Advanced Laboratory Investigations Conducted at Medical Research Unit Laboratory, MHWT, Uttara Model Town, Dhaka, Bangladesh

Among the medical sciences, Diagnostic Immunology has become a versatile branch due to availability of monoclonal antibody (MCA)-based advanced techniques such as radioimmunoassay (RIA), enzyme immunoassay (EIA), fluorescence activated cell sorter (FACS), Nephelometry, Immunochromatographic technique (ICT), Immunofluorescence technique (IFT), etc. Laboratory diagnosis and follow-up of immunologically -mediated as well as other diseases are made now-a-days with high precision and accuracy with the application of these advanced techniques. Diagnostic immunology was reorganized and more versatile investigations were introduced at the Medical College for Women & Hospital (MCW&H) laboratory, Uttara, Dhaka in August 2002. The idea was to provide high quality laboratory services for specialized diagnostic immunology tests in a cost effective way. In 2005 Medical Research Unit (MRU) had been set up in at MCW&H building to conduct high quality clinical and biomedical research and provide further specialized biochemical and immunological laboratory tests at affordable costs. Many diagnostic tests were introduced and carried out regularly at MRU (Diagnostic) Laboratory to confirm and pin-point the clinical (provisional) diagnosis of human diseases. The analysis of the results of some advanced laboratory investigations and also the immunodiagnostic tests in various antibody classes for TORCH/ ToRCH infections conducted at MRU Laboratory have been presented in the present article and discussed accordingly.

and also the immunodiagnostic tests in various antibody classes for TORCH/ToRCH infections carried out at MRU (Diagnostic) Laboratory have been presented in the present article. Some of the other immunological test results produced at MRU (Diagnostic) Laboratory such as antinuclear antibody (ANA), anti-dsDNA antibody (Anti-dsDNA), complements (C3, C4), immunoglobulin E (IgE), etc had been published in 2005 previously [6].

Immunodiagnostic Tests
The diagnostic tests introduced and routinely carried out at  [6]. The laboratory procedures adopted were the following.

Tumour/Cancer Markers
The tumour markers (PSA, CEA, AFP) were quantitatively analysed using diagnostic kits based on third generation EIA in human serum11,12,13; Hormone Profile: The analysis of hormones (T3, T4, TSH), were carried out using indirect and competitive EIA based assay kits [6,[14][15][16][17]. Hepatitis Virus Profile: All the hepatitis virus infection tests were done using diagnostic kits based on third generation EIA obtained from different internationally reputed companies [18,19].

Results
The results of the serum specimens analysed from June 2003-July 2004 for autoantibody profile, C3, C4 and IgE, tumour/cancer markers, hormone profile and hepatitis virus profile are presented in Table 1. The results of the complete TORCH panel are stated in Table 2. The results of tests in serum for one or the other component (organism) of TORCH infections are stated in Table 3. Table 2 shows that all 30 specimens analysed for TORCH infections were females (N: 30, Age range: 18-38 years; Mean age + SD: 28+20 years). It was evident from Table 2 that only 3 specimens (i.e. specimen no 06, 07, 25) and 1 specimen (i.e. specimen no 39) were positive for current/ recent infection with Toxoplasma and CMV respectively. All other specimens were positive for past exposure to either all components or negative for one or more components of TORCH infections.     Among the tumour markers, PSA received highest interest   [23][24][25]. The prevalence of these infections varies from one geographical location to another [20,27,28]. Any patient infected with the TORCH agents, mainly two types of antibodies i.e. IgM and IgG classes are produced against the infective organisms. By measuring the antibody classes in mother's blood, one can identify the type of infection [20,23]. When IgM class antibody is present with or without IgG class antibody, it invariably suggests acute/ recent infection and the presence of only IgG class antibody suggests mainly past or present active infection [20,29]. In the present study, an attempt was made to determine the prevalence of seropositivity in of TORCH in requested specimens sent to MRU Diagnostic Laboratory for investigations. However, laboratory evidence for TORCH infections, either multiple or single, was very low in the present study (Table 2, 3) contrary to some other reports from Bangladesh [20,22,25]. The probable reason may be that samples received at our MRU laboratory were from heterogeneous sources rather than concentrated from either Obstetrics and Gynecology or Neonatal units of hospitals and clinics.

American College of obstetrics and Gynecology (ACOG)
currently recommended screening pregnant women for TORCH at the first prenatal visit. Clinicians must be well acquainted with the presentations of these infections, so that proper diagnosis can be made and treatment initiated, thus decreasing the likely wood of maternal and neonatal morbidity and mortality [20,[28][29][30].
the lowest and in the near future, we are inclined to introduce more immunodiagnostic tests with competitive prices. It is of paramount importance, however, to take clinical data into consideration whenever making interpretations of the laboratory (diagnostic) test results. Therefore, it would have been clinically and scientifically more meaningful if the specimens were sent to the laboratory with more clinical details as per as practicable, particularly the provisional diagnosis and other most relevant clinical features of the patients.