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Lab medicine audit 2016

Lab medicine audit 2016

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Lab medicine audit 2016

  1. 1. DEPT OF LABORATORY MEDICINE JPNATC, AIIMS, NEW DELHI Histopathology, Cytopathology Hematology, Biochemistry and Forensic Pathology,
  2. 2. HEMATOLOGY PARAMETERS NO. OF SAMPLES PROCESSED Hb/TLC/Hct/RBC count 45,014 each MCV/MCH/MCHC/RDW 45,014 each DLC 44,350 Platelet count 45,363 Reticulocyte count 1,435 ESR 3,328 Peripheral Blood Smears 5,022 Hemato-progenitor cells (HPC) 24,350 Immature platelet fraction (IPF) 1,435 TOTAL 4,85,395
  3. 3. COAGULATION TESTS PARAMETERS NO. OF SAMPLES PROCESSED PT 25622 APTT 25593 INR 25600 TT 3,836 Fibrinogen 3,628 D-dimer 3,475 Thromboelastogram (TEG) 4,274 TOTAL 54,428
  4. 4. FLUIDS (CSF/PERITONEAL/PLEURAL), URINE ANALYSIS PARAMETERS NO. OF SAMPLES PROCESSED Urine R/M 7392 Urine Myoglobin 809 Urine Fat globules 43 CSF/ pleural/ ascitic fluid 902 TOTAL 9,146
  5. 5. P Vivax
  6. 6.  Patient X,41 yr/M  Hb-7.7 gm/dl  TLC- 59,460/cmm  PBS- target cells,  NRBC- 80/100 WBC  cTLC-17500/cmm  s/o Thalassemia
  7. 7. BIOCHEMISTRY TEST SAMPLES PROCESSED S. Sugar 12461 S. Urea/Creatinine 39976/39976 S. Ca++/Phos- 33756/33674 S. Uric acid 21108 S. Na+/K+ 38797/38794 T.BIL./Direct BIL 24341/24110 T.Protein/Albumin 24367/24369 ALP 24361 S. Cholesterol 3528 S. Amylase/Lipase 3005/16 S. HDL/LDL/TG/VLDL 761 Each
  8. 8. BIOCHEMISTRY S. CK 350 S. Mg 1124 CK-MB 21 CSF-SUGAR/T Protein 860/831 Peritoneal fluid- Sugar/Protein 26/29 Drain fluid Amylase 29 24 hour Urine protein/ sugar 25/25 Urinary Calcium 626 Urine Creatinine 527 Urine osmolarity 11 Serum osmolality 12
  9. 9. ABG ANALYSIS PO2/CO2/PH 4500 each Na+/K+/Ca++/Cl- 4500 each Biochemistry Total test: 4,80,083
  10. 10. TOTAL TESTS IN HEMATOLOGY & BIOCHEMISTRY 4.3 4.9 4.8 5.3 5.4 4.2 4.6 4.9 4.9 4.8 2012 2013 2014 2015 2016 Hemat (lacs) Biochem (lacs)
  11. 11. 369 1120 1291 0 200 400 600 800 1000 1200 1400 Specimens Tissue blocks Histo slides Number 369 1120 1291 Histopathology
  12. 12. 257 62 50 177 General Sx Neurosurg Ortho Forensic HISTOPATHOLOGYSTATISTICS AS PER DEPARTMENTS
  13. 13. 13 12 21 12 19 11 5 11 10 General Surgery- Frequency of specimens
  14. 14. specimen GENERAL SURGERY- FREQUENCY OF SPECIMENS
  15. 15. disc material synovial/ fibrous tissue bone membranes others(sequestrum.loos e bodies) ORTHOPEDICS- SPECIMENS
  16. 16. Series 1 6 8 22 14 5 7 Numberofcases Type of specimen NEURO SURGERY
  17. 17. 13 12 21 12 19 11 5 11 10 14 81 Forensic pathology
  18. 18. CYTOPATHOLOGY 0 5 10 15 20 25 30 cytopathology 2015 2016
  19. 19. HISTOPATHOLOGY CASES Orthopedics  Intraosseous haemangioma  Osteochondroma  Infantile fibromatosis  Tuberculosis vertebrae Neurosurgery  Growing skull fracture  Meningeocele  Traumatic neuroma, Schwannoma  Tubercular brain abscess
  20. 20. Surgery  Nasal glioma  Marjolin ulcer- Sq cell CA  BCC  Glomus tumor, Pyogenic granuloma  Mature cystic teratoma
  21. 21.  Forensic pathology  Lungs- aspiration pneumonia, Difffuse alveolar hemorrhage, TB.  Heart- coronary atherosclerosis  Liver- Hepatitis, liver fibrosis, fatty liver  Kidney- Diabetic nephropathy
  22. 22. INTERESTING HISTOPATHOLOGY CASES
  23. 23. PAPILLARY CARCINOMA THYROID METASTASIS IN A CERVICAL LYMPH NODE  37-year-old male, alleged h/o RTA,  cervical vertebra (C6) burst fracture with anterolisthesis grade I.  No palpable thyroid mass  Clinical- granulation tissue with d/d of heterotopic thyroid gland/ Koch’s disease was made.  Biopsy 1. granulation tissue 0.8 × 0.4 × 0.2 cm ) 2. cervical lymph node ( 0.5 × 0.5 × 0.2 cm) brownish
  24. 24. ECTOPIC PANCREAS IN STOMACH  55 year, M, h/o trivial trauma  Had c/o pain in abdomen- 2 day, h/o malena- 3 episode  Exploratory laprotomy was done for gastric perforation  On IHC: CK+  Chromogranin -  Ki-67 -low
  25. 25. ECTOPIC PREGNANCY IN TRAUMA VICTIM  A 32 year F h/o of assault by her husband  FAST positive with mild pericardial effusion,  UPT was positive,  Ultrasound- ruptured ectopic  Histopath- products of conception confirmed
  26. 26. MOLLUSCUM CONTAGIOSUM  Mass on left, lower eye lid- 3 months  Gross- 7 mm to 5 mm tissue
  27. 27. 5. INFECTION Gastric perforation margin for HPE- Candida Right upper limb skin biopsy- Degloving injury, Mucor
  28. 28. 6. PULMONARY METASTASIS OF DFSP  K/C/O Recurrent DFSP- scalp  CT chest- Left lower lobe tumor  IHC- CD34+
  29. 29. AUTOPSY- NEUROCYSTICERCOSIS  Deceased 70 year F  h/o recurrent seizure- 3 years  MRI (AIIMS)- s/o Neurocysticercosis, 1 month back  Sudden death
  30. 30. AUTOPSY- FAT EMBOLISM  Brought death case  Died after Ilizarov procedure  Suspicious of Fat embolism
  31. 31. AUTOPSY- PTTM IN A CASE OF CA COLON (PULMONARY TUMOR THROMBOTIC MICROANGIOPATHY)  23 year, M  presented with alleged h/o found unconscious  Clinical diagnosis- refractory sepsis with ventilator associated pneumonia with acute kidney injury.  Past h/o- known case of IBD and t/t with Azathioprim and prednisolone  Lost to follow up since last 8 month  HPE- pulmonary tumor cell emboli with recanalization and intimal fibrocellular proliferation of small arteries.  A postmortem diagnosis of poorly differentiated signet ring cell carcinoma of colon with PTTM
  32. 32. COMPLETED PROJECTS  Identification of circulating procoagulant markers in traumatic brain injury patients and their involvement in development of Early Trauma Induced Acute Coagulopathy (ETIC). ICMR 2012-12610, 1.6.14 to 30.5.16  Histopathological evaluation of Traumatic brain injury (TBI) induced gastro intestinal injury (Institute project) (2014-15)
  33. 33. ONGOING PROJECTS  Identification of novel circulating procoagulant microparticles in traumatic brain injury patients and their involvement in Pathophysiology of Early Trauma Induced Acute Coagulopathy (DBT)  Study of coagulation response in thrombocytopenic Head injury patients receiving platelet transfusion (ICMR)  Assessment of platelet function in patients with acute traumatic Brain injury (Institute)  Utility on novel Coated Platelets as a marker for early prognostication of neurocognitive impairment following traumatic injury (DST, Cognitive science research initiative (CSRI))
  • VikashYadav216

    Jan. 12, 2021
  • DrAjayBhengra

    May. 1, 2019
  • AadanGalayr

    Sep. 16, 2018

Lab medicine audit 2016

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