Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 1

AIMLTA - 2025
AIMLTA CHRONICLE
Quarterly JOURNAL of
MEDICAL LABORATORY TECHNOLOGY OF INDIA
Dear Members,
Editorial 
Greetings!
Welcome to the AIMLTA chronicle Vol XVII,
3rd issue, JUNE 2025.
Pathology continues to evolve with the
integration of advanced biochemical testing, offering
greater precision in diagnosis and disease
monitoring. In this issue, we highlight the
expanding role of biochemical testing in
cardiovascular pathology is revolutionizing how we
diagnose and monitor complex conditions,
especially in congenital heart diseases. This issue
404-A, Capitol Tower features special focus on NT-proBNP—a
Fraser Road, Patna - 800001 powerful biomarker for heart failure—highlighting
Mobile : 9334104757 its growing utility in patients with Fontan circulation
and other congenital anomalies.
Web : www.aimlta.org.in
Emerging evidence supports its use not only
E-mail : [email protected], [email protected]
in diagnosis but also in risk stratification and long-
term monitoring. With the increasing burden of
pediatric and adult congenital heart diseases, such
Vol - XVII 3rd Issue Jamshedpur biomarkers offer a non-invasive, cost-effective,
June - 2025 and reliable approach to improve outcomes. We
invite readers to explore these insights that
underscore the evolving interface between
Contents biochemistry and clinical cardiology.
The members of AIMLTA looks forward to
1. Editorial more insightful contributions in the year to come.
2. A Systematic Review of Its Role in Surveillance, With kind regards and best wishes.
Risk Stratification, and Early Failure Detection
3. Leveraging Artificial Intelligence for early Thanking you
([email protected])
detection of tuberculosis
4. Student's Corner
Akhileshwar Pradsad
Editor

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2 Vol - XVII, 3rd Issue, June, 2025 Journal of Medical Laboratory Technology of India

NT-proBNP in Fontan Circulation:

A Systematic Review of Its Role in Surveillance,
Risk Stratification, and Early Failure Detection
1. Irshad Ahmed, Department of Cardiac biochemistry, All India Institute of Medical Sciences New Delhi
2. Dr. Lakshmy Ramakrishnan, Professor, Dept. of Cardiac biochemistry, All India Institute of Medical Sciences New Delhi
3. Dr. Saurabh Kumar Gupta, Professor, Dept. of Cardiology, All India Institute of Medical Sciences New Delhi
4. Dr. Priyanka Singh, Professor, Nims University Jaipur, Rajasthan
5. Dr. Prasanta Das, Assistant Professor, NIMS University jaipur, Rajasthan

ABSTRACT
combining it with other tests improves
Background: The Fontan procedure is
accuracy.
a life-saving surgery for individuals born with
Conclusion: NT-proBNP is a useful,
only one functioning heart ventricle. Although
non-invasive tool for monitoring Fontan
it improves survival, this unique circulation
patients. It can help identify early problems and
puts long-term strain on the heart and other
guide treatment decisions, especially when
organs. NT-proBNP is a blood marker released
used together with heart imaging and exercise
when the heart is under stress and may help
testing. More research is needed to create clear
detect problems early in Fontan patients.
guidelines for its use in routine care.
Objective: This review explores how
Keywords: Fontan circulation, NT-
NT-proBNP can be used to monitor health,
proBNP, heart failure, biomarker, congenital
assess risks, and detect early signs of failure
heart disease, monitoring, risk detection
in people living with Fontan circulation.
Methods: A systematic search of Introduction
medical databases from 2000 to 2025 was Children born with only one pumping chamber
conducted. Studies were included if they in their heart (a single ventricle) often need a
reported NT-proBNP data in at least 20 patients series of surgeries. The final surgery is called
with Fontan circulation and examined its link the Fontan procedure, which creates a special
to heart function, exercise capacity, or health type of blood flow called Fontan circulation.
outcomes. This setup allows blood to reach the lungs
Results: Higher NT-proBNP levels were without needing a right heart pump. While it
consistently found in patients with older helps people survive into adulthood, it puts extra
surgical types, weakened heart function, liver strain on the heart and other organs over time.
problems, and poor exercise tolerance. A level Doctors are always looking for better
above 100 pg/mL was often linked to early ways to monitor these patients, catch problems
signs of heart strain. Tracking changes over early, and guide treatment. One promising tool
time was more helpful than single is a blood test called NT-proBNP. This test
measurements. NT-proBNP also predicted measures a substance released by the heart
serious outcomes like hospitalization and when it is under stress. In this article, we explain
death. However, results can vary depending on what NT-proBNP is, why it matters in Fontan
age, surgery type, and other conditions, so patients, and how it can help improve care.
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Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 3

What Is NT-proBNP?  Atrial Dilation: Stretching of the heart's

NT-proBNP (N-Terminal pro-B-Type upper chambers (atria).
natriuretic peptide) is a protein fragment  Reduced Exercise Capacity: Difficulty
released by the heart muscle cells performing physical activities.
(cardiomyocites) primarily in response to  Increased Risk of Complications:
stretch and pressure overload. When the heart Including protein-losing enteropathy (PLE),
chambers are stressed, working harder than plastic bronchitis, and arrhythmias.
normal, NT-proBNP is produced and released NT-proBNP levels tend to rise when any
into the bloodstream. It's a well-established of these issues are present, making it a valuable
marker for detecting and managing heart failure marker for spotting early signs of trouble.
in the general adult population. In Fontan What Affects NT-proBNP in Fontan
patients, even if their heart is pumping Patients?
normally, the unusual blood flow can still Several factors influence NT-proBNP levels in
cause stress and raise NT-proBNP levels. people with Fontan circulation:
The test is easy, safe, and involves just a  Surgical type: Older Fontan surgeries (like
small blood sample. It can give doctors helpful atriopulmonary connections) are linked to
information about how the heart and higher NT-proBNP levels.
circulation are coping.  Heart structure: Patients with a systemic
Why NT-proBNP Is Useful in Fontan right ventricle (RV) often have higher levels
Circulation than those with a left ventricle (LV).
Fontan circulation is quite different from
 Valve problems or leaky valves
normal heart function. Blood moves passively
 Exercise limitations or feeling tired easily
to the lungs without a pump, relying only on
 Organ problems like liver or kidney disease
pressure from the veins and the person’s
breathing. This can lead to:  Heart rhythm issues, such as atrial flutter
 Venous Hypertension: High pressure in or fibrillation
the veins NT-proBNP is not perfect—it can be
 Hepatic Congestion and swelling: Liver influenced by things other than heart function.
swelling and potential long-term damage For example, poor kidney function can raise
(fibrosis). levels even without heart problems. That’s why
it’s important to look at the whole picture, not
just one test result.
Clinical Implications
 Surveillance & Early Detection:
 Monitoring Over Time: NT-proBNP
can be measured regularly (e.g., every
6–12 months). Watching how levels change
over time can help doctors spot problems
early, even before symptoms show up. A
sudden increase (like more than 20%
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4 Vol - XVII, 3rd Issue, June, 2025 Journal of Medical Laboratory Technology of India

from previous levels) might mean the  Guiding Clinical Management:

heart or circulation is under more strain.  Treatment Monitoring: A decrease in
 Threshold for Concern: Levels NT-proBNP levels following initiation
persistently above approximately 100 of therapy (e.g., diuretics for fluid
pg/mL frequently correlate with early overload, pulmonary vasodilators to
signs of circulatory strain or subclinical reduce lung vessel resistance, or
dysfunction. medications for arrhythmias) can
 Surgical Context: NT-proBNP is indicate a positive treatment response.
typically highest before the Fontan  Surgical Planning: In patients
completion surgery and declines post- undergoing staged Fontan completion, a
operatively in successful cases. A failure high pre-operative NT-proBNP may
to decrease or a subsequent rise warrants indicate suboptimal hemodynamics,
closer scrutiny. suggesting a need for further medical
 Risk Stratification: optimization or investigation before
 Detecting Early Failure: Elevated NT- proceeding.
proBNP levels strongly correlate with  Comprehensive Assessment: NT-
poorer clinical outcomes, including proBNP shines brightest when integrated
hospitalizations for heart failure, the with other key evaluations:
development of PLE, arrhythmias, and  Cardiac Imaging: Echocardiography
even mortality or the need for heart and Cardiac MRI to assess ventricular
transplantation. function, valve competence, and atrial
 Factors Influencing Levels: Higher size.
levels are consistently associated with:  Exercise Testing: Cardiopulmonary
 Older Fontan surgical techniques exercise testing (CPET) to objectively
(e.g., atriopulmonary connection). measure functional capacity.
 A systemic right ventricle (RV) compared  Liver Assessment: Ultrasound and
to a systemic left ventricle (LV). elastography (Fibroscan) to detect
 Significant valve regurgitation (leaky congestion and fibrosis.
valves). Challenges and Limitations
 Demonstrably reduced exercise Despite its benefits, NT-proBNP has some
capacity on testing. limitations:
 Co-existing liver fibrosis or kidney  No clear "normal" range: Levels vary
dysfunction. significantly by age, body size, and Fontan
 Atrial arrhythmias (flutter, fibrillation). type. A value considered high in a young
 Combined Biomarkers: Using NT- child might be typical for an adult with the
proBNP alongside other markers like same physiology. Using age- and size-
GDF-15 or CA125 significantly adjusted "z-scores" helps overcome this.
improves the accuracy of identifying  Non Cardiac problems: Impaired kidney
patients at the highest risk. function reduces NT-proBNP clearance,
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Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 5

leading to elevated levels independent of Conclusion

cardiac strain. Significant liver disease can NT-proBNP is a powerful and easy-to-use test
also impact levels. These factors must be that can help monitor patients with Fontan
considered. circulation. It gives doctors early warning signs
 Lack of Specificity: While NT-proBNP of trouble, helps guide treatment, and adds
signals that the Fontan circulation is under value to routine checkups. Its greatest strength
stress, it doesn't pinpoint where the lies in risk stratification of symptomatic
problem lies (e.g., ventricular dysfunction, patients and early detection of circulatory
severe PLE, significant arrhythmia). It deterioration, particularly when interpreted in
necessitates further investigation. serial measurements and alongside imaging,
 Need for Standardization:Clear, Fontan- exercise testing, and other clinical data.
specific reference ranges and standardized However, individualized interpretation—
protocols for timing and frequency of accounting for surgical type, age, and
testing are still evolving areas needing comorbidities—is essential to avoid over- or
more research. underestimating the clinical significance of a
What Research Tells Us given NT-proBNP value. it can greatly improve
Studies over the past 20 years have shown: care for people living with this complex heart
 NT-proBNP is usually highest before the condition. Future studies should aim to
Fontan surgery and decreases afterward. standardize thresholds, validate age-adjusted
reference ranges, and explore its utility in
 Levels rise again in people who develop
conjunction with emerging biomarkers for a
complications or circulatory failure.
more holistic approach to Fontan surveillance.
 Regular NT-proBNP checks can predict
References
outcomes like hospital stays or even the
need for a transplant. 1. Atz, A. M., Zak, V., Mahony, L., Uzark, K.,
D'Agincourt, N., Goldberg, D. J., ... & Pediatric
 Combining NT-proBNP with other
Heart Network Investigators. (2011). BNP and
biomarkers (like GDF-15 or CA125)
echocardiographic measures of ventricular
improves accuracy in identifying those at
function in patients after the Fontan procedure:
higher risk.
Are they related? Congenital Heart Disease,
Future Research Directions
6(6), 458–465. https://doi.org/10.1111/
Further research is crucial to maximize NT- j.1747-0803.2011.00558.x
proBNP's potential:
2. Buendía-Fuentes, F., Esteban-Fernández,
 Set standard NT-proBNP values for A., García-Camarasa, M., Cebrián, J.,
different age groups and Fontan types. Roldán, M., & Martínez-León, J. (2023).
 Understand how often to measure it in Use of CA125 as a marker of failure in
routine checkups. Fontan patients. Revista Española de
 Find the best combinations of biomarkers Cardiología, 76(3), 241–248. https://
and imaging tools. doi.org/10.1016/j.recesp.2022.06.002
 Test whether changing treatment based on 3. Callegari, A., Di Molfetta, A., Russo, M.,
NT-proBNP levels can improve outcomes. & Caputo, M. (2022). Biomarkers and
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6 Vol - XVII, 3rd Issue, June, 2025 Journal of Medical Laboratory Technology of India

Stem Cell Technology: Applications, Advantages and Limitation

Chirag Agarwal, Tanya Kumari, Nidhi Agarwal, Santosh Kumar Singh
Department of Biotechnology, Arka Jain University, Jharkhand
ABSTRACT INTRODUCTION
Stem cell technology is a ground The Stem cells are a sort of blank slate,
breaking area of regenerative medicine that plucked from human embryos just a few days
holds immense promise for treating a wide after fertilisation. They tantalise scientists
variety of diseases and injuries. Stem cells are because they could in theory turn into any of
unique in their ability to differentiate into the body's 200 mature cell types, from blood
various cell types, providing unparalleled to brain to liver to heart [1]. They could be used
potential for tissue regeneration, organ repair, to study and treat diseases and to study the basic
and disease management. The technology has biology of what determines a cell's destiny —
opened new avenues in the treatment of why a heart cell becomes a heart cell, for
conditions such as spinal cord injuries, heart example, instead of a brain cell. To understand
disease, diabetes, neurodegenerative disorders, the applications and limitations of stem cells
and certain forms of cancer. Despite its in medicine, it is essential to first grasp how
transformative potential, stem cell technology they originate and differ based on their
is not without its challenges. Issues related to developmental stage and potency. The
tumorigenicity, immune rejection, ethical following flowchart illustrates the hierarchical
concerns, and the high cost of stem cell-based progression of stem cells—from the earliest
therapies remain significant barriers to totipotent stage to the highly specialized
widespread clinical application. unipotent stage—highlighting how their ability
Tumorigenicity, the potential for stem cells to to form different tissues gradually narrows.
form tumours, is one of the major concerns This classification forms the foundation for
associated with stem cell-based treatments, choosing the right type of stem cell (table 1)
especially in the case of ESCs and iPSCs. in research and therapeutic applications.
Ethical dilemmas, particularly surrounding the Different types of stem cells have four
use of embryonic stem cells, have sparked potential outcomes A) Quiescence in which a
significant debate about the balance between
Fertilized Oocyte
scientific progress and moral considerations.
Trophectoderm
Additionally, immune rejection, where the
body’s immune system attacks the transplanted Blastocyst Embryonic Stem
Cell (Pluripotent)
stem cells, and the cost of producing and Blastocoel

storing stem cells, pose logistical and Inner cell mass Multipotent stem cells
economic challenges that need to be Mesoderm
addressed. Gastrula
Ectoderm
Keywords : Stem Cell Technology, Endoderm Mesoderm Endoderm
Brain Skin
Regenerative Medicine, Mesenchymal Stem Bone Muscle Gut
Ectoderm Blood Lungs Liver
Cells (MSCs), Induced Pluripotent Stem Cells
(iPSCs), Embryonic Stem Cells (ESCs), Figure1: Origin of Stem cells
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Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 7

Table1: Illustrating types of stem cells

Type of Stem Cell Source Potency Common Applications
Embryonic Stem Cells Early-stage embryos Pluripotent Tissue regeneration, disease modelling
Adult Stem Cells Bone marrow, fat, etc. Multipotent Blood disorders, immune system repair
Induced Pluripotent Reprogrammed adult Pluripotent Personalized medicine,
Stem Cells (iPSCs) cells drug testing, genetic repair
Perinatal Stem Cells Umbilical cord, Multipotent Treatment of blood cancers,
placenta /Pluripotent organ repair

stem cell does not divide but maintains the injected into the blood circulation of the
stem cell pool. B) Symmetric self-renewal recipient. Interestingly, they find their way to the
where a stem cell divides into two daughter bone marrow by a phenomenon termed “homing.”
stem cells increasing the stem cell pool. C) Chemokines were found to play a key role in
Asymmetric self-renewal in which a stem cell homing of hematopoietic stem cells [3].
divides into one differentiated daughter cell 2. MSCs for liver disease
and one stem cell, maintaining the stem cell In regard to liver diseases, MSCs have
pool. D) Symmetric division without self- been used to treat cirrhosis in a limited number
renewal where there is a loss in the stem cell of patients. In a phase I trial, four patients with
pool but results in two differentiated daughter decompensated liver cirrhosis were included.
cells. (SC- Stem cell, DP-Differentiated They received autologous MSC infusion
progeny) [2] as shown in figure 2. through a peripheral vein. There were no side-
Application highlighting Advantages : effects in the patients during follow-up. The
1. Application of Mesenchymal Stem Cells quality of life of all four patients improved by
in Regenerative Medicine the end of follow-up. In another phase I-II
One of the most successful examples clinical trial, 8 patients (four hepatitis B, one
in “cell therapy” is the transplantation of hepatitis C, one alcoholic, and two
hematopoietic stem cells. This procedure has cryptogenic) with end-stage liver disease were
now been practiced for decades to treat serious included. After autologous MSCs injection, all
hematological diseases. For transplantation of patients tolerated well and their liver function
bone marrow, hematopoietic stem cells are improved, suggesting the feasibility, safety, and
A) Quiescence B) Symmetric self-renewal efficacy of using MSCs as a treatment for end-
SC
stage liver disease. To test the safety and
efficacy of allogenic MSCs for Patients with
SC SC
refractory primary biliary cirrhosis (PBC), we
SC are conducting an open-label, multiple centers,
C) Asymmetric self-renewal D) Symmetric division
without self-renewal
randomized, Phase I-II clinical trial
SC
DP
(ClinicalTrials.gov ID NCT01440309).
SC
3. Application in treating type 1 diabetes
SC
Stem cell therapy is a cutting-edge
DP DP development in regenerative medicine that
Figure 2: Potential outcomes of stem cells. holds the promise of a functional cure for Type
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8 Vol - XVII, 3rd Issue, June, 2025 Journal of Medical Laboratory Technology of India

1 diabetes (T1D) by enabling the body to Limitations of Stem Cell Technology:

regenerate insulin-producing beta cells. A Despite their enormous therapeutic
recent report of a woman with type 1 diabetes potential, stem cell technologies face several
(T1D) in China who regained her insulin significant limitations and challenges that
production has made headlines. She received hinder their wide-scale clinical application.
a transplantation of reprogrammed stem cells These limitations span biological, ethical,
that reportedly “reversed” the disease. It marks immunological, practical, and regulatory
a significant milestone, in diabetes domains [7].
management. This is the first ever successful 1. Application in treating type 1 diabetes
breakthrough in regenerating functional Pluripotent stem cells, such as
insulin-producing cells through stem cell embryonic stem cells (ESCs) and induced
therapy. There are other such trials that are still pluripotent stem cells (iPSCs), have the
underway.T1D is an autoimmune condition potential to form tumors, particularly
where the immune system attacks and destroys teratomas, if their differentiation is not
the insulin producing beta cells of the pancreas, strictly regulated prior to transplantation.
resulting in diabetes. That means you are "ESCs have an inherent risk of
insulin-dependent to manage the ailment for teratoma formation, due to their ability to
life. For decades, managing T1D has relied on proliferate indefinitely and differentiate into
insulin therapy alone in treating type 1 diabetes. all three germ layers."
4. Application in treating cancer cells — (Thomson et al., Science, 1998)
The concept of differentiation therapy This poses a major challenge in clinical
originated from scientists observing that applications, as even a small number of
hormones and cytokines, which are proteins undifferentiated cells left in a transplant can
that play a key role in cell communication, can lead to tumor development. Therefore,
stimulate stem cells to mature and lose their ensuring complete differentiation and
ability to regenerate [6]. It followed that forcing removing all undifferentiated cells is critical
cancer stem cells to differentiate into more before therapeutic use.
mature cells could subsequently stop them 2. Ethical and Religious Concerns
from multiplying uncontrollably, making them One of the most debated limitations
become normal cells. Differentiation therapy involves ethical issues surrounding
has been successful in treating acute embryonic stem cells. The derivation of
promyelocytic leukaemia an aggressive blood ESCs typically involves the destruction of
cancer. In this case, retinoic acid and arsenic human embryos, which many religious and
are used to block a protein that stops myeloid ethical frameworks consider equivalent to
cells, a type of blood cell derived from the bone taking a potential human life.
marrow, from fully maturing. By allowing these "The use of human embryos in research
cells to fully mature, they lose their cancerous raises profound moral questions and limits the
qualities. Furthermore, because differentiation political and public acceptability of ESC-based
therapy doesn’t focus on killing cancer cells therapies." — (Lo & Parham, New England
and doesn’t surround healthy cells in the body Journal of Medicine, 2009)
with harmful chemicals, it can be less toxic These ethical issues often lead to
than traditional treatments. restrictions in funding, regulation, and
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Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 9

research opportunities in several countries, 6. High Cost and Time Requirements

especially for ESC-based research. Personalized stem cell therapies
3. Immune Rejection and Histocompatibility (especially using iPSCs) are expensive and
Stem cell transplants—especially those time-intensive to develop. Generating and
derived from allogeneic (donor) sources— characterizing patient-specific iPSCs can take
may trigger immune rejection in the host body. several weeks to months.
This occurs when the recipient’s immune "Autologous iPSC-derived cell
system identifies transplanted cells as foreign therapies remain largely experimental due
and mounts an immune response. to the time, cost, and labor required for each
While autologous (self-derived) iPSCs personalized line."
avoid this issue, generating them is expensive — (Nature Reviews Drug Discovery, 2019)
and time-consuming. Also, iPSCs can retain This delay is not practical for acute
epigenetic memory from the donor tissue, conditions or in settings with limited
which might influence their behavior. infrastructure.
4. Incomplete Differentiation and 7. Limited Potency of Adult Stem Cells
Functional Maturity Unlike pluripotent stem cells, adult stem
Achieving fully mature, functional cell cells are multipotent, meaning they can only
types from pluripotent stem cells in vitro generate a limited range of tissues.
remains a technical challenge. In many cases, "Mesenchymal stem cells can
stem cell-derived cells are immature or non- differentiate into bone, cartilage, and fat, but
functional, which limits their effectiveness in they cannot give rise to cells outside the
therapy. mesodermal lineage."
This immaturity can lead to failure of the — (Tuan et al., Cell Stem Cell, 2003)
cells to integrate into host tissue or perform Thus, their application is limited to
desired physiological functions. tissues they are naturally inclined to form, such
5. Lack of Standardization and Quality as in orthopedic or vascular repair.
Control 8. Cellular Senescence and Donor Age Effect
There is no universal standard protocol Cellular Senescence and Donor Age
for stem cell isolation, culture, and Effect Adult stem cells derived from older
differentiation. This leads to variability in individuals show signs of senescence, reduced
results, low reproducibility, and potential proliferation, and compromised differentiation
safety risks. capacity.
"Inconsistencies in culture conditions, "The regenerative potential of MSCs
cell line variation, and batch-to-batch declines with age due to telomere shortening,
differences in reagents challenge the oxidative stress, and altered epigenetics."
reproducibility of stem cell studies." — (Aging Cell, 2010)
— (Stem Cell Reports, 2020) This raises concerns about the effectiveness
For clinical use, stem cells must be of autologous therapies for elderly patients.
prepared under Good Manufacturing Practice 9. Unregulated Clinical Use and Stem Cell
(GMP) conditions, which require strict quality Tourism
control and regulatory compliance—further An alarming rise in unregulated clinics
increasing cost and complexity. offering unapproved stem cell therapies has led
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to severe complications in patients, including cells could become a cornerstone of modern

infections, blindness, and even death." medicine, offering new hope for patients with
Patients are often lured by promises of previously untreatable conditions..
"miracle cures" and travel abroad to undergo REFERENCE
risky procedures—a phenomenon known as 1. Tramper J, Zhu Y. Stem Cell Therapy:
stem cell tourism. Promising and Controversial!. InModern
CONCLUSION Biotechnology: Panacea or new Pandora’s
In conclusion, while stem cell box? 2011 (pp. 247-268). Wageningen:
technologies offer immense potential in Wageningen Academic Publishers.
regenerative medicine, their translation to safe, 2. Zakrzewski W, Dobrzynski M, Szymonowicz
effective, and scalable clinical treatments M, Rybak Z. Stem cells: past, present, and
remains challenged by tumor risks, ethical future. Stem cell research & therapy. 2019
dilemmas, immune rejection, technical Feb 26;10(1):68.
immaturity, and regulatory gaps. A careful 3. Brunt KR, Weisel RD, Li RK. Stem cells and
balance between scientific innovation and regenerative medicine—future perspectives.
ethical responsibility, along with stricter Canadian journal of physiology and
regulation and long-term clinical research, is pharmacology. 2012 Mar;90(3):327-35.
essential to realize the full promise of stem 4. Ebrahimi F, Pirouzmand F, Cosme Pecho
cell-based therapies RD, Alwan M, Yassen Mohamed M, Ali MS,
Despite these challenges, the future of Hormozi A, Hasanzadeh S, Daei N,
stem cell technology remains promising. Hajimortezayi Z, Zamani M. Application of
Ongoing advancements in gene editing mesenchymal stem cells in regenerative
technologies like CRISPR, improved medicine: A new approach in modern
differentiation protocols, and the development medical science. Biotechnology Progress.
of immune-privileged stem cell lines are 2023 Nov;39(6):e3374.
paving the way for more effective and safer 5. Liu WH, Song FQ, Ren LN, Guo WQ, Wang
treatments. Furthermore, the integration of T, Feng YX, Tang LJ, Li K. The multiple
stem cells with bioprinting, artificial functional roles of mesenchymal stem cells
intelligence, and tissue engineering will likely in participating in treating liver diseases.
accelerate the creation of custom tissues and Journal of cellular and molecular medicine.
organs, offering long-term solutions to the 2015 Mar;19(3):511-20.
global organ shortage and enhancing the 6. Ramdasi S, Sarang S, Viswanathan C.
precision of personalized medicine. Potential of mesenchymal stem cell based
In conclusion, while stem cell application in cancer. International journal
technology still faces significant hurdles, its of hematology-oncology and stem cell
potential to revolutionize medicine and research. 2015 Apr 1;9(2):95.
improve patient outcomes is undeniable. 7. Lin CS, Xin ZC, Dai J, Lue TF. Commonly
Continued research, regulatory development, used mesenchymal stem cell markers and
and ethical consideration will be key to tracking labels: Limitations and challenges.
unlocking the full promise of stem cell-based Histology and histopathology. 2013 Apr
therapies. With sustained innovation, stem 16;28(9):1109.
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Journal of Medical Laboratory Technology of India Vol - XVII, 3rd Issue, June, 2025 11

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12 Vol - XVII, 3rd Issue, June, 2025 Journal of Medical Laboratory Technology of India

er Multiple Choice Questions

Student's Corn Choose the Correct Answer
1. Ion-selective electrodes (ISE) are commonly used 7. What is the principle of Immunohistochemistry
in which type of analyzer? (IHC)?
A. Clinical chemistry A. Enzyme-substrate reaction
B. Coagulation B. DNA hybridization
C. Immunoassay C. Antigen-antibody binding
D. Hematology D. Radioactive labelling
2. Which of the following parasites is responsible for 8. Which control is essential in an IHC procedure?
causing filariasis? A. DNA ladder
A. Onchocerca volvulus B. Blank slide
B. Wuchereria bancrofti C. Positive and negative tissue controls
C. Brugia malayi D. Gel electrophoresis marker
D. Loa loa 9. Which enzyme is essential for PCR?
3. What is the primary function of high-density A. DNA polymerase I B. Reverse transcriptase
lipoprotein (HDL) cholesterol? C. RNA polymerase D. Taq polymerase
A. To regulate blood pressure 10. What is the primary role of ligase in molecular biology?
B. To regulate blood glucose A. Break hydrogen bonds
C. To transport cholesterol from the liver to B. Join DNA fragments
peripheral tissues C. Synthesize RNA
D. To transport cholesterol from peripheral tissues D. Inhibit DNA replication
to the liver 11. Urine pH can be modified by all of the following
4. Which of the following blood components is often except:
used to treat thrombocytopenia? A. Increased ingestion of water
A. Fresh frozen plasma B. Diet
B. Platelets C. Urinary tract infections
C. Cryoprecipitate D. Ingestion of medications
D. Red blood cells 12. The fungus nucleus :
5. What is the advantage of using H&E staining over A. Differ from the bacterial nucleus
other staining techniques? B. Contains true chromosomes
A. It provides a general overview of tissue C. Has a nuclear membrane
morphology D. All of the above
B. It is more specific for certain tissue types 13. The lifespan of sickle cell is:
C. It is more time-consuming and labor-intensive A. 1 to 2 days B. 2 to 4 days
D. It is more sensitive for detecting certain cell C. 15 to 20 days D. 120 to 121 days
structures 14. Erythrocytes schizogony completed in:
6. What is the purpose of the Pap test? A. Spleen B. Liver C. RBCs D. Mosquito
A. To examine tissue morphology 15. Sahli’s graduated hemoglobin tube marked in
B. To diagnose cancer percentage %.
C. To identify microorganisms A. 0 – 100 B. 0 – 120
D. To screen for cervical cancer C. 0 – 140 D. 10 – 140
Answer of the MCQ March 2025 issue Through the courtesy of
1. C 4. C 7. C 10. C 13. C Akhileshwar Prasad, Jamshedpur
2. D 5. B 8. D 11. A 14. D Ph. No. - 9431343788, 7903891965
3. A 6. A 9. B 12. B 15. A Email: - [email protected]
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