Laboratory MedNews

Precautions  for Glucose Determination (Ortho-Toluidine Method)

As presented by  kit procedure

1. Patient should have fasted for 8-12 hours.
2. Unhemoylzed, non icteric and non turbid serum should be used to avoid interferences
with the procedure.
3. The reagent contains sodium azide, which is corrosive, so PPE should be worn.
4. The solution should be brought to a boil to ensure proper reaction.

MANUAL PROCEDURE PROPER: ORTHOTOLUIDINE  METHOD

1. Prepare Three tubes labeled, SA (Sample)/ C (Control), ST (Standard) and RB (Reagent Blank).

2. To the SA/C tube add 0.1 ml of the test specimen/ Control specimen.

3. To the ST tube add 0.1 ml of the standard stock solution.

4. To the RB tube add 0.1 ml of distilled water.

5. Add 4 ml of glucose reagent to all tubes. Cap and mix by gentle inversion.

6. Boil all tubes at 100 degrees centigrade for 8 minutes.

7. Cool tubes in running tap water for about 2 minutes.

8. Read absorbance of solutions in the spectrophotometer with appropriate cuvets at 636 nanometers against the RB (Reagent Blank).

9. Compute for the Cu (Concentration of the Unknown making use of the formula:

Cu= Absorbance of Unknown(Au) multiplied by the Concentration of the
Standard(Cs) divided by the Absorbance of the Standard (As)

Adapt the unit of the Cs

Normal Values = 60 – 100 mg/dL
to convert values to mmol/L multiply values in mg/dL with 0.0555

Normal high can reach   as far  as  120 mg/dL

You can outline the differences of serum and plasma in the several  aspects. They are both blood specimens used in laboratory testing, but each has its own characteristics.

These are major differences of serum from plasma. What is important is when to know what specimen is ideal for a particular laboratory blood test.

If you are hypertensive, then you should know what to eat and what not to. The ideal food for hypertensive patients are the following.

Low salt foods

Salt increases blood pressure, so you should lessen your salt intake. Salt can come not only from table salt but also from most preserved foods. Opt for fresh foods instead of these types of foods.  Saltine crackers and some oatmeal brands are also rich in salt. Read the labels and ascertain that the salt content is low before eating it.

Low fat foods

Hypertension can result from high lipids or fats, so these types of foodstuffs should be avoided.  Fat can come from meat fat, like pork and chicken fat.

Dairy products

Most dairy products are rich in triglycerides and cholesterol which are predisposing factors in increasing the likelihood of hypertension.

Foods for hypertensive patients include fruits and vegetables because these foodstuffs are low in calories and are fat free. Vegetable oil and fish oil are healthy fats so they can be taken in. Knowing what food to eat and what not to, is a big factor in controlling your hypertension. You should therefore know the ideal foods for hypertensive patients to help you out in maintaining your health.

Bilirubin is the major bile pigment in the body.  There are crucial precautions you should observe in performing bilirubin tests because the substance can be affected by many factors. Here are precautions that are observed in the Jendrassik and Grof method and Evelyn and Malloy method.

Avoid hemolysis of blood specimen.

Bilirubin is a degradation product of Red Blood Cell or RBC, so any lysis or rupture of these blood cells will increase inaccurately the results of the bilirubin test.

Avoid exposure to light.

Biluribin is photosensitive. It is easily destroyed by light, so exposing it to natural or artificial light will erroneously decrease its laboratory results.

Maintain the correct pH.

Maintaining the correct pH or alkalinity and acidity of the test solution and reagent will ensure the reliability of results. This is vital precaution in performing bilirubin tests.

Avoid interference from proteins and foreign substances.

Protein and foreign substances will greatly affect you bilirubin tests.  Be sure to cover your solutions at all times with a rubber stopper or a parafilm. This will ensure that the results of your bilirubin tests are accurate and precise.

The demand for Gouty Arthritis homemade cures increased in the past few years because more people today suffer from gouty Arthritis. There are also many people who are now turning back to nature for treatment of most health problems.  One way to avoid gouty arthritis is to avoid eating foods that are rich in uric acid like organ meat products and animal protein.

What is Gouty Arthritis?

Gouty arthritis is a kind of arthritis that is caused by uric acid build-up in joints; usually the big toe. However, it could also affect the ankles, knees, elbows, fingers, toes, wrists, and the foot (heel/instep).  Gouty arthritis is one of the most painful forms of arthritis.  Symptoms include inflammation, acute pain, tenderness, and redness in the affected area.

The best gouty arthritis homemade cures

One of the best gouty arthritis homemade cures is eating a proper diet.  Add fruits that are rich in vitamin C to your daily menu.   Fruits that are rich in vitamin C include Indian gooseberries, guavas, strawberries, cherries and other citrus fruits.  Another vitamin C rich fruit is Lemon.  Green leafy vegetables and apples should also be included in your diet.

Eat at least 3-4 bananas daily, this fruit is rich in phosphorous and minerals that can help eliminate uric acid from the body.  Eating a well-planned diet is one of the best gouty arthritis homemade cures. You can also take supplements of zinc, and calcium.  Aside from eating a balance diet, drink at least 8-12 glasses of water to rid some of the uric acid from the kidneys and liver.

To relieve joint pains caused by gouty arthritis, try these gouty arthritis homemade cures:  gently massage warm olive oil or castor oil on the affected area.  If your ankles or toes are affected try soaking your feet in warm water with ground ginger this will relieve the swelling and the pain.

People should realize early in life that a healthy diet and a healthy life style lead to long life and good health.   So teach you kids what food to eat and what to avoid.  You should also formulate or learn more of gouty arthritis homemade cures to be able to help yourself and your loved ones fight the disease.

By: Johanna Vallo

Below are signs and symptoms manifested by individuals with Type 2 Diabetes Mellitus:

* Hyperglycemia – increased blood glucose to 200 mg/dL or higher secondary to lack of insulin or the cells of the body do not react properly to insulin, insulin resistance.

* Increased urinary frequency – glucose leaks into the urine and the weight of sugar in the urine triggers urge to urinate.

* Increased thirst – due to frequent urination dehydration occurs and thirst receptors are activated.

* Weight loss

Some of the major complications of Type 2 Diabetes Mellitus are listed below:

* Retinopathy – blurring of vision may occur due to continuous increased pressure in the veins and arterioles of the retina.

* Nephropathy – destruction of the nephrons secondary to the heavy weight of the sugar continuously passing through the kidneys’ filters.

Type 2 Diabetes Mellitus can be managed by diet and lifestyle modification. For a complete diet modification consult a licensed dietician or your doctor. Light exercises and weight loss can also slow or prevent the progress of the disease.

By: Joycelyn Maderas

In the desire to reduce the risks of stroke and heart attacks, anticholestrol drugs are prescribed to lower bad cholesterol level. Patients taking anticholesterol drug must be given precautionary measure before taking the drug and must be aware of the side effects of anticholestrol drugs to prevent possible undesirable effects of the drug.

Gastrointestinal Side effects of Anticholesterol Drugs

-          Constipation

-          Diarrhea

-          Heartburn

-          Abdominal pain

-          Black stool

Hepatic Side effects of Anticholesterol Drugs

-          Liver dysfunction, rarely causing mild hepatitis. Patients with liver disease should undergo liver function tests before the treatment

Muscular Side effects of Anticholesterol Drugs

-          Leg cramps

-          Myopathy or muscle damage

-          Rhabdomyolysi, fatal muscle damage caused by chemical, biological and physical factors

-          Unexplained muscle tenderness and weakness

-          Deformation of facial muscle

-          Increased in muscle movement

Neurologic Side effects of Anticholesterol Drugs

-          Loss of sensation in the lower extremities such as hands and feet

-          Headaches

-          Difficulty falling asleep

-          Polyneuropathy, simultaneously malfunctions of the peripheral nerves

-          Memory lost or disturbed

-          Back pain

-          Change in eye sight

-          Dysgeusia, lack of taste sensation

-          Depression

-          Lack of movement coordination

Renal Side effects of Anticholesterol Drugs

-          Fluid retention, accumulation of fluid within tissues of the body

-          Kidney failure, the kidney’s filtering system is damaged due to clogged muscle fibers

-          Urinary problems
Many of the side effects of anticholesterol drugs are dose dependent, it is very important to notify the doctor immediately if you experience some of the side effects. Balanced diet, exercise and weight loss are some of the important things to be considered in controlling the level of bad cholesterol in the body. We only take anticholesterol drugs when the natural remedies fail to lower the level of cholesterol in the body.

Gout is a pathologic medical condition that encompasses several biochemical processes in the body. It is the elevation of (BUA) blood uric acid in the blood stream which maybe because of various underlying occurrences. When you can’t stretch those hands in the morning, or you feel pains in your joints every now and then, or you have low back pains, then you most probably have gout.

Uric acid comes from our diet and is the breakdown product of purines. Purines come from a variety of foods like cabbage, lettuce, sardines, visceral organs, and legumes (peas, beans, nuts, etc).

When we are fond of these foods and the excretory organ of our body could not excrete these substances normally, then they accumulate in the blood causing hyperuricemia, amass in the joints resulting to gouty arthritis and are turned in the kidney into kidney stones causing nephrolithiasis.

What are the symptoms of gout?

*You have early morning numbness or tight muscles. You can open and close your fist only with difficulty, as the day progresses this usually “loosens”. Even your feet feel tight and you have difficulty walking upon waking up.

*You have pain in your joints. Sometimes swelling occurs on your knee joints, ankle joints, or hand joints.

*You have a low back pain and sometimes have difficulty walking.

*You may have difficulty in urinating. In serious conditions, blood may even be present in your urine.

How can you be sure you have the condition?

*Consult your physician. He would be responsible in collating all your symptoms and lab results to give the correct diagnosis.

*Your Blood Uric Acid laboratory test would be elevated above the normal levels. Normal Values are usually between 2-6 mg/dL for females and 3-7 mg/dL for males.

*Your routine urinalysis may yield uric acid stones in the microscopic examination. Uric acid crystals may appear as rhombic plates or rosettes which are light or dark brown in color.

How is gout treated?

*Your family physician would be the best person to treat you if you have gout. This is because he knows about your medical history and is familiar with whatever other existing conditions you may have (i.e. diabetes, etc).

*The usual treatment is an anti-hyperuricemic drug that can “dissolve” the stones either in your joints or kidneys.

*Anti-inflammatory and analgesic drugs maybe given to reduce swelling and alleviate pain.

*Water therapy is advised. More than 8 glasses of water should be consumed each day.

Are there any preventive measures?

Eating a healthy diet is the foremost preventive measure. The body needs purines but you should learn how to balance your intake. Legumes (beans, peas, anything in pods) are proteins and are needed as building blocks of the body.

*You should eat dishes with visceral organs moderately. We need the calcium coming from these dishes but too much will lead to hyperuricemia.

*Balance your intake of sardines and other canned goods; these are rich in uric acid.

*Balance your intake of the kale vegetables (cabbage, lettuce, etc) as these have high uric acid content.

*Do not drink alcohol when you are on a high purine diet as this will decrease the excretion of purines from your system. When the excretion of uric acid is decreased; this will then start to amass in your system and will eventually lead to gout. This is because uric acid can only be excreted in an acid urine because the can be dissolved an alcohol may cause eventual alkalinity of the urine.

*Exercise can help up to a certain extent to “loosen” the joints so make it a habit to have light exercises everyday. Exercise can also prevent other pathologic conditions like heart ailments, hypertension and the like.

Awareness of these preventive measures will help you avoid gout. Be informed and stay healthy.

By: Ireen B. Banasan, BSC

Type 1 Diabetes Mellitus is also called “juvenile diabetes” for it occurs in an early age. It is also known as Insulin Dependent Diabetes Mellitus (IDDM) because the islets responsible for producing insulin are damaged or destroyed maybe secondary to previous viral illness or to trauma thus, no insulin is produced at all. This type of Diabetes is often treated with insulin replacement.

The Pancreas Insulin

The pancreas is a yellowish, fish-shaped organ located at the upper abdomen.  It has two secretory functions : endocrine and exocrine.  Its endocrine function is to secrete insulin.

Specifically, insulin is secreted by the beta cells of the islets of Langerhans. The Insulin is like a carrier of blood glucose. It is like a “key” so glucose can enter the “doors” of the cells of our body and be used as energy for our daily needs. Without insulin, the glucose we take in cannot be used by our body to produce energy. Thus, the glucose stays in the blood.

Pathophysiology

In the case of Type 1 Diabetes Mellitus, there is a complete destruction of the beta cells of the islets of Langerhans which causes no insulin production. Since insulin is essential to glucose utilization, glucose stays and builds up in the blood stream causing hyperglycemia, or excess glucose in the blood. This excess glucose puts pressure to the kidneys and eventually leak into the urine. Due to the weight of glucose in the urine, urination is triggered so frequent – polyuria. Dehydration from frequent urination results to excessive thirst called polydypsia. And since glucose is not utilized by the body a person with Type 1 Diabetes Mellitus is always hungry, a sign called polyphagia. Chronic Type 1 Diabetes Mellitus can lead to complications such as hypertention, retinopathy, and renal failure. Untreated Type 1 Diabetes Mellitus can lead to Diabetic Ketoacidosis. Diabetic Ketoacidosis results from rapid catabolism of fats. Since glucose cannot be utilized as a source of energy, fat breakdown is an alternative energy source. But fat catabolism has ketone byproducts, accumulation of which leads to Diabetic Ketoacidosis.

Below are signs and symptoms of Type 1 Diabetes Mellitus

• hyperglycemia
• polyuria
• polydipsia
• polyphagia
• glucose in urine
• weight loss

Arterial puncture is one method of blood collection. Licensed and skilled personnel should perform it.   Laboratory technologists usually use arterial blood in blood gas analysis (BGA) or analysis of blood gas (ABG).

The procedure is similar to venipucture but should be done under anaerobic (no exposure to air) conditions to avoid escape of gas and shift from intracellular to extracellular fluid.

Materials needed

Luer lock syringe or appropriate syringe

Dry and sterile cotton

Wet and sterile cotton

Test tube rack

Test tube (optional depending on the type of collection vessel)

PPE

Here are the steps in performing arterial puncture.

Step 1

Wear your personal protective equipment properly.

Step 2

Prepare materials by checking each item and arranging them within arm’s reach.  Do not place near the patient, especially if patient is a child.

Step 3

Select the best site of puncture. Arterial puncture sites are at the radial artery, femoral artery or brachial artery.  Be certain that it is an artery instead of a vein, by feeling for the pulsations, which is characterized by a strong beating pulse.  Veins usually disappear when you push hard.

Step 4

Puncture the artery at about 90 degrees angle. When you have correctly hit the vein, blood will push the plunger upwards.  You just have to be ready to remove the needle from the artery when done the collecting the needed volume of arterial blood.

Step 5

After collection, remove the needle smoothly and apply pressure with sterile, dry cotton for 10 to 20 minutes. You could ask assistance from the patient, and then leave the cotton and place micropore.

Step 6

Depending upon the type of syringe used, you must seal the specimen container to ensure anaerobic exposure.  Dispense in sealed containers.

Step 7

The blood sample or arterial blood should be covered at all times.  Label the specimen properly.  If you are not testing the blood immediately then keep it in chilled ice.  Even when transporting, it should be placed in an icebox with crushed ice.

Step 8

Check the wound of the patient. Be certain there is no bleeding, before you allow him to stand.

Step 9

Dispose your used materials in specified containers.   Clean your working area.

Step 10

Wash your hands thoroughly after the procedure.

Licensed personnel should do arterial puncture, as there is the danger of hitting major nerves, which can debilitate or paralyze a person.  It may also cause hemorrhage if there is no correct patient’s after care.