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Gurdeep Singh Dhatt

Publications and source records attributed to Gurdeep Singh Dhatt.

5 recordsLinked to original sources

Thyrotrophin and free thyroxine trimester-specific reference intervals in a mixed ethnic pregnant population in the United Arab Emirates.

BACKGROUND: Physiological alterations in the homeostatic control of thyroid hormones cause changes in thyroid function tests in pregnant women. A lack of method, trimester and population-specific reference intervals for free thyroxine (FT4) and thyrotrophin (TSH) makes interpretation of FT4 and TSH levels in pregnancy difficult. We established trimester-specific reference intervals for TSH and FT4 in a mixed ethnic population of pregnant women attending two antenatal clinics in the United Arab Emirates. METHODS: TSH and FT4 result from 1140 women with uncomplicated singleton pregnancy were available. The 95% reference intervals were determined for TSH and FT4 for each trimester for Arab women from the United Arab Emirates and other Arab countries and Asian women. RESULTS: Suppressed TSH levels in the first trimester recovered to non-pregnant levels in the third trimester. There was a significant difference in TSH levels between trimesters 1 and 2, and 2 and 3 (p<0.0005). There was no significant difference in the TSH levels between the various ethnic groups. Mean FT4 levels decreased with each progressive trimester in all groups. There were significant differences in FT4 levels between all three trimesters (p<0.005), especially between the first and second trimesters. FT4 differed significantly between UAE nationals and Asians in the first and second trimesters (p<0.005). CONCLUSIONS: In general, the findings were in keeping with earlier reports. Use of trimester-specific reference intervals should help in the appropriate interpretation of thyroid hormone results in the mixed UAE population.

Adolescent↗

Thyroid hormone reference intervals in an ambulatory Arab population on the Abbott Architect i2000 immunoassay analyzer.

BACKGROUND: Considerable differences in reference intervals for FT4 and TSH have been reported between countries. Method related differences in the distribution of free thyroxine (FT4) have also been reported. The aim of this study was to establish reference intervals for thyrotrophin (TSH) and FT4 in an ambulatory adult (16-75 y) Arab population attending a general practice clinic using the Abbott Architect i2000 immunoassay analyzer. METHODS: TSH and FT4 results from 959 consecutive ambulatory Arab subjects were available. After excluding data sets from pregnant women, patients with known and newly diagnosed thyroid disease, individuals taking medication that may affect TSH and FT4 and individuals with acute illness, 742 data sets were available for analysis. A 2-way between-groups ANOVA was conducted to explore the impact of age and gender on TSH and FT4. RESULTS: TSH showed a non-Gaussian distribution, FT4 showed a near normal distribution. There was no significant main effect on FT4 and TSH for age and gender. The interaction effect of age and gender also did not reach significance. The 95% reference intervals were: TSH 0.30-4.32 mU/l and FT4 9.8-18.6 pmol/l. The reference intervals for TSH and FT4 determined in this study differed from those reported from other countries using the same analytical platform and from the 99% reference intervals, provided by the manufacturer. CONCLUSIONS: These differences in reference intervals in different populations may affect patient management. The data reported reemphasize that each laboratory should determine population and method-specific reference intervals.

Adolescent↗

HbA1c: a comparison of NGSP with IFCC transformed values.

BACKGROUND: An approved IFCC reference method for measuring HbA1c, with a firm and reproducible correlation with NGSP values, is now available. We established (i) the degree of agreement of HbA1c results between the NGSP-certified and the IFCC-calibrated (converted to NGSP values) immunochemical method and (ii) the difference in the classification of control of diabetes mellitus (DM) in individual patients between the methods. METHODS: HbA1c was measured on the same hemolysate from each patient by both methods (n=92). Results were analyzed by the kappa statistic, linear regression, and McNemar's chi(2) test. RESULTS: Both methods achieved acceptable analytical performance. The kappa statistic measure of agreement was 0.65 and r(2)=0.937. Overall, 21 (22.8%) patients were classified differently in the extent of diabetes control (good, acceptable, or poor), with a significant difference between the 2 methods (p<0.0005). CONCLUSIONS: The IFCC converted to NGSP values were significantly different from the previously used NGSP-certified method. The differences between the 2 methods are of sufficient magnitude that HbA1c results from these methods are not interchangeable. The IFCC method being scientifically superior in concept and design should replace the NGSP method. New HbA1c targets for DM management need to be established for the IFCC method.

Blood Chemical Analysis↗

Evaluation of a glucose meter against analytical quality specifications for hospital use.

BACKGROUND: The value of glucose meters in point of care testing (POCT) by medical professionals and self monitoring of blood glucose (SMBG) by patients is well established. We evaluated the SureSteppFlexx glucose meter against objective targets for imprecision and total error (TE). METHODS: The SureStepFlexx blood glucose system uses a reflectance-based glucose oxidase (GO) method and reports plasma-equivalent glucose values. The reference method was the Beckman LX20 Pro glucose oxidase/oxygen electrode method. Patient samples and commercial aqueous, quality control (QC) material were used to assess imprecision. To determine total error of the meters, results obtained on patient heparinized blood were compared against results obtained by the reference method using plasma. Analyses were carried out by an experienced nurse and technologist. RESULTS: Both operators achieved imprecision of < or =5% for all measurements. Overall, the percentage of results deviating from the total error targets were 0-21% and 4-13% for the nurse and technologist, respectively. Compared with earlier studies, the percentages of reported results outside the < or =10% and < or =5% American Diabetes Association (ADA) criteria are significantly lower. CONCLUSIONS: The SureSteppFlexx glucose meter meets analytical quality requirements and is suitable for POCT use in our hospital. We propose a tiered approach and suggest minimum, desirable and optimum total error targets for glucose meters of < or =5%, 7.9% and 13%, respectively.

Blood Glucose↗