ILAJ Medical Laboratory

11/09/2016

Eid Mubarak!!

07/09/2016

10/07/2016

Angiograms and angioplasty

An angiogram is a test to find out which arteries supplying the heart have become narrowed. An angiogram uses X-rays to show 'route maps' of blood vessels and arteries in the heart. Angiograms also give detailed information about heart function as well as blood pressure, and oxygen levels in the blood as it passes through the heart. Angioplasty is a procedure to expand narrow arteries that may follow on from an angiogram. Both procedures are done in hospital under local anaesthetic. Many people we talked to had experienced angiograms and a few had had angioplasty.

Most people had been reassured by nurses during an angiogram and said that the dye gave them a warm sensation. Most were pleased to have had the test and one woman said she would have liked an angiogram earlier on in her treatment. Generally the test had not been worrying and people talked about the number of monitors and technicians required for the procedure; one man remarked that his doctors seemed excited about his angiogram and told him he was lucky to be alive. Occasionally people had found the procedure rather uncomfortable and said that keeping still for the length of time required had been tiring; one woman said that her angiogram had taken longer than she expected.

Angioplasty is a treatment performed by a doctor which involves inserting a small inflatable balloon into a narrowed artery. Sometimes angioplasty may also involve putting a stent (a short tube of expandable mesh) into a narrowed artery. Angioplasty may not be suitable for everyone.

A year after heart by-pass surgery a woman was fitted with a special kind of stent that slowly releases a drug that can help prevent the artery from narrowing again. She said that it had made her feel much better, though she wondered with hindsight how long the stent would last. A man who had had a heart attack in the US underwent emergency angioplasty which he recalled in detail. He thought that there seemed to be a shortage of specialist staff and equipment in the UK which had delayed him getting treatment when he needed it.

Heart failure patients with “hibernating myocardium’ (where the heart muscle stops working temporarily because of reduced oxygen supply) are often offered angioplasty. People with unexplained heart failure or heart failure which worsens without reason should be investigated and they may benefit from angioplasty and stenting or best of all from coronary artery bypass grafting (CABG). The effect can be dramatic and life–prolonging

08/07/2016

08/07/2016

What Are Blood Cell Disorders?

A blood cell disorder is a condition in which there’s a problem with your red blood cells, white blood cells, or the smaller, circulating cells called platelets, which are critical for clot formation. All three cell types form in the bone marrow, which is the soft tissue inside your bones. Red blood cells transport oxygen to your body’s organs and tissues. White blood cells help your body fight infections. Platelets help your blood to clot. Blood cell disorders impair the formation and function of one or more of these types of blood cells.

What Are the Symptoms of Blood Cell Disorders?

Symptoms will vary depending on the type of blood cell disorder. Common symptoms of red blood cell disorders are:

fatigueshortness of breathtrouble concentrating from lack of oxygenated blood in the brainmuscle weaknessa fast heartbeat

Common symptoms of pediatric white blood cell disorders are:

chronic infectionsfatigueunexplained weight lossmalaise, or a general feeling of being unwell

Common symptoms of platelet disorders are:

cuts or sores that don’t heal or are slow to healblood that doesn’t clot after an injury or cutskin that bruises easilyunexplained nosebleeds or bleeding from the gums

What Are the Types of Blood Cell Disorders?

There are many types of blood cell disorders that can drastically affect your overall health.

Red Blood Cell Disorders

Anemia is one type of red blood cell disorder. A lack of the mineral iron in your blood usually causes this disorder. Your body needs iron to produce the protein hemoglobin, which helps your red blood cells carry oxygen from your lungs to the rest of your body.

Sickle cell anemia (SCA) is a type of anemia that draws its name from the unusual sickled shape of the affected red blood cells. A normal red blood cell is shaped like a disc, but due to a genetic mutation, the red blood cells of people with sickle cell anemia contain abnormal hemoglobin molecules and so are rigid and curved. The sickle-shaped red blood cells can’t carry as much oxygen to your tissues as normal red blood cells can. They may also become stuck in your blood vessels, blocking blood flow to your organs.

SCA is an inherited disease that passes down to children if both parents have the condition. It’s most common among African-Americans.

Platelet Disorders

Blood platelets are the first responders when you have a cut or other injury. They gather at the site of the injury, creating a temporary plug to stop blood loss. If you have a platelet disorder, such as von Willebrand disease, your blood doesn’t have enough platelets, contains too many platelets, or contains platelets that don’t clot correctly.

Having too few platelets is quite dangerous because even a small injury can cause serious blood loss. If you have too many platelets in your blood, blood clots can form and block a major artery, causing a stroke or heart attack. Sometimes, deformed platelets can’t stick to other blood cells or the walls of your blood vessels and so can’t clot properly. This can also lead to a dangerous loss of blood.

Pediatric White Blood Cell Disorders

These disorders affect the white blood cells of children. They occur when the bone marrow produces too many or too few white blood cells. When there aren’t enough white blood cells, the body can’t fight off infections. Too many white blood cells, known as “a high white blood cell count,” can indicate the presence of leukemia, certain infections, or conditions such as measles or whooping cough. Rarely, a bone marrow disease or autoimmune condition, which occurs when your body attacks its own cells, can lead to the production of too many white blood cells.

What Causes Blood Cell Disorders?

Blood cell disorders may be the result of disease. They may also be hereditary, or inherited from parents. For example, an iron deficiency due a lack of iron in the diet or problems with absorbing iron can result in your body not being able to produce enough red blood cells. A genetic condition, such as polycythemia vera, can cause it to produce too many.

If you have an autoimmune disease, such as lupus, your immune system may destroy your own blood platelets. This will hamper your body’s ability to stop episodes of bleeding.

Low or compromised white blood cells are due to infections that destroy or overwhelm them. Some health conditions destroy white blood cells faster than the bone marrow can produce them. Your body may also increase its production of white blood cells to fight a disease or infection.

Who Is at Risk for Blood Cell Disorders?

You or your child may be at risk for red blood cell disorders if you have low blood iron levels. You may be at risk for white blood cell disorders if you have a serious infection or autoimmune disease. A family history of blood cell disorders puts you at a higher risk of having one.

How Are Blood Cell Disorders Diagnosed?

Your doctor may order several tests, including a complete blood count (CBC) to see how many of each type of blood cell you have. Your doctor may also order a bone marrow biopsy to see if there are any abnormal cells developing in your marrow. This will involve removing a small amount of bone marrow for testing.

What Are the Treatment Options for Blood Cell Disorders?

Your treatment plan depends on the stage of your illness, your age, and your overall health status. Your doctor may use a combination of treatments to help correct your blood cell disorder.

Medication

For platelet disorders, medications such as Nplate (romiplostim) can treat clotting problems. For white blood cell disorders, antibiotics can help fight infections. Dietary supplements such as iron and vitamin B-9 or B-12 can treat anemia due to deficiencies. Vitamin B-9 is also called folate, and vitamin B-12 is also known as cobalamin.

Surgery

Bone marrow transplants may repair or replace damaged marrow. These involve transferring stem cells, usually from a donor, to your body to help your bone marrow begin producing normal blood cells. A blood transfusion is another option to help you replace lost or damaged blood cells. During a blood transfusion, you receive an infusion of healthy blood from a donor.

Both procedures require specific criteria to succeed. Bone marrow donors must match or be as close as possible to your genetic profile. Blood transfusions require a donor with a compatible blood type.

What Is the Long-Term Outlook?

The variety of blood cell disorders means that your experience of living with one of these conditions may vary greatly from someone else. Early diagnosis and treatment are the best ways to ensure that you live a healthy and full life with a blood cell disorder.

08/07/2016

White blood cells (WBCs), also called leukocytes, are an important part of the immune system. These cells help fight infections by attacking bacteria, viruses, and germs that invade the body. White blood cells originate in the bone marrow, but circulate throughout the bloodstream. There are five major types of white blood cells:

neutrophils
lymphocytes
eosinophils
monocytes
basophils
A WBC count is a test that measures the number of white blood cells in your body. This test is often included with a complete blood count (CBC). Your blood contains a percentage of each type of white blood cell. Sometimes, however, your white blood cell count can fall or rise out of the healthy range

Healthline : Power of Intelligent Health
WBC (White Blood Cell) Count
Written by Valencia Higuera
Medically Reviewed by Deborah Weatherspoon, Ph.D., MSN, RN, CRNA on 20 April 2016
OverviewPurposeWBC count procedurePreparationResultsComplicationsRead This Next
Part 1 of 6
Overview
Highlights
White blood cells help fight infections by attacking bacteria, viruses, and germs that invade the body.
A WBC count can detect hidden infections and undiagnosed medical conditions.
A healthcare provider or lab technician will draw blood to check your WBC count.
White blood cells (WBCs), also called leukocytes, are an important part of the immune system. These cells help fight infections by attacking bacteria, viruses, and germs that invade the body. White blood cells originate in the bone marrow, but circulate throughout the bloodstream. There are five major types of white blood cells:

neutrophils
lymphocytes
eosinophils
monocytes
basophils
A WBC count is a test that measures the number of white blood cells in your body. This test is often included with a complete blood count (CBC). Your blood contains a percentage of each type of white blood cell. Sometimes, however, your white blood cell count can fall or rise out of the healthy range.

Purpose of a WBC count
purpose
It is normal for doctors to order a complete blood count and check your WBC count during an annual physical examination. Your doctor may recommend a WBC count if you complain of persistent body aches, fever, chills, or headaches. A WBC count can detect hidden infections within your body and alert doctors to undiagnosed medical conditions, such as autoimmune diseases, immune deficiencies, and blood disorders. This test also helps doctors monitor the effectiveness of chemotherapy or radiation treatment in cancer patients.

What to expect from a WBC count
process
A healthcare provider or lab technician will draw blood to check your WBC count. This blood sample is taken either from a vein in your arm or a vein on the back of your hand. It only takes a couple of minutes to draw your blood and you may experience minor discomfort. The healthcare provider will clean the needle site to kill any germs and then tie an elastic band around the upper section of your arm. This elastic band helps the blood fill your vein, making it easier for the blood to be drawn.

The healthcare provider slowly inserts a needle into your arm or hand, and collects the blood in an attached tube. The provider then removes the elastic band from around your arm and slowly removes the needle. The technician will apply gauze to the needle site to stop the bleeding.

Healthcare providers use a different technique when drawing blood from young children and infants. With these patients, providers first puncture the skin with a lancet (a pricking needle) and then use a test strip or a small vial to collect the blood. Results are sent to a lab for review.

How to prepare for a WBC count
Diagnosis
A WBC count requires no specific preparation. You simply schedule an appointment with your doctor or set up an appointment at a local medical laboratory. Certain medications can interfere with your lab results and either lower or increase your WBC count.

The drugs that may affect your test results include:

corticosteroids
quinidine
heparin
Clozapine
antibiotics
antihistamines
diuretics
anticonvulsants
sulfonamides
chemotherapy medication
Prior to having your blood drawn, tell your doctor about all prescription and nonprescription medications that you’re currently taking.
Understanding WBC count test results
Results/Exams
An average normal range is between 4,500 and 10,000 white blood cells per microliter (mcL). Abnormal test results are classified by numbers that are higher or lower than this range. It’s important to note that age can also affect the number of white blood cells, with infants having a higher count than adults.

A low or high WBC count can point to a blood disorder or other medical condition. To identify the exact cause of a high or low WBC count, your doctor will take several factors into consideration, such as your list of current medications, symptoms, and medical history.

Leukopenia is the medical term used to describe a low WBC count. A low number can be triggered by:

HIV
autoimmune disorders
bone marrow disorders/damage
lymphoma
severe infections
liver and spleen diseases
lupus
radiation therapy
Leukocytosis is the medical term used to describe a high WBC count. This can be triggered by:

anemia
tumors in the bone marrow
leukemia
inflammatory conditions, such as arthritis and bowel disease
stress
exercise
tissue damage
pregnancy
allergies
asthma
After diagnosing the cause of a high or low WBC count and recommending a treatment plan, doctors will periodically recheck your white blood cells. If your white blood cell count remains high or low, this can indicate that your condition has worsened. Your doctor may adjust your treatment. If your WBC count shows a normal range, this usually indicates that the treatment is working.
Potential complications
Complications Icon
Having your blood drawn is a simple procedure, and complications are extremely rare. It can be difficult to take blood from people with small veins. The lab technician may be unable to locate a vein, or once the needle is inside the arm or hand, they may have to move the needle around in order to draw blood. This can cause a sharp pain or a stinging sensation. Rare complications include:

infection at the needle site
excessive bleeding
lightheadedness or fainting
bleeding underneath the skin (hematoma)

06/04/2016

Kidney Function Tests

You have two kidneys on either side of your spine that are each approximately the size of a human fist. They’re located posterior to your abdomen and below your rib cage.

Your kidneys play several vital roles in maintaining your health. One of their most important jobs is to filter waste materials from the blood and expel them from the body as urine. The kidneys also help control the levels of water and various essential minerals in the body. In addition, they’re critical to the production of:

vitamin D
red blood cells
hormones that regulate blood pressure
If your doctor thinks your kidneys may not be working properly, you may need kidney function tests. These are simple blood and urine tests that can identify problems with your kidneys.

You may also need kidney function testing done if you have other conditions that can harm the kidneys, such as diabetes or high blood pressure. They can help doctors monitor these conditions.

Symptoms of Kidney Problems
Symptoms that may indicate a problem with your kidneys include:

high blood pressurev
blood in the urine
frequent urges to urinate
difficulty beginning urination
painful urination
swelling of the hands and feet due to a buildup of fluids in the body
A single symptom may not mean something serious. However, when occurring simultaneously, these symptoms suggest that your kidneys aren’t working properly. Kidney function tests can help determine the reason.

Types of Kidney Function Tests

To test your kidney function, your doctor will order a set of tests that can estimate your glomerular filtration rate (GFR). Your GFR tells your doctor how quickly your kidneys are clearing waste from your body.

Urinalysis

A urinalysis screens for the presence of protein and blood in the urine. There are many possible reasons for protein in your urine, not all of which are related to disease. Infection increases urine protein, but so does a heavy physical workout. Your doctor may want to repeat this test after a few weeks to see if the results are similar.

Your doctor may also ask you to provide a 24-hour urine collection sample. This can help doctors see how fast a waste product called creatinine is clearing from your body. Creatinine is a breakdown product of muscle tissue.

Serum Creatinine Test

This blood test examines whether creatinine is building up in your blood. The kidneys usually completely filter creatinine from the blood. A high level of creatinine suggests a kidney problem.

According to the National Kidney Foundation (NKF), a creatinine level higher than 1.2 for women and 1.4 for men is a sign of a kidney problem.

Blood Urea Nitrogen (BUN)

The blood urea nitrogen (BUN) test also checks for waste products in your blood. BUN tests measure the amount of nitrogen in the blood. Urea nitrogen is a breakdown product of protein. However, not all elevated BUN tests are due to kidney damage. Common medications, including large doses of aspirin and some types of antibiotics, can also increase your BUN. It’s important to tell your doctor about any medications or supplements that you take regularly. You may need to stop certain drugs for a few days before the test.

A normal BUN level is between 7 and 20. A higher value could suggest several different health problems.

Estimated Glomerular Filtration Rate (GFR)

This test estimates how well your kidneys are filtering waste. The test determines the rate by looking at factors, such as:

test results, specifically creatinine levels
age
gender
race
height
weight
Any result lower than 60 may be a warning sign of kidney disease.

Kidney function tests usually require a 24-hour urine sample and a blood test.

24-Hour Urine Sample

A 24-hour urine sample is a creatinine clearance test. It gives your doctor an idea of how much creatinine your body expels over a single day.

On the day that you start the test, urinate into the toilet as you normally would when you wake up.

For the rest of the day and night, urinate into a special container provided by your doctor. Keep the container capped and refrigerated during the collection process. Make sure to label the container clearly and to tell other family members why it’s in the refrigerator.

On the morning of the second day, urinate into the container when you get up. This completes the 24-hour collection process.

Cap and label the container, and follow your doctor’s instructions about where to drop it off. You may need to return it either to your doctor’s office or a laboratory.

Blood Samples

BUN and serum creatinine tests require blood samples taken in a lab or doctor’s office.

The technician drawing the blood will tie an elastic band around your upper arm. This makes the veins stand out. The technician will clean the area over the vein. They will then slip a hollow needle through your skin and into the vein. The blood will flow back into a test tube that will be sent for analysis.

You may feel a sharp pinch or prick when the needle enters your arm. The technician will place gauze and a bandage over the puncture site after the test. The area around the puncture may develop a bruise over the next few days. However, you shouldn’t feel severe or long-term pain.

06/04/2016

Urinalysis: Three Types of Examinations
Also known as: Urine Test; Urine Analysis; UA
Formal name: Urinalysis
Related tests: Urine Culture; Urine Protein; BUN; Creatinine; Creatinine Clearance; Microalbumin; eGFR; Kidney Stone Analysis
At a Glance
Test Sample
The Test
Common Questions
Ask Us
Related Pages
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Visual Exam | Chemical Exam | Microscopic Exam
The Chemical Examination
To perform the chemical examination, most clinical laboratories use commercially prepared test strips. These are narrow plastic strips that hold small squares of paper called test pads, arranged in a row. The test pads have chemicals impregnated into them. When a strip is briefly, but completely, dipped into urine, the test pads absorb the urine and a chemical reaction changes the color of the pad within seconds to minutes.
The laboratorian compares the color change for each reaction pad to a color chart provided with the test strips to determine the result for each test. Each reaction pad must be evaluated at the appropriate time for that chemical. If too little time or too much time has passed since the reaction, the laboratorian may get incorrect results. To reduce timing errors and eliminate variations in color interpretation, automated instruments are frequently used to “read” the reaction color on each test pad.
The degree of color change on a test pad can also give an approximation of the amount of substance present. For example, a slight color change in the test pad for protein may indicate a small amount of protein present in the urine whereas a deep color change may indicate a large amount.
The most frequently performed chemical tests using reagent test strips are:
Specific gravity
pH
Protein
Glucose
Ketones
Blood
Leukocyte esterase
Nitrite
Bilirubin
Urobilinogen
Some reagent test strips also have a test pad for ascorbic acid [vitamin C].
Specific Gravity (SG)
The first test, specific gravity, is actually a physical characteristic of the urine, a measure of urine concentration that can be determined using a chemical test.
There are no "abnormal" specific gravity values. This test simply indicates how concentrated the urine is. Specific gravity measurements are actually a comparison of the amount of solutes (substances dissolved) in urine as compared to pure water. If there were no solutes present, the SG of urine would be 1.000 – the same as pure water. Since all urine has some solutes a urine SG of 1.000 is not possible. If a person drinks excessive quantities of water in a short period of time or gets an intravenous (IV) infusion of large volumes of fluid, then the urine SG may be as low as 1.002. The upper limit of the test pad, an SG of 1.035, indicates a concentrated urine, one with many solutes in a limited amount of water.
Knowing the urine concentration helps health care providers decide if the urine specimen they are evaluating is the best one to detect a particular substance. For example, if they are looking for very small amounts of protein, a concentrated morning urine specimen would be the best sample.
pH
As with specific gravity, there are typical but not "abnormal" pH values. The kidneys play an important role in maintaining the acid-base balance of the body. Therefore, any condition that produces acids or bases in the body such as acidosis or alkalosis, or the ingestion of acidic or basic foods, can directly affect urine pH.
Diet can be used to modify urine pH. A high-protein diet or consuming cranberries will make the urine more acidic. A vegetarian diet, a low-carbohydrate diet, or the ingestion of citrus fruits will tend to make the urine more alkaline.
Some of the substances dissolved in urine will precipitate out to form crystals when the urine is acidic; others will form crystals when the urine is basic. If crystals form while the urine is being produced in the kidneys, a kidney stone or “calculus” can develop. By modifying urine pH through diet or medications, the formation of these crystals can be reduced or eliminated.
Protein
The protein test pad measures the amount of albumin in the urine. Normally, there will not be detectable quantities. When urine protein is elevated, a person has a condition called proteinuria; this can be an early sign of kidney disease. Albumin is smaller than most other proteins and is typically the first protein that is seen in the urine when kidney dysfunction begins to develop. Other proteins are not detected by the test pad but may be measured with a separate urine protein test. Other conditions that can produce proteinuria include:
Disorders that produce high amounts of proteins in the blood, such as multiple myeloma
Conditions that destroy red blood cells
Inflammation, malignancies (cancer), or injury of the urinary tract - for example, the bladder, prostate, or urethra
Vaginal secretions that get into urine
Glucose
Glucose is normally not present in urine. When glucose is present, the condition is called glucosuria. It results from either:
An excessively high glucose concentration in the blood, such as may be seen with people who have uncontrolled diabetes mellitus
A reduction in the "renal threshold." When blood glucose levels reach a certain concentration, the kidneys begin to excrete glucose into the urine to decrease blood concentrations. Sometimes the threshold concentration is reduced and glucose enters the urine sooner, at a lower blood glucose concentration.
Some other conditions that can cause glucosuria include hormonal disorders, liver disease, medications, and pregnancy. When glucosuria occurs, other tests such as blood glucose are usually performed to further identify the specific cause.
Ketones
Ketones are not normally found in the urine. They are intermediate products of fat metabolism. They can form when a person does not eat enough carbohydrates (for example, in cases of starvation or high-protein diets) or when a person's body cannot use carbohydrates properly. When carbohydrates are not available, the body metabolizes fat instead to get the energy it needs to keep functioning.
Ketones in urine can give an early indication of insufficient insulin in a person who has diabetes. Severe exercise, exposure to cold, and loss of carbohydrates, such as with frequent vomiting, can also increase fat metabolism, resulting in ketonuria.
Blood (Hemoglobin)
This test is used to detect hemoglobin in the urine (hemoglobinuria). Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). Its presence in the urine indicates blood in the urine (known as hematuria). The small number of RBCs normally present in urine (see microscopic examination) usually result in a "negative" test. However, when the number of RBCs increases, they are detected as a "positive" test result.
Even small increases in the amount of RBCs in urine can be significant. Numerous diseases of the kidney and urinary tract, as well as trauma, medications, smoking, or strenuous exercise can cause hematuria or hemoglobinuria.
This test cannot determine the severity of disease nor be used to identify where the blood is coming from. For instance, contamination of urine with blood from hemorrhoids or vaginal bleeding cannot be distinguished from a bleed in the urinary tract. This is why it is important to collect a urine specimen correctly and for women to tell their health care provider that they are menstruating when asked to collect a urine specimen.
Sometimes a chemical test for blood in the urine is negative, but the Microscopic Exam shows increased numbers of RBCs. When this happens, the laboratorian may test the sample for ascorbic acid (vitamin C), because vitamin C has been known to interfere with the accuracy of urine blood test results, causing them to be falsely low or falsely negative.
Leukocyte Esterase
Leukocyte esterase is an enzyme present in most white blood cells (WBCs). Normally, a few white blood cells (see microscopic examination) are present in urine and this test is negative. When the number of WBCs in urine increases significantly, this screening test will become positive.
When the WBC count in urine is high, it means that there is inflammation in the urinary tract or kidneys. The most common cause for WBCs in urine (leukocyturia) is a bacterial urinary tract infection (UTI), such as a bladder or kidney infection.
Nitrite
This test detects nitrite and is based upon the fact that many bacteria can convert nitrate to nitrite in the urine. Normally the urinary tract and urine are free of bacteria. When bacteria find their way into the urinary tract, they can cause a urinary tract infection (UTI). A positive nitrite test result can indicate a UTI. However, since not all bacteria are capable of converting nitrate to nitrite, someone can still have a UTI despite a negative nitrite test.
Bilirubin
Bilirubin is not present in the urine of normal, healthy individuals. Bilirubin is a waste product that is produced by the liver from the hemoglobin of RBCs that are removed from circulation. It becomes a component of bile, a fluid that is secreted into the intestines to aid in food digestion.
In certain liver diseases, such as biliary obstruction or hepatitis, bilirubin leaks back into the blood stream and is excreted in urine. The presence of bilirubin in urine is an early indicator of liver disease and can occur before clinical symptoms such as jaundice develop.
Urobilinogen
Urobilinogen is normally present in urine in low concentrations. It is formed in the intestine from bilirubin, and a portion of it is absorbed back into the bloodstream. Positive test results help detect liver diseases such as hepatitis and cirrhosis and conditions associated with increased RBC destruction (hemolytic anemia). When urine urobilinogen is low or absent in a person with urine bilirubin and/or signs of liver dysfunction, it can indicate the presence of hepatic or biliary obstruction