Lohitha Polisetty , Battula Roopa Neeharika ,
Volume 20, Issue 2 (3-2026)
Abstract
Background: Glycated haemoglobin (HbA1c) reflects estimated average blood glucose levels over a period of 2-3 months and is essential for both diagnosing and managing diabetes. High-performance liquid chromatography (HPLC), particularly ion-exchange HPLC, is widely regarded as the reference and gold standard method for HbA1c assessment, whereas nephelometry is commonly adopted in clinical laboratories because it provides faster results. This study compared the accuracy, reliability, and clinical applicability of these two methods.
Methods: A total of 50 patients diagnosed with diabetes mellitus and attending a tertiary care hospital were included in this cross-sectional study. For each participant, HbA1c levels were estimated using both ion-exchange HPLC and nephelometric techniques. Data analysis involved descriptive statistics, Pearson’s correlation, the intraclass correlation coefficient (ICC), Bland-Altman plots, and receiver operating characteristic (ROC) curve evaluation. A paired t-test was performed to determine statistical significance, and values with p < 0.05 were considered statistically significant.
Results: The mean HbA1c values obtained by HPLC (6.2% ± 1.5) and nephelometry (6.3% ± 1.4) were closely aligned. A strong correlation was observed between the two techniques (r = 0.96, p < 0.01), and the intraclass correlation coefficient also indicated excellent concordance (ICC = 0.96). Bland-Altman plotting revealed only a slight bias, with a mean difference of 0.09%. ROC curve evaluation showed that both methods exhibited good diagnostic capability, although HPLC achieved marginally higher sensitivity (90%) and specificity (92%) than nephelometry (88% and 91%, respectively). While nephelometry offered faster processing, its diagnostic accuracy was slightly lower.
Conclusion: Although HPLC demonstrated superior diagnostic accuracy and method agreement, nephelometry offers operational advantages in high-volume settings. Despite the high correlation between the two methods, their interchangeability should be approached with caution, particularly in borderline cases. Further studies with larger and more diverse cohorts, as well as evaluation of potential confounding factors such as hemoglobin variants, are warranted.
Sarangi Wankhade, Smita Bhide,
Volume 20, Issue 4 (9-2026)
Abstract
Introduction:
A Frozen section is a rapid diagnostic procedure performed on tissues obtained intraoperatively, which helps the operating surgeon make immediate decisions during surgery, primarily to distinguish between benign and malignant neoplasms. It plays a significant role in guiding intra- and perioperative patient management and reduces the need for re-operation.
Aims & Objectives:
The present study aims to evaluate the diagnostic accuracy, sensitivity and specificity of the frozen section.
Materials & Methods:
Analysis of 49 frozen sections was conducted in the Pathology department from September 2022 to May 2024. The frozen section diagnoses were compared to those of the routine paraffin sections. The results were classified as concordant and discordant. Diagnostic accuracy, sensitivity, and specificity were calculated.
Results:
Out of 49 cases, the diagnosis was concordant with routine histopathology in 47 cases, while 02 cases were discordant. The overall diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 95.92%, 96%, 95.43% ,96%, and 95.43%, respectively. The discordance rate was 4.08%.
Discussion:
The overall diagnostic accuracy rate of 95.92% & discordance rate of 4.08% of present study is comparable to previous studies which range from 94 to 98% & 1.4% to 12.9% respectively. The sensitivity & specificity of frozen section diagnosis in present study are comparable with studies from other Institutes.
Conclusion:
Frozen section is a reliable, accurate and rapid technique for intraoperative consultation. Several factors can affect the accuracy of Frozen Section diagnosis, including sampling error, technical error and interpretation error.
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