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Purpose: The aim of this study was to determine the impact level of improvements and positive contributions in clinical laboratory processes by using the six sigma protocol as quality management tool. Materials and Methods: In this study, “Six Sigma Protocol” has been applied for classification and investigation of errors and their reasons as well as evaluation of method performances of Çukurova University Medical Faculty Balcalı Hospital Central Laboratory. In order to study at universal standards, the base line status was established by analyzing the resources and frequency of the errors. As a result of detection and classification of the errors, corrective activities, beginning from the most affected processes, have been planned. Results: Six sigma levels of the preanalytical stage were found to be increased from 4,250-4,357 to 4,500-4,625. The highest six sigma level of analytical phase was 10,5 for amylase test. Sigma level of potassium turn around time was increased from 2,250 to 2,500 in the postanalytical stage. Conclusion: This study has given the opportunity for elimination of errors potentially harmful for patient health and choosing appropriate internal quality control rules. Therefore, high quality services were shown to have positive contribution to hospital budget by decreasing costs due to lack of quality, despite the costs of corrective activities and actions taken. Laboratory performances were calculated in means of universal criteria and compared with that of other clinical laboratories, as well. Sigma levels of laboratory processes which were found above 4-5 confirm that services provided by our laboratory were in accordance with international quality standards [ABSTRACT FROM AUTHOR]

Since 11 March 2020, when COVID-19 was declared as a pandemic by the World Health Organization, the number of cases has increased all over the world and this uncontrolled increase has created a great burden on health systems. Strict measures such as quarantine have been taken for billions of people all over the world to prevent the spread of the disease. This, in particular, has adversely affected the economy and health systems of countries and continues to do so. In particular, due to the high rates of asymptomatic COVID-19 cases, the measures taken remain insufficient and make it difficult to combat the pandemic. Nucleic acid amplification test is the gold standard method in the diagnosis of SARS-CoV-2 infection. However, due to the long duration of giving results and the false negativity rate of up to 40%, the rapid screening of the patients and the initiation of treatment are delayed. Accelerating the diagnosis and treatment of patients by evaluating them with biochemical tests in the early period is important both in terms of early control of the disease and control of the spread of the epidemic and the correct and efficient use of resources during the epidemic. With this review; it is aimed to summarize the biochemical tests used in the diagnosis, follow-up of the disease, in the regulation of appropriate treatment for the patient, and the biochemical tests used in the risk prediction scores created to determine the prognosis of the disease. [ABSTRACT FROM AUTHOR]

COVID-19 has become a major public health problem since December, 2019 and no highly effective drug has been found until now. Numbers of infected people and deaths by COVID-19 are increasing every day worldwide, therefore self-isolation and protection are highly recommended to prevent the spread of the virus and especially to protect major risk groups such as the elderly population and people with comorbidities including diabetes, hypertension, cancer, cardiovascular diseases and metabolic syndrome. On the other hand, young people without any secondary disease have died by COVID-19 as well. In this study we compared two male patients infected by COVID-19 at the same age and one of them was diagnosed with G6PD deficiency. Both COVID-19 and G6PD deficiency enhance the risk of hemolysis and thrombosis. Serum biochemistry, hemogram and immunological parameters showed that risk of hemolysis and thrombosis may increase in the G6PD deficient patient infected by COVID-19. [ABSTRACT FROM AUTHOR]

Objective: Medical laboratories encounter critical obstacles in External Quality Assessment (EQA) practices that are key to assessment of the analytical period. Present study aims to unveil the challenges in nationwide inter-laboratory harmonization and suggest practical solutions. Materials and methods: EQA results of 1941 laboratories participating in 18 different EQA-programs between 2010 and 2017 were examined. Standard Deviation Index (SDI) of each program calculated using 801,028 sample data from 24 different clinical chemical tests were used to conduct a process assessment. Results: There is a significant discrepancy in unsatisfactory performance ratio among different EAQ-programs with an average of 3.4% (27,074 cases) between 2010 and 2017 and a decreasing trend (~40–50%) in 7-years. Programs with higher SDI display lower discrepancy rates. Reasons for unaccepted results appear to be data entry errors (8.27–22.2%), material dilution errors (5–11.4%), technical problems (3.76–7.9%); while random or unidentified causes account for a major of 44.9–59.5%. In 7-years, 15.7% reduction was observed in average SDI of all tests. Conclusion: With the launch of national EQA follow-up program, increased awareness of the analytical processes led to a decrease in unaccepted results and variances in the analytical period. Staff training is suggested as a significant measure. In addition, simultaneous assessment of SDI and allowable total error rates would reduce the variation between programs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: COVID-19 has become the major public health problem since December, 2019 worldwide and no treatment or vaccine have been found until now. Elderly population and people with secondary diseases such as diabetes, cancer, hypertension, cardiovascular diseases, endocrine diseases and metabolic syndrome. However people without comorbidities or individuals belonging to the young population have died because of COVID-19 infection. We have suggested that people with enzyme deficiencies including glucose-6 phosphate dehydrogenase (G6PD) deficiency may become more vulnerable against COVID-19 infection. MATERIALS and METHODS: We have evaluated hemogram and biochemistry results of two male patients at the same age and one them is diagnosed as G6PD deficiency. RESULTS: Serum biochemistry and inflammation markers including CRP, fibrinogen, D-Dimer, total bilirubin, lactate, ALT, AST, ferritin, glucose and eGFR increased in the G6PD deficient patient, where CK levels decreased. WBC, MCH, Hgb, lymphocyte #, lymphocyte %, eosinophil %, basophil %, HCT and PLT levels as hemogram parameters decreased in the G6PD deficient upon COVID-19 infection, however monocyte % and RDW levels increased during infection. On the other hand, magnesium, sodium, potassium, calcium and levels were evaluated in both patients to evaluate electrolyte balance. Only calcium levels decreased in G6PD deficient patient within 2 weeks following diagnosis. CONCLUSIONS: Clinical data showed that COVID-19 infection causes severe symptoms in the G6PD-deficicent patients. Our clinical report is important, because we have showed that currently used drugs may worsen COVID-19 symptoms in the G6PD deficient patients infected by COVID-19. [ABSTRACT FROM AUTHOR]