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LaboratoryDiagnostics(in-vitro)MedicalImaging(in-vivo)sSharing breakthrough technologies and solutions in laboratory scienceIssue 01 / Sep 2012www.siemens.com/healthcareDear Reader,Greetings from Siemens! It gives me immense pleasure to introduce our new communication initiative Lab-trendz; our brand new clinical newsletter. As you may be aware, Siemens is the only integrated healthcare company that provides in-vitro and in-vivo diagnostic solutions worldwide. Our innovative solutions and services enable our customers achieve tangible, sustainable clinical and financial outcomes. At Siemens, we are relentlessly focused on innovating, shaping and transforming the future of healthcare delivery and patient care. Our Diagnostics Division has been on the forefront of these changes with our consistent advancements in diagnostic innovations. Through this newsletter, we provide you a quick and regular update on the best clinical practices and exciting technological innovations in laboratory diagnostics, which make an impact on clinical practice. We hope you find value in this newsletter and we look forward to meaningful interactions that are mutually beneficial. D. RagavanSector Cluster Lead - South Asia Healthcare Sector, Siemens Ltd.Newzflash, we would like to share some of the latest technological advances that we showcased at the 2012 AACC and ASCLS Annual Meetings and Clinical Lab Expo in California. We would also highlight a few exciting initiatives that Siemens Healthcare Diagnostics has launched towards better healthcare delivery.We appreciate your support in the form of clinical cases and suggestions that will add value to this newsletter. I take this opportunity to thank you for your support and belief in Siemens Healthcare Diagnostics and assure you our best services always.Sushant Kinra Vice President South Asia Diagnostics Division Healthcare Sector, Siemens Ltd.Lab-trendz Newzflash1 Introduction2 HealthcareDiagnosticsportfolioLabAutomationSolutions3 1st StreamLAB installation AptioAutomation New4 CystatinC NewEnzymaticCreatinine NewCLINITEKNovus Analyzer New5 EmergingResistanceandMicroScanSystemsEducation&Training6 Newinitiatives:PersonalizedEducationPlanTechnicalSolutionsCenterClinicalMarketing7 CustomerExperience8 Quiz#1Dear Reader,Siemens believes that the heart of a hero beats in every lab professional. Their ability to provide clinicians with accurate and timely information can change lives. Thats what heroes do every day. And through the power of innovation that Siemens places in the hands of our customers, our forward-thinking solutions can equip these heroes to become super heroes as they improve care for generations to come. Lab-trendz from Siemens, is dedicated to the interests of professionals working in laboratory diagnostics across the country. The objective is to create a medium where we can interact and I believe this newsletter will be a valuable resource for you and your laboratory personnel. Our intention is to offer a platform for the industry stalwarts to share their experiences and clinical insights like best practices and industry trends, which can benefit their peers and can be implemented on a wider canvas. It will also cover the recent innovations and technologies from Siemens.In this inaugural issue of Lab-trendz Siemens is the only company to offer a complete portfolio from medical imaging to laboratory diagnostics to therapy systems to healthcare IT. Our innovations combine state-of-the-art products and solutions for an earlier prevention and more specific diagnosis, thus enhancing patient care.2 Lab-trendz Newzflash Issue 1 / 2012A portfolio of performance-driven solutionsSiemens Lab Automation SolutionsThe Diagnostics division of Siemens Healthcare serves a critical role in the healthcare continuum, providing more effective and Immunosuppressive Drugs & TDMInfectious DiseaseInflammationLiver FibrosisMetabolicNephropathiesNutritional AssessmentPancreatic DiseaseReproductive EndocrinologyThyroidAllergyBone MetabolismCancerCoagulation DisordersDiabetesDrugs of Abuse / ToxicologyGrowthAnemia / Iron MetabolismAutoimmune / RheumatoidHepatic DiseasesCardiovascularNervousMuscularRespiratoryExcretorySkeletalCirculatoryDigestiveMeeting expectations in todays healthcare environment requires more than reporting accurate results. It requires innovation, customization and flexibility. Timely reporting of comprehensive test findings, effective staff utilization and cost-effectiveness to maximize productivity require novel thinking that stretches across the entire continuum of care.For a diagnostics laboratory, the challenges can vary from handling more tubes per hour to maintain speed and efficiency during workload peaks. The challenges may be different for different setups or it can also be summarized as the challenge to do more with less. Our leadership in laboratory automation means that every automation platform is customized to work seamlessly with your selected components.You get the results that you have been striving for: Throughput that increases productivity while reducing errors Healthcare IT integrationOur Automation Solutions, featuring the ADVIA LabCell system and the StreamLAB system, offer a high performance option to connect your laboratory analyzers in a single, consolidated high-volume workstation. They guarantee speed, capacity and scalability to customize laboratory of any size. Whats more, besides streamlining workflow by automating manual steps, lab achieves greater clinical efficiency by increasing the capacity of handling the number of sample tubes for analysis and freeing staff to perform other critical tasks. In addition to these advantages, there is a significant reduction in errors and you can achieve shorter, more predictable turnaround times (TAT). Peakperformance Handle all your workload up to 1600 tubes/hour for efficient ways to anticipate, diagnose, monitor and treat disease. While working closely with laboratory professionals, clinicians and hospital administrators, we create innovative products and solutions that are transforming diagnostics. Our broad spectrum of integrated chemistry, immunoassay, routine chemistry, hematology, hemostasis, microbiology, diabetes, plasma proteins, urinalysis, blood gas monitoring and molecular testing systems, in conjunction with automation, informatics and consulting solutions, truly serves the needs of laboratories of any size today and tomorrow.Our products and services offer the right balance of science, technology and practicality, to improve clinical outcomes, streamline workflow and enhance the operational efficiency of clinical laboratories. Our dedicated professionals are committed to meet the needs of our customers by providing high-quality products and highly-responsive service support to deliver better, more personalized healthcare to patients.configurable systems, get results completed on time, and meet your TAT goals consistently.Processefficiency Harness the power of your primary tube and combine multiple disciplines onto one platform.Expansivemenu Offer more than 275 assays into a common track system for screening, diagnosis, prognosis and monitoring of most disease states. Capacityforgrowth Drive volume and revenue through outreach and elimination of send-outs.Confidence Customize as per needs to work seamlessly with your laboratories components.The plug-and-play approach for adding or switching instruments and components allows each system to evolve as your needs change. With our Automation Solutions, you get more options and greater stability for your lab automation investment.3 Lab-trendz Newzflash Issue 1 / 2012First StreamLAB automation in India Babina Diagnostics, Imphal, ManipurThe StreamLAB at Babina Diagnostics integrates the reporting capabilities of an integrated chemistry system (Dimension RxL MAX) and an immunoassay system (ADVIA Centaur XP), both from Siemens and facilitates enhanced benefits, such as: No sample splitting Facilitates sample sorting for post-processing by other departments Integrates the workflow by way of Unique Sample Identification and Automated Centrifuge LIS enabled requisition & test reporting and thereby restricts the human errors The system is capable of handling 300 tubes/hour and this processing speed has eased the workflow and has facilitated quicker reporting patterns Automates the inventory management on-board for both processing analyzers Automated QC management, ensuring the quality protocol for reporting patient results.Babina Diagnotics, with this state-of-the-art technology, is fully equipped to meet the fast growing needs of a city like Imphal, and is poised for an upward trend to meet the increased sample loads, both in terms of quality and accuracy, inclined to enhance human lives. StreamLAB has added a new dimension to my diagnostic centre in offering the latest technology to the people of Manipur.Dr. Dhabali Singh, Proprietor - Babina DiagnosticsThe StreamLAB Automation Solution links multiple integrated chemistry, immunochemistry and coagulation systems via a single operator interface with automated pre and post-analytical functions.StreamLAB, the true laboratory automation, is first-of-its-kind system in the country. It has enhanced the workflow at Babina Diagnostics and features many benefits to the operator: A single operator interface for multi-tasking and workload management Intelligent software to optimize throughput and TAT Flexible handling of multiple tube types simultaneously Space efficient, expandable, open architecture design Reduces labor requirements by eliminating non-value-added tasks Provides fully automated, integrated testing of routine and specialty chemistries, immunoassays, cardiac markers, STATs, therapeutic drugs, drugs-of-abuse and endocrinology.Introducing Aptio Automation NewAptio Automation is a unified solution developed expressly for the changing workload and expanding needs of todays clinical laboratory. It provides unlimited potential for lab optimization by combining peak performance, adaptability and intelligent technology with Siemens signature automation workflow expertise. With Aptio Automation, labs of all sizes can transform their operations to harness change and drive maximum performance and efficiency. Aptio Automation workcell is a modular solution that automates pre-analytical processing, sample handling and processing in the laboratory. It consolidates multiple analytical instruments into a unified workstation by employing a common sample processing capability. Aptio Automation provides workload management, sample order management and instrument operational status monitoring. This is accomplished through communication connections between Aptio Automation, analyzers and the LIS (Laboratory Information System) or middleware.4 Lab-trendz Newzflash Issue 1 / 2012Cystatin C NewQuantitative determination of Cystatin C in human serum and plasma is possible on Siemens platform. Measurement of Cystatin C aids in the diagnosis and treatment of renal disease. Cystatin C is a cysteine proteinase inhibitor with a relatively low molecular weight (13250 Daltons). This protein is an effective marker of renal function because it is formed by all nucleated cells at a constant rate and freely filtered by the healthy kidney. Serum concentrations of Cystatin C are almost totally dependent on the glomerular filtration rate (GFR). A reduction in GFR causes a rise in Cystatin C concentration. GFRistherate(mL/min)ofplasmafilteredbytheglomerulusfrom the blood to the tubular system. eGFR is estimated Glomerular Filtration Rate. Literature suggests that Cystatin C measurement can generally be used instead of Creatinine measurement as an indicator of GFR and may be superior indicator for some patient populations Cystatin C test is not affected by non-renal factors such as age and nutrition and it more consistently changes with renal activity than Creatinine Cystatin C on Siemens platform offers these advantages as a better marker for GFR No extra-glomerular elimination Not dependent on muscle mass Does not need correction for age, gender and weight Does not require urine collection Offers high throughput capabilities.Enzymatic Creatinine NewEnzymatic Creatinine is an in-vitro diagnostic test for the quantitative measurement of Creatinine in human serum, plasma and urine via enzymatic methodology. Creatinine measurements are used in the diagnosis and treatment of renal diseases, in monitoring renal dialysis and as a calculation basis for other urine analytes.Excellentaccuracyandprecision: More reliable Creatinine assay, improves early detection of impaired kidney function via eGFR.MeetsNKDEP(NationalKidneyDiseaseEducationProgram)Guidelines: Provides method standardization for more accurate eGFR results and thus better patient management.Lessvulnerabletoendogenousinterferences: Improved specificity means more accurate Creatinine results; highly useful in neonatal populations where NKDEP cautions use of Jaffe method.Point Of Care (POC)Siemens provides point-of-care products and services that range from blood gas and urinalysis systems, to diabetes and cardiac analyzers, to POC informatics. We strive to be your most trusted source for POC diagnostics.Bloodgassystems: Comprehensive range of RAPIDSystems portfolio of blood gas analyzers produces results in minutes, enabling critical treatment decisions to be made instantly.Cardiac: Stratus CS Acute Care Diagnostic System delivers fast, accurate, laboratory-quality cardiac results, optimizing patient outcomes in POC settings.Diabetes: DCA Vantage System better manages diabetes patients by enabling quick results and actionable physician-patient conversations at the time of visit.Urinalysis: CLINITEK and MULTISTIX family of urine analyzers and strips offers one of the most comprehensive and trusted urinalysis portfolios. CLINITEK Novus Analyzer NewCLINITEK Novus Automated Urine Chemistry Analyzer combines proven dry-pad urine chemistry technology with an easy-to-use cassette test format to ensure standardized test results and maximum productivity in busy laboratories. The CLINITEK Novus analyzer streamlines workflow, simplifies routine urinalysis and STAT testing and delivers consistent, high-quality results, even during peak periods. ClinicalConfidence Proven test pads provide reliable results with clinically relevant sensitivity and specificity Ready-to-use liquid calibration of all analytes Offers full spectrum of tests for routine urinalysis, early detection of kidney disease (protein-to-creatinine ratio) and microalbuminuria (albumin-to-creatinine ratio) testing on a single strip.Pre-analyticSampleQualityCheck Color correction Humidity exposure check to assess sample integrity Reduction in missed disease state Reduce unnecessary confirmatory tests, detect disease earlyImproved Reliability Improvement in reagent handling, pipette reliability, lamp life reduces the number of failures and system downtime ImprovedWorkflow 450 test sets on-board, processing of 240 test/hour Load up to 200 samples at one timeExpandedMenu Measurement of Micro-albuminuria (A:C ratio) reduces cost of manual testing and send-outsEaseofUse Tiltable color touch screen Flexible menu options for easy system customization, setup, maintenance, QC and troubleshooting5 Lab-trendz Newzflash Issue 1 / 2012Staying Ahead of Emerging Resistance and Evolving Laboratory Requirements the Trusted way with Siemens MicroScan Microbiology Systems Automated processing reduces technologists time Provides clinically relevant identification from an extensive database of gram-negative microorganisms resistant to most common therapies; e.g. ESL (extended spectrum beta-lactamases) - mortality can be up to 75% if not detected KPC (klebsiella pneumoniae carbapenemases) - KPC producing bacteria are resistant to all -lactam agents Provides clinically relevant identification from an extensive database of gram-positive microorganisms resistant to most common therapies; e.g. VRSA (Vancomycin resistant Staphylococcus aureus) - Infrequently isolated, mortality high MRSA (Methicillin resistant Staphylococcus aureus) - Seen frequently in ER departments, may require immediate hospitalization, Community-acquired MRSA rates are on the rise VRE (Vancomycin resistant Enterococci) - A cause of endocarditis, frequently cause infection in dialysis patients.Todays microbiology laboratory is continuously faced with challenges through the rapid emergence of antimicrobial resistance, new formularies and therapies and changing conditions in the laboratory setting. Of particular clinical significance today is the expanding prevalence of multi-drug-resistant species. Antibioticresistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. For more than 30 years, MiscroScan systems have been exclusively focused on ID /AST (Identification and Antimicrobial Susceptibility Testing), offering unmatched experience, expertise and technical support. MicroScan systems continue to provide technological advancements to adapt to evolving organisms and the changing healthcare environment. And thus helping todays laboratory to provide accurate and actionable information quickly.All this demands for a reliable automated system for a microbiology laboratory that can...a) Provide automated identification of organismsb) Provide a complete and true MIC (Minimal Inhibitory Concentration) of antibioticsProperdetection=propertherapy=reducedmortalityrateGoldStandardAccuracywithMicroScan: FDA approved family of products that follows CLSI (Clinical and Laboratory Standard Institute) testing recommendations All MICs use DIRECT method (i.e. True growth base and no extrapolation of curve) Continuously updating antibiotics offerings with lower dilutions to keep up with emerging resistant pathogens Visual confirmation of biochemical and susceptibility results for added confidence With Alert rules in LabPro software, customized reports can be generated to provide detailed analysisEducation and Trainingexcellence to patient services. This well-rounded combination of training and education through classroom instruction and e-learning techniques reinforces our commitment to the ongoing success of our customers. ClassroomTrainingOur Education Center located in India is equipped with a wide spectrum of instruments needed for hands-on practical training across South Asia. Our trainers are certified and training delivery is as per the global standards for both, our technical staff as well as for our customers. We provide a unique and flexible learning environment for the laboratory staff using comprehensive training programs that give users the skills they need to operate and maintain the instrumentation. Our training programs focus on helping your key operators understand our technology and methods, as well as gain valuable hands-on experience in achieving optimum productivity levels. We at Siemens, value education as a strategy for continuous development of individuals. We offer unparalleled educational opportunities and training excellence that keeps laboratory staff up-to-date on product information and key trends in disease state management. As part of this endeavor, we offer education in form of classroom trainings and online trainings. We also offer a comprehensive range of onsite trainings conducted by experienced and trained staff. World leader in eLearning: 50,000 customers and 520,000 contact hours since 2002 More than 700,000 global learning events annually Accredited courses, including recent developments and input from key opinion leaders Over 52,000 client training days/year globally in classroomSiemens has been offering laboratory managers educational opportunities to improve their management techniques and business acumen in a broad range of areas from clinical 6 Lab-trendz Newzflash Issue 1 / 2012New InitiativesTechnical Solutions CenterSome of you may have already availed the services of our Technical Solutions Center (TSC), a first-of-its-kind facility in the Indian laboratory diagnostics industry. It was launched in 2009 to further strengthen our after sales services. The objective is to ensure minimal downtime by providing dedicated phone support to resolve your hardware (Engineering) and application related issues. The TSC group comprises the best talents in the industry coupled with great hands-on experience across multiple product lines. The TSC support hours have been extended from 8 a.m. to 8 p.m. In addition, the 1800 Toll Free Number will be made available 24x7 shortly to register and monitor your complaints.CustomerCareHelpline18004197478(tollfree)The TSC team has been greatly successful in remote troubleshooting of our instruments and has resolved complex issues over the phone; thus resulting in faster TAT for our customers. The team members are certified and continuously trained on newer products and real world challenges. It is the goal of the TSC division to delight our customers with streamlined troubleshooting and minimal instrument downtime. We encourage our customers to utilize the expertise of this group and would like to hear their feedback on the operations of the TSC division. For more information, please e-mail us at service. diagnostics. in@ siemens. comThe solution to our problem is just a call away. The technical experts know their subject very well and are able to fix most of our problems on the phone.Dr. Mrs. S.S. Rudrakshi Ashwini Sahakari Rugnalaya Ani Sanshodhan Kendra Nyt. Solapur, Maharashtra.PEP (Personalized Education Plan)Improves Efficiency of Education DeliveryNew Industry StandardImproves the quality of EducationResults in a Paradigm Shift in EducationReduces Overall CostsOur e-Learning courses are designed in a very detailed and innovative manner in order to ensure the personalized educational benefits to the individual, say for a lab technician or a lab manager. Online trainings can be accessed anywhere (i.e. no classroom required); anytime (i.e. no time constraints) using internet (www.siemens.com/diagnostics-education) and it covers broad spectrum of laboratory diagnostics topics. For the new entrants in the lab diagnostics field, it offers basic laboratory skills, laboratory management, workflow, analytical methodology, informatics, quality control and other topics of interest applicable across the clinical laboratory. For the employee who are users and / or new to Siemens instruments can refresh or learn the operational aspects by themselves. This means, newly recruit must undergo the e-Learning course and be certified, before operating the instrument.Clinical Application library is helpful on how laboratory results are used for patient care and also covers disease state management. Sponsored webinars by Siemens are archived and made available for the biochemists, pathologists or laboratory employees through this website. This ensures regular updates to our business partners and helps to stay updated with current events and trends in Diagnostics. For further queries, please e-mail us at dx_training.india@siemens.comTraining, which is offered by Siemens to clients and their employees is unique and their recent Personalised Education Programme is establishing their commitment to knowledge driven business in the ecosystem in which we work.Dr.AVelumani,Founder and CEO,Thyrocare Technologies Ltd.TSC Call FlowCall forwarded to concernedTechnical ExpertCustomer CallsSIPS CenterTelephonic resolution byTSC Group - Experts adviceClinical MarketingThe growth in the Indian healthcare infrastructure and delivery is negatively impacted by three factors Accessibility to quality healthcare, Awareness on disease and solutions and Affordability (AAA). Without overcoming these impediments, the vision of providing quality and affordable healthcare to the teeming millions in the country will remain a pipedream.We at Siemens, are conscious of our role as healthcare providers to the nation and have launched numerous initiatives to address the 3As. One such initiative, Clinical Marketing, aims to enhance awareness among the clinicians, other healthcare professionals and the patient community about the latest technological innovations and associated clinical benefits. We have been successfully engaging our imaging customers, since 2007, through clinical newsletters, conducting research collaborations and providing marketing consultancy to name a few. For our customers in the laboratory diagnostics field, we are making the beginnings of such an engagement through this newsletter and more would follow that will not only cover technology and product related information, but will also bring to you exciting scientific and clinical work from subject experts and your peers. We have been contributing to the scientific temper within the country in the field of imaging through research collaborations with leading institutes such as AIIMS, Shree Chitra Tirunal, etc. We take this opportunity to invite you to join our mission of nurturing innovation and those interested in collaborative work could write to us at labtrendz.in@siemens.com We look forward to engage with each of you through this newly formed team and contribute significantly to the Indian laboratory diagnostics field - together.7 Lab-trendz Newzflash Issue 1 / 2012Customer ExperienceIn IMMULITE equipment, barcoding is meant not to recognize the reagents and standards but provide a common standardization map with others who have such machines from the same source. The system uses pre-calibrated assay kits and we need to transfer the calibration map by barcode reading and start-up run. The standard graph remains in the memory of machine for future use. This feature is common to fully automated system, but in IMMULITE analyzer the calibration remains stable for several months, an added advantage to save cost on reagents purchase.The prestige of a laboratory (independent private laboratory or referral lab at national level or clinical labs in hospitals) is dependent on the reliability of the lab reports. An ideal way here is to participate in a national or international Quality Control program. Not all labs participating will do all parameters and different automated systems will have normal ranges in various units. A much simpler and best viable economical approach is to use lyophilized control (Bio-Rad/Siemens) as an internal quality control. In our experience with control sera obtained from Siemens and Bio-Rad, IMMULITE analyzer showed excellent correlation with others having IMMULITE analyzer, as well as labs with other types of analyzers. The capability of a machine over years is bound to alter over a period of years. But it is not true with our IMMULITE analyzer. The inter-assay precision, as well as intra-assay precision were below 10% even after six years. There is no defect or sluggishness in the machine and we have not replaced any part of the equipment. The equipment maintenance is very easy. Replenishing reagents and emptying waste are the primary tasks of daily maintenance, replacing probe wash and water filters constitute monthly maintenance. We never had any problem with various parts of machine like pump, reagent wedge and conveyer to move samples and test unit cup holders into the machine. Based on the quality of reports, we thought we can have one more unit in our lab. In June 2009, we purchased IMMULITE 1000 analyzer, which has added facility like touch screen monitor and fewer key strokes on Windows operating system.Fully automated machine can be advantageous to any institution that has a shortage of trained laboratory technician or that needs to reduce cost or improve the workload or turnaround time of test result. Automated techniques allow the user to improve the speed, efficiency, standardization, accuracy, reliability, fewer hands on time and ease of use. The IMMULITE analyzer is easy to use analyzer with extensive assay menu. It handles 95 percent of our laboratory workload and has given us efficient service over the years.Impressive Results with IMMULITE AnalyzerIMMULITE analyzer with extensive assay menu handles 95 percent of our laboratory workload.Dr.AKarunanidhi, Director, Endocrine Laboratory & Research Centre, Coimbatore karunanidhi@hotmail.comDr. A Karunanidhi worked in Christian Medical College Hospital, Vellore, Tamil Nadu as Junior Lecturer cum Associate Clinical Biochemist in the Department of Clinical Biochemistry (1981 1985). His primary job in Vellore was to develop or establish RIA methodologies for Hormones. With considerable experience in the assay of Hormones, he established a referral immunoassay lab in Coimbatore catering the needs of private hospitals and laboratories in Tamil Nadu and Kerala state. Impressed by IMMULITE immunoassay analyzer supplied by Siemens, he narrates and shares his opinion in this article.In 1990, I had the opportunity to start Endocrine Laboratory and Research Centre in Coimbatore, as a referral lab to the needs of Hospitals in Kerala and Tamil Nadu, as well as to private laboratories. Probably, my lab was one among the few laboratories in South India to handle specialized laboratory investigations. The response was good and it exceeded our capability to handle various parameters by RIA and Enzyme immunoassay (ELISA) methods. Both methods are manual and restricted our capability to process higher inflow of samples for various tests like T4, T3, FreeT4, Free T3, TSH, FSH, LH, Prolactin, etc. We switched over to fully automated System when DPC USA introduced IMMULITE analyzer. We were impressed by the machine and it can process patients samples for various analysts (Thyroid Function, Reproductive Endocrinology, Adrenal, Allergy, Anemia, autoimmune, infectious diseases, bone metabolism, cancer, tumor markers, cardiac markers, as well as therapeutic drugs). Similar machines were available at that time but IMMULITE had more assay parameters and easier to use. The major advantage is that IMMULITE analyzer can run any test or combination of tests when required. It allows continuous loading of samples and test units and up to 12 assays can reside on the system and be changed without disrupting assay process. This true continuous random access is common feature in all automated systems, but very easy and flexible with IMMULITE analyzer. 8 Lab-trendz Newzflash Issue 1 / 2012Compiled by Clinical Marketing Team, Healthcare Sector, Siemens Ltd., Enkay Centre, 5th floor, Vanijya Nikunj, Udyog Vihar, Phase V, Gurgaon 122 016.Tel.: 91 124 4760149. Fax: 91 124 4760162. www.siemens.com/healthcareTechnological innovations spur new clinical applications. This gives the medical community an edge in diagnosis and helps detect / treat diseases at an early stage. This in turn will help the society at large. These are the primary objectives with which we developed Lab-trendz. We would like to know how we can make this initiative more valuable for your practice and the wellbeing of patients. 2012 by Siemens Ltd., India All trademarks are properties of Siemens AG or associate companies. Third-party trademarks are properties of their respective companies. The content of this publication does not necessarily reflect the opinion of the publisher. Reproduction of articles in whole or in part requires the permission of the editorial office. This also applies to storage in electronic databases and on the internet.Intended for use by Registered Medical Practitioners or Pathologists or Laboratory or Hospital Staff only. The medical information in this newsletter is for individuals of the healthcare community and not for general public. The information and reference materials contained here are intended solely for the general information of the reader and is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a pathologist or physician for any given health issue.Quiz #11. Siemens has introduced many innovations to the Laboratory Automation market that have set the standards in the field. The upcoming Siemens AptioTM automation solution:a) Consolidates multiple analytical instruments into a unified workstationb) Provides unlimited potential for lab optimization by combining peak performance, adaptability, and intelligent technology with automation workflow expertisec) Both the above2. Cystatin C is an effective marker for GFR assessment since ita) Needs correction for age, gender and weight for GFR calculationb) Shows increased sensitivity compared to Serum Creatinine especially in early stage kidney diseasec) Needs urine collection for GFR calculation3. True or False: Siemens CLINITEK Novus Automated Urine Chemistry Analyzer offers full spectrum of tests for routine urinalysis, including early detection of kidney disease (Protein-to-Creatinine ratio) and microalbuminuria (Albumin-to-Creatinine ratio) testing on a single strip.Please send your answers along with your contact details and the lucky five will receive a special prize.E-mail to labtrendz.in@siemens.comIfyouhaveinterestingcasestobeshared,pleasee-mailusatlabtrendz.in@siemens.comOur next edition will be equally exciting with the latest innovations and solutions in laboratory science.Our Experience with BN ProSpec SystemWe have preferred to use the Siemens BN ProSpec analyzer, which is a fully automated nephelometer, for all of our Plasma Proteins testing.Dr.VijaySBhat, Consultant - Biochemist, Manipal Hospital, Bengaluru vijay.bhat@manipalhealth.comManipal Hospital, Bengaluru, is a 650 bedded quaternary care super-specialty hospital. The hospital is focused on providing quality and affordable care in Bengalurus rapidly changing healthcare environment and has emerged as a landmark destination for people from over 20 countries. Manipal Hospital Diagnostic Services (MHDS), a unit of Manipal Hospital is the first quaternary care hospital based laboratory in India to be accredited by NABL. It is also a referral centre to several institutions in the city, as well as the state of Karnataka.We at MHDS, in order to meet the ever increasing demands of society and also to strive for clinical excellence, have preferred to use the Siemens BN ProSpec analyzer, which is a fully automated nephelometer, for all of our Plasma Proteins testing. Our decision to use BN ProSpec analyzer was based on its on-board stability, barcode sample identification, auto dilution, extensive menu, calibration of various assays in parallel using multi analyte standards and the walk-away convenience.After procuring the BN ProSpec, we even got two large projects referred from a research institute; one was on SolubleTransferrinReceptor(sTfr) as the most sensitive serum biochemical marker for the identification of iron deficient erythropoiesis and the other was RetinolBindingProtein(RBP) study along with other parameters of anemia in a community based field project among young children living in rural Karnataka.We have also used hs-CRP extensively as a marker for coronary risk. Recently in a project work titled Metabolic Syndrome and Multivariate Analysis towards Insulin Resistance and Risk, hs-CRP and Homocysteine on BN ProSpec were used as markers for the correlation study.Our experience on CystatinC by immunonephelometric assay on BN ProSpec was found to be more superior to that of other methods like ELISA; Bias (95% CI) was 0.08 0.28 on BN ProSpec vs. 0.58 0.54 by ELISA. One of our resident doctors from Nephrology department, as part of his DNB studies did an analysis of Cystatin C with creatinine and the creatinine clearance.To support our evidence that serum Cystatin C level increases with mild reduced GFR of 70 to 90 ml/min/1.73m2 in creatinine blind range, we had a renal transplant case wherein creatinine was in the normal range and due to improper clearance of immunosuppressant Tacrolimus from one of the brands being used, we found Cystatin C to be marginally elevated. Later on, the dosage and brand of Tacrolimus was changed and the value of Cystatin C reduced, thus improving the GFR also in the patient.Upcoming EventWebinar on BringEfficiencytoYourLabon September 27, 2012 at 9:30 pmIf interested, please register at www.meetme.net/labsgoleanFor more information on Siemens educational offerings, please visit www.siemens.com/diagnostics-education

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