Vitamin B12 assay is one of the most frequently ordered tests particularly as a part of regular medical checkups. The deficiency is rampant in vegetarian population. It is of immense importance that laboratories establish their own reference interval (RI) of analyte specially Vitamin B12 as a diagnosis of Vitamin B12 deficiency based on RI of kit insert inadvertently leads to unnecessary treatment or work up. A blind reliance on RI of kit insert should be discouraged as they do not take into account population characteristics and do not truly reflect RI specific to the population under study.

Concomitant narcolepsy and sleep apnea (SA) can be present in the same patient. We present a patient with recurrent episodes of syncope and subsequent falls, which were found to be due to narcolepsy and Obstructive Sleep Apnea (OSA). She was initially treated with continuous positive airway pressure (CPAP) but continued to have symptoms sustaining injury. Her symptoms resolved with placement of a permanent pacemaker (PPM) implant and to date has not had any recurrence.

Background: There is a need for laboratories to participate in EQA schemes to achieve a harmonization of test results and to improve serological testing and research on COVID-19 and SARS-CoV-2. The Boditech iCHROMA point of care immunoassay analyser has a Covid-19 antibody assay for the qualitative determination of IgG antibodies in human whole blood/serum/plasma. The National Institute for Biological Standards and Control (NIBSC) in the United Kingdom has a portfolio of reference and research reagents, including reagents for EQA that are available to laboratories to help them set up and develop accurate diagnostic tests for SARS-CoV-2 assays. Objectives: To determine the performance of the Boditech iCHROMA Covid-19 IgG antibody assay using the external quality control material provided by the UK NIBSC (National Institute for Biological Standards and Control). Results: The Boditech iCHROMA Covid-19 IgG assay using the cut off index >1.1, reported the results of the 33 positive control samples as positive with index range from 19.50 – 29.00, with a mean of 23.75 and standard deviation of SD of 2.53. It also reported the results of the 33 negative control samples as negative with an index range of 0.00 for all samples. Conclusion: The performance of the Boditech iCHROMA Covid-19 IgG antibody assay using external quality control material from the UK NIBSC was very good, confirming the precision of the Boditech iCHROMA Covid 19 IgG antibody method.

Non neoformans cryptococci are usually regarded as saprophytes and human infections are rare. C.laurentii is rare of the non neoformans Cryptococci that can cause human infections. Incidence of human infections with Cryptococcus laurentii and albidus has increased over last couple of decades. The risk factors for C. laurentii infections usually include diminished Cell mediated immunity and presence of invasive devices, while mortality risks increases with CNS involvement and age above 45 years. Clinical manifestations are indistinguishable from other invasive yeast infections. High index of suspicion with any yeasts associated with raised inflammatory biomarkers and presence of neutrophils in the specimen’s stained smear is important in the diagnosis and prompt initiation of appropriate treatment since C. laurentii shows low susceptibility to fluconazole. We report here a case of lower respiratory infection due to Cryptococcus laurentii in a 57 years old female patient with bronchiectasis. The patient was admitted with complaints of fever, dyspnoea with productive cough. She was on antibiotic treatment. Her chest x-ray report revealed infiltrative opacities at right upper mid zone of the lungs and pleural effusion at left lower zone. The patient later also developed quadruparesis and urinary incontinence.

The strategy of price liberalization and privatization had been implemented in Sudan over the last decade, and has had a positive result on government deficit. The investment law approved recently has good statements and rules on the above strategy in particular to pharmacy regulations. Under the pressure of the new privatization policy, the government introduced radical changes in the pharmacy regulations. To improve the effectiveness of the public pharmacy, resources should be switched towards areas of need, reducing inequalities and promoting better health conditions. Medicines are financed either through cost sharing or full private. The role of the private services is significant. A review of reform of financing medicines in Sudan is given in this study. Also, it highlights the current drug supply system in the public sector, which is currently responsibility of the Central Medical Supplies Public Corporation (CMS). In Sudan, the researchers did not identify any rigorous evaluations or quantitative studies about the impact of drug regulations on the quality of medicines and how to protect public health against counterfeit or low quality medicines, although it is practically possible. However, the regulations must be continually evaluated to ensure the public health is protected against by marketing high quality medicines rather than commercial interests, and the drug companies are held accountable for their conduct.