In the rural areas of India, women generally use a piece of old cloth as a menstrual device. The aim of this study was to detect human papilloma virus (HPV) from menstrual blood on the menstrual pad and assess whether this could be a useful screening tool for cervical cancer. In Jamkhed area of rural Maharashtra, (population A), we collected menstrual pads from women who provided consent in the 30-50 year age group. The women who had provided menstrual pads underwent HC2 testing. We standardized the method for extracting DNA by PCR from the menstrual pad. The women who tested HPV positive, on the basis of HC2/PCR testing, underwent colposcopy. In the rural population of Pune area of Maharashtra state (population B), menstrual pads were collected. HPV was tested using the PCR method. HPV-positive women and a few HPV-negative women, selected randomly, underwent colposcopy and HC2 testing. In population A, 164 women provided their used menstrual pads and also underwent an HC2 screening test. Of these, six (3.2%) cases were reported as HPV positive. In population B, 365 women provided their used menstrual pads for HPV testing, of which 18 (4.9%) cases were diagnosed as HPV positive. The women who tested HPV positive, on the basis of PCR testing, and 10% randomly selected HPV-negative cases (37) and 18 women who voluntary requested testing underwent colposcopy and HC2 testing. The sensitivity of menstrual pad HPV testing compared with gold standard HC2 testing was 83% [95% confidence interval (CI): 0.47-0.97], 67% (95% CI: 0.30-0.91) and specificity was 99% (95% CI: 0.96-0.99), 88% (95% CI: 0.77-0.94) in population A and population B, respectively. The sensitivity of diagnosing CIN lesion was 83% (95% CI: 0.44-0.97) and specificity was 95% (95% CI: 0.91-0.97). On the basis of the sensitivity and specificity results, and the completely noninvasive, simple and convenient method of detecting HPV, menstrual pad might be considered a cervical cancer screening tool in rural Indian women.

Breast cancer is an emerging public health problem in low-and middle-income countries. The main objective is to describe the clinical characteristics and patterns of care of breast cancer patients diagnosed and treated in a rural cancer hospital in Barshi, Western India. The results from a cross-sectional study of 99 consecutive breast cancer patients diagnosed and treated between February 2012 and November 2014 in Nargis Dutt Memorial Cancer Hospital is reported. The case records of the patients were scrutinized and reviewed to abstract data on their clinical characteristics, diagnostic, and treatment details. The mean age at diagnosis of the patients was 52.8 ± 11.6 years; 83.5% of women were married, and 60.6% were illiterate. Sixty percent of patients had tumors measuring 5 cm or less. Almost half of the patients (46.4%) had stage I or II A disease and a third (36.0%) had axillary lymph node metastasis. Estrogen, progesterone, and human epidermal growth factor receptor2 receptor status were investigated in 41 (41.4%) of patients only. The median interval between diagnosis and initiation of treatment was 11 days. Modified radical mastectomy was done in 91% of patients, and nearly a third of patients who were prescribed chemotherapy did not complete treatment. The rural-based tertiary cancer care center has made treatment more accessible to breast cancer patients and has reduced the interval between diagnosis and treatment initiation. However, there are still many challenges like noncompliance to and incomplete treatments and poor follow-up that need to be addressed.

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OBJECTIVEEvaluation of leading causes of pre-analytical errors in Clinical Biochemistry Laboratory. MATERIALS AND METHODSSamples were obtained from the OPD and indoor admitted patients and analysis of the results obtained from clinical chemistry laboratory obtained during one year of study period was done retrospectively. Data was summarised regarding the frequency of factors affecting the pre-analytical quality of results. Laboratory personnel were asked to register all the rejected samples and reasons for rejections. RESULTSOut of 62541 inpatient samples collected and screened over period, pre-analytical errors were observed in 4611 samples, which is approximately 3.75% of the total blood samples received. Insufficient volume of samples accounted for rejection of 2428 samples, which is 1.9% of total samples received during this period. Haemolysis accounted for rejection of 1.1% of samples and gross lipaemia was responsible for rejection of 0.4% samples. 0.26% of samples were rejected for having wrong/incomplete patient information. Out of 60244 samples collected total from OPD, 5552 samples were rejected for the presence of pre-analytical errors. This accounted for rejection of 4.5% of total samples received during this period. 2.7% of samples were rejected for the presence of visible haemolysis after centrifugation. Samples rejected for insufficient volume accounted to 1.9%. 0.3% of samples were rejected for having gross lipaemia. 800 samples were rejected for having wrong/incomplete patient information, which accounted for rejection of 0.8%. CONCLUSIONThe overall rate of rejection of samples is 8.52%, which is very high. Haemolysis was major reason for rejection of samples collected from OPD and error due to insufficient sample volume was found to be equal in both type of samples collected from OPD and indoor patients. KEYWORDSPre-analytical Errors, Hemolysis, Lipemia. The main aim for the diagnostic service is to get correct result on correct patient to the requesting doctor without unnecessary delays. It is also the duty of laboratory to protect patients from wrong or potentially wrong results. Typical request test report cycle consists of three phases, pre-analytical, analytical, and post-analytical phases. HOW TO CITE THIS ARTICLE:Errors arising during the sample processing are classified into pre-analytical, analytical, and post-analytical errors depending upon their source and time of presentation respectively. 1 Overall, the three processes combined are Financial or Other, Competing Interest: None. Submission 20-06-2016, Peer Review 04-08-2016, Acceptance 11-08-2016, Published 17-08-2016. Corresponding Author: Dr. Amit Ramesh Barapatre, Room No. 415, Department of Biochemistry, Fourth Floor, College Building, TNMC NAIR and B.Y.L. Ch. Hospital, Mumbai Central-08. E-mail: amit12patre@gmail.com DOI: 10.14260/jemds/2016/1076 called as 'total testing processes.' Errors can arise at any step and lead to a faulty report generation that can affect patient care like misdiagnosis, improper t...