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Background: Clinical laboratories errors can impose serious adverse effects on patient management. Clinical laboratories can evaluate their analytical performance by effective quality management tool i.e. Six Sigma metrics. Objectives: To evaluate the analytical performance of routine chemistry parameters by Six Sigma approach. Methods: Cross sectional, study carried out from July 2022 till February 2024 in the Chemical Pathology section of University of Lahore Diagnostic Lab and Research Center, Lahore. Analytical performance of nineteen routine chemistry parameters were evaluated by using the external and internal quality control material. Only those parameters were selected who enrolled in External Quality Assurance Scheme. Inclusion criteria for IQC following West gard rule +/- 2 SD while for EQAS results follow +/- 2 Z score. Sample size for 19 parameters analyzed in EQAS from July 2022 till December 2023 was 342. 2700 IQC samples were analyzed from August 2023 till February 2024. All control values were entered in Microsoft Excel 2013 calculated manually by conventional equations. Results: Most of our laboratory parameters showed satisfactory analytical performance in between 3-6 when evaluated by six sigma metrics. Conclusion: Control frequency for parameters showed score > 6 can be reduce for saving laboratory resources whereas parameters with sigma score around 3 needs more vigilant monitoring. Health care and laboratory outcome need high quality results to improve patient health. Six sigma tool allows laboratory to identify the right method, right rule, run controls at right frequency to enable the right patient outcome. [ABSTRACT FROM AUTHOR]

Introduction The incidence of human immunodeficiency virus (HIV) infection, is increasing in Pakistan. Seborrheic dermatitis (SD) can be seen in patients having HIV infection, so it can be a marker of disease diagnosis and progression. Objective To see the occurrence of HIV infection in patients with SD. Methods A prospective study was conducted in Dermatology Department, DHQ teaching hospital, University Medical Complex and Research Center, Sargodha, from September, 2019-February, 2020. Two hundred and eighty-five cases of SD diagnosed clinically were taken and serological examination for HIV by rapid diagnostic test was done on all cases. Data analysis were done by Statistical Package for the Social Sciences (SPSS) Version 20 and expressed as frequency and percentage. Results In 285 cases of SD majority (53.6%) were males. Ages of patients ranged from 8 months to 60 years. Out of the 31 patients positive for HIV, 25 were males and rest were females. Majority of HIV positive cases (70.96%) had severe SD. Conclusion SD is a dermatological manifestation of HIV infection. As in developing countries like Pakistan with limited health facilities it is difficult to have CD4+ counts done, skin examination should be an important tool for assessing immune status and management of HIV positive patients. [ABSTRACT FROM AUTHOR]

Objective To determine the frequency of undiagnosed diabetes mellitus in patient with vaginal candidiasis. Methods This is a cross-sectional study. It was conducted in DHQ Hospital Sargodha from June 2017 to December 2017.A total number of 160 patients were enrolled for the study ranging from the age of 20-60 years. After informed consent from all patients, high vaginal swab was taken from vagina and send for microscopic examination, to confirm the diagnosis of vaginal candidiasis. Fasting blood glucose levels were taken at the same time and were sent to hospital laboratory. Results There were 160 female patients who were selected for study. Frequency of undiagnosed diabetes mellitus in patients with vaginal candidiasis was found to be 33 (20.63%) while 127 (79.37%) patients did not have high blood sugar level. According to marital status, 30(18.75%) were married and rest 3 (1.875%) were unmarried. Out of 33 cases of undiagnosed diabetes, 19 (11.857%) were between 20-40 years of age while 14 (8.75%) were in 41-60 years of age group. Conclusion Frequency of undiagnosed diabetes mellitus is higher among patients with vaginal candidiasis. So, it is advised that every patient who presents with vaginal candidiasis should also be evaluated for diabetes mellitus. [ABSTRACT FROM AUTHOR]

Aim To determine the Efficacy of isotretinoin in acne vulgaris daily versus pulse therapy. Study design A randomized controlled trial. Place and duration of study Outpatient Department of Dermatology, Sargodha Medical College, Sargodha, from June 2017 to July 2018. Methods There were total 150 patients (both male and female) having 75 patients in each group. Group A was given oral isotretinoin capsule 20 mg twice daily for one week after 3 weeks as intermittent/ pulse therapy for 6 months. Group B was given oral isotretinoin capsule 20 mg/daily continuously for 6 months. Group A and B further sub divided into mild, moderate and severe, having 25 patients in each subgroup. The patients were advised to revisit after every 4 weeks for follow-up. Both groups were also advised to apply 1% clindamycin gel twice a day for 6 months on lesions. The drug is considered efficacious if acne lesion of the patient reduced to 0-5 lesion only. Results In group A, the oral isotretinoin pulse therapy was efficacious in 22 patients (88%) of mild acne, 23 patients (92%) of moderate acne and 19 patients (76%) of severe acne. In group B, the oral isotretinoin continuous therapy was efficacious in 23 patients (92%) of mild acne, 22 patients (88%) of moderate acne and 21 patients (84%) of severe acne. There was no difference in efficacy of drug in mild moderate or severe acne in group A and B as the p - value calculated by One way Anova is 0.091 and 0.098 respectively, which is not significant. It also revealed that there was no statistical difference in efficacy of drug in group A and B, having p value of >0.05. Conclusion It is concluded that the efficacy of oral isotretinoin for acne in intermediate/pulse therapy is same. So, we should prefer intermediate/pulse therapy as it is cost effective, there are reduced side effects of drug due to shorter duration and the patient is more compliant. [ABSTRACT FROM AUTHOR]