation is done; whereas direct ISE (dISE) -based equipment are mostly used in blood gas analyzers and in the point-of-care (PoC) setting. CONTENT: Both the techniques, iISE as well as dISE, are scientifically robust; however, the results are often not interchangeable. Discrepancy happens between the two commonly due to interferences that affect the two measuring principles differently. Over the last decade, several studies have reported discrepancies between dISE and iISE arising due to abnormal protein and lipid contents in the sample. SUMMARY: The present review endeavors to consolidate the knowledge accumulated in relation to interferences due to abnormal protein and lipid contents in sample with the principal focus resting on probable solutions thereof.

Screening peripheral blood smear: A tale of the "TAIL".

Examining a well-stained slide in a systematic manner is the key to being a good pathologist. For a blood smear, it involves examining first at low power (40× or 100×) for broader details and then going on to high power (400×) for finer details, from the tail end to the body of the slide. The 'tail end' is the key to early diagnosis.

Comparison of Two High-Pressure Liquid Chromatography Instruments Bio-Rad Variant-II and Tosoh HLC-723G11 in the Evaluation of Hemoglobinopathies.

Hemoglobin High-performance liquid chromatography (Hb HPLC) is a standard first-line technique for diagnosis of thalassemia and hemoglobinopathies. We compared two HPLC systems for detection and quantification of normal and abnormal Hb fractions. EDTA samples from 100 normal healthy subjects and 107 subjects affected with hemoglobinopathies or carriers were analysed using HPLC systems Tosoh HLC-723G11 and Bio-Rad Variant-II. Retention time (RT) and area of peaks for HbA2, HbF and other structural variants were compared. In discrepant cases samples were run on Sebia Capillary zone electrophoresis (CZE) for confirmation of results (39 out of 107 cases with HbE, HbD Iran, Hb Lepore and HbQ). Measurement of HbA2 and HbF in normal samples and HbF in those with variant Hbs showed good correlation by both analyzers (R 2 = 0.83, 0.9 and 0.99 respectively). HbE co-elutes with HbA2 in Bio-Rad. Correlation done using the apparent HbA2 concentration from Bio-Rad with (HbE + HbA2) from Tosoh G11 showed good correlation (R 2 = 0.97). Correlation of HbS (Eluting at S-window at RT 3.11 min in Tosoh G11 and 4.33 min in Bio-Rad) as well as HbD Punjab (Eluting at D-window at RT 2.82 min in Tosoh G11 and 4.06 min in Bio-Rad) by both instruments was good. HbD Iran (Eluting at E-window at RT 2.69 min in Tosoh G11 and with HbA2 at 3.53 min in Bio-Rad); HbQ (Eluting at C-window at RT 3.78 min in Tosoh G11 and unknown window at 4.7 min in Bio-Rad), HbH (Eluting at P00 window at RT 0.13 min in Tosoh G11 and giving pre-integration peak in Bio-Rad), Hb Lepore (Eluting at P08 window at RT 2.67 min in Tosoh G11 and with HbA2 at 3.46 min in Bio-Rad) gave comparable results. Correlation with findings of CZE was done in few cases when needed. Two automated HPLC instruments demonstrated similar usefulness for screening patients for hemoglobinopathies. However, complex elution patterns as well as co-elution of variants like HbA2, HbE, Hb Lepore, HbD Iran (in Bio-Rad); HbD Iran and HbE (Tosoh G11) pose difficulty in interpretation. A complementary second method like CZE may be required.

Discrepancies in Electrolyte Measurements by Direct and Indirect Ion Selective Electrodes due to Interferences by Proteins and Lipids.

Objectives We aim to report the simultaneous effect of different protein and lipid concentrations on sodium (Na + ) and potassium (K + ) measurement by direct and indirect ion selective electrodes (dISE and iISE) in patient samples. Materials and Methods Na + and K + were measured in 195 serum samples received in the laboratory using iISE by Roche Modular P800 autoanalyzer and using dISE by XI-921 ver. 6.0 Caretium electrolyte analyzer. Serum total protein (TP), cholesterol (Chol), and triglycerides (TG) were measured using conventional photometric methods on Roche Modular P800 autoanalyzer. Differences for each pair of results for Na + (Diff_Na + = [Na + dISE- Na + iISE ]) and K + (Diff_K + = [K + dISE- K + iISE ]) were calculated. Patient subgroups with high, normal, or low TP (< 5, 5-7.9, or ≥ 8 g/dL), Chol (< 150, 150-299, or ≥300 mg/dL), or TG (< 150, 150-299, or ≥300 mg/dL) were compared using analysis of variance. Note that 95% confidence interval of Diff_Na + and Diff_K + were calculated to see the number of samples showing clinically significant differences. Results Diff_Na + ( p = 0.007) and Diff_K + ( p = 0.002) were found significant between samples with normal and high TP. However, effect of TG was not significant. Chol concentration affected Diff_Na + significantly between low versus normal ( p = 0.002), and high versus normal ( p = 0.031) Chol groups. Diff_K + was significant ( p = 0.009) between low versus normal Chol. Clinically relevant disagreement of ≥|5| mmol/L for Na + was observed in high percentage of samples including all subcategories; however, for K + only 3.6% of the total samples showed disagreement of ≥ |0.5| mmol/L. A multivariate regression equation based on fit regression model was also derived. Conclusion Summarily, interchangeable use of electrolyte results from dISE and iISE is not advisable, especially in a setting of hyperproteinemia (≥8 g/dL) or hypercholesterolemia (≥300 mg/dL); more so for Na + .

Doctors and Padma awards.

UNLABELLED: BACKGROUND; The announcement of the annual Padma awards in January always generates a great deal of interest as well as controversy and, some believe that many good candidates are excluded and many less deserving ones included. We analysed the recipients in the field of medicine to determine whether or not a pattern emerged regarding who were bestowed these honours. We were not able to objectively evaluate whether or not the honours were 'deserved'. METHODS: We obtained and then analysed the list of awardees from newspapers and the official website of the Ministry of Home Affairs. Between 2000 and 2010, a total of 1166 awards were announced, of which 157 (13.4%) were in the field of medicine. We excluded foreigners and those from 'alternative' fields (20), and evaluated the remaining 137 in detail. RESULTS: Sixty-two (45.3%) recipients were from Delhi, 18 (13.1%) from Maharashtra and 17 (12.4%) from Tamil Nadu. Of the 137 awardees, 31 (22.6%) were cardiologists or cardiac surgeons. Many large states of the country, such as West Bengal, Gujarat, Rajasthan, Madhya Pradesh, Punjab and Haryana, did not have a single awardee. CONCLUSION: The over-representation of Delhi and cardiology in the Padma awards for medicine suggests that their distribution is not entirely fair.