ConclusionAnti-TPO antibody subsequently leads to hypothyroxinemia, for which it is necessary that cases with high titer of anti-TPO antibody though euthyroid should be meticulously followed up and screened for to detect development of hypothyroidism or SCH, particularly in future pregnancies. However, GDM prevalence was at par with the national figure, but with no significant association of SCH and a high anti-TPO ab titer was found with GDM in our study. Further studies with a larger cohort may establish a causal association between the two most common endocrinological disorders observed in pregnancy.

Background:: Serum ferritin concentrations are altered in hypothyroidism, but there is no available literature regarding the status of serum ferritin in anti-thyroid peroxidase (anti-TPO) positive hypothyroidism. The objectives: of our study were to evaluate the titer of anti-TPO and serum ferritin in newly diagnosed hypothyroid patients and to find out any difference of serum ferritin concentration between antibody-positive and antibody-negative patients. Methods:: A total of 143 subjects above the age of 18 years were recruited, and serum Thyroid Stimulating Hormone (TSH), free T3, free T4, anti-TPO, and ferritin were assayed by chemiluminescence method. According to their serum analysis findings, three groups were made as Group 1 of 49 subjects with hypothyroidism and anti-TPO positive, Group 2 of 47 subjects with hypothyroidism and anti-TPO negative, and Group 3 of 47 euthyroid and anti-TPO negative controls. Results: : Kruskal Wallis H test was applied, and the difference in concentration of TSH, FT3, FT4, Ferritin, anti-TPO amongst the three groups was found to be significant. The relationship between anti-TPO levels and serum ferritin concentration was further studied by multinomial logistic regression. We have found that there is a significant difference between the concentrations of ferritin; hence, it is highly likely that those with a high level of anti-TPO antibody shall have a higher concentration of serum ferritin. Conclusion:: ferritin concentrations were decreased in anti-TPO negative hypothyroidism, but in case of anti-TPO positive hypothyroidism the ferritin concentrations are raised. Hence, hypothyroidism should not always be considered as an iron deficiency state.

Introduction Delay in the analysis of serum electrolytes along with clot contact time can lead to difference in results significant enough to affect clinical decisions. This study was undertaken to evaluate the effect of time lag between centrifugation and analysis on levels of serum sodium, potassium, and ionized calcium in a tertiary level health care set up. Materials and Methods In this cross-sectional study, 70 serum samples were analyzed for ionized calcium, sodium, and potassium under different conditions with respect to time lag and clot contact time. The analysis of ionized calcium was done on Eschweiler Combiline 2, a direct ion-selective electrode (ISE) analyzer. Serum sodium and potassium were analyzed on fully automated chemistry analyzer, which is an indirect ISE analyzer. The statistical analysis was done in IBM SPSS software version 21. Results The results for intergroup comparison with different time lag and clot contact time between all the four groups for sodium, potassium, and ionized calcium were statistically significant, as obtained by application of Kruskal–Wallis test. There was consistent decrease in the concentration of sodium and ionized calcium, and an increase in serum potassium with increased delay in analysis and clot contact time. Conclusion The accurate measurement of electrolytes is of paramount importance for the treatment and better prognosis of critically ill patients. This can be accomplished by better management of the preanalytical phase of analysis by maintaining a standard protocol in the laboratory and sample transportation.

Background: Healthcare setups in India are encountering a lot of medical, ethical, legal, and social challenges endorsed by the ongoing COVID-19 crisis, modifying the healthcare protocols, which are considered a standard of care. The ethical conflicts are pressurizing the decision-makers of society, to revamp the basic principles and traditional assumptions of our present healthcare modalities. Objectives: This report addresses the common but crucial ethical issues, encountered by healthcare workers e.g., doctors and paramedics in day-to-day healthcare practice during the COVID-19 pandemic. Materials and methods: This report tries to cover several ethical aspects of COVID-19 such as: setting priority of screening; professional responsibility of healthcare workers; dilemma encountered by a doctor; compromise of patient confidentiality; allocation of scanty resources; end-of-life situation, and certain critical clinical scenarios. Results and conclusion: COVID warriors from the health sector possess dual responsibilities of taking utmost care of COVID patients ethically, along with self-protection from this havoc. COVID-19 has taught us the lesson that, extra-ordinary time calls for extra-ordinary measures. Also, intervention performed upon the patient affects not only the patient, but also the whole of society.