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Blood
Blood bank

Blood bank notes

Blood banking index:- 1. Blood Bank Management & Documentation of Packaging:- Reception, Indexing & Recording Decontamination of blood bags, workbench, andal and immune antibodies) Distribution of ABO antigens (A, B, and H Antigens) on red cells and antibodies in the serum. Rh blood group system Sources of errors in ABO grouping  instruments Sterilization of transfusion sets (physical & Chemical) 2. Discovery of Human Blood Group:- Theory of inheritance and nomenclature of ABO and Rh blood group system Subgroup of ABO system and Bombay group. 3. Technique for Determination of Various Blood Groups and Rh factors:- Determination of various blood groups (NaturABO hemolytic disease 4. Cross Matching and Complications of Blood Transfusion Cross math Immunological complications, non-immunological complications. History of blood bank:- The history of Blood Bank began in 1616 when William Harvey  Discovered that blood circulation through the body. In 1665, a transfusion of blood from lamp saved a young patient’s life. This led to- animal to human transfusion becoming common. The first blood bank was established in a Leningrad hospital in 1932. IN 1937, Bernard Fantus was the director of the therapeutics at cook county hospital in Chicago. Established the first hospital blood bank in the United States. Fantus created a hospital laboratory that preserved refrigerated and stored donor blood.  He also coined the term “blood bank”. The first blood bank in India was established in Kolkata in March 1942. The red cross managed the blood bank at all India institute of Hygiene and public health. The first successful transfusion of human blood to a patient was performed in 1818 by British obstetrician James Blundell.   Blundell’s transfusion was to treat postpartum hemorrhage.  In 1901, three main blood groups were discovered in 1902, the blood group is discovered in 1907. Cross matching was first used in 1914; the first non-directed transfusion was performed. In 1917, the first blood depot was established -: Universal safety rules for blood bank technicians: –  Working in blood bank is a noble profession that’s required almost care and precautions. Blood bank technicians play a crucial role in ensuring the safety of both donors and recipients. To maintain a lifesaving legacy, it is essential for these technicians to follow universal safety rules. Personal protective equipment (PPE): – Always wearing appropriate PPE including Gloves Lab Coat / Gown / Apron Face Protection Head Cover / Cap Shoe Covers / Closed Shoes Additional PPE (when needed) Safety goggles When handling blood and blood products. 1.Hand hygiene: – Hand hygiene is one of the most critical infection control practices in blood bank, since staff handle human blood, component, and samples that may carry infectious agents like HIV, HCV. Wash your hands frequently and thoroughly with soap and water, apply 3-5 ml of sanitizer, rub for 20-30 second until dry should contain 60-95% alcohol. 2. Sharp object safety: – Prefer safety engineered needles and syringes with retractable or shielded tips. Do not recap needles after use. Avoid passing sharps directly from hand to hand (use trays). Dispose of used needles, scalpels, and glass pieces immediately after use in puncture-proof, leak-proof, clearly labelled sharps containers. Keep the blood collection area clean, uncluttered, and well-lit. Handle glass blood bottles, vacutainers, and pipettes carefully to prevent breakage.   Regular staff training on safe handling, disposal, and emergency procedures.   Posters and reminders in the blood bank to reinforce best practices.   3.Infection control:- Follow standard precaution to prevent the spread of infectious disease treat all blood product are potentially infectious. 4. Labelling: – Ensure proper labelling of all blood products and specimens confirm the information and levels match the requisition forms. 5..Blood typing and cross match: -Double check patients’identification and blood compatibility before transfusion to prevent error. Blood typing is the process of determining a person’s blood group based on the presence or absence of specific antigens on red blood cells (RBCs). Crossmatching is done before a blood transfusion to ensure compatibility between donor and recipient blood. It prevents haemolytic transfusion reactions. 6. Blood donation: – blood donation is the voluntary process of giving blood, which is then used for transfusions or to make blood components (like plasma, platelets, or red blood cells) for patients in need. If involved in the collection process, ensure that all blood donation equipment sterile and used according to established procedures 7. Equipment maintenance: – Regularly inspect and maintained equipment like refrigerator, freezer, and centrifuge to ensure the integrity of blood products 8.Storage:- Follow strict instructions of guidelines for storing blood products ensure proper temperature control and monitor for any signs of spoilage or contamination. 9.Emergency procedures: – Stay calm and follow the laboratory’s Standard Operating Procedures (SOPs) Protect yourself first using PPE (gloves, mask, apron) Alert staff and supervisor immediately Document the incident properly 10.Disposal: – Dispose of biohazardous waste including contaminants materials and sharps, accordance with rule -regulation and guidelines. 11.Training and education: – Stay current with blood banking procedures and safety practices throughout the regular training and continuing education. 12.Quality control:- Participate in quality control and assurance programs to maintain the highest standards of safety and accuracy. 13.Documantaion: – Maintain accurate records of all blood product handling testing and transfusions. Document any incidents or deviations from standards procedures 14. confidentially: – Maintain strict confidently of patient information and blood donor records. 15.Communication: – Clearly and accurately communicate with healthcare providers and other staff involved in the blood transfusion process. 16.Safety data sheets (SDS): – Familiarize yourself with safety data sheets for all chemicals and reagents used in the blood bank follow safety instructions and guidelines. 17. zero tolerance for risky behaviour: – Report any unsafe practices or deviations from safety protocols to your supervisor immediately 18.contnuous monitoring: – Regularly monitor and assess safety practices to identify and address potential risks and improvement. Donor selection:- Pre-donation counselling by trained staff should be made available maintaining privacy and confidentiality pre donation information should be included. Modes of transmission leading to risk behaviour and self-exclusion for patients’ safety. Alternative testing site Test carried out on donated blood.

Microbiology

MOTILITY TESTING OF MICROORGANISUM

Motility testing of the microorganism or hanging drop preparation:- Requirements:- 1.       Hollow ground (depression) or cavity slide 2.       Coverslip 3.       Petroleum jelly 4.       Two known cultures (one containing motile and other non-motile organism) 5.       Microscope Procedure– 1.      Apply petroleum jelly at the four corners of the coverslip. 2.       Place aseptically loopful of culture at the middle of the coverslip. 3.       Take the cavity slide and invert the concave portion over the drop. 4.       Invert the whole preparation so that the coverslip is on the top. 5.      Examine the suspension under low power lens first. Cut down the light by adjusting the diaphragm of the condenser and then swing the objectives to the high dry lens, 6.      Observe for motility (it can be detected by the presence of directional motion). Note– 1.       Look at one organism for about 1 minute and see if it moves out of its original position. 2.       Jumping or dancing organisms are not necessarily true motiles, but these movements may be due to Brownian movement. 3.       Record the results of the observations by indicating “motile” or “non-motile” organism. After finishing the observations, place the cavity slide in disinfectant solution.

Simple Staining
Microbiology

Gram staining Theories

Gram stain:- Very commonly used differential staining is Gram staining, used to differentiate gram-positive & gram-negative bacteria. Developed by Hans Christian Gram in 1884. Gram’s Staining Principle:- 1.   Bacteria having cell walls with a thick layer of peptidoglycan will resist decolorization of primary stain and appear violet or purple. 2.    Bacteria having a thin peptidoglycan layer with lesser cross-linkage lose primary stain during decolorizing and gain counter stain appearing pink orred.  3.    In an aqueous solution of crystal violet dye, their molecules dissociate into CV+ and Cl– ions. These ions easily penetrate the cell wall components of both positive and negative bacteria. 4.  When Gram’s Iodine is added as mordant, the iodine (I) interacts with CV+ion and forms CV-I complex within cytoplasm and cell membrane and cell wall layers. 5.When decolorizing solution (ethanol or a mixture of ethanol and acetone) is added it interacts with lipids in the cell wall. 6.  The outer membrane of the Gram-Negative bacterial cell wall is dissolved exposing the peptidoglycan layer 7.     The peptidoglycan layer is thin with less cross-linking in the Gram-Negative cell wall, hence becoming leaky. This causes cells to lose most of the CVI complexes. 8.Whereas in Gram-Positive bacteria, there is no outer membrane, and the peptidoglycan layer is also thick with higher cross-linkage. 9.So, the decolorizing solution dehydrates the peptidoglycan layer trapping all the CVI complexes inside the cell wall and bacteria retain the purple orviolet color of crystal violet. 10.When counterstain, positively charged safranin, is added, it interacts with the free negatively charged components in Gram-Negative cell wall and membrane and bacteria becomes pink/red. 11.Whereas, there is no space to enter inside the dehydrated Gram-Positive cell wall due to CVI complex and dehydration. Hence, safranin can’t stain themred or pink and Gram-Positive bacteria reveal the purple or violet color. Gram’s Staining Protocol:- •       Flood crystal violet solution over fixed smear •       After 30 – 60 seconds, pour off the Crystal Violet solution and rinse with gentle running water. •       Flood the Gram’s Iodine solution over the smear •       Leave the iodine solution for 30 – 60 seconds and pour off the excess iodine and rinse with gentle running water •       Shake off the excess water over the smear •       Decolorize the smear by passing the decolorizing solution till the solution runs down in clear form. Alternatively, add a few drops of decolorizing solution and shake gently and rinse with distilled water after 5 seconds. •       Rinse with distilled water to wash decolorizer •       Shake off the excess water over the smear •       Pour counter stain over the smear •       Leave for 30 – 60 seconds and wash with gentle running water •       Air-dry or blow-dry the smear.

Microbiology

BACTERIAL DISEASES

PULMONARY TUBERCULOSIS Pathogen:-      Mycobacterium tuberculae  Incubation Period:-      2-10 weeks Symptoms:-Coughing; chest pain and bloody sputum with tuberculin. Epidemiology:-Airborne & Droplet infection Therapy/ Prophylaxis:-Streptomycin,para-amino salicylic acid, rifampicin etc./ BCG vaccine Isolation, Healtheducation DIPHTHERIA Pathogen:- Corynebacterium diphtheriae Incubation Period:-     2-6 days Symptoms:-Inflammation of mucosa of nasal chamber, throat etc. respiratory tract blocked. Epidemiology:-Airborne & Droplet infection Therapy/ Prophylaxis:-Diphtheria antitoxins, Penicillin, Erythromycin/ DPT vaccine CHOLERA:- Pathogen:-   Vibrio cholerae Incubation Period:-6 hours to 2 – 3 days Symptoms:-Acute diarrhoea & dehydration. Epidemiology:-Direct & oral (with contaminated food & water) Therapy/Prophylaxis:-Oralrehydration therapy & tetracycline/ Sanitation, boiling of water &cholera vaccine Leprosy:- Pathogen:-Mycobacterium leprae Incubation Period:-  2-5 years Symptoms:-Skin hypopigmentation, nodulated skin, deformity of fingers & toes. Lepromin in skin tests. Epidemiology:-lowest infectious & contagious Therapy/Prophylaxis:-Dapsone, rifampicin, Clofazimine./ Isolation Pertussis(Whooping Cough):- Pathogen:-Bordetella pertussis Incubation period:- 7-14 days Symptoms:-Whoops during inspiration Epidemiology:-Contagious & Droplet infection Therapy/Prophylaxis:-Erythromycin / DPT vaccine Tetanus(Lock Jaw):- Pathogen:-Clostridium tetani Incubation Period:- 3-21 days Symptoms:-Degeneration of motor neurons, rigid jaw muscles, spasm and paralysis Epidemiology:-Through injury Therapy/Prophylaxis:-Tetanus- antitoxins. / ATS and DPT vaccines. Gonorrhoea:- Pathogen:-          Neisseria gonorrhoeae Incubation Period:-   2-10 days Symptoms:-   Inflammation of urinogenital tract. Epidemiology:-   Sexual transmission Therapy/Prophylaxis:-Penicillin & Ampicillin / Avoid prostitution Syphilis:- Pathogen:-Treponema pallidum Incubation period:-3 weeks Symptoms:-Inflammation of urinogenital tract. Epidemiology:-Sexual transmission Therapy/Prophylaxis:-Tetracycline & penicillin. / Avoid prostitution Viral Disease:-Chickenpox(Varicella): Pathogen – Herpes-zoster virus (DNA- virus) Epidemiology – Contagious & Formite borne Incubation Period – 12-20 days Symptoms – Dark red coloured rash or pox changing into vesicles, crusts and falling. Prophylaxis – Now vaccine available, isolation. Therapy – Zoster Immunoglobulins (ZIG). 2. Smallpox(Variolla):- Pathogen – Variola-virus (DNA-Virus) Epidemiology – Contagious & Droplet infection Incubation Period – 12-days Symptoms – Appearance of rash changing into pustules, scabs and falling. Prophylaxis – Smallpox vaccine. Therapy – No case reported after 1978. 3.Poliomyelitis:- Pathogen – Polio-virus (RNA-virus) Epidemiology – Direct & oral Incubation Period – 7-14 days Symptoms – Damages motor neurons causing stiffness of neck, convulsion, paralysis of generally legs. Prophylaxis – ‘Salk’ vaccine and Oral Polio vaccine. Therapy – Physiotherapy. 4. Measles(Rubeolla Disease):- Pathogen – Rubeolla-virus (RNA-virus) Epidemiology – Contagious & Droplet infection Incubation Period – 10 days Symptoms – Rubeolla (skin eruptions), coughing, sneezing etc. Prophylaxis – Edmonston- B-vaccine, isolation Therapy – Antibiotics & sulpha drugs. 5. Mumps:- Pathogen – Mumps-virus (RNA-virus) Epidemiology – Contagious & Droplet infection Incubation Period – 12-26 days Symptoms – Painful enlargement of parotid salivary glands. Prophylaxis – Mumps- vaccine isolation Therapy – Antibiotics. 6. Rabies(Hydrophobia) Pathogen – Rabies-virus (RNA-virus) Epidemiology – Indirect & inoculative (vectors are rabid animals monkeys, cats, dogs) Incubation Period – 10 days to 1- 3 months Symptoms – Spasm of throat & chest muscles, fears from water, paralysis and death. Prophylaxis – Immunization of dogs.  Therapy – Pasteur- treatment (14 vaccines in stomach). 7.Trachoma:- Pathogen – Chlamydia trachomatis Epidemiology – Contagious, formite-borne and flies (vectors) Incubation Period – 5-12 days Symptoms – Inflammation of conjunctiva & cornea leading to blindness. Prophylaxis – Isolation Therapy – Tetracycline & sulfonamide. 8.Influenza(Flu):- Pathogen – Myxovirus influenzae (RNA-virus) Epidemiology – Air borne and pandemic Incubation Period – 24-48 Hours Lasts for 4-5 days Symptoms – Bronchitis, sneezing bronchopneumonia, leucopenia, coughing, etc. Prophylaxis – Isolation. Therapy – Antibiotic therapy. 9.Hepatitis(Epidemic Jaundice):- Pathogen – Hepatitis-B virus Epidemiology – Direct & oral (with food and water) Incubation Period – 20-35 days Symptoms – Damage to liver cells releasing bilirubin which causes jaundice. Prophylaxis – Proper sanitation proper coverage of food, water, milk etc. use of chlorinated or boiled water, etc.  Therapy – Hepatitis-B vaccine.

Microbiology
Microbiology

MICROBIOLOGY AND SEROLOGY PRACTICAL INDEX

MICROBIOLOGY INDEX 1.      Safety measures in the Microbiology Laboratory working area. 2.      Isolation of bacteria 3.      Culture media a.     Introduction and preparation technique of     Culture Media b.    Type of Culture Media       Nutrient Agar       MacConkey Agar        Blood Agar         EMB Agar         XLD Agar          Deoxycholate Citrate Agar          Lowenstein Jensen Acid Medium 4.      Isolation of Bacteria       a.  Inoculation Technique           Streaking Method,     Pouring Method     Spreading Method       Lawn Method b. Incubation of micro-organisms on or in Culture media c.  Study of Bacterial Colony morphology d.   Biochemical identification of microbiology  i.     Catalase Test ii.     Coagulase Test iii.     Oxidase Test iv.     Urease Test v.     Indole Test vi.     Bile Solubility test vii.    Cetrimide test viii.  Decarboxylase test. e.     Slide preparation of various Specimens f.     Staining Technique  i.     Simple Stain  ii.   Gram’s Stain  iii. AFB or ZN Stain   iv.  Albert Stain   v.     Negative Stain 5.       Cultivation of Fungi 6.       Motility Testing of micro-organisms 7.       Anti-bacterial sensitivity testing 8.       Preparation of VDRL buffer and Antigen emulsion Serology practical index 1.       VDRL Agglutination test for syphilis by Quantitative and Qualitative method 2.       Rapid Plasma Reagin (RPR) test for syphilis 3.       Widal test by Qualitative and quantitative method. 4.       Ring Test 5.       Nepier Aldehyde Test 6.       ASO test by Quantitative and Qualitative 7.       Rheumatoid Arthritis Test (RA Test) 8.       C-Reactive Protein Test (CRP) 9.       Immunologic Pregnancy Test

Biochemistry

GLOBULINE AND A/G RATIO

Globulin & AG Ratio Aim:-   Find out of globulin protein and AG Ratio from Total protein and Albumin. Method: – Calculation Globulin (g/dl) = Total Protein – Albumin If, Total Protein is = 6.46 g/dl, &  Serum Albumin is = 4.30 Then,  Globulin (g/dl) = 6.46 – 4.30 Globulin (g/dl) = 2.16  AG Ratio Calculation:- AG Ratio = Albumin / Globulin  AG Ratio = 4.30/2.16 AG Ratio = 1.99  Normal Value:- AG Ratio = 0.9 – 2.0 g/dl  Globulin = 2.5 – 3.5 g/dl

Clinical Pathology

MEN INFERTILITY

MEN INFERTILITY:- Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant. About 13 out of 100 couples can’t get pregnant with unprotected sex. There are many causes for infertility in men and women. In over a third of infertility cases, the problem is with the man. This is most often due to problems with his sperm production or with sperm delivery. What Happens Under Normal Conditions? The man’s body makes tiny cells called sperm. During sex,ejaculation normally delivers the sperm into the woman’s body. The male reproductive system makes, stores, and transports sperm. Chemicals in your body called hormones control this. Sperm and male sex hormone (testosterone) are made in the 2 testicles. The testicles are in the scrotum, a sac of skin below the penis. When the sperm leave the testicles, they go into a tube behind each testicle. This tube is called the epididymis. Just before ejaculation, the sperm go from the epididymis into another set of tubes. These tubes are called the vas deferens. Each vasdeferens leads from the epididymis to behind your bladder in the pelvis. There each vas deferens joins the ejaculatory duct from the seminal vesicle. When you ejaculate, the sperm mix with fluid from the prostate and seminal vesicles.This forms semen. Semen then travels through the urethra and out of the penis. Male fertility depends on your body making normal sperm and delivering them. The sperm go into the female partner’s vagina. The sperm travel through her cervix into her uterus to her fallopian tubes. There, if sperm and egg meet, fertilization happens. Causes:– Making mature, healthy sperm that can travel depends on many things. Problems can stop cells from growing into sperm. Problems can keep the sperm from reaching the egg. Even the temperature of the scrotum may affect fertility. These are the main causes of male infertility: Sperm Disorders Varicoceles Retrograde Ejaculation Immunonologic Infertility Obstruction Hormones Medication Sperm Disorders:- The most common problems are with making and growing sperm. Sperm may: not grow fully be oddly shaped not move the right way be made in very low numbers (oligospermia) not be made at all (azoospermia) Sperm problems can be from traits you’re born with. Lifestyle choices can lower sperm numbers. Smoking, drinking alcohol, and taking certain medications can lower sperm numbers. Other causes of low sperm numbers include long-term sickness (such as kidney failure), childhood infections (such as mumps), and chromosome or hormone problems (such as low testosterone). Damage to the reproductive system can cause low or no sperm. About 4 out of every 10 men with total lack of sperm (azoospermia) have an obstruction (blockage) within the tubes the sperm travel through. A birth defect or a problem such as an infection can cause a blockage. Varicoceles:-  Varicoceles are swollen veins in the scrotum. They’re found in 16 out of 100 of all men. They are more common in infertile men (40 out of 100). They harm sperm growth by blocking proper blood drainage. It may be that varicoceles cause blood to flow back into your scrotum from your belly. The testicles are then too warm for making sperm. This can cause low sperm numbers. For more information please refer to the Varicoceles information page. Retrograde Ejaculation:- Retrograde ejaculation is when semen goes backwards in the body. They go into your bladder instead of out the penis. This happens when nerves and muscles in your bladder don’t close during orgasm (climax). Semen may have normal sperm, but the semen is not released from the penis, so it cannot reach the vagina. Retrograde ejaculation can be caused by surgery, medications or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or “dry” ejaculation. Immunologic Infertility:– Sometimes a man’s body makes antibodies that attack his own sperm. Antibodies are most often made because of injury, surgery or infection. They keep sperm from moving and working normally. We don’t know yet exactly how antibodies lower fertility. We do know they can make it hard for sperm to swim to the fallopian tube and enter an egg. This is not a common cause of male infertility. Obstruction:- Sometimes the tubes through which sperm travel can be blocked. Repeated infections, surgery (such as vasectomy), swelling or developmental defects can cause blockage. Any part of the male reproductive tract can be blocked. With a blockage, sperm from the testicles can’t leave the body during ejaculation. Hormones:- Hormones made by the pituitary gland tell the testicles to make sperm. Very low hormone levels cause poor sperm growth. Chromosomes:- Sperm carry half of the DNA to the egg. Changes in the number and structure of chromosomes can affect fertility. For example, the male Y chromosome may be missing parts. Medication:- Certain medications can change sperm production, function and delivery. These medications are most often given to treat health problems like: arthritis depression digestive problems anxiety or depression infections high blood pressure cancer Diagnosis:- Causes of male fertility can be hard to diagnose. The problems are most often with sperm production or delivery. Diagnosis starts with a full history and physical exam. Your health care provider may also want to do blood work and semen tests. History and Physical Exam:- Your health care provider will take your health and surgical histories. Your provider will want to know about anything that might lower your fertility. These might include defects in your reproductive system, low hormone levels, sickness or accidents. Your provider will ask about childhood illnesses, current health problems, or medications that might harm sperm production. Such things as mumps, diabetes and steroids may affect fertility. Your provider will also ask about your use of alcohol, tobacco, marijuana and other recreational drugs. He or she will ask if you’ve been exposed to radiation, heavy metals or pesticides. Heavy metals are an exposure issue (e.g. mercury, lead arsenic). All of these can affect fertility. Your health care provider will learn how your body works during sex. He or she will want to

Sterilization
Microbiology

STERILIZATION

STERILIZATION:- Sterilization (or sterilisation) refers to any process that eliminates, removes, kills, or deactivates all forms of life and other biological agents.(suchas:- fungi, bacteria, viruses, spore forms, prions, unicellular eukaryotic organisms such as Plasmodium, etc) present in a specified region, such as a surface, a volume of fluid, medication, or in a compound such as biological culture media. Sterilization can be achieved through various means, including: heat, chemicals, irradiation, high pressure, and filtration. Sterilization is distinct from disinfection, sanitization, and pasteurization, in that sterilization kills, deactivates, or eliminates all forms of life and other biological agents which are present. Sterilization are classified as following:- physical methods of seterilization (i)Sun-Light:- Ultraviolet rays present in the sun-light are responsible for spontaneous sterilization in natural conditions. In tropical countries the sun light is more effective in killing bacteria due to combination of ultraviolet rays and heat. By killing bacteria in suspended water, sunlight provides natural method of disinfection of water bodies such as tanks and lakes. Those articles which cannot withstand high temperature can still be sterilised at lower temperature by prolonging the duration of exposure. (ii)Heat:- It is considered to be the most reliable method of sterilization of articles—that withstand heat. There are two methods of the sterilization: dry heat and moist heat. (A) Dry Heat: It acts by protein denaturation and oxidative damage. Sterilization by dry heat is as follows:-  (a) Red Heat: Articles such as bacteriological loops, straight wires, tips of forceps and searing spatulas are sterilised by holding them in a Bunsen flame, till they become hot red. (b) Flaming: Articles are passed over a Bunsen flame but not heating it to redness. (c) Incineration: Contaminated, materials are destroyed by burning them in incinerator. (d) Hot Air Oven: Articles are exposed to high temperature (160°C) for duration of one hour in an electrically heated oven (method was introduced by Louis Pasteur). (B) Moist Heat: It acts by coagulation and denaturation of proteins. (i)At Temperature below 100°C:   Pasteurization: This process was originally employed by Louis Pasteur. Currently this procedure is employed in food and dairy industry. There are two methods of pasteurization, the holder method (heated at 63oC for 30 minutes) and flash method (heated at 72oC for 15 seconds) followed by quickly cooling to 13oC. Other pasteurization methods include Ultra-High Temperature (UHT), 140oC for 15 sec and 149oC for 0.5 sec. This method is suitable to destroy most milk borne pathogens like Salmonella, Mycobacterium, Streptococci, Staphylococci and Brucella, however Coxiella may survive pasteurization. Efficacy is tested by phosphatase test and methylene blue test. Vaccine bath:- The contaminating bacteria in a vaccine preparation can be inactivated by heating in a water bath at 60oC for one hour. Only vegetative bacteria are killed and spores survive. Serum bath:- The contaminating bacteria in a serum preparation can be inactivated by heating in a water bath at 56oC for one hour on several successive days. Proteins in the serum will coagulate at higher temperature. Only vegetative bacteria are killed and spores survive. (ii) At Temperature 100°C:- (a)Boiling:- Boiling water (100C°) kills most vegetative bacteria. (b) Steam at 100°C:- Passing the steam at 100°C over articles kills bacteria. Sugars and gelatin in medium may get decomposed by autoclaving. So, these can be sterilised by exposing them to free steaming for 20 minutes for three successive days. This process is known as tyndallisation (after John Tyndall). (iii)At Temperature above   100°C:- (a) Autoclave:- Sterilization can be effectively achieved at a temperature above 100°C using an autoclave. Structure of Autoclave:- A simple autoclave has vertical or horizontal cylindrical body with a heating element, a per-forted tray to keep the articles, a lid that can be fastened by screw clamps, a pressure gauge, a safety valve and a discharge tap (Fig. 1). The lid is closed but the discharge tap is kept open and the water is heated. As the water starts boiling the steam drives air out of the discharge tap, when all the air is displaced and steam starts appearing through the discharge tap, the tap is closed. The pressure inside is allowed to rise up to 15 lbs. per square inch. At this pressure the articles are heated for 15 minutes, after which the heating is stopped and the autoclave is allowed to cool. Once the pressure gauge shows the pressure equal to  atmospheric pressure, the discharged tap is opened to let the air in. The lidis opened and articles are removed. Culture media, dressing, certain equipment’s can be sterilised by autoclave. (iii) Sonic and Ultrasonic Vibrations- Sound waves of frequency 720,000 cycle/second kills bacteria and some viruses exposing for one hour. (iv) Radiation:- Two types of rays are used for sterilization: Non-ionizing and ionizing. (a) Non-Ionizing Rays:- These are low-energy rays with poor penetrative power, e.g., U.V. rays (wavelength 200-280 nms, effective 260 nm). (b) Ionizing Rays:- These are high-energy rays with good penetration power. These are of two types:- Particulate and electromagnetic.Electron beams are particulate while gamma rays are electromagnetic in nature. High speed electrons are produced by a linear accelerator from a heated cathode. Electromagnetic rays such as gamma rays emanate from nuclear disintegration of certain radioactive isotopes (Co60, Cs137). A degree of 2.5 megabrands of electromagnetic rays kills all bacteria, fungi, virus and spores. In some parts of Europe, fruits and vegetable are irradiated to increase their shelf life up to 500 percent. Since radiation does not generate heat, it is called Cold sterilization. Chemical Methods of Sterilization: Chemicals destroy pathogenic bacteria from inanimate surfaces and are all also called disinfectants. Liquid:- Alcohols:- E.g., Ethyl alcohol, Isopropyl alcohol and methyl alcohol.  (A 70% solution kills bacteria). Aldehydeles: E.g.,Fomaldehyele,Gluteraldehydele(40% formaldehyde is used for surface disinfection). Phenol:- E.g., 50% phenol, 1-5% cresol, 5% lysol, chloroxylenol (Dettol). Halogens: E.g.,chlorine compounds (chlorine bleach, hydrochloride) and iodine compounds (tincture, iodine, iodophores). Tincture of iodine (2% iodine in 70% alcohol) is antiseptic. Heavy metals:- E.g., Mercuric chloride, silver nitrate, copper sulfate, organic mercuric salts. Surface active agents: e.g., soaps or detergents. Dyes:- Acridin dyes e.g., acriflavin and aminacrine are bactericidal (interact with bacterial nucleic acids). Gaseous: E.g.Ethylene oxide, formaldehyde gas, highly effective, killing of spores. Physiochemical Methods of Sterilization: A

Lipase Test
Biochemistry

LIPASE

Methyl Resorufin Method: INTENDED USE: The reagent kit is intended for the in vitro quantitative determination of lipase in serum/plasma. PRINCIPLE: In the presence of colipase and bile acids, lipase splits the synthetic substrate (1,2-O-dilauryl-rac-glycero-3-glutaric acid 6-methylresorufin ester) to form lauric acid and methylresorufin. The rate of hydrolysis is measured photometrically and is proportional to the catalytic activity of lipase present in the sample. CONTENTS: Reagent 1: Lipase Reagent R1 Reagent 2: Lipase Reagent R2 Reagent 3: Lipase Calibrator SAMPLE: Serum or plasma with sodium citrate, EDTA, or heparin. PRECAUTION: To avoid contamination, use clean laboratory materials, use clear reagents and glassware. Avoid direct exposure of reagents to light. PROCEDURE: Pipette into clean dry test tubes labeled as Blank (B), Calibrator (C), and Test (T): Component Blank (B) Calibrator (C) Test (T) Reagent 1 1.0 ml 1.0 ml 1.0 ml Calibrator — 20 µl — Sample — — 20 µl Mix carefully (do not vortex). Incubate for 1–5 min at 37°C and read absorbance at 580 nm.Add Reagent 2: 250 µl to each tube, mix gently and read absorbance after exactly 120 sec (A2). CALCULATION: For kinetic:Lipase U/L = (ΔOD/min Sample / ΔOD/min Blank) × Calibrator Concentration For fixed time:Lipase U/L = (Abs (A2–A1) Sample / Abs (A2–A1) Calibrator) × Calibrator Concentration NORMAL RANGE: Up to 60 U/L(Each laboratory should establish its own normal range.) CLINICAL SIGNIFICANCE: Lipase is a pancreatic enzyme necessary for the absorption and digestion of nutrients. The deficiency of lipase or disorders of fat digestion may result in the abnormal digestion of fats and malabsorption. Clinical diagnosis necessitates the presence of pancreatic duct obstruction, acute pancreatitis, and other conditions. GENERAL SYSTEM PARAMETERS: Reaction type: Kinetic Reaction slope: Increasing Wavelength: 580 nm Cuvette: 1 cm Reaction temperature: 37°C Dead time: 60 sec No. of readings: 3 Sample volume: 20 µl Calibrator: 2 points Working reagent volume: 1.25 ml (1000 + 250) Blank: Reagent Assay procedure: 1 cm light path LINEARITY: Up to 300 U/L. If activity is greater than 300 U/L, dilute the sample with normal saline and repeat the assay. Multiply result by dilution factor.

Sodium
Biochemistry

SODIUM (MONO TEST)

Sodium Reagent Kit (Mono Test) INTENDED USE: This reagent kit is intended for the in vitro quantitative determination of sodium in serum. PRINCIPLE: The reagent is based on reaction of sodium with a selective chromophore producing a chromogenic complex whose absorbance is directly proportional to sodium concentration in the sample. CONTENTS: Reagent 1: Sodium Reagent Reagent 2: Sodium Standard (150 mEq/L) SAMPLE COLLECTION AND PRESERVATION: Serum or heparinized plasma. Sodium is stable for 2 weeks at 2–8°C. REAGENT PREPARATION AND STORAGE: All reagents are ready to use. Store reagents at room temperature (2–30°C).  PROCEDURE:- Pipette into clean dry test tubes labeled as Blank (B), Standard (S), and Test (T): Component Blank (B) Standard (S) Test (T) Sodium reagent 1.0 ml 1.0 ml 1.0 ml Standard — 10 µl — Sample — — 10 µl Mix well and incubate at RT for 5 minutes.Measure the absorbance of Standard (Abs S) and Test (Abs T) against reagent blank at 630 nm. CALCULATION: Concentration of Sodium (mEq/L) = (Abs T / Abs S) × 150 NORMAL VALUES: Serum/Plasma: 135 – 155 mEq/L It is recommended that each laboratory establish its own normal range depending on patient population. QUALITY CONTROL: It is recommended that controls be included in each set of assays. GENERAL SYSTEM PARAMETERS: Reaction type: End point Wavelength: 630 nm Cuvette: 1 cm Reaction temperature: Room temperature Reagent volume: 1.0 ml Sample volume: 10 µl Incubation time: 5 minutes Blank absorbance limit: ≤ 1.2 Standard: 150 mEq/L NOTE:-   As sodium is a very widely distributed ion, care should be taken to avoid any contamination. All glassware being used for the test should first be rinsed with 150 mEq/L sodium-free water.

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