Objective: To observe the effect of delayed serum separation on various chemistry analytes. Study Design: Quasi Experimental study. Setting: Clinical Chemistry Laboratory, Sheikh Zayed Medical College & Hospital, Rahim Yar Khan. Period: 1st December 2021 to 31st January 2022. Material & Methods: Fifty healthy volunteers of age 25-55 years from both genders were included in the study using consecutive sampling technique. Informed verbal consent was taken from all the study subjects. 4 cc blood was drawn from each subject and was divided into 3 plain tubes. 1 tube was analyzed at 1 hour for glucose, urea, creatinine, ALT, AST, ALP, sodium, potassium, chloride and calcium. 2nd tube was analyzed for same analytes 2 hours after sample collection and 3rd tube was analyzed at 4 hours. Results were recorded on a predesigned performa. Data was entered and analyzed using SPSS Software 23 for Windows. Data was presented in terms of mean and SD. P value p < 0.05 was considered significant. Results: Glucose, ALT, sodium, potassium and chloride showed statistically significant variation over time while others remained stable for up to 4 hours. There was decrease in glucose (p=0.000) while increase was observed in sodium (p=0.0001), potassium (p=0.0001), chloride (p=0.0001) and ALT (p=0.002). Conclusion: Blood samples should be transported to laboratory immediately and when received in laboratory samples should be centrifuged and processed within 2 hours as delayed transportation and separation affects many chemistry analytes and may lead to erroneous test results.

Objective: To determine the frequency of post-operative asymptomatic hypocalcaemia in patients with total and subtotal thyroidectomy. Study Design: Cross-sectional study. Setting: Department of Surgery, Sheikh Zayed Hospital, Rahim Yar Khan. Period: 1st July 2021 to 30th April 2022. Material & Methods: One hundred and Sixteen post thyroidectomy male and female patients of age 18-50 years were included in the study using consecutive sampling technique and two groups were formed. Group-A included those patients who underwent total thyroidectomy and in Group-B patients underwent sub-total thyroidectomy. Samples for serum calcium levels were collected in gel tube before and 24 hours after surgery. Post-operative Hypocalcemia was defined by serum total calcium < 8.5 mg/dL 24 hours after surgery. Patients with symptomatic post-operative hypocalcemia following total or subtotal thyroidectomy or hypocalcemia due to any other reason or systemic disease e.g. renal disease and pregnant females were excluded by history and medical record. Data was analyzed using SPSS 20. Results: In Group A the Mean age was 30.94 ±9.6 years, while those in Group B were 31.59± 11.03 years. In Group A 62 (35.63%) and in 30 (17.245%) of Group B patients respectively were identified with asymptomatic hypocalcemia. A statistically significant difference was seen in both groups. 0.00 is the probability value. Conclusion: When compared to sub-total thyroidectomy, the frequency of asymptomatic hypocalcaemia was substantially higher following total thyroidectomy. Asymptomatic hypocalcaemia after complete or partial thyroidectomy might affect both men and women equally. After subtotal or total thyroidectomy, both younger and older age groups had an equal likelihood of developing asymptomatic hypocalcaemia.

Objective: To determine the serum uric acid levels in diabetic, pre-diabetic and euglycemic study subjects. Study Design: Cross Sectional. Setting: Department of Pathology Sheikh Zayed Medical College /Hospital Rahim Yar Khan. Period: 1st December 2022 to 31st May 2023. Material & Methods: 144 patients of both genders with age 20 -70 year were included. Data was collected from the patients who came to lab for their HbA1C test. The blood samples for HbA1C and serum uric acid was collected in EDTA and gel tube respectively. HbA1C and serum uric acid was performed on Atellica CH930 fully automated chemistry analyzer based on photometry. The patients were grouped based on HbA1C as euglycemic group (Hba1C 4%-5.6%), pre-diabetic group (HbA1C 5.7%-6.4%) and diabetics group (HbA1C >6.5%) as per American Diabetes Association (ADA) criteria. Data was entered and analyzed using SPSS 22 version. ANOVA was applied to access the significance of difference of serum uric acid between euglycemic, prediabetic and diabetic groups. P-value <0.05 was taken as statistically significant. Results: The mean serum uric acid level in euglycemics, prediabetics and diabetics was 5.59±1.16, 6.07±1.04 and 5.01±1.61 respectively and the difference of serum uric acid between these 3 groups was statistically significant with p value 0.001. Conclusion: Serum uric acid was higher in prediabetics as compared to diabetics and euglycemics. Serum uric acid level should be done in prediabetic patients for prompt diagnosis of hyperuricemia and to avoid its related complications.