Blood Sugar & Blood Hemoglobin – Old Wine, New Skins

DIABETES MELLITUS

Definition

  • Metabolic disease characterized by hyperglycemia caused by defective insulin secretion and/or action
  • results in long-term multi-organ complications.
  • can now be found in almost every population in the world and epidemiological evidence suggests that, without effective prevention and control programmes, its prevalence will likely continue to increase globally.

Symptoms

  • Polyuria, polydipsia, weight loss despite polyphagia
  • Blurred vision
  • Growth impairment
  • Increased susceptibility to infections

Classification of diabetes mellitus

  • Type 1 diabetes (ß-cell destruction, usually leading to absolute insulin deficiency)
  1. Immune mediated
  2. Idiopathic
  • Type 2 diabetes

–insulin resistance with relative insulin deficiency

–secretory defect with insulin resistance

  • Gestational diabetes
  • Secondary diabetes

For more information, contact IGCLM

Point of Care Testing – Principles & Practice

INTRODUCTION

  • ‘Near-patient testing’ (NPT) and ‘Point-of- care testing’ (POCT) are used synonymously to describe analytical procedures performed for patients by healthcare professionals outside of the conventional laboratory.
  • Advances in technology have led to the development of instruments and kits designed for use in this role and which are able to provide an increasing repertoire of tests.
  • Analytical tests are now available for use in operating theatres, hospital wards, or outpatient departments in the acute sector, in general practice surgeries and in the homes of patients in primary care.
  • POCT can lead to improved patient care.
  • It is imperative that, wherever POCT is operated, it must be monitored and supervised by qualified staff of a clinical laboratory

Implementation

  • The head of the clinical unit or directorate and the head of pathology should establish an initial clinical need for POCT –
  • in consultation with relevant clinicians, depends on the relevance of the analysis and the efficacy of the analyte(s) for the specific clinical requirement; and the ability of the laboratory to provide that
  • Responsibility for the maintenance of the service should normally reside with a delegated senior med tech
  • He/she should be authorised by the head of pathology to act as the trainer and general ‘liaison officer’.
  • Create ‘liaison person’ with appropriate seniority and authority in each clinical area using POCT.
  • appropriate supplier contacts for service/support

For more information, contact IGCLM

Smile and Smile with IVF Technology in our hands in sickle cell traits pregnancies

The Second Distinguished Lecture presented at the Institute of Genetic Chemistry & Laboratory Medicine, Bodija, Ibadan

by

Oladapo Ashiru

MB.BS, M.Sc, Ph.D, HCLD, FNSEM, OFR

 

Introduction

The history of ART dates back to 1963 when Yanagimachi and Chang reported in-vitro fertilization of hamster eggs and thereafter Yanagimachi reported in vitro capacitation of hamster spermatozoa in follicular fluid [1, 2]. Capacitation, a term used to describe hyper-activated motility of the sperm, is required for fertilization to take place. Following this, in 1977, Andrew Schally and Roger Guillemin were awarded the Nobel Prize in Medicine and Physiology for their work in the isolation of LHRH from the hypothalamus [3].

figure1

FIGURE 1 Roger Guilleman and Andrew V Schally

In 1978, Ashiru and Blake also reported FSH positive feedback mechanism on the pituitary [4, 5]. These and many others have been the bedrock for the achievement of the first live birth via in vitro fertilization (IVF), Louis Brown, popularly called the first ‘test-tube’ baby in 1978, after a failed attempt that resulted in ectopic pregnancy in 1976. 6 This ground breaking success was achieved by Steptoe and Edwards in Oldham, England and Robert Edwards was subsequently awarded the Nobel Prize in Medicine/Physiology in 2010.

figure2

FIGURE 2 Patrick Steptoe and Robert Edwards 1978.

Other countries reported their successes, Australia by Carl Woods in 1980 [7], USA by Howard & Georgeanna Jones in 1981 [8] and Nigeria by Oladapo Ashiru, Osato Giwa-Osagie in 1984 and the delivery of a baby through IVF in 1989. [9-17]

figure3

FIGURE 3 O. F. Giwa-Osagie, R. Edwards and O. A. Ashiru, November 1992

 

WHAT IS IVF?

IVF means fertilization achieved outside of the body. It involves ovulation induction, oocyte retrieval, sperm preparation, oocyte stripping, insemination followed by fertilization in a culture dish and finally embryo transfer. Oocyte retrieval and embryo transfer processes are usually done under ultra-sound guidance. Also, it is important to know that gamete handling is usually done under strict temperature control. Without the development of IVF, pre-implantation genetic diagnosis (PGD) would not have been possible.

home3

FIGURE 4. Illustration of Steps involved in IVF

WHAT IS PGD?

PGD as the name implies involves testing for specific genetic defects in the DNA code prior to embryo implantation. Usually, there is targeted testing of a known genetic abnormality in the couple.

Preimplantation genetic diagnosis (PGD) is diagnosis of a genetic condition prior to achievement of a pregnancy. PGD was first performed in the early 1990’s as a way for couples to prevent the pregnancy of a child with a genetic disease. Currently at Medical Art Center, we are able to offer PGD testing for genetic conditions including sickle cell anaemia and chromosome aneuploidies. We work in collaboration with Genesis Genetics, a world renowned genetics institute. They pioneered PGD testing of embryos for inherited genetic abnormalities.

 

For more information, contact IGCLM