Hypoglycaemia is not a disease per se but a manifestation of underlying perturbations of glucose homeostasis. Among the biochemical tests commonly requested in newborns with confirmed, persistent/recurrent hypoglycaemia of unknown origin is the measurement of insulin and C-peptide in a blood sample(s) taken during the period of hypoglycaemia. Accepting an elevated insulin result with/without raised C-peptide as bona fide could trigger unnecessary investigations and/or diagnostic misapplications. The focus of this review is to highlight the significance of the "maternal-fetal-newborn" associations and the effect of transplacental transfer of two types of harmful IgG autoantibodies which could affect the measurements of insulin/C-peptide and confuse their interpretation. One is maternal insulin binding autoantibodies (IAA), a double whammy which can cause hypoglycaemia and distort insulin results due to insulin autoimmune syndrome (IAS also known as Hirata's disease). The other is non-IAA autoantibodies which if present, do not cause hypoglycaemia per se but interfere analytically causing fictitious hyperinsulinaemia if measured in infants with hypoglycaemia. IgM is not transferred but could be produced by the fetus and continue after birth. The presence of IgM in newborns' blood in substantial amounts occurs if a congenital infection is encountered in-utero or early neonatal period. IgM has also the potential to interfere in immunoassays causing fictitious results. Irrespective of insulin/C-peptide levels; maternal/obstetric history coupled with early tests for antibodies by polyethylene glycol (PEG) followed by confirmatory biochemical tests on both maternal and newborn samples would identify distorted/fictitious hyperinsulinaemia, thus helping appropriate interpretation of insulin/C-peptide results and avoids diagnostic misapplications.
Objectives:Brainstem dysfunction and brain death are important determinants of End-of-life care (EoLC) decisions in intensive care units (ICUs). In many low- and middle-income settings, withdrawal or withholding of life-sustaining treatment remain ethically and culturally challenging despite high costs and limited critical-care resources. This study reviewed the incidence, causes and outcomes of brainstem dysfunction/brain death and examined relatives' decisions regarding EoL care (EoLC) in a tertiary hospital ICU. Materials and Methods:A retrospective chart review was conducted in the ICU of the University College Hospital, Ibadan, covering March 2020- February 2022. Data were extracted from ICU nurses' spreadsheets and patients' case notes and analysed using IBM Statistical Package for the Social Sciences software. Descriptive statistics were used to summarise demographic variables, causes of brainstem dysfunction, duration of survival after diagnosis and family decisions about EoLC. Results:Among 232 ICU deaths during the study period, 24 (10.3%) were preceded by brainstem dysfunction or death. Males constituted 75% of affected patients. The leading causes were severe head injury (54%) and haemorrhagic stroke (21%). About 58% of patients died within 24-72 h of diagnosis and 37.5% had cardiac arrest before brainstem death. Prognosis was discussed with relatives in only 37.5% of cases. The gag and pupillary reflexes were the most frequently used diagnostic tests (100%), while apnoea testing was performed in 12.5% of cases. Conclusion:Brainstem dysfunction accounted for about one-tenth of ICU deaths, predominantly following trauma and stroke. Limited family counselling and cultural reluctance toward EoL decisions remain major challenges. Strengthening communication, ethical awareness and policy support for EoLC could improve patient management and optimise utilisation of limited ICU resources.
Objectives:Early palliative-care integration is recognised by the World Health Organization, American Society of Clinical Oncology and European Society for Medical Oncology as an essential component of comprehensive oncology care, yet referral practices in many low- and middle-income countries (LMICs) remain inconsistent. At our cancer care department in a private tertiary superspeciality hospital with integrated medical, surgical, radiation oncology and palliative care services, only 7.5% of newly registered patients with Stage IV cancer were being referred to the specialist palliative-care team. The objective of this palliative care quality-improvement project was to raise the referral rate to 25% within the next 6 months through structured, system-level interventions. Materials and Methods:Guided by the National Cancer Grid Enable Quality Improvement in the Patient Care-India programme and the Stanford promoting assessment and improvement of the cancer experience framework, we applied an A3-based Plan-Do-Study-Act cycle. A multidisciplinary team following this methodology refined the problem statement, created a SMART goal, mapped the process using GEMBA walk, performed root-cause analysis using fishbone diagram, formulated key drivers and an impact-effort matrix to prioritise interventions while maintaining a run chart. Key actions included (1) finalising and implementing consensus referral criteria, (2) placing placards in outpatient areas/sending referral criteria on e-mail, (3) ensuring mandatory documentation of treatment intent and referral status in electronic prescriptions and tumour-board reports respectively and (4) bi-monthly compliance audits. The primary outcome was the monthly percentage of patients with Stage IV cancer referred to palliative care, plotted on a run chart from November 2020 to July 2021. Results:During the study period, 537 patients with Stage IV cancer (range 35-72/month) were registered; 66 patients were referred to specialist palliative care (range 4-13/month). In the months of November and December 2020, the baseline referral proportion averaged 7.5%. After sequential implementation of the intervention bundle, referrals rose steadily, and an absolute increase of 10.8% was noted, reaching 18.3% in July 2021 despite pandemic-related limitations. Although the project fell short of its target which was 25%, informal oncologist-palliative-care dialogue and tumour-board documentation of treatment intent and referral status compliance improved. Due to COVID-19-related restrictions, certain activities, e.g. standees, Hindi patient leaflets, could not be implemented. Conclusion:This initiative demonstrates that targeted mentorship, locally tailored referral criteria and seamless workflow prompts, can substantially strengthen palliative care integration in oncology, laying the groundwork for durable culture change and better patient outcomes. Scaling similar QI models across services and institutions will be essential to normalise early palliative care as a core component of high-quality cancer care in LMICs.
Objectives:Cancer is a life-changing diagnosis that can cause a lot of emotional pain for both patients and their families. Alongside medical treatments, it is really important to have supportive methods in place that can help ease stress and improve overall well-being. This study aimed to assess the effectiveness of Laughter Yoga in reducing perceived stress among patients with cancer. Materials and Methods:This study employed a time-series, non-randomised control group design with pre-test and post-test measures, conducted within the oncology department of a tertiary care hospital. A total of 60 cancer patients were assessed for stress levels using the perceived stress scale (PSS-10). Participants in the intervention group received Laughter Yoga sessions 3 times per week, each lasting 30 min, over a period of 30 days. Post-intervention assessments were conducted on the 10th, 20th and 30th days for both the intervention and control groups through face-to-face interviews. Results:The findings revealed that the mean pre-test stress score in the intervention group was 33.6 ± 5.74, which significantly declined to 18.9 ± 7.45 following the intervention. In contrast, the control group maintained a relatively stable stress score of 32.53 ± 5.72. Statistical analysis indicated a significant difference in mean stress levels across various time intervals before and after the intervention (F = 383.4, p = 0.001). Post hoc Bonferroni tests further confirmed significant reductions in stress levels at each follow-up point, day 10, day 20 and day 30 when compared to baseline measurements (p = 0.001). Conclusion:The study demonstrated that Laughter Yoga was associated with a significant reduction in perceived stress among individuals with cancer, highlighting the importance of integrating such adjunctive therapies into oncology centres to better support patients experiencing varying levels of psychological distress.
Spirituality significantly shapes how individuals with cancer cope with illness and find meaning throughout the course of the disease. As cancer continues to impose a global burden, understanding these spiritual experiences is essential for holistic, patient-centred care. This scoping review synthesises existing evidence on the constructs and dimensions of spiritual experiences among adults with cancer. Following Arksey and O'Malley's scoping review framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, a systematic search was conducted using medical subject headings terms and keywords across PubMed, Google Scholar and other sources. Eligible studies included adults with confirmed cancer and examined their spiritual experiences. Qualitative, quantitative and mixed-method studies published in English were included. After screening 1,098 records, 133 studies met the inclusion criteria. Data were charted to summarise study characteristics and derive key themes. Among the 133 included studies, 73 were qualitative, 55 were quantitative and 5 were mixed-method. Research spanned 39 countries and included participants across the cancer progression from diagnosis to survivorship and palliative care. Publication trends indicated a steady increase in interest since 2000. Assessment of qualitative component identified core codes of (1) Relationship/Association with God or a Higher Power, (2) Spiritual Practices and Coping, (3) Inner Strength and Transformation, (4) Meaning-Making and Existential Themes, (5) Spiritual Responses and (6) Community and Interconnectedness. Patients frequently relied on prayer, faith and rituals as primary coping mechanisms. Many described inner transformation, strengthened resilience and renewed life purpose. Existential reflections on mortality and life's meaning were common. Some patients also reported spiritual struggles, including doubt or perceived abandonment, reflecting the multidimensional nature of spirituality. The present scoping review explores the multi-dimensional nature of experiences influencing coping, meaning-making, and emotional well-being across illness trajectories. The six identified categories reflect how patients draw on faith, practices, inner strength and community, while navigating through spiritual struggles. The wide variation in constructs and assessment tools underscores the need for more context-specific and culturally sensitive approaches. Integrating spiritual dimension into cancer care can support more holistic, patient-centred care and direction for future research in this area.
Objectives:Non-adherence to pharmacotherapy in an ambulatory palliative care setting can negatively affect therapeutic outcomes. Only a limited number of studies have explored the determinants of therapeutic compliance in the Indian palliative care context. This study aims to evaluate therapeutic compliance, assess attitudes toward medication adherence, and the factors influencing it among patients accessing an ambulatory palliative care service in a tertiary care hospital in India. Materials and Methods:One hundred and five adult patients accessing the ambulatory palliative care service and prescribed palliative pharmacotherapy for at least 1 month participated in this observational study. Data were collected using a study questionnaire that included socio-demographic details, the Morisky-Green test and a validated 17-item Likert scale assessing attitudes towards medication adherence. Statistical analysis comprised descriptive statistics, chi-square tests, Fisher's exact test and logistic regression. Results:Adherence to palliative pharmacotherapy was significantly associated with age, with older individuals (>60 years) showing greater compliance with medications compared to the young (p = 0.041, adjusted odds ratio [AOR] = 2.48, confidence interval [CI]: 1.04-5.95). Individuals with lower literacy levels demonstrated greater compliance than those with higher levels of education (p = 0.049, adjusted odds ratio [AOR] = 3.23, CI: 1.01-10.42). Furthermore, women were more compliant towards palliative pharmacotherapy compared to men (p = 0.017, adjusted odds ratio [AOR] = 3.03, CI: 1.22-7.56). Although other factors such as forgetfulness, affordability and assistance to take medications correlated with medication adherence, these were not found to be statistically significant. Conclusion:In the context of Indian palliative care, older age, female gender and lower literacy levels were associated with increased adherence to palliative pharmacotherapy; these demographic associations with compliance with palliative pharmacotherapy warrant further exploration.
Objectives:This study aimed to compare the Malayalam versions of the 9-item Achutha Menon Centre-Caregiver Burden Inventory (AMC-CBI) with the 22-item Zarit Burden Interview (ZBI-22), hypothesising that caregiver burden in palliative home care settings could be measured comparably using either tool. We also tried to identify a global question or brief screening items for caregiver burden based on the performance of the AMC-CBI items relative to the ZBI-22. In addition, we explored how participants understood and interpreted the ZBI-22 items. Materials and Methods:The study used a convergent mixed-methods design comprising a quantitative survey and qualitative interviews. The survey covered 60 adult primary caregivers of palliative care patients receiving home care in rural Kollam, Kerala, who were interviewed telephonically using a structured interview schedule with the ZBI-22 and the AMC-CBI scales and demographic, socioeconomic and caregiving-related details. Analysis was through descriptive statistics, internal consistency assessments using alpha and omega coefficients and validity assessments using agreement methods on z-transformed scores available in the SimplyAgree package for R and Jamovi, including average bias and limits of agreement and Receiver Operating Characteristic (ROC) analyses. Qualitative interviews were conducted telephonically, audio recorded and done by AMC-CBI. Cognitive interviews (n = 7) were conducted with four experts and three caregivers, using a semi-structured guide, to explore item clarity, relevance, redundancy and comprehension of ZBI-22. In-depth interviews (n = 4) were conducted with four additional caregivers (2 cancer, 2 non-cancer cases; one each with low and high burden) to explore caregiving experiences, and transcripts were analysed to compare narrative alignment with ZBI-22 and AMC-CBI items by two independent reviewers. Results:Internal consistency was high for both tools (α and ω > 0.8). Three AMC-CBI items ('lost hope', 'feel sad', and 'financial burden') were selected for a Brief AMC-CBI (ω = 0.787). Both AMC-CBI p = 0.747) and Brief AMC-CBI p = 0.731) strongly correlated with ZBI-22. Agreement analyses with z-scores (Bland-Altman, Deming regression) demonstrated good agreement, though one outlier was noted. ROC analysis showed AMC-CBI ≥12 and Brief AMC-CBI ≥3 as optimal cut-offs. Identity-related strain over a long caregiving duration might lead to discordant classification with ZBI-22 more likely to elicit burden. Qualitative interviews highlighted some item complexity and translation issues in ZBI-22, especially with the word 'duritham'. Reviewers found the AMC-CBI easier to apply during transcript coding. Conclusion:Both tools, the AMC-CBI and Brief AMC-CBI correctly categorised caregiver burden levels in comparison to the ZBI-22, but AMC-CBI was more contextually appropriate. Selecting the full or the Brief AMC-CBI for caregiver burden assessments would be a thoughtful decision that considers the unique requirements and considerations present in palliative care settings. Further studies on the AMC-CBI or its short form for inter-rater reliability assessments and concordance with the ZBI-22 in larger samples would be useful for enhancing the applicability of these tools.
Objectives:Palliative care aims to enhance the quality of life for patients facing terminal or life-threatening illnesses. Unfortunately, many patients encounter difficulties in understanding their condition, treatment processes and available care options due to limited access to clear and relevant information. This often leads to confusion, disrupted decision-making and increased anxiety. This study aimed to explore patient experiences and information needs in the context of palliative care. Materials and Methods:A qualitative descriptive design was employed, involving 20 participants, consisting of 10 palliative patients and 10 family members, to triangulate data sources. Participants were selected through purposive sampling based on predefined inclusion criteria. Data were collected through semi-structured face-to-face interviews and analysed using thematic analysis. Results:Five main themes with 10 subthemes were identified: (1) Sources of information about palliative care: information from physicians and nurses, information from family members and information from friends or community; (2) Alternative sources of health information included the internet (e.g., Google, websites) and educational videos on social media platforms (e.g., YouTube and TikTok); (3) Facilitators in accessing health information: Direct information provided by physicians and support from family members in obtaining information; (4) Barriers in understanding health information: difficulty understanding medical terminology and (5) Expectations for the Use of Digital Technology: easily accessible online health information and Digital applications or platforms for communication with healthcare professionals. Conclusion:Patient experiences in accessing palliative care information are shaped by interactions with doctors, family members and communities, while the internet and social media serve as additional sources. Most patients reported no difficulties due to the support of healthcare providers and their families. However, medical terminology created barriers to comprehension. Patients expressed strong expectations for hospitals to implement digital technologies to enhance access to information and continuity of care.
BACKGROUND:Pre-analytical interferents such as hemolysis, lipemia, and icterus are major sources of error in coagulation testing and frequently lead to sample recollection. Visual inspection, although widely used, is subjective and may fail to identify unsuitable samples. Automated pre-analytical interferent detection using hemolysis, icterus, and lipemia (HIL) indices has been introduced to improve reliability and laboratory efficiency. OBJECTIVE:Evaluate the impact of automated pre-analytical interferent detection on the number of sample recollections due to hemolysis in routine coagulation tests. METHODS:A retrospective study compared two one-year periods in a tertiary hospital laboratory. In 2022, samples were assessed by visual inspection using the STA-R® analyzer, while in 2023 automated inspection was implemented using the ACL Top® 750 system. Recollections due exclusively to hemolysis were analyzed for PT, aPTT, FV, fibrinogen, and D-dimer tests. Statistical analyses included binomial, Wald, and Student's t tests, with p ≤ 0.005 considered significant. RESULTS:A significant reduction in recollections was observed after implementation of automated inspection (0.49% vs. 0.35%; p < 0.001). PT showed a statistically significant decrease in recollections (p = 0.003), while other tests demonstrated non-significant reductions. Monthly average recollections decreased by 18.9% (p < 0.001). Annual costs related to recollections were reduced from US$ 638.49 to US$ 399.74, representing savings of US$ 238.75. A significant reduction was also observed in emergency department recollections. CONCLUSIONS:Automated pre-analytical interferent detection significantly reduced hemolysis-related recollections, costs, and subjectivity in coagulation testing, supporting its implementation as a valuable tool to improve laboratory workflow and result reliability.
Background K2EDTA contamination of serum samples is a preanalytical error that poses a risk to patient safety. Contamination is most frequently mild to moderate, which standard detection procedures often miss. We examined whether machine learning models could improve the detection of K2EDTA contamination. Methods Artificial neural network, decision tree (both simple and complex), extreme gradient boosting, k-nearest neighbours, logistic regression, naïve Bayes, random forest, and support vector machine models were developed. Models were trained using extracted patient results for electrolytes, urea, creatinine, albumin-adjusted calcium, magnesium, and phosphate, with K2EDTA contamination errors simulated in silico. Model performance was evaluated on 300 real-world samples, half of which were intentionally contaminated with mild to moderate amounts of K2EDTA. Model performance was compared with that of limit checks, multi-analyte rules and two novel parameters, the potassium/calcium ratio and the potassium/magnesium ratio. Results All nine machine learning models identified K2EDTA contamination more accurately than standard approaches (p-values <0.05). Seven models performed similarly, with accuracies of 91.3-93.3%, sensitivities of 88.0-90.0%, specificities of 94.7-96.7%, and area under the receiver operating characteristic curve (AUROC) of 0.9727-0.9787. The simple decision tree and naïve Bayes models performed slightly worse. The potassium/calcium ratio was the most effective of the standard approaches, with accuracy of 79.7%, sensitivity of 68.7%, specificity of 90.7%, and AUROC of 0.9233. Conclusions Using machine learning models would enable better detection of mild to moderate K2EDTA serum contamination and improve patient safety. For laboratories unable to implement machine learning models, the best alternative is the potassium/calcium ratio.
OBJECTIVE:To optimize the retesting process for hepatitis B screening, reduce false positives in samples with weak positive signals, and improve the laboratory management system, ensuring no missed cases and eliminating resource waste. METHODS:131 HBsAg-positive samples with initial signal to cut-off (S/CO) values ranging from 0.05 to 10 were divided into 5 intervals. After high-speed centrifugation, the samples were retested for HBsAg, and the initial and retest results were compared. By evaluating the repeatability and accuracy of the HBsAg results in different intervals, the "gray zone" of the HBsAg screening test was identified, and a laboratory optimization process plan was established. The new plan was piloted in parallel with the old plan to assess the reliability of the new plan. RESULTS:In the interval of initial cutoff (S/CO) values [0.05∼0.2], the difference rate between the initial test group and retest group was the highest (40%), and there was a significant difference in the qualitative results (p<0.01). In the interval (1,2], although there was no significant difference in the qualitative results before and after the retest (p=0.47), there were two samples with qualitative differences in the two groups. Under the new plan, the missed detection rate was reduced to 0, and it had excellent clinical application effects. CONCLUSION:On the premise of ensuring 0 missed detection, fully considering the economic benefits and the rational allocation of resources, the hepatitis B screening "gray zone" is set to [0.05,2]. For "gray zone" specimens, the retesting process must be implemented.
Background Folate, vitamin B9, is an essential micronutrient for DNA replication and repair. Deficiency is associated with megaloblastic anaemia and fetal neural tube defects. Serum folate measurement provides a convenient biomarker of folate status in clinical and research settings. The overall aim of this evaluation was to compare serum folate results measured from three different technologies within the same laboratory to determine systematic biases and equivalence between methods. Methods 58 serum samples from the UK National Diet and Nutrition Survey were used to compare a microbiological method, a liquid chromatography tandem mass spectrometry method (LC-MS/MS) and a commercial immunoassay (Tosoh CL1200). Results Within-run imprecision of all three assays was ≤7%, measured at two concentrations. The microbiological and LC-MS/MS methods were accurate against NIST Standard Reference Material and VITAL External Quality Assessment (EQA) target values. The plasma-based sample used for the NIST Standard Reference Material (SRM) was unsuitable for analysis by the Tosoh immunoassay, however comparison with the VITAL EQA target values showed good accuracy. Using the serum samples, both the LC-MS/MS and Tosoh immunoassay methods showed a slight positive proportional bias compared to the microbiological method, whilst the Tosoh method also had an additional constant bias of 3-4 nmol/L compared to the other methods. Conclusions This data shows that the microbiological method, LC-MS/MS and Tosoh CL1200 immunoassay have acceptable accuracy, imprecision and agreement. The small concentration dependant bias is likely explainable by the expected characteristics of the individual methods and ability to detect and respond to different forms of folate.
OBJECTIVE:To assess the analytical performance and diagnostic accuracy of an automated analyzer HELIOS in external proficiency testing for diagnosing autoimmune disorders based on antinuclear antibody (ANA) images and titer values. METHODS:Total 09 CAP shipments over the period of 03 years were included in our study, comprising of 05 samples in each shipment making a total of 45 samples. All samples were analyzed on HELIOS by the technique of Indirect Immunofluorescence (IFA) having built-in library for ANA image comparison and end point titer estimation. RESULTS:The data showed that there was 100% agreement with the positivity and negativity of the PT samples in detecting autoimmune disorders, however, for ANA pattern agreement, it was an average of 90.3% compared to peer mean. The most frequent ANA pattern in all 3 years was nuclear homogenous (40%) followed by nuclear speckled (32%). However, for end-point titer, there is a huge difference of mutual agreement with the PT peer group showing the lowest harmony of 35.3% in 2022 which was reported with titer of 5120, however peer group reported titer was ≤ 640. Thus, the analyzer has a limitation in evaluating end point titer and it should always be critically evaluated by the pathologist before final approval. CONCLUSION:HELIOS has an acceptable performance in detecting autoimmune disorders and ANA pattern identification, however, for end-point titer, there were many variations for which manual dilutions should be done in routine for accurate analysis of results. KEY WORDS:Autoimmune disorders, External Proficiency testing, HELIOS, Analytical Performance.
To evaluate medical costs associated with palliative care (PC) and hospice care (HC) compared with usual care among patients with terminal cancer, while accounting for variations in cost definitions and models of care. A systematic review and meta-analysis of observational studies were conducted. Literature searches were performed in PubMed, Scopus, and ProQuest (January 2010-July 2025). Eligible studies compared the medical costs of palliative or hospice care with usual care in adult terminal cancer patients. Care models were defined according to study-specific criteria. Data were pooled using a random-effects meta-analysis, and heterogeneity was assessed using the I2 statistic. Eighteen studies were included. PC was associated with lower medical costs than usual care (standardised mean difference [SMD] -0.31; 95% confidence interval [CI] -0.35--0.27; p < 0.00001), while HC showed greater cost reductions (SMD -0.64; 95% CI -0.67--0.62; p < 0.00001). The overall pooled effect favoured palliative-oriented models (SMD -0.54; 95% CI -0.57- -0.52). However, substantial heterogeneity (I2 up to 100%) likely reflects differences in cost components, care models and health system contexts. PC and HC reduce medical costs and support integration into routine oncology and end-of-life care.
Hypercalcaemia of malignancy (HCM) is a recognised paraneoplastic complication of advanced cancer, with HHM being mediated predominantly by parathyroid hormone-related protein (PTHrP) secretion. While commonly observed in squamous cell carcinomas, it is exceedingly rare in gallbladder adenocarcinoma, with only isolated case reports described in the literature. We report a man in his 50s with metastatic gallbladder cancer who presented with colicky abdominal pain, constipation, fatigue, low mood, delayed responses and insomnia. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders- 5 th Edition criteria. Laboratory evaluation revealed severe hypercalcaemia with a corrected serum calcium of 18.92 mg/dL, suppressed parathyroid hormone of 7.83 pg/mL and markedly elevated PTHrP of 701.3 pg/mL, consistent with HHM. His condition improved with intravenous hydration, bisphosphonates and calcitonin, along with multidisciplinary palliative care addressing psychological, emotional and spiritual concerns. This case highlights the need to recognise hypercalcaemia as a potential cause of delirium, even in rare malignancies, as timely diagnosis may facilitate prompt symptom management and prevent potentially life-threatening complications.
ObjectiveTo investigate the interfering factors and correction methods in the determination of serum uric acid (UA) using the uricase method in patients with elevated immunoglobulin M (IgM).Materials and MethodsIn clinical practice, the UA levels of five patients with elevated IgM were measured using the Beckman AU5800 analyzer with its reagents or Zhongyuan reagents. The reaction curves were analyzed. Three methods dilution with normal saline, dilution with saturated saline, and polyethylene glycol 6000 (PEG 6000) precipitation were applied to eliminate interference. For comparison, UA was also measured using the Abbott Ci8200 analyzer with its reagents.ResultsThe serum IgM levels for cases 1 to 5 were 12.39, 27.0, 12.09, 7.33, and 11.05 g/L, respectively. The initial UA results obtained with the Beckman AU5800 and its reagents were 48.4, 101.3, 96.6, 0.6, and 66.6 μmol/L. All five cases exhibited abnormal biochemical reaction curves. After treatment with normal saline, samples 1 and 5 yielded negative values, while after saturated saline treatment, sample 5 still showed a negative value and sample 1 showed an extremely low value, indicating incomplete correction of the interference. In contrast, the PEG precipitation method markedly improved the UA results, and the obtained values were comparable to those from the Abbott system.ConclusionThe PEG precipitation method provides superior correction compared to dilution with normal or saturated saline and yields results that are closer to the patient's true value.
