In the clinical setting of neonatal hepatitis, hepatosplenomegaly and undiagnosed neurological symptoms, NP-C disease should be considered in the differential diagnosis. Electron microscopic examination of skin biopsy is an effective screening test, although the definitive diagnosis should be made by the cholesterol esterification assay and filipin staining.
Background Nucleic acid amplification testing (NAT) for the screening of blood donations is known to improve blood safety. The decision to initiate NAT requires careful deliberation of infrastructure, skilled manpower, and financial resources. This report outlines the initiative of the Government of Odisha to implement NAT screening in government blood banks in the state of Odisha, India, through public–private partnership (PPP) and evaluates the incremental yield of minipool NAT screening over serology testing of blood donations.
Methods Blood donations collected between June 2016 and September 2018 were initially screened for HBV (HBsAg), HCV (anti-HCV), and HIV (anti-HIV-1 and HIV-2) by ELISA, and syphilis and malaria. Sero-nonreactive donations were further screened in pools of six by Roche cobas TaqScreen MPX test version 2.0 (MPX2) NAT.
Results On screening 3,39,472 blood donations, 1.34% seroreactive donations were detected. In all, 847 NAT-reactive donations (0.26%): 693 HBV, 58 HCV, and 96 HIV were detected. The NAT yields were 1:386 overall, 1:472 for HBV, 1:5642 for HCV, and 1:3409 for HIV.
Conclusion NAT testing using the highly sensitive MPX2 assay leads to incremental detection of TTIs over serology. Implementation of NAT along with serological testing in blood centers all over India will be an important step towards providing safe blood. Our study not only highlights the benefits of minipool NAT testing but also presents a scalable PPP model that can serve as a template for application across other states.
Background: In India, thyroid cancer accounts for less than 1% of all malignancies (2% of women and 0.5% of men). Thyroid cancer is responsible for 6 deaths per 1 million persons annually. Serum TSH is a well-established growth factor for thyroid nodules, however its role in thyroid malignancy is inconclusive hence this study was conducted with the objective to determine the association between serum Thyroid stimulating hormone (TSH) concentrations with thyroid carcinoma. Methods: Case control study was conducted in a tertiary care centre. 120 Benign and malignant thyroid subjects respectively were included in the study. Newly diagnosed and record based data collection was done. Measurements of serum TSH concentrations were performed by automated immune chemiluminescent assay. Data was analyzed using SPSS 22 version software, Chi-square test was used as test of significance for qualitative data, p value of <0.05 was considered as statistically significant. Results: Majority of them were females in the age group 26 to 40 years in both the groups and were diagnosed to have solitary thyroid nodule. In malignant thyroid nodules 51.7% were diagnosed to have follicular carcinoma, 46.7% had papillary carcinoma and 1.7% were diagnosed to have Hurthle cell carcinoma. Significant association was observed between TSH levels and diagnosis of thyroid lesions. TSH was raised (>4mIU/L) in 46.6% of malignant nodules and in 15% of benign nodules. Raised TSH had an odds ratio of 4.958 for Thyroid malignancy compared to benign nodules Conclusions: Higher TSH levels were associated with Thyroid malignancy and the risk of malignancy rises in parallel with serum TSH within normal range, and high levels of serum TSH concentrations was associated with advanced stage of thyroid cancer.
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