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Although the automation of instruments has reduced the variability of results and errors of analysis, in some laboratories, repeating a test to confirm its accuracy is still performed for critical and noncritical results. However, the importance of repeat testing is not well established yet, and there are no clear criteria for repeating a test.
In this cross-sectional study, all repeated tests for 26 biochemical analytes (i.e., albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), bilirubin total (BT), bilirubin direct (BD), blood urea nitrogen (BUN), calcium, chloride (Cl), cholesterol total (CholT), creatine kinase (CK), creatinine (Cr), glucose, gamma-glutamyl transferase (GGT), high-density lipoprotein-cholesterol (HDL-c), iron, lactate dehydrogenase (LDH), LDL-c, lipase, magnesium (Mg), phosphorus (Ph), protein total (ProtT), total iron binding capacity (TIBC), triglyceride (TG), and uric acid) were assessed in both critical and noncritical raing based on its own practice.The dating of ink in questioned documents remains a significant challenge in forensic investigations in Vietnam and other countries. Many forensic examination methods have been usually applied to ensure the highest accuracy of the assessment results while maintaining high environment awareness. In this study, paper characteristics were physically tested to confirm source similarity, and the relative ink dating was established by high-performance thin-layer chromatography (HPTLC). Absolute ink dating by solvent and dye identification was performed by Raman spectrometry-a green technique, using a time-dependent degradation model for crystal violet and the comparison between 2-phenoxyethanol peak intensities. We found that the relative dating of the questioned document was 14 ± 3 months lesser than that of the reference samples, i.e., the absolute age of the questioned samples was estimated to be 24 ± 3 months. The combination of the conventional HPTLC method with the dynamic crystal violet degradation Raman model provides promising results for relative and absolute ink dating of ballpoint pens, which can be applied for documents written 1-15 years prior to the time of examination. The combination of the abovementioned methods demonstrated an acceptable error margin, affording highly practical applications in modern forensic science.We report a case of Conn's adenoma in a 35-year-old female successfully managed in a poor hospital technology environment.Antiphospholipid syndrome is a rare complication of postural orthostatic tachycardia syndrome. AOA hemihydrochloride Clinically, the presentation has overlapping symptoms of both diseases, with lightheadedness or syncope when moving from a supine to a standing position as well as blood clots, headache, or pregnancy complications in women. This case presentation involves a 39-year-old patient identified as female who has been diagnosed with POTS and elevated anticardiolipin antibodies.
Epilepsy is a chronic central nervous system disorder characterized by the recurrence of unprovoked seizures and can affect people of all ages. Seizure symptoms can vary widely in patients. Many papers have been published about agitation and epileptic seizures, but almost nothing about sugar cravings and agitation related to epilepsy. The purpose of this case report is to shed light on possibly a hidden symptom within the epilepsy field, in fact sugar cravings.
. A 12-year-old boy was referred to the children and adolescent psychiatric outpatient clinic with suspicion of ADHD. The boy has struggled with anxiety, concentration, and impulsivity. Because of intense agitation and sugar cravings, the patient was referred to EEG. The EEG shows pathological activity with bilatero-temporal to central epileptiform activity, not synchronized. After pathological EEG findings, the patient started treatment with Lamotrigine. Great improvement when it comes to agitation, moodiness, and reduction of sugar craving after starting with Lamotrigine.
We consider inexplicable behavior or symptoms such as agitation and sugar craving may be related to epilepsy seizure. Therefore, it is important that these patients should be examined more closely with EEG to confirm or deny epilepsy.
We consider inexplicable behavior or symptoms such as agitation and sugar craving may be related to epilepsy seizure. Therefore, it is important that these patients should be examined more closely with EEG to confirm or deny epilepsy.We report on the case of a 7-year-old boy with Shiga toxin-producing Escherichia coli-related hemolytic uremic syndrome (STEC-HUS), initially presenting with abdominal pain as the only clinical feature and thus requiring differential diagnosis with a surgical emergency. Diagnosis of STEC-HUS was made with the appearance of bloody diarrhea and renal function impairment, and the clinical picture rapidly progressed to multiorgan failure. Relatively late and severe central nervous system (CNS) involvement was present, characterized by subacute encephalitis progressing to coma, which became apparent when the acute phase of thrombotic microangiopathy was resolving. Therefore, neurologic manifestations were thought to be related to reperfusion damage to the CNS and high-dose IV steroid pulse therapy was empirically administered. Following this therapeutic scheme, neurologic involvement resolved with no sequelae. This case offers several points of discussion on the clinical presentation and the diagnostic approach to STEC-HUS, on the related neurologic complications, and on a novel approach to their management.Background. Methemoglobinemia is a potentially life-threatening condition which presents with cyanosis and characteristic "chocolate-coloured blood." Although a co-oximetry would give a prompt diagnosis, there have been multiple reports of misdiagnosing this treatable condition-from being diagnosed as sepsis to asthma and even being operated for "ruptured ectopic pregnancy." Here, we report a case which presented without the classical signs of poisoning and methemoglobinemia-without vomiting, cyanosis, or chocolate-coloured blood. We also discuss the common misconceptions regarding anemia physiology and the pitfalls in diagnosing this condition and warn the reader regarding the reflexive use of antidotes like methylene blue. Case Presentation. A well-grown 3-year old boy presented with an acute history of irritability, cola-coloured urine, and desaturation on examination. The child was pale, with tachypnoea and in failure. Blood smear was suggestive of severe hemolytic anemia. Methemoglobinemia was diagnosed on co-oximetry.
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