The prevalence of pre-analytical errors in the laboratory of the Cantonal Hospital Zenica in Bosnia and Herzegovina

Aim To identify rates of most common pre-analytical errors and to document possible (different) error rates between inpatients and outpatients. Methods This retrospective study was conducted at the Department of Medical Biochemistry and Immunology Diagnostics, Cantonal Hospital Zenica, from December 2016 until March 2017. Data on rejected blood samples in the laboratory information system were analysed. Results During the 3-month period 35,343 patient blood samples (25,545 inpatients and 9,798 outpatients) were received in the laboratory. The study identified 602 (1.70%) rejected samples because of pre-analytical errors, mostly due to haemolysis, 292 (48.50%), and clotted samples, 240 (39.87%). The remaining 70 (11.63%) samples were rejected because of inappropriate sample volume, inappropriate container and identification errors (7.81%, 2.16% and 1.66%, respectively). The proportion of inpatient rejected samples was 8.7-fold higher than in the outpatient samples. The proportion of inpatient rejected samples because of haemolysis, clotted samples, inappropriate sample volume and inappropriate containers were higher than in the outpatient samples (20.5-, 12.1-, 2.3- and 1.3-fold higher, respectively); proportion of rejected samples because of identification errors was 8.0-fold higher in the outpatient (collection sites outside the hospital) than in the inpatient samples. Conclusion Higher pre-analytical sample error rates were connected with inpatient samples, while higher identification error rates were connected with outpatient samples. Establishment of periodic stuff training and introduction of information technology could reduce pre-analytical errors

Fasting state requirements for blood sampling: a survey of patients in Cantonal Hospital Zenica, Bosnia and Herzegovina

Aim To explore patient’s awareness and appliance of the fasting state requirements for blood sampling. Methods This observational survey was performed at the Department of Medical Biochemistry and Immunology Diagnostics, Cantonal Hospital Zenica, from June to July 2019. An anonymous questionnaire was conducted on 200 consecutive outpatients older than 18, who were admitted to the laboratory for routine blood testing. Results A total of 134 (67%) patients were informed that they needed to be at fasting to perform laboratory tests. Patients were mostly informed by a requesting physician or a nurse, 68 (50.8 %), and by other patients, members of the family and friends, 58 (43.3%); only seven (5.2%) patients were informed in the laboratory. A total of 75 (37.5%) patients arrived to the laboratory properly prepared. Conclusion Most patients were not well informed about fasting state requirements for blood sampling and consequently they were not adequately prepared for laboratory tests. Laboratory should establish updated fasting recommendations available to patients and healthcare professionals, and conduct continuing education of patients and health care staff

Function of B-Cells and Insulin Resistance in Long-Standing Type 2 Diabetes Mellitus

Introduction. Every patient with type 2 diabetes mellitus secretes less insulin thannecessary for his/her level of insulin sensitivity, and many of them have some degreeof insulin resistance. The mix of insulin defi ciency and insulin resistance is differentfor each patient and, in any patient, it may vary during the course of the disease. Theaim of our study was to examine the degree o

C-Reactive Protein And Fibrinogen In Type 2 Diabetes Mellitus

Introduction. Chronic,low-grade infl ammation is important in the development andprogression of type 2 diabetes mellitus (T2DM). Indicators of increased infl ammatory activityinclude elevated values of circulating acute phase proteins like C-reactive protein (CRP) andfi brinogen. The aim of the study was to test sex-related differences in CRP and fi brinogenblood levels in T2DM patients.Patients and Methods. The cross-sectional study included 40 T2DM patients, bothsexes (19 males and 21 females), median age 70 (36-90) years. Patients were hospitalizedat the Clinic of Endocrinology, Clinical Center University of Sarajevo. The fasting glucoselevels, glycated haemoglobin, fi brinogen and CRP in the blood of T2DM patients weredetermined by standard laboratory methods. The data were analysed by statistical softwareSPSS 19.Results. The median values of CRP and fi brinogen in blood were not statistically differentbetween female and male T2DM patients, although values had tendency to be higher infemale patients [17.30 mg/L (3.40-61.35) vs. 9.60 mg/L (3.50-28.90); p=0.573]; [5.70 g/L(4.20-6.35) vs. 3.80 g/L (3.60-6.00); p=0.078]. A positive correlation between CRP andfi brinogen was found in samples from female T2DM patients (rho=0.606;p<0.01).Conclusion. Elevated CRP and fi brinogen indicate the presence of infl ammation in T2DMpatients. Female patients had higher values of both infl ammatory markers in blood incomparison to males, but we did not prove statistically signifi cant sex-related differences