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World Health Organization (WHO) clinical case definition for the diagnosis of measles lacks diagnostic accuracy. We thus propose two separate scoring criteria for the diagnosis of acute and post measles cases. This study was conducted to determine the diagnostic accuracy of scoring criteria in confirmed cases of measles. This cross-sectional validation study was conducted in the Department of Paediatrics Unit-I, King Edward Medical University, Lahore, Pakistan, from March-August 2009. Sixty-one cases fulfilling the WHO clinical case definition of measles were included in the study, and divided into Group A (Acute measles) and Group B (Post measles). A separate criterion was used for each. Positive Serology (IgM) was taken as confirmed cases. At scores = 3, = 4 and = 5, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. Appropriate statistical tests were applied. In Group A, out of 36 cases, 28 (78%) had total score = 4, whereas IgM was positive in 24 (67%). The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 86% and 100% respectively. In Group B, out of 25 cases, 23 (92%) had a total score = 4 whereas IgM was positive in 22 (88%) cases. The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 96% and 100% respectively. The measure and strength of association were statistically significant for both Groups. At scores = 3 and = 5, sensitivity, specificity and predictive values were not statistically significant in either group. This study has shown that the criteria for the diagnosis of acute and post measles cases at a score = 4 are valid to make a clinical diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To assess the cross-reactivity of COVID-19 IgG assay with known immune-mediated and infectious disorders and evaluate for any false-positive reactions to determine the specificity of the serological assay. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Chemical Pathology, Chughtai Institute of Pathology, Lahore Pakistan, from Sep to Oct 2020. Methodology: A total of 116 samples were included in the study of both males and females. Diagnosed cases of typhoid fever, viral hepatitis, systemic lupus erythematosus (SLE), syphilis, multiple connective tissue disorders (MCTD), varicella-zoster infection, rabies, toxoplasmosis, epstein-barr virus (EBV) infection, rubella, rheumatoid arthritis, AIDS, cytomegalovirus (CMV) infection and dengue fever were included in the study. Three samples of multiparous women aged more than 40 years were also included in the study. IgG antibody levels were measured against SARS-CoV-2 with a cut-off index of 1.4. Results: Out of 116, only 3 (2%) samples were reactive for IgG against SARS-CoV-2. The categories showing cross-reactivity were typhoid, hepatitis C, and CMV. All specimens showing cross-reactivity were of females. Assay under consideration showed a specificity of 97.4%. Conclusion: Cross-reactivity was seen in pre-pandemic cases of infectious diseases with COVID-19 IgG antibody assay. Medical lab professionals must verify the serological assays before use in the clinical laboratory to avoid false-positive results. [ABSTRACT FROM AUTHOR]

Background: Diabetic Nephropathy (DN) is a renal disease that leads to progressive renal failure across the world and it is among the most challenging of all renal diseases. The categorization of DN is centered on the lesions of glomeruli and exhibits varied morphological features. These patients outcome is also affected by evaluating the lesions of tubules, interstitium and renal vessels. Objective: The objective of this study was to apply the current pathological categorization of DN by Tervaert et al to evaluate the lesions of kidney in DN and to correlate clinical and histopathological features. Methods: This was a retrospective study of 10 years' duration from 2010-2019 at the Histopathology Department, Chughtai Institute of Pathology, Lahore. Fifty two cases of DN were included in the study. Parameters which were assessed included age, gender, duration of diabetes, 24 hours' urinary proteinuria, serum creatinine, histologic classes of diabetic nephropathy, Interstitial inflammation Score, interstitial fibrosis & tubular Atrophy (IFTA) score, Arteriolar Hyalinosis (AH) score and large vessel arteriolosclerosis. Results: Out of 52 cases, 28 were males and 24 were females. Mean age of patients was 51.40 years. Mean duration of diabetes was 11.54 years. Mean serum creatinine level was 5.42 mg/dl. Mean proteinuria was 4.72 g/24 hours. The most frequent glomerular lesions were in Class III comprising 48% of all classes. Conclusion: There was a significant correlation of glomerular classes with serum creatinine levels and also with proteinuria. There was also correlation of IFTA with rising serum levels of creatinine and proteinuria. [ABSTRACT FROM AUTHOR]

World Health Organization (WHO) clinical case definition for the diagnosis of measles lacks diagnostic accuracy. We thus propose two separate scoring criteria for the diagnosis of acute and post measles cases. This study was conducted to determine the diagnostic accuracy of scoring criteria in confirmed cases of measles. This cross-sectional validation study was conducted in the Department of Paediatrics Unit-I, King Edward Medical University, Lahore, Pakistan, from March-August 2009. Sixty-one cases fulfilling the WHO clinical case definition of measles were included in the study, and divided into Group A (Acute measles) and Group B (Post measles). A separate criterion was used for each. Positive Serology (IgM) was taken as confirmed cases. At scores ≥ 3, ≥ 4 and ≥ 5, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. Appropriate statistical tests were applied. In Group A, out of 36 cases, 28 (78%) had total score ≥ 4, whereas IgM was positive in 24 (67%). The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 86% and 100% respectively. In Group B, out of 25 cases, 23 (92%) had a total score ≥ 4 whereas IgM was positive in 22 (88%) cases. The scoring criteria had sensitivity, specificity, PPV and NPV of 100%, 66.7%, 96% and 100% respectively. The measure and strength of association were statistically significant for both Groups. At scores ≥ 3 and ≥ 5, sensitivity, specificity and predictive values were not statistically significant in either group. This study has shown that the criteria for the diagnosis of acute and post measles cases at a score ≥ 4 are valid to make a clinical diagnosis. [ABSTRACT FROM AUTHOR]

Background and Objective: Protein induced by vitamin K absence II (PIVKA-II) is an upcoming and promising new biological marker cited as having a definitive role in the early detection and diagnosis of hepatocellular carcinoma (HCC). Preliminary research shows PIVKA-II reference intervals (RIs) in serum to have substantial racial disparities globally. Hence, this study aimed to determine the RIs and cut-off value of the serum PIVKA-II for the first time in healthy and patients with HCC in Pakistan. Methods: This cross-sectional study comprised 240 participants (120 diagnosed cases of HCC and 120 healthy individuals) registered at the Department of Chemical Pathology and Immunology, Chughtai Institute of Pathology, Lahore, Pakistan. The PIVKA-II serum level was analyzed using the Chemistry Analyzer through chemiluminescent micro-particle immunoassay. The RI was subsequently established using the percentile method. Results: In healthy Pakistani adults, the 95% RI for PIVKA-II was 15.55-43.03 mAU/ml, and the cut-off was 148.81 mAU/ml in HCC cases. The male participants, exhibited higher PIVKA-II levels than the females (p < 0.002). There were no significant differences in the serum levels of PIVKA-II with respect to age however variations were observed with respect to gender. Conclusion: Determination of the RI for serum PIVKA-II in healthy adult Pakistani individuals and a cut-off for HCC diagnosis emphasizes the growing need to establish and verify RIs of analytes at a larger scale in our population. Ideally all clinical laboratories should establish their own RIs. [ABSTRACT FROM AUTHOR]