CLINICAL NOTES

Examination of CSF: Cerebro Spinal  Fluid   Function of CSF: Cerebro Spinal Fluid is formed by choroid plexus of ventricles of brain. It protects the brain and spinal cord from external pressure injuries. It also provides nutrients thus acting as a nutrient medium. It is involved in the excreting waste product of metabolism of nervous tissues. Features of CSF: Color: CSF is clear, colorless fluid. Volume: Total volume in adult is 100-150 ml. Specific Gravity: 1.006-1.008. Reaction: Alkaline in reaction. Collection of specimen: CSF is collected by puncturing the space between 3rd and 4th lumber vertebrae. It is called lumber puncture. Specimen collection may be done by expert doctor under sterilized conditions. About 3-5 ml of CSF can be collected in 3 tubes (5 ml each). It is sent immediately to the laboratory for tests. Physical Examination : Normally CSF is crystal clear. Color of CSF is changed in the diseases. Presence ...

Histopathology Techniques:     Histology is the technique of examination of normal tissues at microscopic level.     Histopathology is examination of tissues for presence or absence of changes in the structure due to disease processes.     Both are done by examine thin sections of tissues which are colored differently by different dyes and stains.     . Selected part of tissue (<4mm) thin is placed in steel or plastic capsules or cassettes and is subjected to the following sequential processing (Tissue processing) Fixation Dehydration Clearing Impregnation Embedding and Blocking Section cutting Routine staining 1. Fixation:     Any tissue removed from the body starts decomposing immediately because of loss of blood supply and oxygen, accumulation of products of metabolism, action of autolytic enzymes and putrefaction by bacteria.     Process of decomposition is prevented by fixation.     Fixation is the method of ...

Examination of Semen:     -Semen is formed by testes present only in male.     -Semen consists of spermatozoa and seminal plasma.     -Semen examination is done in patient of sterility.     -The cause of male sterility may be defective spermatozoa or number number of spermatozoa is quite less.     -Semen examination is also done in person who are operated upon vasectomy, to check that spermatozoa are present in the semen. Collection of Semen: Patient should be asked not to pass semen for about 2-5 days before test. Patient is asked to discharge semen using his hand (masturbstion). Specimen of semen may be collected in clean and dry tube. Specimen should reach laboratory for examination with 15 minutes. Note the date, time of collection, and time of receiving specimen. Examine semen only after liquefication (30-60 minutes). Physical Examination: Volume:    - Measure the volume of semen in graduated cylinder.    - Norma...

Blood group System :  ABO, MNS, P, Rh, Lutheran, Kell,Lewis, Duffy, Kidd,Diego, Yt, Xg,Scianna, Dombrack, Colton, Landseiner- weiner, Chido / Rogers,Hh, Kx, Gerbich, Cromer, Knops, Indian, Ok, Raph.   Principle:  Landsteiner's Law     If an agglutinogen (antigen) is present on the RBCs the corresponding agglutinin (antibody) must be absent in the plasma.     If an agglutinogen (antigen) is absent on the RBCs  the corresponding agglutinin (antibody) must be present in the plasma. ABO Grouping.     There are two methods for ABO grouping: Cell Grouping (Forward grouping): Red cells are tested for the presence of A and B antigens employing known specific anti-A and anti-B (and sometimes anti-A, B) sera. Serum Grouping (Reverse grouping): Serum is tested for the presence of anti-A and anti-B antibodies by employing known group A and group B reagent red cells.   Both cells and serum grouping should be done since each test acts as...

     Balantidum Coli     - Lives in small intestine of human, pigs, and monkeys.      Morphology:     - Parasite exist in 2 phases:     a. Trophozoite     b. Cyst     A.  Trophozoite     - Oval in shape.     - Anterior end is narrow, with groove leading to mouth.     - Posterior ends is broad, with excretory opening.     - Cell is covered with (short - cilia).     - Cilia that line the mouth part is (large - cilia).     - Macro nucleus is kidney shaped.     - Micro nucleus is small, and round shaped.     B.Cyst:     - Spherical / oval in shape.     - Surrounded by thick and transparent double layered wall.     - Macro nucleus, Micro nucleus, and Vacuoles are present in the cyst.     Life Cycle:     - B.Coli passes its life cycle in one host only.     - Pig is the na...

        Giardia Lamblia           - Present in duodenum and upper part of jejunum.      Morphology          -  Parasite exist in 2 phases:          a. Trophozoite          b. Cyst      A.  Trophozoite     - It's shape is like tennis racket     - Dorsal surface convex, ventral surface concave with sucking     - Anterior end is round, posterior end is pointed     - It's bilaterally symmetrical     - Trophozoite is motile by flagella     B. Cyst     - Cyst is oval in shape     - Contain 4 nucleus      Life Cycle:           Infection of man occurs by ingestion of cyst in contaminated food and water.     Pathogenesis:     - Continues looseness of bowl     - Silent cas...

Haemolytic Disease of Newborn (HDN) Disorder o the fetus or newborn where fetal red cells are destroyed by maternal IgG antibodies. It is also called Erythroblastosis Fetalis. The IgG antibodies cross the placenta and short red cell survival. The prematurer red cell destruction results in disease varying from mild Anaemia to death in utero.  The most immunogenic RBC antigens belong to Rhesus blood group D, followed by C and E.  Hemolytic disease of Fetus can be also caused by Kell antigen sensitization.  Kell antigen can cause hypoproliferation of erythroid precursors leading to severe anaemia.  Other Non- RhD antibodies include Rhesus-c, Cotton, Diego, Duffy, etc. HDN does not usually affect first pregnancy.  It is more common in "O" blood group mothers have been shown to have high titers of IgG than "A" or "B" group mothers. In type "A" and "B" individuals, naturally occurring anti- B and anti-A isoantibodies which are largely IgM mol...