Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh...

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Laboratory Technician Manual Pathology Tests iS iS iS iSFkk kk kk kkykW ykW ykW ykWh ¼iz; ¼iz; ¼iz; ¼iz;ks ks ks ksx’kk ’kk ’kk ’kkyk yk yk yk Vs Dfuf’k ’k ’k ’k;u ;u ;u ;u ekxZnf Znf Znf Znf’k ’k ’k ’kZd Zd Zd Zdk½ Dr. Sajay Wasik, MD Dr. B.S.Ohri, MD PGMO (Drug Cell) Director (Traiig) Diretorate of Health Servies Diretorate of Health Servies Madhya Pradesh, Bhopal Madhya Pradesh, Bhopal 1

Transcript of Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh...

Page 1: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Laboratory Technician Manual

Pathology Tests

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Dr Sa jay Was ik MD Dr BSOhri MD

PGMO (Drug Cell) Director (Trai i g)

Dire torate of Health Servi es Dire torate of Health Servi es

Madhya Pradesh Bhopal Madhya Pradesh Bhopal

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3 iwkZ yky jDrdk xk k frac14RBC C unt frac12 10

4 IysVysV xk k (Platelet C unt) 11

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6 foHksnd osr jDrdk xk k (Differential Leuc cyte C unt) 13

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8 CyhfMax Vkbe] (BT) 19

9 DykfVax VkbEk (CT) 20

izksFkzksEch Vkbe (Pr thr mbin Time) 21

11 APTT (Activated Partial Thr mb plastin Time) 23

12 CyM xzqi (Bl d gr uping) 24

13 isjhQsjy CyM fQYe esa eysfjk ijthoh dh tkap (Peripheral bl d film f r

Malarial parasite)

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14 LiqVe dh tkap flM QkLV csflykbZ ds fy (Sputum examinati n f r

Acid fast bacilli)

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fLd Lehj kjk flM QkLV csflykbZ dh tkap (Skin Smear f r Acid fast

bacilli)

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16 wfj esa Xywdkst o izksVh dh tkap LVordfhi kjk (Urine f r SugarPr tein) 33

17 wfj dh tkap frac14LVordfhi kjk frac12 35

18 wfj dh tkap ekbdkzsLdksih] flVks ] ckbylkYV oa ckby fixesaV (Urine test) 36

19 lsjsczksLikb y paraywM forsquoyskk (CSF analysis) 41

IyqjylkbfVd paraywM dk forsquoyskk (PleuralAscitic fluid analysis) 44

21 lhe dh tkap (Semen Analysis) 47

22 LVwy dh tkap (St l Examinati n) 49

23 CyM kwxj (Bl d Sugar) 57

24 lhje wfjk (Serum Urea) 59

lhje fcfych (Serum Billirubin) 61

26 lhje dksysLVordfky (Serum ch lester l) 62

27 lhje fdzfVf dk v qeki (Estimati n f serum Creatinine) 63

28 lhje izksVh dk v qeki (Estimati n f Serum Pr tein) 64

29 SGOT 65

SGPT 66

31 Ydsykb QkLQsVst dk v qeki (Estimati n f Alkaline Ph sphatase) 67

32 fyfiM izksQkby (Lipid Pr file) 68

33 G-6 PD Deficiency Test 72

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34 wfj kjk xHkkZoLFkk dh tkap LVordfhi kjk (Urine f r Pregnancy Test) 73

35 eysfjk aVht kjk IykteksfMe okosDl oa QsfYlisje (Malaria antigen

f r P Vivax amp P Falciparum)

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36 VkQkbM dkMZ VsLV (Typh id Card Test) 75

37 gesVkbM vkFkZjkbfVl QsDVj (RA Fact r) 76

38 fgisVkbfVl aVht (HBsAg) 77

39 Veneral Disease Research Lab rat ry (VDRL)Test 79

40 HCV jsfiM dkMZ VsLV 80

41 p-vkbZ-Ogh aVht VsLV amp(HIV Antigen test) 81

42 CPK- MB dkMZ VsLV 82

43 MsUxw dkMZ VsLV (Dengue Card Test) 83

44 fpd xqf k dkMZ VsLV (Chickengunia Card Test) 84

45 C-fjDVho izksVh ( C- Reactive Pr tein) 85

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HAEMOGLOB NE COLOUR SCALE

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6

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fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

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At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

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NEUBAUER CHAMBER

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WBC and RBC diluting pipettes

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4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

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efgykamp 4-8- 5-8 milli n microL

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tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

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yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

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= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

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lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

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2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

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ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 2: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiiLzLLzLrrrrkkkkoooo z kkkkz

iSFkksykWth izksxrsquokkyk VsDf frsquok ekxZnfrsquokZdk

kkldh fpfdRlkyksa esa dkZjr iSFkkykWftLV oa izkxrsquokkyk VsDf frsquok gs srq

gSA gekjk mn~nsrsquo bl iqLrd kjk kkldh vLirkykas esa fds tk s okys izksxrsquokkyk

tka zfdzk dks a miyCk djk k gSAp dh i ljy Hkkkk es

vkrsquokk gS] g iqLrd f fer i ls iz s lHkh izksxrsquokkykvks esa miyCknsrsquok d a

gks a s q eknZnrsquokZ djxhA fn iq s fdlh va rqdj leample ij tkp gr s Lrd d rsquok gs

lqgtko ns k pkgsa rks vkidk Lokxr gSA

MMMMkkkkWWWW0000 cccchhhh----llll----vvvvkkkksss sggggjjjjhhhh frac14frac14frac14frac14eeee----MMMMhhhhfrac12frac12frac12frac12 aaa a ffff a a a axxxxs frac12frac12frac12frac12sllllppppkkkkyyyydddd frac14Vordffrac14Vordffrac14Vordffrac14Vordfss

aaa a ooookkkks s aaa allllppppkkkkyyyy k k k kyyyy LLLLooookkkkLLLLFFFF llllss sss seeeeiiiizzzznsnsnsnsrsquorsquorsquorsquokkkk

1

5

10

15

20

25

30

vvvv q q q qddddezeezeffffkkkkddddkkkkzz

Sr No nvestigations Page No

1 gheksXyksfc tkap frac14Hem gl bin test) 4

2 iwoZ osr jDrdk xk k frac14T tal Leuc cyte C unt frac12 8

3 iwkZ yky jDrdk xk k frac14RBC C unt frac12 10

4 IysVysV xk k (Platelet C unt) 11

iSDM lsy okWYwe frac14 Packed Cell V lumefrac12 12

6 foHksnd osr jDrdk xk k (Differential Leuc cyte C unt) 13

7 bfjFkzkslkbV lsfMesaVsrsquok jsV (ESR) 17

8 CyhfMax Vkbe] (BT) 19

9 DykfVax VkbEk (CT) 20

izksFkzksEch Vkbe (Pr thr mbin Time) 21

11 APTT (Activated Partial Thr mb plastin Time) 23

12 CyM xzqi (Bl d gr uping) 24

13 isjhQsjy CyM fQYe esa eysfjk ijthoh dh tkap (Peripheral bl d film f r

Malarial parasite)

28

14 LiqVe dh tkap flM QkLV csflykbZ ds fy (Sputum examinati n f r

Acid fast bacilli)

30

fLd Lehj kjk flM QkLV csflykbZ dh tkap (Skin Smear f r Acid fast

bacilli)

32

16 wfj esa Xywdkst o izksVh dh tkap LVordfhi kjk (Urine f r SugarPr tein) 33

17 wfj dh tkap frac14LVordfhi kjk frac12 35

18 wfj dh tkap ekbdkzsLdksih] flVks ] ckbylkYV oa ckby fixesaV (Urine test) 36

19 lsjsczksLikb y paraywM forsquoyskk (CSF analysis) 41

IyqjylkbfVd paraywM dk forsquoyskk (PleuralAscitic fluid analysis) 44

21 lhe dh tkap (Semen Analysis) 47

22 LVwy dh tkap (St l Examinati n) 49

23 CyM kwxj (Bl d Sugar) 57

24 lhje wfjk (Serum Urea) 59

lhje fcfych (Serum Billirubin) 61

26 lhje dksysLVordfky (Serum ch lester l) 62

27 lhje fdzfVf dk v qeki (Estimati n f serum Creatinine) 63

28 lhje izksVh dk v qeki (Estimati n f Serum Pr tein) 64

29 SGOT 65

SGPT 66

31 Ydsykb QkLQsVst dk v qeki (Estimati n f Alkaline Ph sphatase) 67

32 fyfiM izksQkby (Lipid Pr file) 68

33 G-6 PD Deficiency Test 72

2

34 wfj kjk xHkkZoLFkk dh tkap LVordfhi kjk (Urine f r Pregnancy Test) 73

35 eysfjk aVht kjk IykteksfMe okosDl oa QsfYlisje (Malaria antigen

f r P Vivax amp P Falciparum)

74

36 VkQkbM dkMZ VsLV (Typh id Card Test) 75

37 gesVkbM vkFkZjkbfVl QsDVj (RA Fact r) 76

38 fgisVkbfVl aVht (HBsAg) 77

39 Veneral Disease Research Lab rat ry (VDRL)Test 79

40 HCV jsfiM dkMZ VsLV 80

41 p-vkbZ-Ogh aVht VsLV amp(HIV Antigen test) 81

42 CPK- MB dkMZ VsLV 82

43 MsUxw dkMZ VsLV (Dengue Card Test) 83

44 fpd xqf k dkMZ VsLV (Chickengunia Card Test) 84

45 C-fjDVho izksVh ( C- Reactive Pr tein) 85

3

gggghhhhekekekeksss s sss s piexclppiexclp (Hemogolbin)XyXyXyXykkkkffffcccc ttttkkkkiexcliexcl

gheks s iexclp dh f E fyf[kr fofkk gSampXykfc tk

1- dyj Lds a Sek kfrac12y frac14jx i

2- Lkkgyh dh flM ghesfV fofk 3- Lk es s sFk ghekXykfc fofk

4- lsydkmaVj

gheks s sampXykfc dh lkekU ek=k jDr ea

iqk 14amp17 xzke izfrrsquokr (gm)

efgyk 12amp16 xzke izfrrsquokr (gm)

cPpksa 13amp14 xzke izfrrsquokr (gm)

frac1410amp12 okZfrac12 jjjjDDDDrrrrkkkkYYYYiiiirrrrkkkk (Anemia)amp tc gheksXyksfc k yky jDr dfkdkvksa dh ek=kla[k lkekU

ls de gks tks tks mls jDrkYirk (Anemia) dgrs gSA

1- jjjjaaaaxxxx iiiiSSSSeeeekkkk kkkk frac14frac14frac14frac14ddddyyyyjjjj LLLLddddSSSSyyyyfrac12frac12frac12frac12 ffffofofofofkkkkampampampamp frac14flQZ Ldzhf ax ds fy miqDrfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz a Sek k frac14dyj LdSyfrac12amp ja Sek k k dyj Ldy dkMZ gks S] ftleahhhhamp jx i x i s rk g svyxampvyx rhozrk ds yky ja ~VhkW c h gks S tks gheks sx dh iV rh g Xykfc dh vyxampvyx ek=k nrsquokkZrk gSA tSls 4] 6] 8] 12 amp 14 xzke izfrrsquokr (gm)A

HAEMOGLOB NE COLOUR SCALE

4

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- cksa gkFk dh vaxqyh frac14Ring Fingerfrac12 dks LizhV ls lkQ djsaA 2- bZ hMyys s s izhd djaUlV l As3- jDr dh d cwa s xs VLV dkMZ ij MkysAn fn s

dM d4- 30 ls sa s fy bartkj djsA 5- vc jDr ds ja s xs ja Sek k frac14dyj LdSyfrac12 ds yky ja ~VhkW lsx dk fn x i x dh fofHkU iV

feyk djsAa6666---- jDr dk ja x dh iV~Vh ls feyrk gS mlds lke s fy[ks gqs ghekXykfc dhx ftl yky ja s s

ek=k dks ns[ks] ogh ml OfDr ds jDr eas gheksXyksfc dh ek=k gksxhA

LLLLkkkkkkkkggggyyyyhhhh ddddhhhh ffffllllMMMM gggghhhheeeesss s ffffofofofofkkkkampampampampffffVVVV

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1- lkgyh gheksXyksfc ksehVj Hkwjs dkap ds daizsVj ckDl ds lkFkA 2- gheks fc ij[k yh frac14Vs ~wcfrac12Xyks LV V3- gheks fc fiisV 0-02 fe-yh-Xyks4- 0-1N (N10) gkbMordfksDyksfjd flM 5- fMLVhy okVj 6- Mordfkij

SAHL rsquoS HAEMOGLOB NOMETER

5

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- gheks fc ij[k yh frac14Vs ~wcfrac12 ea 0-1N (N10) gkbMordfks s s f rsquokk rdXyks LV V s Dykfjd flM 20 dMkysA

2- gheks fc fiisV dks 0-02 fe-yh- ekdZ rd jDr ls HkjaXyks As3- fiis s jDr ghekXykfc V~wc esa flM kks s Mky k gSAV l s s y ea 4- fiis s de ls de rh ckj flM jDr feJk [khpdj o ckgj f dkydj lkQ djaV dk a As5- jDr flM feJk dks V~c es Hkyh Hkka s fy j[k nsAw a fr feykdj djhc nl fef V d a6- vc bl kky dks khjsampkhjs ik h Mkydj MkYwV djrs gq feykrs gq dka s daizss p d Vj

ckDl ls feyk djsAa7- da zs s vPNs izdkrsquok ea ns[k k pkfg o canampcan ik h rc rd feykrs jg k pkfgiVj ckDl dk s w w s

tc rd dia zsVj ckDl o kksy feJk dk jax d lk k gks tksA 8- vc ghekXykfc dh ek=k xzke izfrrsquokr esa ys s gheks s ~c ij vfdr gs s h pkfg] tk Xykfc V w a SA 9- kksy feJk dh lcls f pyh lrg dks ilt+ k pkfgsA 10- kks s zke izfrrsquokr (gm) ds f rsquokk rd gks ogh ml jDr ew sy feJk dk Lrj frac14yoyfrac12 ftl x

eas gheksXyksfc dh ek=k gksxhA

3333---- llllkkkk eeeesss s ss sss s zzkkkkkkkkyyyyhhhhampFFFFkkkk gggghhhheeeekkkkXXXXyyyys kkkks ffffcccc iiiizz vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhh frac14mfrac14mfrac14mfrac14miiiiddddjjjjkkkkfrac12frac12frac12frac12

(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

(iii) 20 ekbdzk sV k ghek s syhVj fii VAs sXykfc fii

UsUUsUVVVV frac14frac14frac14frac14s MMMMs ordfordfordfordfss sss s s s s wrsquok frac14Mordfscfd frac12 js M miks esaffffjjjjtttt ss yfrac12yfrac12yfrac12yfrac12ampampampamp lk eFk ghek fc lkY fMes x yksccccffffdddd ddddkkkk kkkkkkkk Xykk 50 xz s s sV dks ik h es feykrs gS] fQj 0-250 xzke iks ske lkfMe ckbdkckZ a Vfrsquoke lkb kbV bles feykrs gS]fQj djhc d yhVj ik h vkSj blds ckn 1-0 xzke ikVs fjlkb kbVa s frsquoke QsMkydj ik h esa kkyrs s gq bldh ek=k 5 yhVj c k nh tkrh gSA rrrrSS ordfordfordfordfccccffffdddd ddddkkkk kkkkkkkksss sSSkkkkjjjj MMMMsss s yyyyampampampamp

(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

(i) rh lkQ o ehjfgr ij[k fyka frac14Test tubesfrac12 yAs(ii) igyh eas 5 fe-yh gheksXyksfc ek d frac14Standardfrac12 60mg100 ml fe-yh MkysaA (iii) nw s 2-5 fe-yh ek d frac14Standardfrac12 o 2-5 ml Mordfcfd kky Mkys s Hkyh Hkaljh e s s A bl kfr

feyk frac1430 fe- xzk-100 fe-yhfrac12 (iv) rhljh ij[k yh es 5-0 fe-yh Mordfcfd kks s w SAa s y y] g kU ek d g

6

4444---- vvvvkkkkffffIIIIVVVVddddyyyy MMMMffffUUUUllllVVVVhhhh frac14frac14frac14frac14vvvvkkkkssss ----MMMMhhhh----frac12frac12frac12frac12 ddddkkkk eeeekkkkiiii ampampampampss ss

1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

2- vc nw s sljh ij[k yh dk ghekXykfc ek d frac14Standardfrac12 A 3- blds mijkUr igyh ij[k yh ds gheks s s a sXykfc ek d dh vk-Mh- ekiA

4- x kqjh ij ghekXyks qjh ij vk-Mh- j[kdj ek dhdjk ifjkke pkVs Zs fc ek d o y kc ksAa

gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

IIIIkkkkwww kkkkw ZZZ Z oooosss srrrr jjjjDDDDrrrrddddkkkk xxxxkkkk kkkk frac14frac14frac14frac14Total Leucocyte Countfrac12frac12frac12frac12ampampampamp

lkekU osrjDr dk xk k OLd frac14Adultfrac12amp 7000amp11000 CellsCumm

At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 os sV frac14WBC Pipettefrac12r jDrdk fii2 r qdjk kksy (Turkrdquos Fluid)amp frac142ml f 4 izfrrsquokr Xysfly flfVd flM] 1ml 1

ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 3: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

5

10

15

20

25

30

vvvv q q q qddddezeezeffffkkkkddddkkkkzz

Sr No nvestigations Page No

1 gheksXyksfc tkap frac14Hem gl bin test) 4

2 iwoZ osr jDrdk xk k frac14T tal Leuc cyte C unt frac12 8

3 iwkZ yky jDrdk xk k frac14RBC C unt frac12 10

4 IysVysV xk k (Platelet C unt) 11

iSDM lsy okWYwe frac14 Packed Cell V lumefrac12 12

6 foHksnd osr jDrdk xk k (Differential Leuc cyte C unt) 13

7 bfjFkzkslkbV lsfMesaVsrsquok jsV (ESR) 17

8 CyhfMax Vkbe] (BT) 19

9 DykfVax VkbEk (CT) 20

izksFkzksEch Vkbe (Pr thr mbin Time) 21

11 APTT (Activated Partial Thr mb plastin Time) 23

12 CyM xzqi (Bl d gr uping) 24

13 isjhQsjy CyM fQYe esa eysfjk ijthoh dh tkap (Peripheral bl d film f r

Malarial parasite)

28

14 LiqVe dh tkap flM QkLV csflykbZ ds fy (Sputum examinati n f r

Acid fast bacilli)

30

fLd Lehj kjk flM QkLV csflykbZ dh tkap (Skin Smear f r Acid fast

bacilli)

32

16 wfj esa Xywdkst o izksVh dh tkap LVordfhi kjk (Urine f r SugarPr tein) 33

17 wfj dh tkap frac14LVordfhi kjk frac12 35

18 wfj dh tkap ekbdkzsLdksih] flVks ] ckbylkYV oa ckby fixesaV (Urine test) 36

19 lsjsczksLikb y paraywM forsquoyskk (CSF analysis) 41

IyqjylkbfVd paraywM dk forsquoyskk (PleuralAscitic fluid analysis) 44

21 lhe dh tkap (Semen Analysis) 47

22 LVwy dh tkap (St l Examinati n) 49

23 CyM kwxj (Bl d Sugar) 57

24 lhje wfjk (Serum Urea) 59

lhje fcfych (Serum Billirubin) 61

26 lhje dksysLVordfky (Serum ch lester l) 62

27 lhje fdzfVf dk v qeki (Estimati n f serum Creatinine) 63

28 lhje izksVh dk v qeki (Estimati n f Serum Pr tein) 64

29 SGOT 65

SGPT 66

31 Ydsykb QkLQsVst dk v qeki (Estimati n f Alkaline Ph sphatase) 67

32 fyfiM izksQkby (Lipid Pr file) 68

33 G-6 PD Deficiency Test 72

2

34 wfj kjk xHkkZoLFkk dh tkap LVordfhi kjk (Urine f r Pregnancy Test) 73

35 eysfjk aVht kjk IykteksfMe okosDl oa QsfYlisje (Malaria antigen

f r P Vivax amp P Falciparum)

74

36 VkQkbM dkMZ VsLV (Typh id Card Test) 75

37 gesVkbM vkFkZjkbfVl QsDVj (RA Fact r) 76

38 fgisVkbfVl aVht (HBsAg) 77

39 Veneral Disease Research Lab rat ry (VDRL)Test 79

40 HCV jsfiM dkMZ VsLV 80

41 p-vkbZ-Ogh aVht VsLV amp(HIV Antigen test) 81

42 CPK- MB dkMZ VsLV 82

43 MsUxw dkMZ VsLV (Dengue Card Test) 83

44 fpd xqf k dkMZ VsLV (Chickengunia Card Test) 84

45 C-fjDVho izksVh ( C- Reactive Pr tein) 85

3

gggghhhhekekekeksss s sss s piexclppiexclp (Hemogolbin)XyXyXyXykkkkffffcccc ttttkkkkiexcliexcl

gheks s iexclp dh f E fyf[kr fofkk gSampXykfc tk

1- dyj Lds a Sek kfrac12y frac14jx i

2- Lkkgyh dh flM ghesfV fofk 3- Lk es s sFk ghekXykfc fofk

4- lsydkmaVj

gheks s sampXykfc dh lkekU ek=k jDr ea

iqk 14amp17 xzke izfrrsquokr (gm)

efgyk 12amp16 xzke izfrrsquokr (gm)

cPpksa 13amp14 xzke izfrrsquokr (gm)

frac1410amp12 okZfrac12 jjjjDDDDrrrrkkkkYYYYiiiirrrrkkkk (Anemia)amp tc gheksXyksfc k yky jDr dfkdkvksa dh ek=kla[k lkekU

ls de gks tks tks mls jDrkYirk (Anemia) dgrs gSA

1- jjjjaaaaxxxx iiiiSSSSeeeekkkk kkkk frac14frac14frac14frac14ddddyyyyjjjj LLLLddddSSSSyyyyfrac12frac12frac12frac12 ffffofofofofkkkkampampampamp frac14flQZ Ldzhf ax ds fy miqDrfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz a Sek k frac14dyj LdSyfrac12amp ja Sek k k dyj Ldy dkMZ gks S] ftleahhhhamp jx i x i s rk g svyxampvyx rhozrk ds yky ja ~VhkW c h gks S tks gheks sx dh iV rh g Xykfc dh vyxampvyx ek=k nrsquokkZrk gSA tSls 4] 6] 8] 12 amp 14 xzke izfrrsquokr (gm)A

HAEMOGLOB NE COLOUR SCALE

4

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- cksa gkFk dh vaxqyh frac14Ring Fingerfrac12 dks LizhV ls lkQ djsaA 2- bZ hMyys s s izhd djaUlV l As3- jDr dh d cwa s xs VLV dkMZ ij MkysAn fn s

dM d4- 30 ls sa s fy bartkj djsA 5- vc jDr ds ja s xs ja Sek k frac14dyj LdSyfrac12 ds yky ja ~VhkW lsx dk fn x i x dh fofHkU iV

feyk djsAa6666---- jDr dk ja x dh iV~Vh ls feyrk gS mlds lke s fy[ks gqs ghekXykfc dhx ftl yky ja s s

ek=k dks ns[ks] ogh ml OfDr ds jDr eas gheksXyksfc dh ek=k gksxhA

LLLLkkkkkkkkggggyyyyhhhh ddddhhhh ffffllllMMMM gggghhhheeeesss s ffffofofofofkkkkampampampampffffVVVV

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1- lkgyh gheksXyksfc ksehVj Hkwjs dkap ds daizsVj ckDl ds lkFkA 2- gheks fc ij[k yh frac14Vs ~wcfrac12Xyks LV V3- gheks fc fiisV 0-02 fe-yh-Xyks4- 0-1N (N10) gkbMordfksDyksfjd flM 5- fMLVhy okVj 6- Mordfkij

SAHL rsquoS HAEMOGLOB NOMETER

5

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- gheks fc ij[k yh frac14Vs ~wcfrac12 ea 0-1N (N10) gkbMordfks s s f rsquokk rdXyks LV V s Dykfjd flM 20 dMkysA

2- gheks fc fiisV dks 0-02 fe-yh- ekdZ rd jDr ls HkjaXyks As3- fiis s jDr ghekXykfc V~wc esa flM kks s Mky k gSAV l s s y ea 4- fiis s de ls de rh ckj flM jDr feJk [khpdj o ckgj f dkydj lkQ djaV dk a As5- jDr flM feJk dks V~c es Hkyh Hkka s fy j[k nsAw a fr feykdj djhc nl fef V d a6- vc bl kky dks khjsampkhjs ik h Mkydj MkYwV djrs gq feykrs gq dka s daizss p d Vj

ckDl ls feyk djsAa7- da zs s vPNs izdkrsquok ea ns[k k pkfg o canampcan ik h rc rd feykrs jg k pkfgiVj ckDl dk s w w s

tc rd dia zsVj ckDl o kksy feJk dk jax d lk k gks tksA 8- vc ghekXykfc dh ek=k xzke izfrrsquokr esa ys s gheks s ~c ij vfdr gs s h pkfg] tk Xykfc V w a SA 9- kksy feJk dh lcls f pyh lrg dks ilt+ k pkfgsA 10- kks s zke izfrrsquokr (gm) ds f rsquokk rd gks ogh ml jDr ew sy feJk dk Lrj frac14yoyfrac12 ftl x

eas gheksXyksfc dh ek=k gksxhA

3333---- llllkkkk eeeesss s ss sss s zzkkkkkkkkyyyyhhhhampFFFFkkkk gggghhhheeeekkkkXXXXyyyys kkkks ffffcccc iiiizz vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhh frac14mfrac14mfrac14mfrac14miiiiddddjjjjkkkkfrac12frac12frac12frac12

(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

(iii) 20 ekbdzk sV k ghek s syhVj fii VAs sXykfc fii

UsUUsUVVVV frac14frac14frac14frac14s MMMMs ordfordfordfordfss sss s s s s wrsquok frac14Mordfscfd frac12 js M miks esaffffjjjjtttt ss yfrac12yfrac12yfrac12yfrac12ampampampamp lk eFk ghek fc lkY fMes x yksccccffffdddd ddddkkkk kkkkkkkk Xykk 50 xz s s sV dks ik h es feykrs gS] fQj 0-250 xzke iks ske lkfMe ckbdkckZ a Vfrsquoke lkb kbV bles feykrs gS]fQj djhc d yhVj ik h vkSj blds ckn 1-0 xzke ikVs fjlkb kbVa s frsquoke QsMkydj ik h esa kkyrs s gq bldh ek=k 5 yhVj c k nh tkrh gSA rrrrSS ordfordfordfordfccccffffdddd ddddkkkk kkkkkkkksss sSSkkkkjjjj MMMMsss s yyyyampampampamp

(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

(i) rh lkQ o ehjfgr ij[k fyka frac14Test tubesfrac12 yAs(ii) igyh eas 5 fe-yh gheksXyksfc ek d frac14Standardfrac12 60mg100 ml fe-yh MkysaA (iii) nw s 2-5 fe-yh ek d frac14Standardfrac12 o 2-5 ml Mordfcfd kky Mkys s Hkyh Hkaljh e s s A bl kfr

feyk frac1430 fe- xzk-100 fe-yhfrac12 (iv) rhljh ij[k yh es 5-0 fe-yh Mordfcfd kks s w SAa s y y] g kU ek d g

6

4444---- vvvvkkkkffffIIIIVVVVddddyyyy MMMMffffUUUUllllVVVVhhhh frac14frac14frac14frac14vvvvkkkkssss ----MMMMhhhh----frac12frac12frac12frac12 ddddkkkk eeeekkkkiiii ampampampampss ss

1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

2- vc nw s sljh ij[k yh dk ghekXykfc ek d frac14Standardfrac12 A 3- blds mijkUr igyh ij[k yh ds gheks s s a sXykfc ek d dh vk-Mh- ekiA

4- x kqjh ij ghekXyks qjh ij vk-Mh- j[kdj ek dhdjk ifjkke pkVs Zs fc ek d o y kc ksAa

gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

IIIIkkkkwww kkkkw ZZZ Z oooosss srrrr jjjjDDDDrrrrddddkkkk xxxxkkkk kkkk frac14frac14frac14frac14Total Leucocyte Countfrac12frac12frac12frac12ampampampamp

lkekU osrjDr dk xk k OLd frac14Adultfrac12amp 7000amp11000 CellsCumm

At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 os sV frac14WBC Pipettefrac12r jDrdk fii2 r qdjk kksy (Turkrdquos Fluid)amp frac142ml f 4 izfrrsquokr Xysfly flfVd flM] 1ml 1

ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 4: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

34 wfj kjk xHkkZoLFkk dh tkap LVordfhi kjk (Urine f r Pregnancy Test) 73

35 eysfjk aVht kjk IykteksfMe okosDl oa QsfYlisje (Malaria antigen

f r P Vivax amp P Falciparum)

74

36 VkQkbM dkMZ VsLV (Typh id Card Test) 75

37 gesVkbM vkFkZjkbfVl QsDVj (RA Fact r) 76

38 fgisVkbfVl aVht (HBsAg) 77

39 Veneral Disease Research Lab rat ry (VDRL)Test 79

40 HCV jsfiM dkMZ VsLV 80

41 p-vkbZ-Ogh aVht VsLV amp(HIV Antigen test) 81

42 CPK- MB dkMZ VsLV 82

43 MsUxw dkMZ VsLV (Dengue Card Test) 83

44 fpd xqf k dkMZ VsLV (Chickengunia Card Test) 84

45 C-fjDVho izksVh ( C- Reactive Pr tein) 85

3

gggghhhhekekekeksss s sss s piexclppiexclp (Hemogolbin)XyXyXyXykkkkffffcccc ttttkkkkiexcliexcl

gheks s iexclp dh f E fyf[kr fofkk gSampXykfc tk

1- dyj Lds a Sek kfrac12y frac14jx i

2- Lkkgyh dh flM ghesfV fofk 3- Lk es s sFk ghekXykfc fofk

4- lsydkmaVj

gheks s sampXykfc dh lkekU ek=k jDr ea

iqk 14amp17 xzke izfrrsquokr (gm)

efgyk 12amp16 xzke izfrrsquokr (gm)

cPpksa 13amp14 xzke izfrrsquokr (gm)

frac1410amp12 okZfrac12 jjjjDDDDrrrrkkkkYYYYiiiirrrrkkkk (Anemia)amp tc gheksXyksfc k yky jDr dfkdkvksa dh ek=kla[k lkekU

ls de gks tks tks mls jDrkYirk (Anemia) dgrs gSA

1- jjjjaaaaxxxx iiiiSSSSeeeekkkk kkkk frac14frac14frac14frac14ddddyyyyjjjj LLLLddddSSSSyyyyfrac12frac12frac12frac12 ffffofofofofkkkkampampampamp frac14flQZ Ldzhf ax ds fy miqDrfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz a Sek k frac14dyj LdSyfrac12amp ja Sek k k dyj Ldy dkMZ gks S] ftleahhhhamp jx i x i s rk g svyxampvyx rhozrk ds yky ja ~VhkW c h gks S tks gheks sx dh iV rh g Xykfc dh vyxampvyx ek=k nrsquokkZrk gSA tSls 4] 6] 8] 12 amp 14 xzke izfrrsquokr (gm)A

HAEMOGLOB NE COLOUR SCALE

4

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- cksa gkFk dh vaxqyh frac14Ring Fingerfrac12 dks LizhV ls lkQ djsaA 2- bZ hMyys s s izhd djaUlV l As3- jDr dh d cwa s xs VLV dkMZ ij MkysAn fn s

dM d4- 30 ls sa s fy bartkj djsA 5- vc jDr ds ja s xs ja Sek k frac14dyj LdSyfrac12 ds yky ja ~VhkW lsx dk fn x i x dh fofHkU iV

feyk djsAa6666---- jDr dk ja x dh iV~Vh ls feyrk gS mlds lke s fy[ks gqs ghekXykfc dhx ftl yky ja s s

ek=k dks ns[ks] ogh ml OfDr ds jDr eas gheksXyksfc dh ek=k gksxhA

LLLLkkkkkkkkggggyyyyhhhh ddddhhhh ffffllllMMMM gggghhhheeeesss s ffffofofofofkkkkampampampampffffVVVV

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1- lkgyh gheksXyksfc ksehVj Hkwjs dkap ds daizsVj ckDl ds lkFkA 2- gheks fc ij[k yh frac14Vs ~wcfrac12Xyks LV V3- gheks fc fiisV 0-02 fe-yh-Xyks4- 0-1N (N10) gkbMordfksDyksfjd flM 5- fMLVhy okVj 6- Mordfkij

SAHL rsquoS HAEMOGLOB NOMETER

5

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- gheks fc ij[k yh frac14Vs ~wcfrac12 ea 0-1N (N10) gkbMordfks s s f rsquokk rdXyks LV V s Dykfjd flM 20 dMkysA

2- gheks fc fiisV dks 0-02 fe-yh- ekdZ rd jDr ls HkjaXyks As3- fiis s jDr ghekXykfc V~wc esa flM kks s Mky k gSAV l s s y ea 4- fiis s de ls de rh ckj flM jDr feJk [khpdj o ckgj f dkydj lkQ djaV dk a As5- jDr flM feJk dks V~c es Hkyh Hkka s fy j[k nsAw a fr feykdj djhc nl fef V d a6- vc bl kky dks khjsampkhjs ik h Mkydj MkYwV djrs gq feykrs gq dka s daizss p d Vj

ckDl ls feyk djsAa7- da zs s vPNs izdkrsquok ea ns[k k pkfg o canampcan ik h rc rd feykrs jg k pkfgiVj ckDl dk s w w s

tc rd dia zsVj ckDl o kksy feJk dk jax d lk k gks tksA 8- vc ghekXykfc dh ek=k xzke izfrrsquokr esa ys s gheks s ~c ij vfdr gs s h pkfg] tk Xykfc V w a SA 9- kksy feJk dh lcls f pyh lrg dks ilt+ k pkfgsA 10- kks s zke izfrrsquokr (gm) ds f rsquokk rd gks ogh ml jDr ew sy feJk dk Lrj frac14yoyfrac12 ftl x

eas gheksXyksfc dh ek=k gksxhA

3333---- llllkkkk eeeesss s ss sss s zzkkkkkkkkyyyyhhhhampFFFFkkkk gggghhhheeeekkkkXXXXyyyys kkkks ffffcccc iiiizz vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhh frac14mfrac14mfrac14mfrac14miiiiddddjjjjkkkkfrac12frac12frac12frac12

(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

(iii) 20 ekbdzk sV k ghek s syhVj fii VAs sXykfc fii

UsUUsUVVVV frac14frac14frac14frac14s MMMMs ordfordfordfordfss sss s s s s wrsquok frac14Mordfscfd frac12 js M miks esaffffjjjjtttt ss yfrac12yfrac12yfrac12yfrac12ampampampamp lk eFk ghek fc lkY fMes x yksccccffffdddd ddddkkkk kkkkkkkk Xykk 50 xz s s sV dks ik h es feykrs gS] fQj 0-250 xzke iks ske lkfMe ckbdkckZ a Vfrsquoke lkb kbV bles feykrs gS]fQj djhc d yhVj ik h vkSj blds ckn 1-0 xzke ikVs fjlkb kbVa s frsquoke QsMkydj ik h esa kkyrs s gq bldh ek=k 5 yhVj c k nh tkrh gSA rrrrSS ordfordfordfordfccccffffdddd ddddkkkk kkkkkkkksss sSSkkkkjjjj MMMMsss s yyyyampampampamp

(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

(i) rh lkQ o ehjfgr ij[k fyka frac14Test tubesfrac12 yAs(ii) igyh eas 5 fe-yh gheksXyksfc ek d frac14Standardfrac12 60mg100 ml fe-yh MkysaA (iii) nw s 2-5 fe-yh ek d frac14Standardfrac12 o 2-5 ml Mordfcfd kky Mkys s Hkyh Hkaljh e s s A bl kfr

feyk frac1430 fe- xzk-100 fe-yhfrac12 (iv) rhljh ij[k yh es 5-0 fe-yh Mordfcfd kks s w SAa s y y] g kU ek d g

6

4444---- vvvvkkkkffffIIIIVVVVddddyyyy MMMMffffUUUUllllVVVVhhhh frac14frac14frac14frac14vvvvkkkkssss ----MMMMhhhh----frac12frac12frac12frac12 ddddkkkk eeeekkkkiiii ampampampampss ss

1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

2- vc nw s sljh ij[k yh dk ghekXykfc ek d frac14Standardfrac12 A 3- blds mijkUr igyh ij[k yh ds gheks s s a sXykfc ek d dh vk-Mh- ekiA

4- x kqjh ij ghekXyks qjh ij vk-Mh- j[kdj ek dhdjk ifjkke pkVs Zs fc ek d o y kc ksAa

gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

IIIIkkkkwww kkkkw ZZZ Z oooosss srrrr jjjjDDDDrrrrddddkkkk xxxxkkkk kkkk frac14frac14frac14frac14Total Leucocyte Countfrac12frac12frac12frac12ampampampamp

lkekU osrjDr dk xk k OLd frac14Adultfrac12amp 7000amp11000 CellsCumm

At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 os sV frac14WBC Pipettefrac12r jDrdk fii2 r qdjk kksy (Turkrdquos Fluid)amp frac142ml f 4 izfrrsquokr Xysfly flfVd flM] 1ml 1

ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 5: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

gggghhhhekekekeksss s sss s piexclppiexclp (Hemogolbin)XyXyXyXykkkkffffcccc ttttkkkkiexcliexcl

gheks s iexclp dh f E fyf[kr fofkk gSampXykfc tk

1- dyj Lds a Sek kfrac12y frac14jx i

2- Lkkgyh dh flM ghesfV fofk 3- Lk es s sFk ghekXykfc fofk

4- lsydkmaVj

gheks s sampXykfc dh lkekU ek=k jDr ea

iqk 14amp17 xzke izfrrsquokr (gm)

efgyk 12amp16 xzke izfrrsquokr (gm)

cPpksa 13amp14 xzke izfrrsquokr (gm)

frac1410amp12 okZfrac12 jjjjDDDDrrrrkkkkYYYYiiiirrrrkkkk (Anemia)amp tc gheksXyksfc k yky jDr dfkdkvksa dh ek=kla[k lkekU

ls de gks tks tks mls jDrkYirk (Anemia) dgrs gSA

1- jjjjaaaaxxxx iiiiSSSSeeeekkkk kkkk frac14frac14frac14frac14ddddyyyyjjjj LLLLddddSSSSyyyyfrac12frac12frac12frac12 ffffofofofofkkkkampampampamp frac14flQZ Ldzhf ax ds fy miqDrfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz a Sek k frac14dyj LdSyfrac12amp ja Sek k k dyj Ldy dkMZ gks S] ftleahhhhamp jx i x i s rk g svyxampvyx rhozrk ds yky ja ~VhkW c h gks S tks gheks sx dh iV rh g Xykfc dh vyxampvyx ek=k nrsquokkZrk gSA tSls 4] 6] 8] 12 amp 14 xzke izfrrsquokr (gm)A

HAEMOGLOB NE COLOUR SCALE

4

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- cksa gkFk dh vaxqyh frac14Ring Fingerfrac12 dks LizhV ls lkQ djsaA 2- bZ hMyys s s izhd djaUlV l As3- jDr dh d cwa s xs VLV dkMZ ij MkysAn fn s

dM d4- 30 ls sa s fy bartkj djsA 5- vc jDr ds ja s xs ja Sek k frac14dyj LdSyfrac12 ds yky ja ~VhkW lsx dk fn x i x dh fofHkU iV

feyk djsAa6666---- jDr dk ja x dh iV~Vh ls feyrk gS mlds lke s fy[ks gqs ghekXykfc dhx ftl yky ja s s

ek=k dks ns[ks] ogh ml OfDr ds jDr eas gheksXyksfc dh ek=k gksxhA

LLLLkkkkkkkkggggyyyyhhhh ddddhhhh ffffllllMMMM gggghhhheeeesss s ffffofofofofkkkkampampampampffffVVVV

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1- lkgyh gheksXyksfc ksehVj Hkwjs dkap ds daizsVj ckDl ds lkFkA 2- gheks fc ij[k yh frac14Vs ~wcfrac12Xyks LV V3- gheks fc fiisV 0-02 fe-yh-Xyks4- 0-1N (N10) gkbMordfksDyksfjd flM 5- fMLVhy okVj 6- Mordfkij

SAHL rsquoS HAEMOGLOB NOMETER

5

ttttkkkkiexcliexcliexcliexclpppp ddddhhhh ffffofofofofkkkkampampampamp

1- gheks fc ij[k yh frac14Vs ~wcfrac12 ea 0-1N (N10) gkbMordfks s s f rsquokk rdXyks LV V s Dykfjd flM 20 dMkysA

2- gheks fc fiisV dks 0-02 fe-yh- ekdZ rd jDr ls HkjaXyks As3- fiis s jDr ghekXykfc V~wc esa flM kks s Mky k gSAV l s s y ea 4- fiis s de ls de rh ckj flM jDr feJk [khpdj o ckgj f dkydj lkQ djaV dk a As5- jDr flM feJk dks V~c es Hkyh Hkka s fy j[k nsAw a fr feykdj djhc nl fef V d a6- vc bl kky dks khjsampkhjs ik h Mkydj MkYwV djrs gq feykrs gq dka s daizss p d Vj

ckDl ls feyk djsAa7- da zs s vPNs izdkrsquok ea ns[k k pkfg o canampcan ik h rc rd feykrs jg k pkfgiVj ckDl dk s w w s

tc rd dia zsVj ckDl o kksy feJk dk jax d lk k gks tksA 8- vc ghekXykfc dh ek=k xzke izfrrsquokr esa ys s gheks s ~c ij vfdr gs s h pkfg] tk Xykfc V w a SA 9- kksy feJk dh lcls f pyh lrg dks ilt+ k pkfgsA 10- kks s zke izfrrsquokr (gm) ds f rsquokk rd gks ogh ml jDr ew sy feJk dk Lrj frac14yoyfrac12 ftl x

eas gheksXyksfc dh ek=k gksxhA

3333---- llllkkkk eeeesss s ss sss s zzkkkkkkkkyyyyhhhhampFFFFkkkk gggghhhheeeekkkkXXXXyyyys kkkks ffffcccc iiiizz vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhh frac14mfrac14mfrac14mfrac14miiiiddddjjjjkkkkfrac12frac12frac12frac12

(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

(iii) 20 ekbdzk sV k ghek s syhVj fii VAs sXykfc fii

UsUUsUVVVV frac14frac14frac14frac14s MMMMs ordfordfordfordfss sss s s s s wrsquok frac14Mordfscfd frac12 js M miks esaffffjjjjtttt ss yfrac12yfrac12yfrac12yfrac12ampampampamp lk eFk ghek fc lkY fMes x yksccccffffdddd ddddkkkk kkkkkkkk Xykk 50 xz s s sV dks ik h es feykrs gS] fQj 0-250 xzke iks ske lkfMe ckbdkckZ a Vfrsquoke lkb kbV bles feykrs gS]fQj djhc d yhVj ik h vkSj blds ckn 1-0 xzke ikVs fjlkb kbVa s frsquoke QsMkydj ik h esa kkyrs s gq bldh ek=k 5 yhVj c k nh tkrh gSA rrrrSS ordfordfordfordfccccffffdddd ddddkkkk kkkkkkkksss sSSkkkkjjjj MMMMsss s yyyyampampampamp

(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

(i) rh lkQ o ehjfgr ij[k fyka frac14Test tubesfrac12 yAs(ii) igyh eas 5 fe-yh gheksXyksfc ek d frac14Standardfrac12 60mg100 ml fe-yh MkysaA (iii) nw s 2-5 fe-yh ek d frac14Standardfrac12 o 2-5 ml Mordfcfd kky Mkys s Hkyh Hkaljh e s s A bl kfr

feyk frac1430 fe- xzk-100 fe-yhfrac12 (iv) rhljh ij[k yh es 5-0 fe-yh Mordfcfd kks s w SAa s y y] g kU ek d g

6

4444---- vvvvkkkkffffIIIIVVVVddddyyyy MMMMffffUUUUllllVVVVhhhh frac14frac14frac14frac14vvvvkkkkssss ----MMMMhhhh----frac12frac12frac12frac12 ddddkkkk eeeekkkkiiii ampampampampss ss

1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

2- vc nw s sljh ij[k yh dk ghekXykfc ek d frac14Standardfrac12 A 3- blds mijkUr igyh ij[k yh ds gheks s s a sXykfc ek d dh vk-Mh- ekiA

4- x kqjh ij ghekXyks qjh ij vk-Mh- j[kdj ek dhdjk ifjkke pkVs Zs fc ek d o y kc ksAa

gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

IIIIkkkkwww kkkkw ZZZ Z oooosss srrrr jjjjDDDDrrrrddddkkkk xxxxkkkk kkkk frac14frac14frac14frac14Total Leucocyte Countfrac12frac12frac12frac12ampampampamp

lkekU osrjDr dk xk k OLd frac14Adultfrac12amp 7000amp11000 CellsCumm

At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 os sV frac14WBC Pipettefrac12r jDrdk fii2 r qdjk kksy (Turkrdquos Fluid)amp frac142ml f 4 izfrrsquokr Xysfly flfVd flM] 1ml 1

ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

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vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

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Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

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2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

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78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

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1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

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1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 6: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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SAHL rsquoS HAEMOGLOB NOMETER

5

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tc rd dia zsVj ckDl o kksy feJk dk jax d lk k gks tksA 8- vc ghekXykfc dh ek=k xzke izfrrsquokr esa ys s gheks s ~c ij vfdr gs s h pkfg] tk Xykfc V w a SA 9- kksy feJk dh lcls f pyh lrg dks ilt+ k pkfgsA 10- kks s zke izfrrsquokr (gm) ds f rsquokk rd gks ogh ml jDr ew sy feJk dk Lrj frac14yoyfrac12 ftl x

eas gheksXyksfc dh ek=k gksxhA

3333---- llllkkkk eeeesss s ss sss s zzkkkkkkkkyyyyhhhhampFFFFkkkk gggghhhheeeekkkkXXXXyyyys kkkks ffffcccc iiiizz vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhh frac14mfrac14mfrac14mfrac14miiiiddddjjjjkkkkfrac12frac12frac12frac12

(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

(iii) 20 ekbdzk sV k ghek s syhVj fii VAs sXykfc fii

UsUUsUVVVV frac14frac14frac14frac14s MMMMs ordfordfordfordfss sss s s s s wrsquok frac14Mordfscfd frac12 js M miks esaffffjjjjtttt ss yfrac12yfrac12yfrac12yfrac12ampampampamp lk eFk ghek fc lkY fMes x yksccccffffdddd ddddkkkk kkkkkkkk Xykk 50 xz s s sV dks ik h es feykrs gS] fQj 0-250 xzke iks ske lkfMe ckbdkckZ a Vfrsquoke lkb kbV bles feykrs gS]fQj djhc d yhVj ik h vkSj blds ckn 1-0 xzke ikVs fjlkb kbVa s frsquoke QsMkydj ik h esa kkyrs s gq bldh ek=k 5 yhVj c k nh tkrh gSA rrrrSS ordfordfordfordfccccffffdddd ddddkkkk kkkkkkkksss sSSkkkkjjjj MMMMsss s yyyyampampampamp

(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

(i) rh lkQ o ehjfgr ij[k fyka frac14Test tubesfrac12 yAs(ii) igyh eas 5 fe-yh gheksXyksfc ek d frac14Standardfrac12 60mg100 ml fe-yh MkysaA (iii) nw s 2-5 fe-yh ek d frac14Standardfrac12 o 2-5 ml Mordfcfd kky Mkys s Hkyh Hkaljh e s s A bl kfr

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6

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1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

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gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

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At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

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NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

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xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

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kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

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2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

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js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

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76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

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77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

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78

Veneral disease research Laboratry testfrac12frac12frac12frac12

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5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

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1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

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Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

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1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

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83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

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3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

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frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

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Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 7: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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(i) dyjhehVjLisDVordfksQksVksehVj amp 540 nm ds fQYVj ds lkFkA

(ii) 5 fe-yh dh fiisVA

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(i) Mordfcfd fjtss UV

(ii) lk es Xykfc LVSFk gheks s MMZ ffffofofofofkkkkampampampamp

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6

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gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

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= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

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8

WBC and RBC diluting pipettes

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4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

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0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

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frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 8: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

4444---- vvvvkkkkffffIIIIVVVVddddyyyy MMMMffffUUUUllllVVVVhhhh frac14frac14frac14frac14vvvvkkkkssss ----MMMMhhhh----frac12frac12frac12frac12 ddddkkkk eeeekkkkiiii ampampampampss ss

1- dyks sa 540 nm dk fQYVj yxka o kw s dqcSV es ys sjhehVj e U ek d dk a A bldyks ss j[kdj kU vk-Mh- ij ls sV djsAjhehVj e w

2- vc nw s sljh ij[k yh dk ghekXykfc ek d frac14Standardfrac12 A 3- blds mijkUr igyh ij[k yh ds gheks s s a sXykfc ek d dh vk-Mh- ekiA

4- x kqjh ij ghekXyks qjh ij vk-Mh- j[kdj ek dhdjk ifjkke pkVs Zs fc ek d o y kc ksAa

gheks s s dk f E fyf[kr rjhdk gSampXykfc f dky

gheks s = vKkr dh vks qdjk dh ek=kfrac12 frac14200frac12Xykfc -Mh x frac14ek d dh ek=k x r ek d dh vks-Mh 1000 xzk

fn ek d dh ek=k frac14C ncentrati nfrac12 600mgL gS] rc

gheks s = vKkr dh vks xXykfc -Mh x 600 2001000 frac14 gmL frac12 ek d dh vk-Mhs

= vKkr dh vk-Mhs x 120 ek d dh vks-Mh

7

IIIIkkkkwww kkkkw ZZZ Z oooosss srrrr jjjjDDDDrrrrddddkkkk xxxxkkkk kkkk frac14frac14frac14frac14Total Leucocyte Countfrac12frac12frac12frac12ampampampamp

lkekU osrjDr dk xk k OLd frac14Adultfrac12amp 7000amp11000 CellsCumm

At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 os sV frac14WBC Pipettefrac12r jDrdk fii2 r qdjk kksy (Turkrdquos Fluid)amp frac142ml f 4 izfrrsquokr Xysfly flfVd flM] 1ml 1

ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 9: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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At Birth- 8000-28000 CellsCumm

Childh d- 6000-15000 CellsCumm

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ts sVfrac12 + 97ml fMLVYM okVj Mgcl2 (Preservative) frsquok oky3 Uw sckj pEcj] dojfLyi 4 ekbdzkLdks si

NEUBAUER CHAMBER

8

WBC and RBC diluting pipettes

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xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

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frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

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lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

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2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

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ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

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ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

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zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 10: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

WBC and RBC diluting pipettes

ffffofofofofkkkkamp 1 os s s 0-5 ds f rsquokk rd jDr ysAar jDr dk fiiV ea 2 fiisV dh ckgjh lrg ij yxk jDr iksaN ysaA 3 vc r qdjk kky dks s 11 ds f rsquokk rd HkjsA 4 fiisV dks kqekdj rh fe V rd feykAa5 igyh pkj cwna sa bl feJk dks fiisV ls Qasd nsAa6 LoPN vkSj eh jfgr Uwckj ps sAEcj ya7 vc doj fLyi dks fd kjs ij j[kdj bl izdkj ljdka fd nks ka va qHkZqt blls ltads fdr prtkA 8 vc fiisV dks 450 ds dks s s chp j[k dj r qdfjr jDr dks dksfrsquokdkk ij pEcj o doj fLyi dizfdzk ls ps s Hkj nsAaEcj ea 9 nks fe V] dks s ds LFkkfiRo ds fy ddj] fQj xk k djafrsquokdkvka As

xxxxkkkk kkkkampampampamp pkjks cM+ prqHkZqtka frac14WBC Countingfrac12 dk k=Qy 1 oxs Z fe-eh- gSA ps Z 110s s Ecj dh xgjkbfe-eh- gSA vc vkr 0-1 k fe-eh- gSA

4 prqHkZqtksa dk vkr = 0-1 x 4 = 0-4 k fe-eh-

dkmaVs s a frac14lsyfrac12 = v x 0-4 k fe-eh- ea gS = v dkfrsquokdkaM dkfrsquokdk s s1 k fe-eh- esa gS = v x 20 frac14r qdjk la[kfrac12

0-4

= v x 50 frac14v = pkjkas cMs+ prqHkZtksa eas xfkr WBC Cellsfrac12

9

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 11: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiiwww kkkkw ZZZ Z yyyykkkkyyyy jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14RBC Count frac12frac12frac12frac12

kkkkeeeeyZyyZy ooooYsYYsYampwampampwamp iqkamp 5-5amp6-5 milli n microLZZ ss ww

efgykamp 4-8- 5-8 milli n microL

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 RBC MkyqfVx fiia sV

2 RBC MkyqfVax parayqM frac14frac14frac14frac14Haymes Fluidfrac12frac12frac12frac12amp 10 ml f 40 QkesZYMhgkbM + 32 mgL VordfkblkfMeslkbVordfsV lkYwl 3 Uw SEcjckj p4 doj fLyi

ffffofofofofkkkkampampampamp 1 RBC MkyqfVax fiisV dks 0-5 ds f rsquokk rd jDr ls HkjasA 2 vc MkyqfVx parayqM dks 101 ds f rsquokk rd yka s Hkjrs le khjs s kqeka ftllsa A bl ampkhj dh vPNk feJk c sA 3 doj fLyi dks Uwckj pSEcj ds nks ksa ekid [kk ksa ds Aringij j[ksAa4 vc pSEcj dks pktZ dj kA

frac14afrac12 fiis s feJk dks rh fe V rd vPNh rjg feDl djsAV d afrac14bfrac12 fiis s yxHkx 6 can kks a s ckgjh yhdk es iMk g kksV l w s a + y f dyy f dky n] bll

tkxkA ftlesa jDr feJk gh gSA frac14cfrac12 vc fiis s 450 ds dks SEcj ds chp ds LFkk ij j[kdj dksV dk k doj fLyi o p frsquokdk

izfdzk (Capillay acti n) ls feJk dks pSEcj esa Hkj tk s fnk tkrk gSA 5- 2 fe V ddj fQj xk k dj h pkfgA 6 xk k f E fyf[kr rjhds ls dh tkrh gSamp

yky jDr dk xk k eas lsUVordfy LDoj (Central Square)izksx fdk tkrk gSA dqy 80 lcls Nks s prqHkZtks es yky jDrdk fx s tkrs gSa Zr chp ds prqHkqZt ds ika sVs [kk sV a a ] vFkk p Nk ] g pkj oky k pkfgA xk k d fd Aringijh o ck gkFk dhdks s s o d chp dk gks s le og jDrdk tks a

js[kk ij iM+s gks [kk s ds vnj ek s tkrs gSa a gkFk dh js s okyh js +a ] o nk [kk o hp [kk ij iMs jDrdk [kk s ls ckgj ek s tkrs gSamp b dh xk k gh dh tkrhA

xxxxkkkk kkkk (Counting)

chp ds prqHkZt dk dq s Z fe-eh- gks SA lcls Nks s chp ds prqHkqZt dk ksy k=Qy 1 ox rk g V =Qy 1400 oxZ fe-eh- gS] Dksfd pa SECkj dh xgjkbZ 110 fe-eh- gS blfy xk k ks= dk vkr 14000 k fe-eh- gSA dqy vkr 804000 k fe-eh- gqvk = 150 k fe-eh-Mkyql 1200 gSA yyyykkkkyyyy jjjjDDDDrrrr xxxxkkkk kkkk = r qdjk x 1vkr x xfkr yky jDrdk frac14dfrac12

= 200 x 50 x d = 10]000 x d yky jDrdkk -fe-eh-

10

sss s VVVV xxxxkkkk k k k ks frac14frac14frac14frac14s Platelet Countfrac12frac12frac12frac12IIIIyyyyVVVVyyyyss

lkekU lhekarjamp 1]50]000amp4]00]000 k-eh-fe-vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- r qdjk kky frac14jhl s ss dj kky Reersquos Ecker fluid )

lks ordfsV amp 3-8 xzkefMe lkbV

fczfyV fds zlkbyCYkw amp 0-05 xzke

eke QkeZyh amp 0-2 fe-fy-

okVj amp 100 fe-fy-

2- yky jDr dk fiisV

3- Uwckj pEcj] dojfLyis

4- ekbdzkLdks si

ffffofofofofkkkk ampampampamp 1- yky jDr dk frac14RBCfrac12 fiisV esa 0-5 ds f rsquokk rd jDr ysaA

2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

3- r qdjk kky dks 101 ds f rsquokk rd fiis s HkjsAas V ea

4- fiis s a aV dk 5 fe V rd HkyhHkkfr fgykA

5- fiis s 4 cwns Qa wckj pEcj HkjaV l a sddj vc U s As

6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1- foUVordfkc fgeSVks zV V~wcs fd2- ikrsquopj fiisV 3- ls ordf wUVhparat ersquokh

ffffofofofofkkkkampampampamp 1 lkQ oa ehjfgr fgeSVkfdzV V~w s ikrsquopj fiisV dh lgkrk ls jDr dks c ea

ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

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ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 12: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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2- fiis sN nsAV dh ckgjh lrg ij yxk jDr ika

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6- vc Uw s s isVordfhMhrsquok es xhys fQYVj iij kjk ltddj 15 fe V j[k nsAckj pEcj dk a s a

7- IysVysV dh xk k lHkh ps s gkbZikoj eaEcj ea s dj h pkfgA

sss s VVVV xxxxkkkk kkkk ffffofofofofkkkks ampampampampsIIIIyyyyVVVVyyyyss

Iys s ~l dh xk k = ly dkmaVM x jDrkksy x pSEcj MIFk FCVyV s s sxk k fd x pSEcj dk k=s

= d x 20 x5 x10 = d x 1000 IysVysVk fe-eh-

11

iiiiDSDDSDMMMM llllysyysy ooookkkkWWYYYYwweeee Packed Cell Volume (PCV)SS ss WW ww

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ew k 100 ds f rsquokk rd HkjsAa2 d vkSj fgeSVks zV V~w w s jks s jDr k ik h ls Hkfjsfd c fdlh nlj xh d A 3 nks kss V~csa vc ls ordfhparaw sa j[kdj 3000rpm ij 30 fe V k 60 fe V rda w UV t els ordfhparaw sAUV t dja

4 vc ih-lh-oh- ilts+A 5 vc nks sa V~w a fQj ls 5 fe V rd ls ordfhparaw s vkSj fQj ls ih-lh-oh- iltsA k cs UV t dja a+6 fn nks ka ckj dh jhfMa a dks Z va S rks g lgh jhfMa SAs x es b rj gh g x g7 iSd gq jDrdkks ds lcls mijh fgLls ea d xklt+ yky ja qdM+ SAa s s x dk V k fn[krk gfrac14dkckZsDlh gheksXykfc ds s dkjkfrac12 ih-lh-oh- frac14PCVfrac12 dh ek=k bldh mijh lrg ls ilt+ h pkfgA

8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

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EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 13: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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8 blds mij d lQsn lrg gksrh gSamp g lQsn jDr dk frac14WBCfrac12 ds bdV~Bk gks s ls c rh gSA

vkSlr dk Slr dk s sfrsquokdk vkr ] frac14MCV mean C rpuscular V lumefrac12 vk fc s sfrsquokdk ghekXykfrac14MCH mean C rpuscular Hem gl bin frac12] vkSlr dkfrsquokdk gheks s a zs Xykfc lknrk frac14MCHC mean

C rpuscular Hem gl bin C ncentrati nfrac12 dks Kkr dj s ds fy

ffff EEEE ffffyfyfyfyf[[[[kkkkrrrr ffffofofofofkkkk ddddkkkk iiiizzz z sss s ampSampampSampkkkkxxxx ffffddddkkkk ttttkkkkrrrrkkkk ggggSS

1 vkSlr dksfrsquokdk vkr frac14Dwfcd ekbdzks frac12= (MCV)

ih-lh-oh- frac14PCVfrac12 RBC C unt

X 10

2 vkSlr dksfrsquokdk gheksXyksfc lkanzrk frac14izfrrsquokr(MCHC)

~frac12= gheksXyksfc Ikh-lh-oh- frac14PCVfrac12

X 100

3 vkSlr dksfrsquokdk gheksXyksfc frac14fidksxzkefrac12 (MCH)

= gheksXyksfc RBC C unt

X 10

12

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

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ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

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zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

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13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

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14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

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4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

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efgyksa 0 ls 07 fe-eh- igys kVs esa

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vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

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2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

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sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

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1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

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5 le ksV djsAa

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19

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lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

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ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

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4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

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4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

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Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

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2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

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llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

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Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

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3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

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www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

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4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 14: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ffffoHoHoHoHkkkksss s sss snnnndddd oooorrrr jjjjDDDDrrrrddddkkkk xxxxkkkk k k k k frac14frac14frac14frac14DLC Differential Leucocyte Count)

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 Xykl LykbM frac144amp5frac12 2 thElk jatdfrac14Giemsa Stainfrac12 3 YkhrsquokeS jtd frac14Leishmanrsquos Stainfrac12 02 gm yhrsquokeS ja s 100 ml lhVk Qs zha td ikoMj dk

ehFkkbZy Ydksgy eas kksysAa4 QkLQsV cQj frac14Ph sphate bufferfrac12

LLLLiiiizzMSMMSMjjjjampampampamp 1 blds fd kjs iwkZi ls fpd s gks s pkfgA 2 g pkSM+kbZ eas ml LykbM ls de gks h pkfg ftl ij jDrysi frac14Smearfrac12 c rk gSA

zzSS

jjjjDDDDrrrr yyyyisiisi frac14ss Smearfrac12 cccc kkkk sss s ddddhhhh ffffofofofofkkkkampampampamp frac14Lehj c k s dh fofkfrac12 Vh ca eh- vs kb a1 jDr dh d Nks wn LykbM ds fd kjs ls 1-2 la anj pkSM+ Z ds chpks chp j[ksAa

2 LizSMj dks 450 ds dksk ij LykbM ij j[ks o fQj [khapdj jDr cawn ds ikl ys tkA 3 vc jDr cwa zs s fd kjs ij iw Sy tkxhAn LiMj d jh rjg Q s4 tSls gh g gks zsMj dks tYnh o lQkbZ ls lke s dh vksj [khp dj jDr ysi frac14Smear)] Li ac k k pkfgA 5 jDr cwn doy br h gk h pkfg fd jDr ys -eh- yEck gh c Aa s s i frac14Smear) yxHkx 3amp4 ls s

13

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 15: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

PREPARAT ON OF BLOOD F LM (BLOOD SMEAR)

jjjjttttdddd ffffofofofofkkkk frac14frac14frac14frac14aaa a Stainingfrac12frac12frac12frac12ampampampamp 1111 tttthhhhEEEEllllkkkk jjjjaaa attttddddamp 3-75 xzke jtd dks 373 fe-yh- feFkkby Ydks s kks sa 373 fe-fy- fXyljkSya gy ea ydj fQj blefeyka l- ij bUDw sVj ea 4 fn rd j[ka a Skj gSAA vPNh rjg fgykdj 370 s c s A vc js td rQkLQsV cQj frac14PH 72frac12 rSkj dj kA kks s 2H2O frac1423-4 xzkefy-frac12y amp 0-15 ekyj NaH2P 4

kks s zy champ 0-15 ekyj Na2HP 4 frac1421-3 xkefy-frac12 cQj c k s ds fy kksy amp 24 fe-fy- o kksy champ 76 fe-fy- feykAa

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkk ampampampamp 1 gok es lq[kk x jDr yi frac14Smear) dks 2 fe V rd es Wyh esa j[ksAa s Fkk a2 fQj 19 cQj ls r qdfjr frac14Dilutefrac12 thElk jtd ea sa mls 8amp10 fe V rd j[ksAa3 fQj kks q[kk ys Adj l a

SSS S ttttdddd frac14aa Leishmanrsquos Stainfrac12YYYYkkkkhhhhrsquorsquorsquorsquokkkkeeee jjjjaa0-2 gm yhrsquokeS jtd ikmMj dks 100 ml flVks Qzh feFkkby Ydks s kks S a gy ea ydj yhrsquokeja Skj djrs gSAtd r

14

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 16: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

vvvvffffHHHHkkkkjjjjaaa attttdddd ddddhhhh ffffofofofofkkkkamp 1 jDr ys ZIr ek=k ea jtd kky Mkys] ftlls lkjk jDr ysi frac14Smearfrac12 ltd tkAi ij ik s a s a +2 bls nks fe V rd jg s nsAaa3 vc ja s s cjkcj dk cQj kks sAtd kky d y Mkya4 ja s s cg k gh pkfgAtd cQj kky LykbM l5 bls vPNh rjg feyk ftlls lrg ij d pedhyh fgtYyh lh tj vkA 6 r qdfjr jatd dks LykbM ij 8 fe V rd jg s nsAa7 vc bls kks ysAa8 LykbM ds fiNys fgLls dks iksa a o lq[kk dj v djaNdj lkQ djs As

D FFERENT PART OF BLOOD SMEAR

Peripheral Smear Stain with Leishman stain sh wing neutr phil m n cytes e sin phils platelets and RBCrsquos

15

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 17: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

xxxxkkkk kkkk ddddkkkk rrrrjjjjhhhhddddkkkkampampampamp 1 os Z vkCtfDVo yasl ls xfkr frac14C untfrac12 dj s pkfgAr jDr dk vky bersquok s2 iwjs jDr yis (Smear) dk v dj k pkfgA 3 fn d Nksj ls nwljs Nksj rd d ckj dh xk k esa 100 dksfrsquokdka feys rks fQj dqN gVdj fQj ls rc rd xk k dj h pkfg tc rd 100 dks a iwjh gkfrsquokdk s tkA

4 xk k dkmfVa S qoyh iss sax ersquokh k e ij ij fy[kdj djA

DLC Normal Value frac14foHks sr jDrdk xk k dk lkekU lhekrj frac14OLdks esfrac12frac12nd o a a aUw ordf sVkfQyamp 40amp75 fyEQkslkbVamp 20amp35 eks s klkbVamp 2amp10 bvks sfl kfQyamp 1amp6 cs slkfQyamp 0amp1

16

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 18: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vovovovollllkkkknnnn kkkkeeeerrrrkkkk (ESR) bbbbffffjjjjFFFFkkkkzzz z ss aaa a sss s rsquosrsquorsquosrsquokkkk a jjjja ssss sss s UUUUVVVVsaa s sVVVVs ampampampamp (Estimation ofkkkkllllkkkkbbbbVVVV llllVhVhVhVheeeeErythrocyte Sedimentation Rate)

YYYYkkkkkkkkyyyy jjjjDDDDrrrr ddddkkkk vvvvoooollllkkkknnnn kkkkeeeerrrrkkkkampampampamp

fn frac14LdUn jks qDr jDr dks d ij[k yh es Mkydj lhkk [kM+ s ykykhfrac12 a k j[k fnk tk rkjDr dk khjs s hps cSB frac14Settlefrac12 tkrs gSa vkSj IykTek Aringij jg tkrk gSampkhj g volkn kerk frac14Sedimentati nfrac12 fn f kkZfjr f e ds v qlkj ekih tk rks mls bZ-l-vkj- frac14ESRfrac12 dgrs gSaA

llllkkkkeeeekkkkUUUU bbbbZZZZ----llll----vvvvkkkkjjjj---- frac14frac14frac14frac14ESRfrac12frac12frac12frac12 iqk oa efgykvksa esaamp ffffooooaaaaVVVVordfordfordfordfkkkkss sscccc ffffofofofofkkkkampampampamp iqkamp 0 ls 9 fe-eh- igys kVs esa

efgyksa 0 ls 20 fe-eh- igys kVs esa oooossssLLLLVVVVjjjjxxxxzzzzhhhh ffffofofofofkkkkampampampamp iqk 0 ls 5 fe-eh- igys kVs esa

efgyksa 0 ls 07 fe-eh- igys kVs esa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 a sxqys WDtyV] bs Z-Mh-Vh-- Bl dfVdk UV vk2 foUVordfksc yhampampampamp yEckbZ 110 fe-eh-

vUr Okl 3-0 fe-eh-0amp100 rd dh ekfdZax

ordfordfordfordf cccc ffffofofofofkkkks ampampampamps1111 ffffoUoUoUoUVVVVkkkkssffffofofofofkkkkampampampamp 1 yh dks 100 ekfdZa s Hkjsx rd jDr l A 2 fQj fcYdqy lhkk] lkekU dejs ds rki ij d kVs rd [kM+ sAk j[ka3 blds irsquopkr yky jDr dkkas dh Aringijh lrg dks ilts+A

2222 sss s z z ffffofofofofkkkkss ampampampampooooLLLLVVVVjjjjxxxxzsszvvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 osLVjxzh V~campampampamp yEckbw Z 300 fe-eh- vUr Ikl amp 3-0 fe-eh-0amp200 rd dh ekfdZax

2 UVhdks qyaV frac14tekojkkdfrac12 amp vkDtys ordfVamp 05 fe-yh] 3-13 izfrrsquokr lkfMe lkbVordfVsx s s V] lkbVs skksy

17

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 19: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Disposable ESR Pipettes with Stand

ffffofofofofkkkkampampampamp 1 aVhdkxqyaV oa jDr dk feJk os z V~w s kw s va s LVSaM ijs s LVjxs c d U d d rd Hkjdj mlfLiza s Aringijh Nkj ij o jcj dh lgkrk ls f pys Nkj ij dl yrs gSaAx fDyi dh lgkrk l s s s2 d kVs ckn yky jDrdk frac14RBCfrac12 lrg dks ilt+ ysrs gSaA

sa

18

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 20: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

jjjjDDDDrrrr ccccgggg sss s ddddhhhh lllleeee nnnnjjjj frac14frac14frac14frac14 Bleeding timefrac12frac12frac12frac12

MMMM~~~~dddd ffffofofofofkkkkwww w (Duke Method)ampampampamp lkekU nj 1 ls 5 fe V gksrh gSA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 CykfVa sx iij 2 LVkWi okWp 3 hMhyys sV l

ffffofofofofkkkkampampampamp 1 Ropk eas ckjhd lqbZ pqHkkdj Nsn djAsa

2 Nsn dj s dk le ks sAV dja

3 gj vkks fe V ij jDr dks CykfVa s s lks sAx iij l [k ya

4 g jDr cg k can gks s rd djasA

5 le ksV djsAa

6 ftr h cawns isij ij lks[kh xbZ ml la[k dks 2 ls foHkDr dj ns s ij jDr cg s dh le nj

frac14CyhMha SAx Vkbefrac12 dk irk pyrk g

19

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 21: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

jjjjDDDDrrrr tttteeeekkkkoooo lllleeeefrac14frac14frac14frac14 Clotting timefrac12

lkekU DykfVa s 11 fe V gSAx Vkbeamp 5 l

yyyyhhhh vvvvkkkkSSS Sjjjj OOOOggggkkkkbbbbVVVV ffffofofofofkkkk

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 5 fe-yh- fljhat 2 75 fe-eh- X 8 fe-eh- dh pkj VsLV V~wc 3 okVj ckFk 4 LVkWi okWp ffffofofofofkkkkampampampamp

1- 5 fe-fy- flfja s frsquokjk ls jDr f dkyAst ea

2- tSls dh jDr flfja s vk k izkjHk gks rc LVki okWp dks kq djaAt ea a s

3- lqbZ dks frsquokjk ls f dky ysAa

4- pkj lkQ lw[kh VsLV V~wckas esa dzersquok 1 fe-fy- jDr Mky nsaA

5- b V~wckas dks 370 igys ls xeZ j[k k pkfgs vkSj mlh rki ds okVj ckFk eas j[kk jg k

pkfgsA

6- gj vkks fe V ckn b V~wckas dks fc k jDr fxjkas 900 ls vfkd Vslt+k fdk tk ldrk gks rc

LVki okp can dj nasA

7- le ks saV dj yA

8- gj V~wc dk te s dk le vyxampvyx ks s m pkjks dk vkSlr f dky yaV djd a As

20

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

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vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

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1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

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6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

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36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

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Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 22: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiikkkkFFFFkkkkkkkkffffEcEcEcEc lllleeeeampampampamp frac14frac14frac14frac14Prothrombin Time) PTzzz z sss s zzz z sss s

llllkkkkeeeekkkkUUUU iiiizkzzkzkksss s kzkkzkffffEEEEcccc lllleeeeamp 12 lsss s s 14 lds SAFFFFkkkkzz s M g

ffffofofofofkkkkampampampamp 1- frsquokjk frac14os frac12 ls bl rjg jDr f dkys fd ikl ds mRrd dks kko yxsA

2- g jDr lkbVordfsV kksy eas fyk tkrk gS ftleas 1 varsquok 3-8 izfrrsquokr~ lkbVordfsV kksy gks vkSj 9

va srsquok jDr gkA

3- bl feJk dks rqjr ls ordfhparaw s ftlls IykTkek vyx gks ldsa UV t dj y A

4- 75 x8 fe-eh- ds V~c ew as 0-1 fe-yh- IykTek vkSj 0-1 fe-yh- Fkkz Ecks IykfLV kks y fiis sV kjk

MkysA

5- bl V~wc dks 370 ls ij 2 fe V rd okVj ckFk eas j[ksaA

6- bleas 0-1 fe-fy- xeZ fdk gqvk M40 dSfYrsquoke DyksjkbM kksy MkyasA

7- bl feJk dks feykasA LVki okWp dks kq djasA

8- okVj ckFk eas gh bl V~wc dks 3amp4 fe V rd fgykasA

9 - ckgj f dkydj V~w s lery djds feJk dks dbZ ckj vkxs ihNs djsAc dk a

10- fQzfc DykV tc te s yxs rks LVki okp can dj nsaA le ksV djsaA

21

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 23: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiizkzzkzkkFFFFkkkkkkkksss s ffffEEEEcccc lllleeeesss s frac14frac14frac14frac14Prothrombin Timefrac12frac12frac12frac12

keZy oYs w amp 11amp15 lsdM

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp frac14zz ifrac12 Fkzks s sEckIykfLV fjtUVl

frac14iifrac12 12 x 75 mm Vs ~cLV V w

frac14iiifrac12 0-1 ml vkSj 0-2 ml fiiVs

frac14ivfrac12 LVki okap

frac14vfrac12 okVj ckFk

frac14vifrac12 Qzs Zy IykTekl ke

Sample Collection-(same for aPPT)

38 S dium citrate 200 ul + 18 ml bl d 10 min ds fy ls ordfhparaw saUV t djA

ffffofofofofkkkkampampampamp

frac14ifrac12 fjts s s zspj frac1420amp30 fMxzh ls zs s oa feDl djsAUV oky dk e VEi UVhxVfrac12 ij j[k a

frac14iifrac12 ikZIr ek=k esa fjts a l[kh VsLV V~c es ysUV d lkQ o w w A

frac14iiifrac12 vc fjts s 37 fMxzh lUVhxzV ij bDw sV djsAUV dk s s c a

frac14ivfrac12 12 x 75 mm Vs ~c ea 0-1 e-y IykTek ys vkSj 3amp5 fe V ds fy 37 fMxzh lUVhxzVLV V w s s sij bDwcsV djsAa

frac14vfrac12 Vs ~wc esa 0-2 e-y fjtUV Mkys oa lkFk gh lkFk LVki okp kq djsAaLV V s

frac14vifrac12 Vs ~c dks khjs ls frjNk djs vkSj LVki okp dks can dj ns tSls gh fQfczLV V w a

Fkzs Z ns s yxs s s s ksV djaM fn[kkb s A le ldM e sA

frac14viifrac12 IV-VI LVsi fjfiV djs mlh ls sEiy d lkFkA

frac14viiifrac12 lHkh os w dk vkSlr f dkys gh izkFkks SAY s fEc le g

22

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 24: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

APPT ( Partial Thromboplastin Time)

kkkkeeeeZZZ Z YYYYsss s www w secyyyy oooo ampampampamp 23 t 38

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- aPPT fjtsaV frac14Ellagic Acid Rabbit brain ph sph lipids Buffer Stabillizer amp

Antimicr bialfrac12

2- dSfYle DyksjkbM

3- ls ordf wUVhparat

4- fiisV

5- LVkWi okp

ffffofofofofkkkkampampampamp

1- aPPT fjtsa s e Vs zs s vkSj IkkZIr ek=k es d lw[kh] lkQ VsLV V~c ea ysaAV dk Eipj ij j[k a w s

2- aPPT fjtsVa dks 370 ij 10 fe V ds fy bDwcsV djasA

3- CaCl2 fjtsV IkkZIRk ek=k ea d lw a lkQ Vs ~wc esa ys oa 370 ij 10 fe V dsa s [kh o LV V

fy ba w s sADcV dja

4- ejht dk IykTek 100microl VsLV DwosV esa ys oa 370 ij 1 fe V ds fy baDwcsV djsAa

5- aPPT fjtsa LV DosV ea MkysaAV 100microl Vs w s

6- vPNh rjg feDl djas vkSj 370 ij 3 fe V ds fy baDwcsV djsAa

7- CaCl2 fjtasV 100microl VsLV DwosV esa MkysaA

8- vc Vkbej LVkVZ djs vkSj DykfVa sds a ksV djaa x Vkbe l M es As

23

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 25: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)

CCCCyyyyMMMM xxxxzzzqqzqiiiiq (Blood Group)- de ls de 100 UVht yky jDr dk dh lrg ij igpk s xs gS vkSj b esa ls djhc 15 lqf ksftr jDr xzqi c krs gSA bUgh esa ls dqN xzqi egRoiwkZ gSamp

1 ABO 2 Rh 3 MNS 4 yFkw sjk 5 dSy 6 yqbZl 7 MQh

ijUrq b lc esa Hkh dsoy ABO vkSj Rh dk gh CyM VordfkUlparaqt esa vfkd egRo gSA

ABO xxxxzzzqqz qq zqi oxhZdjk] yky jDr dk dh lrg ij A k B UVht iiiiampampampamp pkj rjg dk d jDr xeas gks s dh fLFkfr eas fdk tkrk gSA g oxhZdjk bl izdkj gSamp

1 xzqi A amp UVht A dh mifLFkfr 2 xzqi B amp UVht B dh mifLFkfr 3 xzqi AB amp UVht A o B nks ks dh mifLFkfr 4 xzqi O amp nks ks UVht A B v qifLFkfr

Principle of ABO Blood Grouping

blds lkFk gh ns S fd UVht ds lek kUrj jDr esa UVhckMh gkrh gS tSls A amp[kk xk g s

UVh B g flje EyqfVf d ds i es ns S tc yky jDrdk dh lrg ij lek kUrja [kh tkrh g

XywfV kst gh gksrsA bl lkjh izkkyh dks THORNySMrsquokVkb ds f eTHORN (Leindsteinerrsquos Law) hellip

pkjksa jDr xzqi ds XywfVf o XywfV kst

24

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 26: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

jjjjDDDDrrrr xxxxzzzqqz qiiiiq XXXXyyyyffffVVVV w kkkkw tttt Xywww sss s fVf 1- A A UVh B 2- B B UVh A 3- AB A amp B dksbZ gh 4- O dksbZ gh nk ks s

iiii ttttkkkkaaa ajjjjDDDDrrrrxxxxzzzqqzqq pppp ddddhhhh ffffooooffffkkkkampampampamp ABO jjjjDDDDrrrr ttttkkkkaaa appppampampampamp 1- izRk k dksfrsquokdk izqDr xzqi tkap frac14Directfrac12 2- vizRk k ijksk k flje izqDr xzqi tkap frac14Indirectfrac12

1 iiiizzz z pppp frac14frac14frac14frac14Direct Testfrac12frac12frac12frac12 amp bles jks s yky jDrdkks dh lrg ds UVht dhRRRRkkkk ttttkkkkaaa a a xh d a tka s kjk dh tkrh gSAp UVhflje d

Anti Sera A B amp D to be kept at 4 ndash 6 degree centigrade

a- LLLLyyyykkkkbbbbMMMM ffffofofofofkkkk

frac14ifrac12 rh LykbM ys] A B o C xh dh dkfrsquokdkvkafrac14iifrac12 vc jks s s dk 10 izfrrsquokr lsykb kksy ys dj mldh dampd cwUn

rh kas ij ysaA frac14iiifrac12 vc dzersquok UVh A lhje] UVh B lhje o UVh AB lhje A B o C LykbM ij

MkysA frac14iVfrac12 bUgas ydM+h dh rhyh ls HkyhampHkkafr feykAa

frac14Vfrac12 LykbM dks s s akhjampkhj fgykA frac14Vifrac12 2 fe V ds Hkhrj Xyw s s safV rsquok n[kA

b- VVVV~~~~cccc ffffofofofofkkkkwww w

frac14ifrac12 3 VsLV V~w sc yA A B o C frac14iifrac12 vc vKkr yky jDrdk dks s dh 2 izfrrsquokr lykb kky dh 2 cwns izRdfrsquokdkvka s s W s

V~wc eas MkysAafrac14iii) vc dzersquok UVh A] UVh B o UVh AB flje dks A B o C V~wc eas MkyAsfrac14iVfrac12 vc V~cksa dks 1000 rpm ij d fe V rd lsVordfhparaw saw a t djA frac14Vifrac12 vc ekbdzksLdksi ds hps k izRk XywfV srsquok dks n[ks sAa

25

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

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76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 27: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

sss s zzzzDqDDqDrrrr ttttq kkkkq aaa aiiiijjjjkkkkkkkk kkkk llllhhhhjjjjeeee iiii pppp frac14frac14frac14frac14Indirectfrac12frac12frac12frac12 frac14ifrac12 3 VsLV V~w s s s lhje dh 2amp2 cwwn izRd ea MkysAc yA vc jkxh d W s sfrac14iifrac12 vc ek d yky jDrdk 2 izfrrsquokr kky dh xs zqi A] dkfrsquokdkvks as dh 2 cwWns V~wc d

es] xzqi B dkfrsquokdkvks dh 2 cWn V~c eas o xzqi O dks s dh nks cWns V~wc 3 esaa s a w w frsquokdkvka wMkysA

frac14iVfrac12 fgykdj 1000 rpm ij d fe V rd lasVordfhparawt djAsafrac14Vifrac12 blds ckn Xyw srsquok ds fy ns[ka amp izRk k ekbdzks i kjkAfV s Ldks

Discussion -

zzz z ppppa frac14frac14frac14frac14a Direct Testfrac12frac12frac12frac12iiiiRRRRkkkk ttttkkkkaa

Blood group ndash A

1- LykbM A o V~wc A es Xyw rsquok amp jDrxzqi amp Aa fV s2- ds ~c B eas XyfV rsquok amp jDrxzqi amp Boy LykbM B o V w w s3- LkHkh LykbM o V~c es Xyw srsquok amp jDrxzqi amp ABw fV 4- fdlh Hkh V~c k LykbM eas Xyw rsquok gh amp jDrxzqi amp O Aw fV s

sss s ppppa frac14frac14frac14frac14a Indirect Testfrac12frac12frac12frac12iiiijjjjkkkkkkkk ttttkkkkaa

1- dsoy V~wc 1 esa XywfV srsquok amp jDrxzqi amp B 2- dsoy V~wc 2 esa XywfV srsquok amp jDrxzqi amp A

26

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 28: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

3- dks Z Xyw srsquok gh amp jDrxzqi amp ABb fV 4- lHkh es Xyw rsquok amp jDrxzqi amp Oa fV s

Rh System- ABO jDr xzqi flLVe ds vfrfjDr yky jDrdk dh lrg ij Rh UVht mifLFkr gksrs gS vkSj Rh UVhckWMh ds w s s dh fLFkfr esa ghoy LVhEYl frac14 Stimulusfrac12 mifLFkr gk Ms s s gSA Rh factor 85-95 e q eas iks tkrs gSAoyi gkr

Rh xxxxzzzqqz aaa aiiii ddddhhhh ttttkkkkqq pppp ffffofofofofkkkkampampampamp

frac141frac12 LykbM fofk

frac142frac12 V~c fofkw

frac14frac14frac14frac141frac12frac12frac12frac12 LLLLyyyykkkkbbbbMMMM ffffofofofofkkkkampampampamp

frac14ifrac12 d lkQ Xykl LykbM MkysA

frac14iifrac12 d cawn UVhlhje amp D dh LykbM ij MkyAs

frac14iiifrac12 rRirsquopkr d cawn jDr dh UVhlhje amp D ds ikl Mkys vkSj feDl djsaA

frac14ivfrac12 5 fe V rd bartkj djas vkSj Xyw rsquok n[kafV s s sA

www w rsquorsquorsquorsquokkkks s Rh xxxxzzzqqzXXXXyyyyffffVVVV ss qiiiiq mifLFkr + Ve v qifLFkr - Ve

frac14frac14frac14frac142frac12frac12frac12frac12 VVVV~~~~cccc ffffofofofofkkkkampampampampwww w frac14ifrac12 2amp5 izfrrsquokr yky jDrdk oa ls srsquok rSkj djaykb dk lLia Asfrac14iifrac12 d VsLV V~w s d cwn UVhlhjk amp D dh ysc ea a A frac14iiifrac12 rRirsquopkr d cawn yky jDrdk lLisarsquok dh MkyAsfrac14ivfrac12 vc 1500 rpm ij d fe V ds fy lsVordfhparaw sAa t djafrac14vfrac12 vc Xyw s s sAfV rsquok n[ka

27

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

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36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 29: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiiffffjjjjlllljjjjhhhh jjjjDDDDrrrr yyyyisiisis eeees ssaa ss aa sss seyeyeyeyffffjjjjkkkk iiiijjjjtttthhhhoooohhhh ddddhhhh iiiiggggpkpkpkpk frac14frac14frac14frac14Malaria Parasite in Peripheral

blood Smearfrac12frac12frac12frac12

jDr ys s vfHkja s es eys s ijthoh dh igpk djrs SAi frac14Smearfrac12 dk ftr dj yky jDRk dkka a fjk d gbldh nks fofkk gSA 1 irys sjDr yi frac14Fkh fQYefrac12 2 eks sVk jDr yi frac14Fkhd fQYefrac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Xykl LykbM 2 LVS frac14thElk] fyrsquokeS ] tlchj fla ~VkpkZfrac12g HkV3 ekbdzkLdks si

ffffofofofofkkkk amp

1 d cawn jDr dks LYkkbM ij j[k dj bls LykbM ls bl izdkj QSyk fd og djhc 2 ls-eh-dk fgLlk ltd nsa s s jat ds fy dbZ izdkj ds ja zkaA jDr yi (Smear) d td frac14Stainfrac12 i sx fd tkrs gSa] frac14Afrac12 tttthhhhEEEEllllkkkk jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks ZYk Ydkgy es Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s a s s2 gok eas lq[kkdj fQj bls 10amp20 fe V 5 izfrrsquokr thElk jatd esa j[ksAa3 ik h ls kks sa lq[kk yadj gok e sA

frac14Bfrac12 ffffyyyyrsquorsquorsquorsquokkkkeeee jjjjaaa attttdddd frac14frac14frac14frac14Stainfrac12frac12frac12frac12amp

1 flVks Zy Ydkgy esa Mky dj yi dks izfrjfkr djaA jfgr ehFkkb s s s2 LykbM dks lery j[kdj ml ij 7amp8 cwa a ja sans td MkyA 3 20 ls s sAdM da4 fQj bleas 10amp15 cawnas Buffer Mkys vkSj 20 fe V dsaA 5 ik h ls kks sa lq[kk yaadj gok e sA

frac14Cfrac12 ttttllllcccchhhhjjjj ffffllllaaa a V~VV~VkkkkppppkkkkZZZZ jjjjaa td ea nks kks s s gSaggggampampampamp HHHHkkkkVVVV~~ ttttdddda frac14frac14frac14frac14a JSB stainfrac12frac12frac12frac12amp bl ja s y gkrTks-l-ch- frac14 JSB Ifrac12 I Tks-l-ch-frac14 JSB II frac12 II 1 ys s ts es 2amp3 ls s sa fQj eFkk kWl ea d Mqcdh nAi dk -l-ch- I a dM j[k s s s2 blds Ikrsquopkr ts-l-ch- II esa d Mqcdh vkSj fQj rqjar ik h ls kks dj lq[kk yAsa

ffffofofofofkkkk ampampampamp 1 vxa qyh dh Vhi dks izhd djsAa2 jDr dh igyh cwa s fxj s nsAn dk a

28

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 30: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

3333 FFFFkkkkhhhhdddd ffffQQQQYYYYeeee frac14frac14frac14frac14eeeekkkksss s yyyyss s ij rh cwns jDr dh ysaVVVVkkkk jjjjDrDrDrDr ss a a Aiiiifrac12frac12frac12frac12ampampampamp Xykl LykbM dh d fd kjd nw s dks s ls jDr dh rh ks cwnka dks feykdj d ls-eh- dk xkyk c ksAljh LykbM d a a s a s a

ss n jDr dh ys4 FFFFkkkkhhhh ffffQQQQYYYYeeee frac14frac14frac14frac14iiiirrrryyyyhhhh jjjjDrDrDrDr yyyyisiisifrac12frac12frac12frac12ampampampamp Xykl LykbM ds chp frac14efrac12 esa d cwa Aaamp d nw s LisMj dh rjg miksx djsAaljh LykbM dk zamp LizsMj dh lgkrk ls jDr dh cwan dks bl rjg QSyk fd d iryh fQYe c tkAs

5 jDr ysi ds ba s fy dbZ izdkj ds ja zkx fd tkrs gSa Sampt d td frac14Stainingfrac12 i s ] g g1 thElk 2 yhrsquokeS 3 ts-l-ch

P Falciparum Ring F rm (Malaria Parasite) Gemets f P Falciparum(malaria Parasite)

Different f rms f P Vivex(Malaria Parasite)

29

VVVVeeee ddddhhhh ttttkkkkpppp (Sputum for Acid fast bacilli)LLLLiiiiwww w aaa a

LLLLiiiiVwVVwVeeee ddddhhhh ttttw kkkkw ppppamp Qaaa a sQMa s+] czkdl] okl yh o ys SfjDl ls f dys Edl w qDr nzo dks LiVe dgrw s gSaA

LLLLiiiiVVVVeeee dddd====kkkkampampampampwww w

1 jks s HkyhHkka s dqYyk djokrs gSaAxh dk fr ik h l2 fQj mls legtkrs gS fd ds s fd dqN [kkl dj f dys s k gS] Fkwoy dQ tk a xk ogh y d ghA 3 LiwVe dks lhks d=k ik= eas Mky nsrs gSA 4 lqcg dk dQ gh d= dj k pkfgA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 Iys w wfV e yi frac14okj yifrac12 2 Xykl LykbM 3 c Zj k LizhV ySai 4 fjtsaV thyamp hyl frac14Z-N Stainfrac12

ffffofofofofkkkkampampampamp

1 Liw `fr qDr fgLlk ys s w s LykbM dk ysi c k kVe dk fod dj] IyfV e yi dh lgkrk lpkfgA 2 bls mek kjk jfkr dj k pkfgA 3 thyamp hy l frac14Z-N Stainfrac12] kjk vfHkja std yiamp 1111 mek ij ys s 3amp4 ckj kqekdj] izfrjfkr djsAi dk a2 bls dkckZsy Dqlh ls ltad nasaA 3 vc ja s xeZ djs ftlls blesa Hkki f dy s yxsAtd dk a 4 xeZ fd ja s LykbM ij ika s + nsAtd dk p fe V rd NkM a5 ys s ik h ls kks ysAi dk a6 bls 20 izfrrsquokr lYparafjd flM esa ja s ds fy j[ksaAw x f dy 7 1 fe V ykSQyj dks feFkkbyh Cyw ls izfrjaftr djsaA 8 ik h ls kks s saAdj n[k9 lq[kk dj 100x eas ekbdzksLdksi kjk ns[ksaA 10 ekbdzkcSDVhfje V~cjdqyks s ja rk frac14flM QkLVfrac12 o yky jax dhs w fll flM ea x gh gks

nk snkj NMh t+ Slk fn[krk gSA

30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

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78

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79

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80

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81

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82

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83

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84

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amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 31: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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30

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

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32

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33

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34

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35

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36

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frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

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frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 32: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Grading of AFB Smears Examination

Result Grading No of fields to be examined

More than 100 AFB per oil immersion field

Positive 3+ 20

10-99 AFB per oil immersion field

Positive 2+ 50

1-10 AFB per 100 oil immersion fields

Positive 1+ 100

1-9 AFB per 100 oil immersion fields

Scanty Record exact number seen

200

No AFB per 100 oil immersion fields

Negative - 100

Microscopically a negative for AFB bc amp d are positive for AFB(oilimmersion)

31

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

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6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 33: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

LLLLddddhhhh LLLLeeeehhhhjjjj ffffllllMMMM QQQQkkkkLLLLVVVV ccccsss s Zfrac12ZZfrac12Zfrac12frac12ffffllllyyyykkkkbbbb frac14frac14frac14frac14Skin Smear for AFB

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 ekbdzkLdks si 2 LizhV yEis3 LykbM jsd 4 Qks sijl5 dkjcks wlfp lkYql y para6 flM bFks ky 7 es s zh 1 izfrrsquokr~ lkYql eFks s wydkbV x ykb Cy

ffffofofofofkkkkampampampamp

1 LVSf a Sd ij LykbM jf[kAa x j2 dkckZsy Dqlh ls bldks ltfdA 3 LykbM dks rc rd xeZ dhft tc rd LVSa q gks tk fdUrq dh Hkki c k kvc vkSj xeZ dhftA 4 vc LVs s + s dk LykbM ij 10 fe V rd iMk jg nhftA 5 LykbM dks ik h ls kks q mls LVs a Sd ij j[k nhftAdj i f x j6 LykbM dks 1 izfrrsquokr~ flM Ydks s 5 ls s a Sj fQjgy l dM rd jxgh dj nhft vkik h ls kks Mkfy vkSj fQj LVa Sd ij j[k nhftASf x j7 LykbM dks 1 izfrrsquokr~ eSydkbV xzh k esFkkby Cyw ls 30 fe V rd dka Ss mVj LV dhftA 8 ik h ls LykbM dks kks w[k s ds fy NksM+dj l nhftA 9 ekbdzkLdks s s cs Z dkmaV djsAs i kjk vkby bejl vkCtfDVo ea flykb a

ffffjjjjiiiikkkk xs xxs xampampampampffffs VVVVs ZZZaa Z aa

6$ vkSlr QhYM esa cSflyh ds v d xs qPNs 5$ vkSlr ks= eas 1000amp10000 cSflyh 4$ vkSlr ks= eas 100amp1000 cSflyh 3$ vkSlr ks= eas 1amp100 cSflyh 2$ 10 ks s esa 1amp10 cSflyh=ka 1$ 10 ks s esa 1amp10 cSflyh=ka

32

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 34: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ww sss s XXXXyyyyddddw kkkkw ss iiiikzkkzksss s aaffffjjjj eeeeaaa a tw ttw ts oooos aaww zz VhVhVhVh ddddhhhh ttttkkkkpppp LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkk

g d cgqr gh ljy fofk gS ordfhi kjk fj ea Xydks zks] LV w s w t o i Vh frac14YCqfe frac12 dh tkp dj a s dhA

s LVordfhil URISTIX frac14fjfLVDlfrac12 dw s ke ls miyCk gSA blesa d fd kjs ij nks vyxampvyx tka s fjk frac14iV~Vhfrac12 gkrh gS Xyw s a izkVh dsp d s dkt o s fyA

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

(i) fjts ordfhi frac14fjfLVDlfrac12UV LV w

(ii)w SEiyfj dk lffffofofofofkkkkampampampamp

1- d khrsquokh k dUVs s rktk w a j ea fj df=r djAs2222---- LVordfhi ds tka s fd kjs dks w s lSEiy ea Mck ns doy 1 lsp oky fj d s q s 2

ls s s fyAdM d3333---- LVordfhi dks ckgj f dkydj] LVordfhi ds fMCcs s Xyw s a izkVh dhij c dkt o s

mifLFkfr ds dyj pkVZ ls feyk djasA 4444---- Vs ordfhi dk cnyk gqvk dyj] fMCcs s Z ds aLV LV ij c dyj pkV ftl jx

ls feyrk gS] og mr h gh Xywdkst k izkVh dh ek=k Iyl flLVeskjk nrsquokkZrk gSA

XXXXyyyywww w ttttampampampamp dkjkRed] hyk jss ax frac14Bluefrac12ddddkkkkssvYire ek=k

+

+ +

+ + + Hkwjk jax frac14Br wnfrac12 C nfirm by Benedictrsquos test (See page n hellip)

33

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 35: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

iiiikkkkVVVVhhhh ampampampamp dkjkRed frac14ihyk jxfrac12 vYire ek=k

zzz z sss s a

+

+ +

+ + +

+ + + + frac14gjk] hyk jaxfrac12 C nfirm by B iling (See page n helliphellip)

34

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 36: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Urine Test Strips 10 Parameters www wffffjjjj VsVsVsVsLLLLVVVV

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 Urine Test Strips ndash CyM] fcfych ] jkw sfcfyt ] dhVks ] izksVh ] kbVordfkbV] Xyw s s sfoVhAdkt] ih-p-] LifrsquokfQd xz

ffffofofofofkkkkampampampamp

1 d dka s fj ls sap dh khrsquokh ea w Eiy yA 2 w sLV LVordfhi dks w s s 2amp3 fef V ds fy j[k nafj V fj lEiy ea As3 w sLV LVordfhi ds vyxampvyx is s ja Zr gks tksxs mUgs LVhi dfj V jkehVj d x ifjofr a ordf s fMLcs ij c s ja s ls feyk djrs gSaaxk A 4 feyk dj s ij isjkehVj ds LVSa Z ja s VLV LVordfhi dk jx mijkDr isjkehVjMM x l s a sCyM] fcfych ] w s s s zksVh ] kbVordfkbV] Xyw st dh mifLFkfr kjkfcfy kt ] dhVk ] i dkv qifLFkfr nrsquokkZrk gSA 5 fjtYV ksV djasA

35

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 37: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ffffjjjj ddddhhhh ttttkakakakappppwwww

1111 www w sss s llllxqxxqxjjjjfrac14frac14frac14frac14XXXXq yyyyq www w sss s ppppampampampampffffjjjj eeeeaaa a ddddkkkkttttfrac12frac12frac12frac12 ddddhhhh ttttkkkkaaa a

sss s sss scccc ffffMMMMDDDDVVVV ffffofofofofkkkkamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

1 ikjs s ~c frac14ij[k yhfrac12wDl VLV V2 c Zj 3fiisVl 4cs s s fMDV fjtUVA

ffffofofofofkkkkampampampamp

1111 d VsLV V~w s 5 ml cs fMDV fjtsUV yac ea s As2 8 cwa fj dh bles feykdj] 2 fef V rd c Zj is xeZ djsan w a A 3 fQj BMk dj bls f E fyf[kr fofk kjk ifjkke n[ks sAa

jax Ikfjkke Ukhyk dkjkRed gjkamp hyk Yksrsquokek= kdZjk gjk with Precipitate + frac140-5 kdZjkfrac12 gjk Hkwjk with Precipitate ++ frac141 kdZjkfrac12 ihyk with Precipitate +++ frac141-5 kdZjkfrac12 xgjk yky with Precipitate ++++ frac142 kdZjkfrac12

frac142frac12 wwwwffffjjjj eeeessaa ssaa iiiizzzzkkkkss ssVVVVhhhh ddddhhhh ttttkkkkaa aappppampampampamp mek frac14Heatfrac12oa flfVd flM tkapamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ikjs s ~cwDV VLV V2 c Zj k LizhV ysEi 3 fiisV 4 5flfVd flM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s 10 mlw sAc ea fj ya2 blesa flfVd flM dh dqN cawnas Mkydj vEyh dj nsAa3 vc V~c eas j[ks w ap ds c Zj ij xeZ djaw fj dh Aringijh d b As

36

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 38: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

4 fn xeZ dj s ij lQsn voki c s s rks bleas dqN cwansa flfVd flM dh Mkysa o fQj ls xeZ djsaA 5 vc fn voksi fQj c rk gS] rks w s izkVh gs SAfj ea

www w sass sa iiiizkzzkzkkVVVVhhhh ddddhhhh eeeekkkk====kkkk ddddkkkk ffff eeee ampampampampsss sffffjjjj eeeeaa amp = dkjkRed + = ys nh frac140-01 k defrac12rsquokek=] gYdh lQs++ = lQs i fdUrq NksVss nk snh voks nkjfrac140-01amp0-05frac12 +++ = lQnh voks s nk snkj frac140-2amp0-5 frac12s i cM+++++ = xklt+ sn voks k lqn`lt+ fjxfrac140-5amp3a frac12k lQ i] cM+

frac143frac12 www w ass a ffffllllVVVVkkkkss sss s paappffffjjjj eeeesaa s ss pamp kkkk ddddhhhhVVVVkkkk cccckkkkMMMMhhhh ddddhhhh ttttkkkkaajjjjkkkkFFFFs kkkks jjjjkkkk ttttkkkksss s pamppamppamppamp frac14R thera Testfrac12ss aaa a

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhampampampamp frac141frac12 Vs ~wc

zz LV V

frac142frac12 lks ordf s zfMe kbVkilkbM frac143frac12 veks sVf e lYQfrac144frac12 veks ordf sf e gkbMkDlkbM

ffffofofofofkkkkampampampamp 1 d VsLV V~w s bles FkkM+ fMe kbVordfkizlkbM Mkyac y a s k lk lks s As2 blesa 2 xzke vekf e lYQsV feyk vkSj 10 fe-fy- w as fj MkysA 3 bls vPNh rjg feykdj bles yxHkx 2 fe-fy- veks ordfks Aa f e gkbM DlkbM feyka4 fn xgjk tkeq h jx c s rks flVks w sa gSAa fj e5 gYdk lk tkeq h jax k jaxgh rk dkjkRed ifjkke gSA

frac144frac12 ffffjjjj w eeeew ass a cccckkkkbbbbyyyy ffffiiiiaa sss s aaa a Z Z frac12frac12frac12frac12saa s aa pa ppa p frac14frac14frac14frac14ffffoyoyoyoyffffcccc oooo ffffccccffffyyyyofofofofMMMMZZxw xxw xeeeeVVVV ddddhhhh tttta kkkka QQQQqdqqdqddsss s ddddhhhh ttttkkkkpppp frac14frac14frac14frac14Fouchet Testfrac12frac12frac12frac12aaa a

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 cs sfje DykjkbM 3 Qqds fjts zke VordfkbDyksUV frac1425 x j flfVd flM] 100 fe-fy- ik h o 10 fe-fy- 10

fjd Dyk sizfrrsquokr~ Qs sjkbM kkyfrac12 4 okVeS -2 fQYVj isij

ffffofofofofkkkkampampampamp 1 d Vs ~c esa 10 fe-fy- w saLV V w fj yA 2 bles 2 fe-fy- tyh cs sjkbM kky Mkya o feykdj okVeS - 2 dsa fje Dyk s sfQYVj is s Nk ysAij l a3 vc voks s ys o ml ij dqN cwa s Qqds fjts ai dk a na UV dh MkysA

37

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 39: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

4 voks a s tkrk gS tks fcfyfc dh mifLFkfr nrsquokkZrk gSAi dk jx gjk gk

frac145frac12 www w ass a aaffffjjjj eeeesaa s cccckkkkbbbbyyyy llllkkkkYYYYVVVV ddddhhhh ttttkkkkppppa ampampampampa ddddhhhh llllYYYYQQQQggggsss s jjjj iiiikkkkmmmmMMMMjjjj ttttkkkkpappapampaa

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 lYQj ikmMj ffffofofofofkkkkampampampamp 1111 d VsLV V~wc esa 5 fe-fy- wfj yasA 2 w sMk lk lYQj ikmMj fNMdsAfj dh lrg ij Fkk + + a3 lkekUr lYQj ikmMj w Sjrk jgrk g] ijS arqfj dh lrg ij r ckby lkYV dh mifLFkfr esa Mwc tkrk gSA

ffffjjjj ddddkkkk eeeekkkkbbbbddddwww w zkzzkzkkLLLLddddkkkksss s isiisi kkkkjjjjkkkk iiiijjjjhhhhkkkkkkkkampampampampss frac14frac14frac14frac14Microscopic examinationfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 ekbdzksLdksi 2 lasVordfhparawt ersquokh 3 15 fe-fy- dks s ordf w ~f dy lUVhparat V cw4 ikrsquopj fiisV 5 LykbM 6 doj Lyhi

ffffofofofofkkkkampampampamp 1 w s afr feykdj djhc 12 fe-fy- ek=k d lVhparaw ~w a ysafj dk HkyhampHkk sa ordf t V c es A 2 bls 5 fe V rd 1200amp1500rpm ij ls ordfhparat dja o fQj mij dk nzo Qsd naUV w s a As3 tes gqs voks s fgykdj feyk ya o fQj blls d cwn ys aa i dk s a dj LykbM ij j[ksA 4 dojLyhi ls ltddj ekbdzkLdks s nssa as i l [ksA 5 ekbdzkLdki ea 10x ds vkCts s igys s[ks] fQj 40x ds vkWCts sa s[kasAs s s DVho l n a DVho e n

ffffjjjj eeeeaaa a zzz zwww w sss s eeeeqqq q[[[[rrrrkkkk rrrrhhhh iiiiddddkkkkjjjj ddddssss rrrrRRRRoooo iiiikkkk ttttkkkkrrrrsss s ggggSSSampaaampSampampaa frac141frac12 dks afrsquokdkfrac142frac12 dkLV frac143frac12 fdzLVy frac14pjsw nkj jklkf d rRofrac12

frac14frac14frac14frac141111frac12frac12frac12frac12 ddddkkkksss s ampampampampffffrsquorsquorsquorsquokkkkddddkkkkaaa a 1 LdoSel bfifFkfyy dkfrsquokdkamp g s wjsVj] e=krsquok ekxw Z ls f dyrs gSa o n[k s s

es cM+ o xks w qDr gkrs gSaa s y UfDyl s A

38

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 40: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Pus cells in Urine

2 yky jDr dk amp frac14RBCfrac12amp lkekUr v qifLFkr gksrs gSaA

Red Blood Cells in Urine

3 os w s rh osrjDr dk frac14WBCfrac12 izfr ekbdzkyhVjr jDr dkamp lkekUr fj ea sizfrkVk f dyrh gSA blls Tknk f dys rks vlkekU gSA

4 cSDVhfjkamp g lkekUr wfj esa gh iks tkrs gSAa

frac142frac12 ddddkkkkLLLLVVVVampampampamp b dh mRifRr sQzks sa izkVh te tk ls rh gSA e s s gks1 gkbyh dkLVamp [kEHkkdkj ikjnrsquokhZ gks SArh g2 egh nk s Sls s S] ij q egh nk snkj dkLVamp g gkbyh dkLV t gh gkrh g ra ik

tkrs gSaA 3 jDr dkLVamp b es yky jDr dk gksrs gSa a a srk gSAa A b dk jx lrjxh gk4 osr jDrdk dkLVamp g izks s Qls osr dkks ls c s gksr gSaAVh dh fgtYyh ea a a s 5 olk dkLVamp b eas olk ds dk ns[ks tk ldrs gSaA 6 oSDlh dkLV frac14eksehdkLVfrac12amp s vikjnrsquokhZ gkrs s gASa3 jh y QsYj dkLVamp bl rjg ds dkLV jh y QsYj esa fn[kkbZ nsrs gSAa

frac14frac14frac14frac143333frac12frac12frac12frac12 ffffddddzzzz s w sa s tkrs o fj dks j[k sLLLLVVVVyyyyampampampamp g rkt fj e] vfkdrj gh ik w ij b dk voksik gkrk gs SA

vEyh ew s ik tk s okys fdzLVyamp= ea 1 dSfYrsquoke vkDtysVamp g jaxgh ] vVdkkh fds zLVy gSA

Calcium Oxalate Crystals

39

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 41: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

2 w Z rjg ds fdzLVy c krk gS sV] fizTe] kVdks aVsnkjAfjd flMamp g db A Iy k o dkfdzLVy xeZ s ij xkc gks tkrs gSa fMe gkbMordfkDlkbM eas kqy rsquokhy odj A g lksgkbMordfksDyksfjd flM esa vkqy rsquokhy gksrs gSaA

Uric Acid Crystals

3 w s w s ds lek gks s gS o xeZ s qj qy tkr gSajVamp g pj r dj ij r ar k s A 4 flLVh amp g fdzLVy kVdkskh pednkj iRrh tSa s gkrs gSa ordfkDyksfjdl s A g gkbM sflM eas kqy rsquokhy gksrs gSaA 5 Vkjks sdnkj lqbZ k dVhyh gtkM+ s i es ik tkr gSAafl amp g k h d a s

==== eeeessss ss sskkkkkkkkjjjjhhhh eeeewww w assaa ass iiiikkkk ts tts tkkkk ss ooookkkkyyyysss s ffffddddLzLLzLVVVVz yampyampyampyampz 1 QkLQs snkj gkrs gS o flfVd flM esa kqy rsquokhy gSAVamp g vfkdrj pwj s2 fVordfiy QkLQsVamp g lkekUr fizTe dh rjg gksrs gSAa

Triple phosphate crystals

3 dSfYrsquoke dkckZs sVamp g MEcy k xkykdkj gks srs gSa o flfVd flM esa kqy tkrs gSaA 4 veks wjVamp xky yEcs o daVhys ls s vkdkj ds gks s gSa o flM ea kqy rsquokhyf e s s c d r sgkrs s gSAa

40

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 42: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhh---- llll---- QQQQ---- iiiijjjjhhhhkkkkkkkk Cerebro Spinal fluid (CSF) Analysis

CSF ddddhhhh OOOOLLLLddddkkkksss s eeeesss saa llllkkkkeeeekkkkUUUU llllaaa aja jja jpppp kkkkamp

nkcamp 10amp10 e-e-ek=kamp 90amp150 e-y-fofrsquokV k Roamp1-006amp1-008 lkfyM~lamp 0-85amp1-70 gm

dks a 0amp8 fyEQklkbVs cmmfrsquokdkamp Uw ordfks qifLFkrV fQy o yky jDr dk v

izkVh amps 20amp50 mg

Ycqfe amp 50amp70mg

fQfcz kt amps v qifLFkr lks 144amp154 mEqLfMeamp iks s 2-0amp5-0 mEqLVfrsquokeamp Dyks 118amp132mEqLjkbMamp ih-p-amp 7-3amp7-4 fOslashfVf amp 0-5amp1-2 fe-xzk- dksySLVjkyamp 0-2amp0-5 fe-xzk- kdZjk frac14Xywdkst+ zk-frac12amp 50amp80 fe-xXyw zk-Vkeh amp 6amp16 fe-xvkj amp 1amp2 fe-xzk- Fkkjks zk-fDl amp 0-1amp0-2 fe-xw zk-fjkamp 6amp16 fe-xw zk-fjd flMamp 0-5amp4-5 fe-x

CSF ddddkkkk iiiijjjjhhhhkkkkkkkk ffff EEEE ffffccccUUUUnnnnqqqq ass a iiiijjjj ffffddddkkkk ttttkkkkrrrrkkkk ggggSSampampampampvvvvkkkksaa s SS 1 nkc 2 HkkSfrd v 3 jklkf d v 4 dksfrsquokdk v 5 cSDVhfjk dh tkpa6 fljksykWth tkap

1111 nnnnkkkkccccamp lkekU OLd OfDr eas CSF dk nkc 7amp15 mmHg gksrk gSA

2222 HHHHkkkkkkkkSSS Sffffrrrrdddd vvvv ampampampamp frac14frac14frac14frac14afrac12frac12frac12frac12 LLLLooooiiii ooooaaa a jjjjxxxxamp jks a bldk ikjnrsquokhZ ja Zaaa a xnrsquokk frac14chekjhfrac12 es x cnydj vikjnrsquokh k

iwkZ i ls VfcZM gks tkrk gSA Xanth chr mia- CSF dk ja s tkrk gSAx ihyk gk

41

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 43: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Lkcvjs s s a s tkrk gSAD kM gejtamp CSF dk jx yky gkUw s s s a x gjk gks tkrk gSAekjkDdy ef UtkbfVl amp CSF dk ja

2222 FFFFkkkkDDDDddddssss ddddhhhh jjjjpppp kkkkampampampamp g es s gkrk gs SAf UtkbfVl ea V~cjdqyj esf TkkbfVlamp CSF dks dqN kVkas ds fy j[k fnk tk rks edM+ sw a h d

tkys tSlk FkDdk fn[kkbZ nsxk A cSfDVfjy esf UtkbfVlamp FkDdk tYnh c rk gS o eksVk nk s rk gSAa nkj gks

1111 jjjjkkkkllllkkkkffff dddd vvvv ampampampamp izkVh dk xk kRed ifjeki ampsbldh nks fofkka gSaamp

ffffofofofofkkkkampampampamp 1111

1 d VsLV V~w s 0-5 e-y- CSF ysac ea 2 blesa 1-5 e-y- ]3 izfrrsquokr~ lYQkslsfyflfyd flM feyk fQj bls 10 fe V ds fy j[k nsaA 3 vc ek d voks s bldh rqy k dj izksVh dk lgh ek=k Kkr djai l sA

ffffofofofofkkkkampampampamp2222 1 YcqfLVDl ds kjk CSF eas izksVh dh ek=k v qekf r djsaA 2 fn 100 e-th- gS rks tka s fy 0-2 e-y- ys] fn 100amp200 e-th- ds chpp d agS rks 0-1 e-y- yas o fn 300amp1000 gS rks 0-02 e-y- ysaA 3 vc bl izdkj tkap djasA

vvvvKKKKkkkkrrrr CSF EEEEkkkkkkkk dddd CSF

(a) Ekk d frac1480 mgfrac12 ampamp 0-2 e-y-(b) vKkr CSF 0-2 e-y- ampamp (c) dkZdkjh VordfkbDyksjks flfVd flM

fjtsaV 1-0 e-y- 1-0 e-y-

(d) lksfMe gkbMordfksDlkbM frac140-02 e-frac12

2-5 e-y- 2-5 e-y-

vc bls 560 -e- ij nas[ks] 0 ik h ls fLFkj djsAaCSF izkVh frac14s mgfrac12 = TS X 032 X 10002

= TS X 160 mg

kkkkddddjZjjZjkkkk ddddhhhh ttttkkkkaa XXXXkkkkqqkkkkkkkkRRRReeeedddd o xxxxkkkk kkkkRRRReeeedddd iiiiffffjjjjeeeekkkkiiii ampampampamppppp oooo mlmlmlmlddddkkkk XXXXkkkkqqkkkkkkkkRRRReeeeddddqq frac14frac14frac14frac14Qualitativefrac12frac12frac12frac12 1 d Vs ~c esa 0-5 e-y- c s qkkRed kky dj mles

ZZ aa qq

LV V w s fMDV dk x s a 4-5 fe-fy- ik h feykaA 2 bls 1 fe-fy- CSF eas feykdj xeZ dj mcky nsaA

42

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 44: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

3 2 fe V mckydj BMk djsaA 4 fn ja s rks g kdZjk dh deh dk lpd gw SAx k cnyxxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa apppp frac14frac14frac14frac14Quantitativefrac12frac12frac12frac12ampampampamp 1 vkFkkZsVkfyfM k Xywdkst vkDlhMs s dh tkrh gSAt fofk l

ddddkkkkffffkkkkddddkkkk xxxxkkkk kkkkampampampampsss s frac14afrac12 CSF dk r qdjk amp frac14Diluti n f CSFfrac12

V ea A vc CSF l1 feFkkbZyh Cyw dks RBC fiis s 1 f rsquokk rd ysa s bls 101 ds f rsquokk rd Hkj nasA blls WBC hys o RBC ihys gks tkasxAs2 CSF irsquokfrac14Pusfrac12 qDr amp fn vRfkd ek=k eas dkrsquokdka gka rks WBC fiis ss s V l vfkd lqpk i ls tka srh gp gk SA

jjjjDDDDrrrr HHHHkkkkjjjjkkkk CSF-

xxxxkkkk kkkkampampampamp xk k ps s 9 oxksa es RBC o WBC nks kaEcj d Z a s dh fx rh dj h pkfgA dqy dksfrsquokdka X 1-1 = iwkZ dksfrsquokdk xk k izfr oxZZ e-e-SSS S pamppamppamppamp vkorsquodrk aa q DVhfjk dhccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaa lkj lHkh CSF dh Lehj o dYpj kjk cSmifLFkfr ds a sfy tkp gk h pkfgA

LLLLeeeehhhhjjjjampampampamp fn CSF vRfkd eokn qDr gS rks lhks Lehj c ka vUFkk CSF dks ls ordfhparaw zhlhihVsV ls Lehj c kaAUV t dj fQj i

lHkh Lehjkas dks xzke LVS ls LVSaf ax djsaA fn dksbZ cSDVhfjk feys rks ekbdkcs SDVhfjk ns[k s ds fy flM QkLV jatd frac14thyampf yl jatdfrac12 djasA fn CSF es edM+ s tkys tSlk FkDdk c s rks mldk Hkh flM QkLV ja s LVSa h d td l dj k pkfgA fdzIVkdks s ns[k s ds fy ba a zks Ddl dk fMk bd] dk i x dj k pkfgAsfgeks a qth o dqN vU cSDVhfjk ds fys bEq kparayksjks sV ja xfQyl bDy a s la td dk miksfdk tk ldrk gSA ddddYYYYppppjjjjamp eoknqDr CSF dks pkdys wVordfhsV vxkj o vxkj Iys dqysVV vxkj] U a V ij b ksdj k pkfgA blds vfrfjDr bls Fkkks s s sXykbdkyV eke Hkh Mky k pkfgA lHkh dk370 ij ba s qN dks eks s fyfrac12 es Hkh j[kk tkrkDwCkV dj k d ecRrh tkj frac14CO2okrkojk d a gSA llllhhhhjjjjkkkksss s WWWW aa S tc Uw s s s okLdqyj flfQfyl]yyyykkkktttthhhh ttttkkkkaa jkflfQfyl frac14efU xkppppampampampamp g rc dh tkrh gfcl Mk s s yk pkaVs sjlfylfrac12 dk kd gkA fofHkU lhjks Wftdy tka s eas okljeS fjDl dks lcls vPNh tka SAp ek k tkrk g

43

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 45: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

www w MMMM k k k kyyyyffffllllw llllw (Pleural fluid analysis)IIIIyyyyjjjjyyyy paraparaparaparayyyyww

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- ekbdzkLdks si 2- XyklLykbM 3- ls ordf wUVhparat ersquokh 4- ls ordf w ~cwUVhparat V

frsquoke s5- Lis s dVa j 6- 70 feFks ky 7- fjtsVlamp ftElk ja zke ja l a td (Giemsa stain)] x td (Gramrsquos stain)] os

ja Sj thy f yl (Ziehl-Neelsen stain)td (Ways n stain)vk

ffffofofofofkkkkampampampamp tka s sczks zo tkp tSlh gh gSA lcls igysp fofk lj Likb y n a g Kkr dj k pkfg fd nzo VordfklqMsV frac14Transudatefrac12 gS k DlqMsV frac14Exudatefrac12 nks ksa esa fHkU rk hps nh xbZ gSA

Transudate Exudate

Loi ikjnkhZ] gYdk ihyk jax VfcZM k eokn Hkjk LoampLdan frac14C agulati nfrac12

Ukgh gksrk gSA vfkdrj gksrk gSA

LisfrsquokfQd xzsfoVh lt1018 gt1018 izksVh lt2 gm gt2gm

dksfkdka frac14Cells) RBC]aMksfFkyhy dksfrsquokdka dqN fyEQkslkbV] cSDVhfjk gh gksrsA

UwVordfksfQy o fyEQkslkbV dkQh la[k esa cSDVhfjk Hkh gksrs gSaA

HHHHkkkkkkkkSSS S a zkVh dhsffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical examination) ampampampamp bldk LoIk o RBC o Ldfnr imifLFkfr ks SA lkekUr Iyqjy parayw Z o gYds ihys ja srkV dh tkrh g M ikjnrsquokh x dk gkgSA feYdh k nw sfkkamp fyEQfVd flLVe yky ja SAxamp jDr gvikjnrsquokhZ vkSj xklt+k amp ekbdzkvkxs sZf Te dh mifLFkfr nrsquokkZrk gSA

ccccDDDDVVVVhhhhffffjjjjkkkk ddddhhhh ttttkkkkaaSSS S ppppa ampampampampa

1 ls s zo lUVordfhparawt V~wc esa ysrs gS] oa 2000rpm es dqNIVhd VD hd kjk 10 ml n s a a feUkV ds fy lsUVordfhparawt djrs gSAa2 lqij sVsa s vyx djrs gSa oa rh Lehj c krsV dk A 3 Lehj dks lw[k s nas oa ehFks ky kjk fQDl djsaA

44

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 46: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

4 vc LykbM dks LVS djsamp frac14afrac12 xzke LVS frac14Gram stainfrac12 frac14bfrac12 thyamp f yl LVS frac14Ziehl Neelsen stainfrac12 frac14cfrac12 ftElk LVS frac14Giemsa stainfrac12

eeeekkkkbbbbddddkkkkLLLLddddkkkkffffiiiidddd ttttkkkkppppampampampamp (Micr sc pic examinati n)-zzz z sss s sss s aaa a

1 izRsd LykbM dks 40X vkCts DVho es as ns saDVho o 100 X vkby bejl vkCt [kA 2 xzke LVSf a s cSDVhfjk dh mifLFkfr n[ks xzke ikWftfVo k xzke f xfVoAx LykbM ea s s3 flM QkLV cs Z frac14ekbdzkcSfDVfjkfrac12 ns[k s ds fy thy hyl LVS LykbMflykb sns[kAas4 ftElk LVS LykbM dks ns[ksamp YwdkslkbV] fyEQklbV k vks Sj dks Z dksb frsquokdkA

jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk (Chemical Test)

iiiizzz z sss s zo es 4amp5 cwns 5 VordfkbDyks sA VordfklqMsVkkkkVVVVhhhh ampampampamp 3ml n a a j flfVd flM dh Mkyafrac14Transudatefrac12 es dkbZ ifjorZ gh gkxkA DlqMV frac14Exudatefrac12 es lQs sa s s s a n voki c rk gSA

xxxxkkkk kkkkRRRReeeedddd ttttkkkkaaa a zks s gSaApppp amp(Quantitative Test) lhje i Vh dh rjg gh djr

ddddkkkkffffrsquorsquorsquorsquokkkkddddkkkk iiiijjjjhhhhkkkkkkkkampampampampsss s

1 Differential Leuc cyte C unt amp VksVy dkmaV vfkd lwp k gh nsrh gS] blfy Differential Leuc cyte C unt (DLC) dj k mfpr gksrk gSA Transudate amp Exudate

es Hkn dj s ds fy d fLej c kdj mls vfHkja s gS oa dkfrsquokdka dkmaVa s ftr djr sdjrs gSa zo ea vRfkd UwVks s a bUQs w S]A n s ordf fQy dk gk k Transudate o Drsquok dk lpd go vRfkd fyEQks ~wcjdqykslhl oa dzkf d baQs w SAlkbV V s Dl dk lpd g

YYYYccccqqqqffffeeee frac14frac14frac14frac14Albuminfrac12frac12frac12frac12 BCG Dye Method

keZy osYw amp 3-2 amp 5-0 gmdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 fjtsUV frac14afrac12 Ycqfe fjtUVsfrac14bfrac12 Ycqfe LVSaMMZ amp 3-6 gmdl

frac142frac12 ekbdzkfiis sV frac143frac12 dyks s s s ZtjjhehVjleh vkVk kykb

45

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 47: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ffffofofofofkkkkampampampamp

frac14frac14frac14frac141111frac12frac12frac12frac12 rh Vs ~c ys vkSj ekdZ djsA Blank (B) Standard (S)vkSj Test (T)LV V wfrac14frac14frac14frac142222frac12frac12frac12frac12

Blank (B) Standard (S) Test (T)

Ycqfe fjtsUV 1000 ml 1000 ml 1000 ml

fMLVhYM okVj 10ml ampampampamp ampampampamp LVSaMMZ ampampampamp 10 ml ampampampamp VsLV frac14lhjefrac12 ampampampamp ampampampamp 10 ml

frac14frac14frac14frac143333frac12frac12frac12frac12 vPNh rjg feDl djas vkSj Ctkjcaasl frac14ABSfrac12ys LVSaMMZ vkSj VsLV dk CySd ds

vxsLVAa

Calculation-

Ycqfe (gdl) = Abs f Test X C ncentrati n f Standard (gmdl)

Abs f Standard

46

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 48: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

oooohhhhZZZZ iiiijjjjhhhhkkkkkkkk(Semen analysis)

ohZ dk ijhkk f E fcUnqvkas ij fdk tkrk gSamp

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk (Physical Examination) 1amp ek=k 2amp k rk frac14Visc sityfrac12 3amp jax 4amp PH

frac14frac14frac14frac14Bfrac12frac12frac12frac12 eeeekkkkbbbbOslashOslashOslashOslashkkkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkk (Microscopic Examination)LLLLddddkkkksss s 1amp kqdzkkq xk k 2amp fopjk kerk 3amp kqdzkkq dh vdkjkh tkap

frac14frac14frac14frac14A SSS Sfrac12frac12frac12frac12 HHHHkkkkkkkkffffrrrrdddd iiiijjjjhhhhkkkkkkkk 1amp eeeekkkk====kkkkampampampamp vkSlr g 3amp4 fe-fy- ds chp gksrk gSA 2amp kkkk rrrrkkkk amp rktk df=r ohZ vRfkd xklt+ s SA 15amp30 feUkV ds vak gkrk g nj Lor rjyrk gks tk h pkfgA 3amp ja Z kqkyk lQsn gksrk gSAxamp lkekU oh4amp PH amp vfkdrj kkjh gks SArk gPH amp 7-2amp8-0

eeeekkkkbbbbddddzkzzkzkksss s ffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampampLLLLddddkkkksss s bls d=k ds 15amp20 fe V ds va Sls gh ohZ Lor rjy gks tk dj ys knj] tpkfgA 1111ampampampamp kkkkqqq q zzz z xq xxq xkkkk k k k kampampampampddddkkkkkkkkqq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp ohZ r qdjk kkyamp lks ZdkckZs sV 5 xzke] QkeZyh k Qh ky 1 fe-fy-]s fMe ckb sik h 100 fe-fy-A 2amp Uw s Sj dojfLyickj pEcj vk3amp ekbdzkLdks si 4amp osr jDr dk fiisV

ffffofofofofkkkk amp 1 ohZ dks HkyhampHkka s osr jDr dk fiisV frac14WBC Pipetfrac12 dsfr feyk dj bl 0-5 f rsquokk rd ysAa2amp bls 10 ds f rsquokk rd ohZ r qdjk kksy ls HkjasA 3amp vc Uwckj pEcj dks kks s Hkjs frac14pktZ djsafrac12 As y l

47

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 49: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

4amp 2 fe V rd j[k nsa o fQj osr jDr dk xk k dh rjg gh kqdzkkq xk k djsaA 5amp pkjkas dks s okys cMs+ prqHkZqt eas xk k djasA

kqdzkkqfe-fy- = Nx10x20x10004

= Nx50000 lkekU kqdzkkq xk k amp 6amp15 djks +Mfe-fy-

2222ampampampamp ffffopopopopjjjjkkkk kkkkeeeerrrrkkkkampampampamp 1amp rjy ohZ ds ekbdzks s qdzkkq dh tka SALdkfid LykbM ij j[k dj k p dh tkrh g2amp bl ij dojfLyi j[k dj mls oSlyh ls lhy fdk tkrk gSA 3amp LykbM dks vc gkbZikoj vkCtfDVo ds hps ns s gS o de ls de nkS lkSs [krkqdzkkq s dk v djrs gSAavka 4amp lkkkjkrk 80 izfrrsquokr~ kqdzkkq rhoz fopjkrsquokhyrk fn[kkrs gSa o 20 izfrrsquokr~ kheh k vfr lkkkjk fopjk khyrkA

3333ampampampamp kkkkddddkkkkkkkk ddddhhhh vvvvddddkkkkjjjjkkkkhhhh ttttkkkkpamppamppamppamp ffffofofofofkkkkampampampamp 1 ohZ dk d iryk ys s lq[kk ysrs gSA

qqq q zzz z qqq q aaa a

i LykbM ij c k] ml2amp vc Ew s ds fy bl ij dqN fe V ds fy 1 izfrrsquokr Dyksjkeh Mkyrsdl gVk gSaA 3amp bls fQYVj is s nok dj lq[kk yaij l sA 4amp vc bls f E fyf[kr ls ] 2amp5 fe V rd vfHkja sAftr dja

Tkhy hyl dkcksZy QqfDl ----------- 2 Hkkx Lkra `Ir Ydksgy eas bvkslh kksy-------1 Hkkx Ydks zfrrsquokr~------------------------------1 Hkkxgy 95 i

5amp bls ik h ls kks s ykSQyj ds feFkkbyh Cyw ls dqN kk rd jftr djadj] bl a Asdj l a s i es6amp bls kks q[kk ys o fQj ekbdzkLdks a nas[kAs

7amp kqdzkkq ds flj frac14Headfrac12 tkeq h o chp dk Hkkx o nqe frac14Tailfrac12dkys ja s gks s gSaAx d r8amp vc izRd ekbdzks s s s kqdzkkq fx ysA gj k= es vlkekU o vifjiDos Ldkfid k= ea a s a kqdzkkq Hkh fx sAa4444 vvvvUUUU ddddkkkksss s aaa a s a wVordfksffffrsquorsquorsquorsquokkkkddddkkkkamp yky jDr dk] bfiFkhfyy dkfrsquokdk] U fQy] vifjiDo vM

y s fid ijhkk eao fofHkU nk s o xks s Hkh ekbdzkLdks s ns[ks tk ldrs gSAa

48

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 50: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

EEEEkkkkyyyy iiiijjjjhhhhkkkkkkkk (Stool Examination)

ey dk ijhkk f E fcUnqvkas is djrs gSaamp

1111---- HHHHkkkkkkkkSSS Sffffrrrrdddd frac14frac14frac14frac14Physicalfrac12frac12frac12frac12 1- Ekk=k 2- Ikzdkj foUkl 3- jax 4- xak 5- vEyhrkkkjhrk 6- Ewdl 2222---- jjjjkkkkllllkkkkffff dddd frac14frac14frac14frac14Chemicalfrac12frac12frac12frac12 1- jDr 2- fcfyfc 3- w s sfofy frac12jkfcfy frac14LVdkZ4- w s sjkckbfy kt 5- Oklk 6- kbVordf skt 3333---- eeeekkkkbbbbOslashOslashOslashOslashkkkksss s iiiihhhh frac14frac14frac14frac14Microscopicfrac12frac12frac12frac12ampampampampLLLLddddkkkksss s 1- vka s ijthoh] vMs dsr d flLV 2- la SDVhfjkOslashked c3- Hkks s VqdM+st d4- dksfrsquokdk o f L=ko

5- yky jDr dk frac14RBCfrac12

vvvv ddddssss ffffyyyysss s eeeeyyyy dddd====kkkk (Collection of stool for examination)ampampampamp

1- tka s fy df=r ey dks lhks gh d lkQ lw[ks ik= es Rkx k pkfgAp d a bles w k pkfgAa fj o fdlh vU rRo dk feyk gh gks

2- ey dh Fkks + s fy dkQh gSAMh lh ek=k gh lkekU ijhkk d3- vfr khkzrk ls izksxrsquokkyk eas igaqpk k pkfg Dksafd nsjh dj s ij fokV kq

gks ldrk gSA 4- lkekUr ey d=k ls igys jk=h eas de olk] ekal o gjh iRrsnkj lfCtka

gh ns k pkfgA 5- fn tka s nj gk s dk vnsrsquokk gS rks ey dks lqfokkt d ifjog eke esp ea s s a a

df=r dj k pkfgA

49

mmmmnnnnkkkkggggjjjjkkkkampampampamp fofczk ds fyamp kkjh is s WVj o osdVjke jked`k eke vUs IVk ok avka s la zkek CkSDVhfjk ds fy amp dSjh o Cyj ekesr d d

frac14Afrac12 HHHHkkkkkkkkSSS Sffffrrrrdddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Physical examinationfrac12frac12frac12frac12amp

1- EEEEkkkkkkkk====kkkkamp lkekUr 150amp200 gm izfrfn gks k pkfgA amp ek=k lkekUr f E fodkjkas eas clt+ tkrh gSA

1- LVhVksfjZk frac14Steat rrheafrac12 2- dkckZsgkbMordfsV dk vip

2 iiiidzddzdkkkkjjjj oooo ffffoUoUoUoUkkkkllll amp lkekUr eZ fdUrq ckk ga qvkAzz (i) vRfkd dM+ sAk ey amp dCt ea(ii) ey dbZ dM+ s s ds Ik eah xkfyka amp LikLVhd dCts3- eeeeyyyy eeeesasaa sas EEEEwww wddddllll oooo jjjjDrDrDrDramp Mkfjk 5 jjjjaaa a a s Skfk o vU jkxks as ij f HkZj djrk gSAxxxxampampampamp ey dk jx Hkkt ] vk1 Hkkt amp nk dk ls s ihys jas w o amp gYd x dk ey

gjh lCth amp gjk jax 2 vkSkfkamp

ykSg kkrq amp xgjk Hkwjk k dkyk 3 chekjh amp vojkkd ihfyk frac14Obstructive Jaundicefrac12 amp lQs ~Vh ds jxas n feV

dk jDr L=ko amp ey yky k dkyk

6 xxxxaaa a Zf d inkFkZkkkk amp lkekUr dkc lh 1 [kV~Vh lM+h egdamp ey esa olk dh vfkdrk 2 rs qxZUk amp vRlj o xSxfj okyst n fodkj

7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

frac14Bfrac12 jjjjllllkkkkffff dddd iiiijjjjhhhhkkkkkkkk frac14frac14frac14frac14Chemical examinationfrac12frac12frac12frac12amp 1 eeeeyyyy eeeesasaa sas jjjjDDDDrrrramp Occult Blood

f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

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bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

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83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 51: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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gjh lCth amp gjk jax 2 vkSkfkamp

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dk jDr L=ko amp ey yky k dkyk

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7 iiiizzz z a s ds fy dbZ rjhds gSaAffffrrrrffffOslashOslashOslashOslashkkkk frac14frac14frac14frac14PHfrac12frac12frac12frac12 amp ey dk PH tkp 1 ey dk ik h eas feJk c k dj fQj bls yky o ihys fyVel iasij ls tkpa Askkjhrk gks s ij yky fyVel hyk gks tkrk gSA 2 dkSa s jsM iij ls tkapsAaxk s

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f E fofkkas kjk ey eas jDr dh tka Sampp dh tkrh g

1 fsffsfttttMMMMhhhh tttts kkkks aaa accccaaa a ppppampampampamp vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhh ampampampamp frac141frac12 Vs ~wcLV V2 cUkZj 3 casftMh gkbMordfksDyksjkbM 4 flfVd flM 5 gkbMordf skt ijkDlkbM

50

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

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51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 52: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

6 ey dk lsEiy

ffffofofofofkkkkampampampamp 1 ey dk ik h esa kksy c k ysaA 2 d pqVdh ca ordfks jkbM dks 5 fe-fy- flfVd flM es kks sftMh gkbM as Dyks a ydj blecjkcj ek=k eas 10 izfrrsquokr~ gkbMordfkst ijkDlkbM feykaA 3 vc bleas 5 fe-fy- mcyk gqvk ey dk kksy MkysA 4 fn xgjk gjk ja s rks g ey esa jDr dh mifLFkfr nrsquokkZrk gSx c A

frac14frac14frac14frac142222frac12frac12frac12frac12 vvvvkkkkFFFFkkkkkkkksss sVVVVkkkkyyyyqqqq ppppampampampampZZZZ MMMMhhhh ttttkkkkaaa a vkorsquod lkexzhamp frac141frac12 fjts zke vkFkkZsVkyqMh dks 10 fefy Xys aUV frac144 x frsquoky flfVd flM es feykdj fjtsUV c kfrac12 frac142frac12 Vs ~wcLV Vffffofofofofkkkkampampampamp frac141frac12 1 fe-fy- ey ds kks s 1 fe-fy- fjts zfrrsquokr gkbMordfkt sy ea UV o 1 fe-fy- 3 i ~ ijkDlkbM MkysaA 2 30amp60 ls sa a hys gjs ja wpd gdM es x dh mRifRr] jDr dh mifLFkfr dh l SA

vvvvododododkkkkjjjjdddd rrrrRRRRooookkkkssaa ss aa ddddssss aaa affffyyyy ttttkkkkppppampampampamp 1111---- cccckkkkbbbbYYYYkkkk ffffllllMMMM ddddhhhh ttttkkkkaaa apamppamppamppamp

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzhzzhzhh1 VsLV V~wc 2 KOH 3 lkna z H2SO4

ffffofofofofkkkk amp 1 FkkMs s+ ls ey dks Ydksgy eas kkys sa o fQj Nk yssaAa2 N s gq kksy dks mckydj lq[kkysaA 3 vc gYds kkjh ik h eas frac14 KOH feykdjfrac12 blss fQj kksy ysAa4 blesa 0-3 fe-fy- 5 izfrrsquokr lqdzkst dk kksy MkysAa5 bls d Vs ~wc es ydj vc fd kjs ls blea daLk VordfV H2SO4Mkydj ijrLV V a s s sc kaA

6 bls ik h eas BMk djsaA 7 nk ks sa ijrksa ds fey LFky ij c h yky fja SAx ldkjkRed ifjkke g

2222 jjjjw kkkkw sss s ppppampampampampfw ffw fccccffffyyyy ddddhhhh ttttkkkkaaa a

ffffofofofofkkkkampampampamp 1 ey ds d Nks s qdM+ dks lkn ejDw jkbM kks a aV V s a z fjd Dyks y es Hkyh Hkkfr fkl dj feykaA 2 bls fNNys ik= eas Mky dj] 24 kVs jg s nsaA 3 w s s ja s fn[krh gSAjkfcfy dh mifLFkfr xgj x dh mRifRr l

51

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 53: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

(C)ampampampamp eeeekkkkbbbbddddzkzzkzkksss s sss sLLLLddddkkkkffffiiiidddd iiiijjjjhhhhkkkkkkkkampampampamp (A) rrrrSSSSkkkkjjjjhhhh

1111 llllsss syyyykkkkbbbb kkkkjjjjkkkk amp 1 ey dk Fkks k lk fgLlk ls zfrrsquokr es kks wn LykbMM+ ykb 0-9 i a y dj bldh d caij Mkyrs gSaA 2 bl ij doj fLyi yxk dj nckrs gS] ftlls g kks Zy iryh o ikjnrsquokh ijr c kA vvvvkkkkkkkksss s w sy dh vkkfM dks s f E fyf[kr fofk ls c krs gSaampMMMMhhhh kkkkjjjjkkkkamp Yxkvkks zLVy amp 5 xzkeMh fdiksVsfrsquoke vkksMkfM amp 10 xzke ik h amp 100 fe-fy-

ey o lsykb kky dh d ca dj blesa d cwn vkks ys w s a fM kksn LykbM ij yfeykdj bl ij doj fLyi j[krs gSaA

(B) vvvv amp 1 vfHkja o v ja s s izdkj dh LykbM dkftr frac14Stainedfrac12 ftr frac14Unstainedfrac12 nk ka s ekbdzksLdki es sa 10x ds vkCtsfDVo kjk d fd kjs ls nljw s fd kjs rd ns[krs gSaA 2 fdlh Hkh Snkf d egRo ds rRo dks 40x ds vkCtsfDVo ls foLr`r v djrs gSAaekbdzkLdks s ik tk s okys rRo f E fyf[kr gSamps fid o chekjh ea

1111 HHHHkkkkkkkktsttst s dddds sss s vvvvorsquoorsquoorsquoorsquokkkksss skkkkampampampamp 1 lfCtksa ds varsquok 2 olk 3 bykfLVd Qkbcj

2 oooosss s a s la zek o vYlj gk s ij ik tkrs gSarrrr jjjjDDDDrrrr ddddkkkkamp vkr d d s A 3 eeeeSdSSdSddkzkkzk sss s ttttamp cs sphl es ik tkrs gSaAzz QQQQsss s flyjh i a

k h vkr x4 yyyykkkkyyyy jjjjDDDDrrrr ddddkkkkamp iw Z o fokfVr yky jDr dk cM+ a qnk o xqnkkj ds fodkjkaseas ik tkrs gSaA

amp vehfcd is s yky jDr dk ds xqPNs ik tkrs gSaAphl ea

5555 ffffddddzzzzLLLLVVVVyampyampyampyamp 1 fVordfiy QksLQsV 2 dSfYrsquoke vkDtyVs3 kkjdVys zLVyM fd4 fges zLVyVkfM fd5 dks s zLVyyLVjh fd6 cSDVhfjk

52

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 54: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

7 hLV o QQwa ar ea ey lM+ s ij ey es hLV n[kk tk ldrk gSA g NkVnamp vk s a s s s xks s Ik es gksrs gSaAykdkj k pS d a

8888 iiiizkzzkzkkVVVVkkkksss s vvvvkkkkampampampamp f E izdkj ds iksVkstksvk dh vkr es igpk dh tkrh gSampsss s ttttkkkksss s z a a

1111 ffffttttkkkkffffMMMMZZZZ aVVVVa LLLLVVVVkkkkbbbbs s sss skkkk bbbbaa fs ffs fyyyylamplamplamplamp

Cyst f Giardia Tr ph z ite f Giardia

ffffllllLLLLVVVV ddddhhhh iiiiggggpkpkpkpk ampampampamp 1 flLV vMkdkj 12 ekbdzks x 7 ekbdzks eki dh gkrh gs SA

fDyl bld ka s a ij tk h ea2 pkj Uw s nks s vkj k fd kjks Ms + s jgrs gSAa

izkkh krsquokikrh ds vkdkj dk ] 12amp20 ekbdzks eki gksrh gSA bleas 3 parayStsyk d vks Styk dhys Nksj ij gkrk gSA 2 UfDyl gksrs gSAj o d paray s q s w

2 aVkehck fgLVksfyfVdkamp b dh rh iztkfrka ikh tkrh gSAa

Cyst f Entam eba Hist lytica

vvvvkkkkddddkkkkffffjjjjddddhhhh ffffoooooooojjjjkkkk izkkh bbbbZZZZ---- ffffggggLLLLVVVVkkkkss ssffffyfyfyfyfVVVVddddkkkk bbbbZZZZ---- ddddkkkkss ssyyyykkkkbbbbZZZZ bbbbZZZZ---- kkkk kkkk Ekki 20amp30 ekbdzks 20amp40 ekbdzks 8 ekbdzks Xfrrsquokhyrk vfrxfrkhy khek khek UwfDyl gh fn[krs fn[krs gSaA fn[krs gSaA lkbVksIykTe Ykky o osr jDr

dk fdUrq cSfDVfjk ghA

cSfDVfjk Hkh gksrs gSaA Ykky jDr dk dHkh gh gksrs

53

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 55: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

UwfDyl dsUnzh dSksZlkse mRdsUnzh dSksZlkse cM+s vf fer o midsUnzh dSfjkslkse

egh dzksesfV nk s eksVs dzksesfV nk s egh Uwdfyl fgtYyh

egh fgtYyh dzksesfV xszUwy gh

ffffllllLLLLVVVV EEEEkkkkkkkkiiii 6666ampampampamp11115555 eeeekkkkbbbbddddzzzzkkkkss ss 11115555ampampampamp22220000 eeeekkkkbbbbddddzzzzkkkkss ss 8888ampampampamp9999 eeeekkkkbbbbddddzzzzkkkkss ss

Uwdfyl 1amp8 dsUnzh dSksZlkse

1amp8 mRdsUnzh dSksZlkse

1amp4 dsUnzh k mRdsUnzh dSksZlkse

Xykbdkst Xkksykdkj kM+h lek Irys lqbZnkj pkSdksj Ukgh gksrs

8 gggg Fs FFs Fkkkk dddd vs vvs vMMMMampampampamp g vMs tks ek o es ik tkrs gSayyyyffffeeeeaa ss a amp

frac14frac14frac14frac14A sss s hzhhzhddddkkkksss s

ss aa ss ss

frac12frac12frac12frac12 LLLLddddffffjjjjllll yEyEyEyEcccczz bbbbffffMMMMlamplamplamplamp

Ova of Ascaris

amp la s slfpr vMamp amp xks zk yEcs o 40amp45 ekbdzk pkSM+y k vMkdkj frac14 60amp75 ekbd s s kfrac12 amp ges a w s a srsquokk ckby jftr o Hkj jx dA amp ls s larIr kksy esa rSjrk gSAykb d `amp pkjks vks Vk dop o vf fer lh Yoqfe dh fgtYyh Aa j eks

k o vfoHkkftr vM] nk s chp fNik gvk UdfyvlAamp cM+ snkj kd ds q w

2222 vvvvllllalllla sss s ampfa ffa fpppprrrr vvvvMMMMsss s amp irys o yEckdkj frac1480 ekbdzk s x 55 ekbdzks frac12 amp Hkw s a sj jx damp iryk dop o Ywfe fgtYyhA amp g lar`Ir lsykb kksy esa gh rSjrs gSA

frac14B) aaa a ss sss s fsffsfMMMM ssssddddkkkkbbbbyyyykkkkLLLLVVVVs kkkks eeeekkkk ffffMvMvMvMvkkkkss yyyyhhhhamp

amp vMkdkj 60 x 40 ekbdzk s

54

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 56: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

amp jaxgh amp foHkkftr vM vfkdrj pkj CykLVks s s sfej] vM d dop o vM d chp [kkyh LFkk A

frac14Cfrac12 VVVVkkkkbbbbDDDDwww w kordfkkordfkbbbbDDDDwww wffffjjjjllll VVVVordfordf jjjjkkkkampampampamp

Egg of Trichuris Trichuria

amp yxHkx 50x 25 ekbdzk sx Hk aamp ja wjk frac14ckby jftrfrac12

amp vfoHkkftr vM amp lar`Ir ls sy ea rSjrsykb kk s

frac14Dfrac12 VVVVordfordfordfordf sss s ZZZ Z yqyyqySSkkkkffffccccllll oxoxoxoxhhhhddddqq fSffSfjjjjllllamp

gSaaA

Cyst of E Vermicularis

amp jaxgh amp vkdkj vf fer amp eki 60 x 30 ekbdzk samp ja Zxgh ikjnrsquokh dop amp lar`Ir ls sy ea rSjrk gSAykb kk s

frac14Efrac12 VVVVhhhhffff kkkk llllkkkksss s sss s VsVVsVkkkkddddkkkk s kkkks dsddsds kkkks DsDDsDddddlllls xxxxs SSSzzSzz yyyyq kkkkq sss sffffyyyyeeeellllfffftttt lq llq lllll

55

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 57: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Taenia Solium

amp vMkdkj o ckby jaftr amp eki 30 x 43 ekbdzk samp iryk ckgjh ikjnrsquokhZ dop amp vka s s +h gqdysdkLohj] rh tkM V amp lar`Ir ls s s gh rSjrkykb kky ea

frac14Ffrac12frac12frac12frac12 ffffrsquorsquorsquorsquokkkkLLLLVVVVkkkksss s eeeekkkkssllllkkkkss amp vMs fc k ltDd ds o Eczks lfgr fk- gheSVksfce amp 150x 50 ekbdzks ] fljs ij dkVkafrsquok- eSlks 60 ekbdzk ] fljs ij dkVka h amp 150x sfrsquok- tSiksf deamp 100x 65 ekbdzks ] fljs ij kqMh

frac14Gfrac12 QQQQssss ss SSS S QQQQss ss qqq qffffrsquorsquorsquorsquokkkkkkkkss ffffVVVVddddeeee ffffrsquorsquorsquorsquokkkkkkkkssyyyykkkk ffffggggiiii ss yyyykkkk ccccLLLLddddhhhhamp amp cM+s ltDd nkj] Hkjs ihys frac14ckby jaw ftrfrac12A amp eki 140x80 ekbdzk Asamp vfoHkkftr vM] ksd ds chpA amp lar`Ir ls s s gh rSjrAsykb kky ea

56

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 58: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Biochemical Test

keZy osYw aamp QkLVhx amp 70amp110 mgdl

iksLV izasfMyamp 90amp130 mgdl

llllhhhhjjjjeeee XXXXyyyywww w ttttss (Blood Sugar) by GOD-POD Methodddddkkkkss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 GOD-POD Gluc se Testing kit

frac14 ifrac12 fjtasV frac14R1frac12 amp Xywdkt fjtsas V frac14Ph sphate buffer Gluc se xidas Per xidase 4AAPfrac12

frac14 iifrac12 fjtsa wdkt MkYkqoasVV frac14R2frac12 amp Xy sfrac14 iiifrac12 fjtsV frac14R3frac12 amp Xyw t LVSMMZ frac14100mgdlfrac12a dks

2 ekbdzkfiis sV 3 VsLV V~wc 4 dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV] fjtsUV 2 dks fjtV 1 da s mlh dks s oky ls f E rjg lss M d

feykdj rSkj djrs gSamp

REF (C de) R1 R2

93DP100-74 1 Vial 50 ml

93DP100-80 1 Vial 100 ml

93DP100-81 1 Vial 500 ml

ofdZx fjtsaV dks 2amp8 0 C vkSj vaksjs frac14Dark Placefrac12 eas LVksj dj k pkfgA

57

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 59: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

sss s DDDDrsquorsquorsquorsquokkkk s ampampampampsllllEEEEiiiiyyyy ddddyyyyss

frac14 ifrac12 QkLfVa w s s fy ejht dks f nsrsquok ns k pkfg fd 10amp12 kVs dqN k [kksx Xydkt d Z a

ls s s sEiy dyDrsquok l igyA

LV ia t d f n s s afrac14 iifrac12 iks zsfUMy Xywdks s fy ejht dks Zsrsquok n fd [kk ds 2 kVs ckn

ysckWfjVordfh vkA

ffffofofofofkkkkampampampamp F r Fully aut maticSemiaut matic Analyser

1 rh Vs ~wc ys o ekdZ djsLV V Blank (B) Standard (S) amp Test (T)

Glucose Blank(B) Standard (S) Test(T)

VsLV frac14lhjefrac12IykTek) amp amp 10microl

LVSaMMZ fjtsaV amp 10microl amp

ofdZax fjtsaV 1000microl 1000microl 1000microl

2 vPNh rjg ls feyk vkSj 370 ij 10 fe V ds fy ba wcsV djsaD A 3 vc ctkcsl frac14ABSfrac12 ys Cysd] LVSaMMZ oa mlds ckn VsLV ds vkSj dYdqys s]Z a s rsquok djaf E QkeqZyk kjk

Calculation-

Xyw s = ctkcsa sLV X dals sl LVSaMMZ frac14100frac12dkt frac14mgdlfrac12 Zl V UVordfctkcsa SaZl LVMMZ

For Speetrophotometers Colorimeters (Lis ordfks sVkehVjDyks sjhehVj kjk)DV Qk

Blank(B) Standard (S) Test(T)

VsLV frac14lhjeIykTek frac12 amp amp 20microl

LVSaMMZ fjtsaV amp 20microl amp

ofdZax fjtsaV 1500microl 1500microl 1500microl

vPNh rjg feyka vkSj 37 fMxzhls s fy bDwcaV djayfll ij 15 fe V d s AsfMLVYM okVj amp 1500microl 1500microl 1500microl

vPNh rjg feykaA vc Cysad djs LisDVordfksQksVksehVjDyksjhehVj dks fjtsUV Cysad kjkA LtkcsZl ys LVSMMZ dk mlds ckn VsLV dk vkSj dSYdqysrsquok djsaA

58

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 60: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhhjjjjeeee www wffffjjjjkkkk (Serum Urea) Urease Berthelot End point Assay

kkkkeeeeyZyyZyZ ooooZ YsYYsYs s amp ww fjk amp 13amp45 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1- wfjk dhV frac14Urea Kitfrac12 fjtsaV frac14R1frac12 amp Urease Reagent fjtsaV frac14R2frac12 amp Urea Chr m gen

fjtsaV frac14R3frac12 amp Urea Standard (50 mgdl)

fjtsaV frac14R4frac12 amp Purified Water

2- ekbdzkfiis sV 3- Vs ~cLV V w4- dSykjhehVjls s +js eh vkVk kykbt

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

lkYw - 1frac12amp lkYw s ds fy fjtsa s fjtsV 4 lsl 1 frac14S luti n l 1 c k V 1 dk a

feykA

fjtasV 1 fjtasV 4

1 Vial 50 ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 01 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

lkYw - 2frac12amp lkYw ndash 2 c k s ds fy fjtsV 2 dks 14 fjtaV 4 el 2 frac14S luti n l a s as

feykA frac141 Part R1 + 4 Part R4frac12

C de N R1 R4

81DP300-72 40ml 160 ml

81DP300-60 10ml 40ml

ikmMj dks vPNh rjg kks s oa 2amp8 0 C ij la zfgr djas qrsquok 04 ekg dsy x A g lkY

fy lqjfkr jgrk gSaA

59

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 61: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllEEEEiiiiyamp lhjeIykTek frac14v ghekss yyy s ZTMfrac12 amp EDTA as antic agulantss ykb

ffffofofofofkkkkampampampamp

Blank (B) Standard (S) Test (T)

fjtasV 3 ( Standard) - 10 microL amp

Vs ampLV frac14lhjeIykTek frac12amp 10 microL

lkYql 1 1000 microL 1000 microL 1000 microL

- vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDcw sV djsaA

lkYql 2 1000 microL 1000 microL 1000 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsA

Calculation-

w Abs rbance f testX C ncentrati n f Standard (50mgdl)50fjk frac14 mgdl frac12 = Abs rbance f Standard

F r spectr ph t meterc l rimeter (Lis ordfksQkVks sjhehVj kjk)DV s ehVjDyk

Blank (B) ( Standard (S) Test (T)

fjtasV 3 ( Standard) _ 10 microL amp

Vs amp amp 10 microLLV frac14lhjeIykTek

lkYql 1 1500 microL 1500 microL 1500 microL

vPNh rjg feyksa oa 370 ij 3 fe V ds fy bDwcsV djsaA

lkYql 2 1500 microL 1500 microL 1500 microL

1 vPNh rjg feyksa oa 370 ij 5 fe V ds fy bDwcsV djsaA 2 kykbtj dks Cyasd djsa Cyasd fjtsUV kjkA 3 vPNh rjg feyk vkSj LihjsV djs LVSMMZ ds ckn ls s Sj dSYdqyrsquok sa a Eiy frac14VLVfrac12 vkdjsAA

60

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 62: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhhjjjjeeee ffffccccffffyyyyffffcccc VkVkVkVkVsVVsVyyyy oooo Mka MkMka MkjjjjDDDDVVVVssss aa ss

keZy osYw amp oLd oa cPpsamp

VksVy fcfyfc ampUpt 1mgml

dkatqxVs M fcfyfc amps upt 04mgml

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

frac141frac12 lhje fcfyfc fdV

fjtasV frac14R1frac12 amp fcfyfc MkjsDV amp 100ml

fjtasV frac14R2frac12 amp fcfyfc VksVy amp 100ml

fjtasV frac14R3frac12 amp fcfyfc lhje CySd amp 100 ml

fjtasV frac14R4frac12 amp lksfMe kbZVordfkbV amp 15ml

fjtsV frac14a R5frac12 amp LVSMMZ frac14Artificial 04 mgdlfrac12 amp 50ml

2 ekbdzkfiis sV 3 VsLV V~wc

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

ofdZx fjtsaV fjtsaV 1 1-00 ml 500ml 1000ml

MkjsDV fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ofdZx fjtsaV fjtsaV 2 1-00 ml 500ml 1000ml

VksVy fcfyfc fjtsaV 4 0-05ml 025ml 05ml

ffffofofofofkkkkampampampamp frac141frac12 ofdZx fjta Vy k MkjsV frac14Vks s DVfrac12------------------------------------------------------ 1000 microL

lsEiy ------------------------------------------------------------------------------------------------------------ 50 microL

frac142frac12 fjtasV 3 frac14Bilirubin Serum Blankfrac12 ds kjk Zer lsV djsaA

frac143frac12 Mkjs s fy jhfMa qjUr ys s dsDV fcfyfc d x r lhje feyk cknA

ffffjjjjttttYYYYVVVVamp Vks s = ∆ A f test X 21frac14Fact r at 546 mfrac12Vy k MkjDV fcfyfc frac14mgdlfrac12

61

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 63: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhhjjjjeeee ddddkkkkyyyyLLLLVordfVordfVordfVordfkkkkyyyy Serum Cholesterol (CHOD PAP)sss s sss s

keZy osYwamp 140amp250 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp 1 dkys sLVordfky dhV (CHOD PAP)

fjtasV 1 amp dksysLVordfky fjtsaV (Ch lester l reagents) fjtasV 2 amp LVSaMM fjtasV (Standard reagents 200mgdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj ffffofofofofkkkkampampampamp 1 rh VsLV V~wc ysa oa ekdZ djsa B(Blank) S(Standard) amp T(Test)

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl 1000microl LVSaMMZ fjtsaV ----- 10 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 10 microl 2 vPNh rjg feyka oa 10 fe V ds fy 370 ij bUDw s sAcV dja3 CySa s dja mlds ckn LVSMMZ oa VLVAd LihjV s a s4 ctkcZsal ys LVasMMZ oa VsLV dkA

Calculation -

dumlys ordfky(mgdl)= Abs f Test X C ncentrati n f Standard(mgdl) (200)LVAbs f Standard

62

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 64: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhhjjjjeeee ddddzzzzhhhhffffVVVV h h h h (Serum Creatininefrac12frac12frac12frac12

keZy osYw amp Male- 07- 14 mgdl

Female- 06- 12 mgdl

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 lhje dzhfV h fdV (Serum Creatinine Kit)

fjtsaV 1amp fidjhd flM fjtasV 2amp lksfMe gkbMordfkDlkbMsfjtsV 3amp fdzVh h LVSa Z (2mgdl)a MM2 ekbdzkfiis sV 3 Vs ~wcLV V4dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 1 frac14R1frac12 vkSj fjtasV 2 frac14R2frac12 dks 11 Rati eas feykasA

500ml microl + 500 ml microl

ffffofofofofkkkkampampampamp 1 nks Vs ~c ya oa ekdZ djs Standard (S) LV V w s a Test (T)

Standard (S) Test (T)

ofdZax fjtsaV 1000microl 1000microl

LVSaMMZ fjtsaV R3 100 microl ---

VsLVfrac14lhjeIykTekfrac12 amp 100 microl

2 vPNh rjg feyk vkSj 20 lsdsM irsquopkr izFke ctkcZsrsquok frac14absfrac12] frac14A1frac12 ys rFkk 80 ls s a srsquok frac14A2frac12 ysAadM irsquopkr vfre ctkcZCalculation-

∆ A= A2-A1

fdzfV h frac14 mgdl frac12 = ∆ A f test X C ncentrati n f Standard (mg) (2mgdl)

∆ A f Standard

63

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 65: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhhjjjjeeee VkVkVkVkVsVVsVyyyys iiiis zkzzkzkkVhVhVhVh sss s (Serum Total Protein )

keZy osYw amp 6amp8-3 gdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxhzhhzhamp 1 VksVy izks

zz Vh dhVamp

fjtasV R1 amp VksVy izksVh fjtsaV fjtasV R2 amp VksVy izksVh LVSaMMZ (6gdl)

2 ekbdzkfiis sV 3 VsLV V~wc 4 dyks s s +jhehVjleh vkVk kykbtj llllsss s yyyEEEEiiiiyamp lhjeIykTek

ffffofofofofkkkkampampampamp 1 rh Vs ~wc ys o ekdZ djs Blank (B) Standard (S) vkSj Test (T)LV V a

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000microl 1000microl 1000microl

fMLVhYM okVj 20 microl amp ---

LVSaMMZ fjtsaV R2 ----- 20 microl ---

VsLVfrac14lhjeIykTekfrac12 amp amp 20 microl

2 vPNh rjg feyk oa 10 fe V ds fy 370 ij bUDw s sAoV dja3 LVSMMZ vkSj VLV dk Ctkosrsquok ys CySa s vxsLVAaa s Z d d

Calculation -

Vyi s X C ncentrati n f Standard(6gdl)Vks zkVh (mgdl)= Abs f Test

Abs f Standard

64

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 66: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

SGOT AST (Aspartate Aminotransferase)

kkkkeeeeZZZ Z YYYYs s amp 3amp22w IUL 300Cyyyy ooooss5amp34 IUL 370C

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGOT dhV fjtsV frac14a R1frac12ampBuffer

fjtsaV frac14R2frac12ampKet glutarate (EnzymelC enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA

1ml R2 + 4 ml R1

llllEEEEiiiiyamp lhjeIykTek frac14 ghiss yyy sss fj k EDTAfrac12

ffffofofofofkkkkamp 1 ofdZa aV dks 370C ij j[ksaAx fjts2 d VsLV V~w sampc ea

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

3 vPNh rjg feyka oa rqjUr LihjsV djsaA 4- CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation-

AST Activity (IVL frac12 = ∆ Amin X Kinetic Fact r frac141768frac12

Kinetic Fact r= 1768

65

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 67: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

SGPT ALT (Alanine aminotrasferase)

kkkkeeeeZZZ Z YsYYsYs s www w C- femaleyyyy oooo amp Up t 22 IUL at 370

Up t 29 IUL at 370C- male

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp 1 SGPT dhV

SGPT fjtsaV 1 (Buffer)

SGPT fjtsaV 2amp (Enzyme C enzyme)

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSyksjhehVjlseh vkVk kykbts +j

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

llllEEEEiiiiyamplhje] ghiss yyy sss fj EDTA IykTek

ffffofofofofkkkkamp 1 d VsLV V~w s ampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 100microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- Determine the mean absorbance changemin ( ∆ A min) for every reading find the mean value

The general formula for converting absorbance change in to international units (IU) of activity is

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of NADH at 340 nm P = Cuvette light path = 1 CM

Acitivity of ALT at 37 C (IUL) = frac14∆ Aminfrac12 X Kinetic fact r (1768)

∆ Amin = Change in Absorbance per minute Kinetic fact r (K) = 1768

66

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 68: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

yyyykkkkbbbb QQQQkkkkLLLLQQQQVVVVtttt Alkaline Phosphatase (ALP)YYYYddddssss sss s sss s

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhamp keZy osYq amp Male ndash 60 - 306 UL

Female ndash 64 - 306 UL

Children up t ndash 15years lt644UL

Children up t ndash 17years lt483UL

1 Yds Vt fdVsykb QkLQsYds s s sV amp R1ykb QkLQVt fjtaYds sVst fjtsV amp R2ykb QkLQ a

2 ekbdzksfiiVs3 Vs ~wcLV V4 dSykjhehVjls s +s eh vkVk kykbtj

ofofofofddddxZxxZx ffffjjjjZ ttttZ sssaaa sa SSS SVVVV rrrrkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12

bull fjtasV 2 frac14R2frac12 vkSj fjtasV 1 frac14R1frac12 dks 14 Rati eas feykasA 1ml R2 + 4 ml R1

ls s ZTM frac12EiyamplhjeIykTek frac14 v ghekykb

ffffofofofofkkkkamp 1 d VsLV V~w sampc ya

ofdZa sa amp 1000microlx fjtV Vs amp 20microlLVfrac14lhjeIykTekfrac12

2 vPNh rjg feyka oa LihjsV djasA 3 CtkjcsUl frac14Abs rbance) 60 ls M ckn ys x izRd 60 ls aM ea fjihV djaZ ds A jhfMa s ds s s

frac143 fe V ds fyfrac12 vkSj vkSlr CtkjcsZUl ifjorZ frac14∆ Aminfrac12 izfrfe V frac14Mean

Abs rbance Change per Minutefrac12 izkIr djsA

Calculation- The General formula for converting absorbance change in to International units (IU) of activity is-

IUL = frac14∆ Aminfrac12 X TV X 103

SV X Absorptivity X P Where ndash TV = Total reaction Volume in microl SV = Sample Volume in microl Absorptivity = Millimolar absorpitivity of P- nitrophenyl Phosphate at 405 nm = 188 P = Cuvette light path = (CM)

= 1 CM

Acitivity of ALP at 370 (IUL) = frac14∆ Aminfrac12 X fact r (2750)

67

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 69: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Lipid Profile

1111ampampampamp llllhhhhjjjjeeee ddddkkkksss s sss s ordfordfordfordfkkkkyyyy ddddkkkk vvvvkkkkddddy y y y ampampampampyyyyLLLLVVVV

kkkkeeeeyZyyZy ooooYsYYsYw amp fMtkZscy frac14Desirablefrac12 amp lt200 mgdl

CkkMZjykb gkbZfjLd frac14B rderline high risk) amp 200amp239 mgdl

gkbZfjLd frac14High risk) amp gt 240 mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzz

ZZ ss

hhhh amp

frac141frac12 dks s ordf syLVky VLV fdV

fjtasV R1amp dksysLVordfky fjtVsa

fjtasV R2amp dksysLVordfky LVSMMZ frac14200mgdlfrac12

2 Vs ~wcLV V3 flje frac14QkLfVaxfrac12

llllsss s yyyEEEEiiiiyamplhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkamp 1- rh Vs ~c f E rjg l Z sLV V w s ekd djamp

Blank (B) Standard (S) Test (T)

Vs amp amp 10microLLVfrac14lhjeIykTekfrac12

fjtsaV R2 amp 10 microL ampampampamp

fjtasV R1 1000 microL 1000 microL 1000 microL

frac14frac14frac14frac14iifrac12frac12frac12frac12 vPNh rjg feyks oa 370 C ij 10 fe V ds fy k e VsEizspj ij 30 fe V ds fy ba w s sADcV dja

frac14frac14frac14frac14iiifrac12frac12frac12frac12 Cysd fjts a sV dja UV kjk Cys Ad l sfrac14frac14frac14frac14ivfrac12frac12frac12frac12 LVSa Z ds ckn VsLV dk ctkcsrsquok ysAMM Zfrac14frac14frac14frac14vfrac12frac12frac12frac12 fns xs QkeqZyk kjk dsYdqysV djAs

Calculation-

lhje Vks syLVordfks = Abs rbance f Test X 200Vy dk s y frac14mgdlfrac12 Abs rbance f standard

68

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 70: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

2 llllhhhhjjjjeeee HDL ddddkkkksss s LLLLVVVVsss s ordfordfordfordf sss s ddddyyyy ampampampampaaa a (Serum HDL Cholesterol estimation)yyyy kkkkyyyy ddddkkkk vvvvkkkk

frac14frac14frac14frac141111frac12frac12frac12frac12 kkkkeeeeZZZ Z sss syyyy ooooYYYYwww w

yks fjLd frac14Low riskfrac12 amp ge 60mgdl

gkbZ fjLd frac14High riskfrac12 amp lt 40mgdl

vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhamp

HDL dks s ordf syLVky VLV fdV

fjtsV R1 amp dksys ordfky fjtsa LV UV frac14Cholesterol reagentfrac12

fjtasV R2 amp fizflfiVsfVa sUV frac14Precipitating reagentfrac12x fjt

fjtasV R3 amp HDL dksysLVordfksy LVSaMMZ frac14HDL Cholesterol Standard 50 mgdl frac12

frac142frac12 Vs ~cLV V wfrac143frac12 lhje frac14QkLfVaxfrac12 frac144frac12 ekbdzkfiis sV frac145frac12 dyksfjehVj llllsss s yyyEEEEiiiiyamp lhjeIykTek frac149amp12 hrs Fasting frac12

ffffofofofofkkkkampampampamp HDL Cholesterol Seperation

Step-1

Vs 200 microLLVfrac14lhjeIykTekfrac12 fjts 200 microLUV R2 (fizflfiVfVa ss x fjtUV)

(ii) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(iii) 2000 rpm ij 15 fe V ds fy ls ordfhparawt djsa oa lqij aVsV dks vyx djsAaUV s

HDL Cholesterol estimation

Step-2

Blank (B) Standard (S) Test (T)

69

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 71: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

lqij asVsV (fr m step 1) amp amp 100 microL

fjts zflfiVfVa s amp 100 microL ampUV R3 (fi s x fjtUV)

fjts s sLVordfky LVSMMZ) 1000 microL 1000 microL 1000microLUV R1 (HDL dky

(iv) vPNh rjg feyks oa 10 fe V ds fy e Vs zspj ij bDcV djsEi w s A

(vi) CySa sUV kjk kybZtj dks Zer ij lsV djad fjt sA

(vii) LVSMMZ ds ckn VsLV dk ctkcsZrsquok ysA

Calculation-

HDL Cholesterol Concentration frac14mgdlfrac12 = Abs rbance f Test X 50 X 2

Abs rbance f standard

2= Diluti n fact r as sample is diluted 11 in step 1

For LDL ddddkkkksss s ss ordfordfordfordfyyyyss kkkkyyyyamp Friedewaldrsquos equation kjk fdk tkrk gSampLLLLVVVV

LDL ddddkkkksss s ss ordfordfordfordf = Vks s sLVordf ordfkbfXyljkbM amp HDL Cholesterolyyyyss Vy dky ky amp VLLLLVVVVkkkkyyyy 5

kkkkbbbbffffXXXXyyyylllljjjjkkkkbbbbMMMM ttttkkkkbbbba eeeea ffffVVVVdddd ffff kkkkkkkkjjjjkkkk (Serum Triglyceride enzymatic3333 LLLLkkkkhhhhjjjjeeee VVVVordfordfordfordf ddddkkkk aa sss s ZZZ Z estimation) ampampampamp keZy osYq amp Male ndash 60 - 165 mgdL

Female ndash 40- 140 mgdL

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VordfkbfXyljkbM ofdZax fjtsaaV R1

2amp LVSaMMZ fjtsaV R2frac14200 mgdl) fMLVy okVj 3amp VsLV V~wc 4amp ekbdzkfiis sV 5amp dyksfjehVj 6amp vkVks kykbtj

llllsss s yyyEEEEiiiiyamplhjeIykTek ffffofofofofkkkkampampampamp Mannual Method

1 V~cka ij hps fy[ks ltax l+ s yscy yxkdj fiisV Mkysw s amp

70

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 72: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

VsLVfrac14lhjeIykTekfrac12 amp amp 5 microL

LVSaMMZ fjtsaV R2 amp 5 microL amp fMLVhy okVj 5 microL amp amp

2222ampampampamp vPNh rjg feykdj 370 las- rkiek esa 10 fe V rd j[ksAa3amp VsLV o LVSaMMZ dk OD ysaA

Calculation ampampampamp Lkhje VordfkbfXyljkbM mgdl= Abs rbance f Test (Sample) X 200

Abs rbance f standard

For Autoanalyser-

Blank (B) Standard (S) Test (T)

ofdZax fjtsaV R1 1000 microL 1000 microL 1000 microL

LVSaMMZ fjtsaV R2 amp 10 microL amp VsLVfrac14lhjeIykTekfrac12 amp amp 10 microL

71

G-6PD Deficiency Test

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac14ifrac12 CyM lSEiy EDTA Vial esa df=r djsAafrac14iifrac12 G-6 PD VsLV fdV

Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

ofofofofddddZZZZ sss s SSkkkkjjjj ddddjjjj kkkk frac14frac14frac14frac14Working Reagent Preprationfrac12frac12frac12frac12xxxx ffffjjjjttttUUUUVVVV RRRRkkkkSS

llllkkkkYYYYqqqq s s igys fjts s 0-5ml fjts s feyksAallll ampampampamp 1111- mikx d UV R1 oky dk UV R2 ea fjts s srq rSkj gSAUV R3- mikx g

ffffofofofofkkkkampampampamp Step-1111 js s s s Skj dj kAM ly fgeklhyV frac14Red cell hemolysatefrac12 Rk

fMLVhYM okVj amp 2-5 ml Qzs amp 0-05mll CyM

vPNh rjg feyksa oa 5 fe V ds fy e VsEizspj frac1415amp30 0Cfrac12 ij j[k nsAaStep- 2222 (a) 1 ml fgeklhysV oa lkYw s vPNh rjg feykAs l 1 dk

(b) vc rqjUr 2 ml fjtsUV 3 feykA (c) oky dks Yqfef e Qksby ls lhy djas vkSj 370 ij okVjckFk

ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

ffffjjjjttttYYYYVVVV (Result)- (Decolorization Time)- keZy lCtDVs (Normal subject) amp 30amp60 fe V G-6 PD Ms s s a sfQflUV lCtDV (Deficient subject) amp 140 fe V l 24 kVA G-6 PD ds qN fjtYV vkojysi djrs gS keZy iqk ls rFkkfjjl (Carriers) amp d s

vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

ww oZooZoLLLLFFFFkkkkkkkk frac14frac14frac14frac14Pregnancyfrac12frac12frac12frac12 ddddhhhh ttttkkkkppppampampampamp frac14frac14frac14frac14LLLLVordfVordfVordfVordfhhhhiiii kkkkjjjjkkkkfrac12frac12frac12frac12ffffjjjj kkkkjjjjkkkk xxxxHHHHkkkkkkkk aaww ZZ aa

ffffjjjj ddddkkkk w eeeew www w ss w w kkkk yyyy kkkks ampampampamps 1111 d lkQ lw[ks Xykl ckVy esa wfj dk ew k ysAa2 xHkkZoLFkk dh lgh tkp ds fy lqcg d igys w wa s fj dk e k fyk tk k pkfg] ijarq dHkh Hkh fy x rkts w s ew s ls Hkh tka SAfj d p dh tk ldrh g

ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

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78

Veneral disease research Laboratry testfrac12frac12frac12frac12

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79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

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80

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81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

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82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

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83

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84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

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Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 73: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

G-6PD Deficiency Test

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Reagent 1 - Substrate Reagent 2 - Buffer PH 85 Reagent 3 - Mineral oil

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ess w s sbDcV djA

Observation- iz s MkdZ Cyw ls js a s s es yx skjEHk ea fMl ijiy dyj ps at gk okyk le ks s aVs ds fy Qkyks sa 30 fe V ds ba aV djA vfkde 6 k vi dj Vjoy lsA

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vU 90 fe V ls dqN akVs rd dk le yrs s gSA

72

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ffffofofofofkkkkampampampamp

1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

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74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

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IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

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zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

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76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

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77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

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78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

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IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 74: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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1 vkids ijhkk milkk frac14Test Devicefrac12 ij ^^S ew k frac14Samplefrac12 dk f rsquokk ] fjtYV

foUMks ij ^^C frac14dUVordfks s Sj ^^T frac14VsLV ks sy k=frac12 dk f rsquokk vk =frac12 dk f rsquokk LiV i lc k gqvk gSA 2 ijhkk milkk frac14Test devicefrac12 dks lery lrg ij j[ksAa3 Mordfkij dh enn ls w w ~Bk dj yAfj dk e k bdV as

4 w s ew s dh rh cwns ^^S dk f rsquokk c h txg ij MkysAfj d a a aIIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp d ckj w w s ds ckn vkidks w w a sfj dk e k Mky fj dk e k fjtYV foMkls xqtjrk gqvk fn[kkbZ ns a s esa mHkjrh gqbZ ykb ks ds v qlkj vkidsxk] vc fjtYV foMkijhkk dk ifjkke bl izdkj gkxkamp ifjkke ns s[k s ds fy 10 fe V rd bartkj djsaA vkSj 1 kaVs ckn ns[ksA

frac14afrac12 llllddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn VsLV foaMks ij ^^C esa d vkSj ^^T esa d k h nks vyxampvyx cSx h frac14Purplefrac12 ykb fn[kkbZ nsaA frac14bfrac12 ddddkkkkjjjjkkkkRRRReeeeddddampampampamp fn ^^C Vs a s es ds Sx h frac14Purplefrac12 ykb fn[kkbZ ns rkLV foMk a oy d c s 5 fe V das] rkfd vkidk ijhkk dkjkRed ds i esa LiV gks tkA frac14bfrac12 vvvviiiizzz z w qtj s ds ckn Hkh Vs aMks es dkbZeeeekkkkffffkkkkdddd ampampampamp fn Urine dk e k x LV fo a s Hkh ykb mHkjs rks vkidk ijhkke vizekfkd gSA

73

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

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llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

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iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 75: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ffffjjjjkkkk VhVhVhVhtttt kkkkjjjjkkkk IIIIyyyykkkktttteeeekkkkffffMMMMe oe oe oe okkkkooooDDDDllll oooo QQQQffffYYYYlllliiiijjjjeeee (Malaria Antigen foreyeyeyeyssss aaa a sss s sss s aaa a sss s sss s Pvivax amp P Falciparum)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1 VsLV V~wc 2 VsLV V~w s SMfrac12c jd frac14LV3 VsLV fdV frac14frac14frac14frac14 Pvivex amp P Falciparum frac12frac12frac12frac12

ffffofofofofkkkkampampampamp 1 jDr dk ew k yAas2 d cwn jDr dh VsLV V~w a ys s ykfla aV frac14Lysing reagentfrac12 Mkyaa c es dj mlea x fjts As3 ykblM jDr frac14Lysed Bloodfrac12 ew s dks VsLV dkMZ ds d xM~Ms frac14Wellfrac12 esa MkysaA 4 vc ykblM jDr esa fMiLVhd dks rc rd j[ks] tc rd dh jDr ew s dks lks[k frac14Abs rbfrac12 k ysA 5 fMiLVhd ds f pys Hkkx ij d cwan fMVsDl fjtsaV dh MkysaA 6 tc fMVsDl fjtsaV lks[k fyk tk rc okfrsquokax fjtsaV ls ykbtM jDr dks lkQ dj nsaA IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12

llllddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp fMiLVhd ij d iryh yky js[kk vkSj lkFk eas czksds ykb frac14Vw w s s rks ldkjkRed ifjkke gSAVhampVVh j[kkfrac12 gk ddddkkkkjjjjkkkkRRRReeeedddd iiiiffffjjjjkkkkkkkkeeeeampampampamp ds zkd ykb gks s rks dkjkRed ifjkke gSAoy c s

74

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

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iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 76: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ZZZZ LLLLs VVVVs (Typhoid Card Test)VVVVkkkkbbbbQQQQkkkkbbbbMMMM ddddkkkkMMMMampampampamp VVVVss

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VkbQkbM VsLV dhV Mordfkij] cQj lkYql

ffffofofofofkkkkampampampamp 1- 5 microl lhjeIyktek Mordfkij dh lgkrk ls ls s foa s frac14xMlts sa MkysAEiy frac14Sfrac12 fy[ka Mk frac12 e a2 rRirsquopkr~ 2 cawns cQj lkYqrsquok dh MkyasA 3 5 fe V rd ifjkke ds fy bartkj djsAa

IIIIkkkkffffjjjjkkkkkkkkeeeeampampampamp frac14afrac12 ldkjkRedamp fn VsLV foaMksa ij ^^C eas d vkSj ^^T esa xqykchcSx ykbZ fn[kkbZ nsAafrac14bfrac12 dkjkRedamp fn ^^C Vs a s es ds qykchcSx h ykb fn[kkbZ nsLV foMk a oy d x A

75

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 77: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

esesesesVVVVkkkkMMMM QQQQss aa ss fqffqfVVVV s s s srsquorsquorsquorsquokkkk ffffooooffffkkkk kkkkjjjjkkkk (Determination ofDVjDVjDVjDVj ddddhhhh ttttkkkkpppp yyyyVsVsVsVsDDDDllll XXXXyyyyss aa ss qq Rheumatoid Arthritis factor by the latex agglutination technique-

RA factor)

vvvvkkkkoooodddd llllkkkkeeeexxxxhzhhzhampampampamp 1amp VsLV IysV 2amp LVhvja a

zz

hx jkM 3amp VsLV V~wc 5 e-y-4amp ekbdzkfiis sV 5amp f xs W a ordf sfVo o ikftfVo dVky lhjkA 6amp ys s sVkM QsDVj frac14RFfrac12 fjtsaVDl e VA 7amp Nacl 0-85 izfrrsquokr~ lkYql

ffffofofofofkkkkamp 1 VsLV] daVordfks Sj ys sDl frac14RFfrac12 fjtsV dks e Vs zsy vk V a Eipj ij ykA 2amp VsLV vkSj daVordfks s 15 lks s ql ls MkyqV djasAy khjk dk fMe DykjkbM lkY3amp MkyqV fd x lkYql dh dampd cwn Vs sV esa MkyssaAa LV Iy4amp Bhd ls fgykdj ysVsDl frac14RFfrac12 fjtsaV dh damp d cawn VsLV IysV esa MkysaA 5amp LVhvja a s shx jkM kjk Bhd l feDl djA 6amp 2 fe V irsquopkr~] IysV dh tka s vkSj daVordfky khjk dks VsLV khjk ls rqy k djap dja s sA 7amp fn dksbZ khjk ikftfVo ifjkke fn[kkrk gS rks LVs sAi 3amp6 fjihV dja

76

ffffMMMMiiiiLLLLVVVVhhhhdddd VVVVLsLLsLVVVV kkkkjjjjkkkks ggggs iiiisss s sss s llllrrrrgggghhhh aaa a aaa aVVVVkkkkbbbbffffVVVVllll B VVVVhhhhtttt ddddhhhh ttttkkkkpamppamppamppampfrac14frac14frac14frac14Dipstick test for

hepatitis B Surface antigenfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp 1amp VsLV fdV amp fMiLVhd] fjtsaV oa daVordfksy

ffffofofofofkkkk amp 1amp Vs ordfhi ij jks acj fy[kALV LV xh dk ke k as2amp VsLV LVordfhi ij nks fjk gks s gSar A fjk rdquoArdquo o fjk rdquoBrdquo A 3amp d cawn lhje dh fjk rdquoArdquo ij MkysaA 4amp vc lhje dks fjk rdquoBrdquo rd cg s nsaA 5amp 10amp20 fe V rd ba s fQj fjk rdquoBrdquo dk ns artkj dja s [kAs6amp d yky ja ~Vh fn[kkbZ ns rks ifjkke ldkjkRed frac14Positivefrac12 gSAx dh iV7amp vxj yky ja ~Vh fn[kkbZ k ns rks ifjkke dkjkRedfrac14Negativefrac12 gSax dh iV A

77

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

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79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

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80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

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81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

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82

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83

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84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

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amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

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Page 78: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

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77

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78

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80

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81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

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82

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83

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84

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frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 79: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

ffffllllffffQQQQyyyyllll ddddkkkk jjjjkkkksss sxxxx ffff nknknknk ampampampamp frac14frac14frac14frac14Dark fieldfrac12frac12frac12frac12

1111 vvvvkkkkjjjjhhhh iiiiBBBBHHHHkkkkffffeeee iiiijjjjhhhhkkkkkkkk rrrrdddd hhhhddddaaa a sss s `` ` www w

1 kko dh lrg dks ls Sj xkt lykb vk a s lkQ dj k pkfgA 2 pks s pkjks rjQ ls nok dj dqN can rjy lkQ no dks LykkbM ij j[kV frac14kkofrac12 dk a w z

ys k pkfgA a a ykb Mkfy] doj fLyi yxkdj ml kjh i w3 mles d cwn ls s rqjar gh] va s `BHkfe k

daVordfkLV ekbdzkLdks s sa fVordfikf k iSfyMe ds fy ijhkk dj k pkfgAi e s

2222 fffflllljjjjkkkksss syyyykkkktttthhhhampampampamp lkekU aVhckMh ijhkk 1 QykSDqysrsquok frac14VDRLfrac12 2 okljeS dksYEkj frac14CFTfrac12 3 XyqfV srsquok

ffffoooorsquorsquorsquorsquokkkkkkkk ffffVVVVsss s ordfordfordfordf ss aaa a WWiiiikkkkffff eeeeyyyys s VVVVhhhhcccckkkkMMMMhhhh iiiijjjjhhhhkkkkkkkkW ampampampampW 1 FLA- ABS ijhkk 2 TPI 3 fgekXyqfV rsquok s

fyikbs zMksfQy aVhckMh ijhkk frac14STSfrac12 vvvvkkkkoooorsquorsquorsquorsquodddd llllkkkkeeeexxxxzzzzhhhhampampampamp frac141frac12 LykbM 2 r qdjhr aVht frac14dkfMZkfyf frac12s3 lasUVordfhparawt ersquokh

78

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 80: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

Veneral disease research Laboratry testfrac12frac12frac12frac12

fed fjx k 3 x 12 bph Vffffofofofofkkkkamp 1 VDRL ndash 76 x 50 fe-yh- LykbM + fljs a a ~wc ds lkFk fdk tkrk gSA V~wc ls ijhkk LykbM ls ijhkk 0-016 fe-yh-0-5 fe-yh- f fdz flje dks V~wc esa ysaA 0-5 fe-yh- r qdfjr aVht frac14dkfMZksfyfi frac12 feykaA

fljdk vkSj 0-01 fe-fy- r qdfjr aVht dks LykbM ij ysaA kaf=d LykbM jksVsVj ij LykbM kqekaA

5 fe V rd fgykaA 2000 vkj-ih-e- ij lsUVordfhparawt djsaA

amp izRk fxz s SA VDRL VkbZVj xkSkk flfQfyl eas xrsquok VDRL ldkjkRed ek k tkrk g s132 ek=k rd fn[kkrh gSA

79

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 81: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

HCV jjjjsss sffffiiiiMMMM VsVsVsVsLLLLVVVV (HCV rapid testfrac12frac12frac12frac12

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV dhVamp 1 VsLV dlas sV 2 IykfLVd fiisV 3 cQj lkYql frac14Buffer S luti nfrac12

ffffofofofofkkkkampampampamp 1 ikmp dks [kkys as oa VsLV dSlsV dks lery LFkk ij j[ksAa2 ys lhV k f My dh lgkrk ls fizd djAas3 IykfLVd fiisV dh lgkrk ls jDr dks df=r djsAa4 dSlsV ij S dk f rsquokk c s os + s s a d can jDr Mkyay frac14xMltfrac12 e w As5 15 fe V ckn ifjkke ilt+asA

iiiiffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp iiiikkkkWWW a Z ns da ordfks Sj VLV jht sWffffttttffffVVVVoampoampoampoamp jxh ykb frac14C l ured linefrac12 fn[kkb V y jht ^^C vk^^T rc Vs WftfVo gSALV ikffff xxxxsss s a a ordfky jht ^^C eas fn[kkbZ ns ijrq VLV jht ^^T esaVVVVhhhhoampoampoampoamp d jxh ykb dV s a sb xh ykb k fn[kkbdks Z ja Z ns rc VsLV f xsVho gSA

bbbb oooofsffsfyyyyMMMMampampampamp fn dkss s Z Hkh ja s k d ja sLV jht ^^T eb xh ykb gh gk xh ykb V asgks rks ifjkke b os SAfyM g

80

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 82: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

pppp----vkvkvkvkbbbbZZ----OOOOgggghhhh aaVhVhVhVhtttt VsVsVsVsLLLLVVVV ampampampamp(H V Antigen test)ZZ aa

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 p-vkbZ-Ogh- 1amp2 VLV fMokbls sl 2 sls frac14assay diluentfrac12 MkYqoasV 3 fMLikts +scy fiisV 4 ys lhV k hMy

ffffofofofofkkkkampampampamp 1 jDr dk ew k fMLiksts sV ls ysAcy fii a2 d cwn jDr dks VLV fMokblsl ds ls sy ^^S es MkysaAa s Eiyo a 3 rRirsquopkr nks cwa sls MkYqoa sAn s aV frac14 assay diluent frac12 dh Mky4 10amp15 fe V irsquopkr~ ifjkke ilt+sAa

IIIIkkkkffffjjjjkkkkkkkkeeee frac14frac14frac14frac14Resultfrac12frac12frac12frac12ampampampamp d ja ~Vh frac14C l ur Bandfrac12 ckh rjQ dh fjtYV foMks es vkrh gS rks Vsxh iV a a a LV lgh gSA nka aMks es VsLV caM 1 esa jxh iV~Vh vk rks HIV-1 vkSj VsLV csa sh rjQ fjtYV fo a s a M 2 ea ja ~ s HIV-2xh iVVh vk rkffff xxxxsss s axh iV~Vh daVordfks sa fn[kkbZ ns rks fjtYV f xs SAffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp d j y fjt e fVo giiiikkkkWWWW s k nks ls vfkd jaxh iV~Vh fjtYV foaMks es vk] fjtYVffffttttffffVVVVoooo ffffjjjjttttYYYYVVVVampampampamp nk a ikWftfVo gSA bbbb oooosss s a s es dkbZ Hkh jaxh iV~Vh k vk rks fjtYV b ofyMffffyyyyMMMM ffffjjjjttttYYYYVVVVampampampamp fjtYV foMk a s sgSA

81

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 83: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

jjjjffffiiiiMMMMsss s CK-MB VsVsVsVsLLLLVVVV (Rapid CK-MB Test )

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 js sfiM CK-MB VLV fMokbl 2 fiisV 3 ys lhV k fizfdax hMy

ffffofofofofkkkk ampampampamp 1amp fiisV dh lgkrk ls ls s sy frac14Sample wellfrac12 ea 2amp3 ca sAEiy] lEiy o s w aan Mky2amp 10 fe V ckn ifjkke ilt+sAa

bbbb oooofsffsfyyyyMMMMampampampamp 10 fe V irsquopkrss daVks s dks Z ja Vh fn[kkbZ k ns rksy fjk ea b xh iV ifjkke

iiiiffffjjjjkkkkkkkkeeeeampampampamp iiiikkkkWWWWffffttttffffVVVVoampoampoampoamp 10 fe V irsquopkr~ nks ja ~Vkaxh ifV fn[kkbZ nsa frac14CTfrac12 rks ifjkke frac14Resultfrac12

ikWftfVo gSA ffff xxxxfsffsfVVVVoampoampoampoampss 10 fe V irsquopkr~ d gh ja ~Vh daVordfky fjk ^^Ceasxh iV s fn[kkbZ ns oa

Vs sLV fjk ^^Tea dksbZ ja ~Vh k gksxh iV rks ifjkke f xs SAfVo g~ ordf ~

b os SAfyM g

82

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 84: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

MsMsMsMsxxxxaaa a www w QQQQhhhhoooojjjj VsVsVsVsLLLLVVVV (Rapid Test for Dengue Fever)

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1 VsLV fdV 2 VsLV dSlsV 3 MkyqosaV vkSj Mordfkij 4 ekbdzksfiisV 5 microl vkSj 10 microl

ffffofofofofkkkkampampampamp 1 VsLV fdV dSlsV dks lery lrg ij j[ksAa2 jDramp jDr kjk Msaxw dh tkp dj s ds fy 10 microl jDr dk ls SlV i vfdra Eiy] d s s als sy frac14xM~lts sa fiiV dh lgkrk ls MkysAEiy o frac12 e s a3 lhjeamp lhje kjk Msxw dh tkp dj s ds fy 5 microl lhje dSlsV ij vfdr la sa a Eiy y frac14xM s a s Aos ~ltfrac12 es fiiV dh lgkrk ls Mkysa4 irsquopkr 3 cwna qoV dh ls y frac14xM~ sfrac12 es MkysAa s Mky sa Eiy os lt a a5 5 fe V ckn fjtYV ilt+sA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp ddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Nagativefrac12frac12frac12frac12ampampampamp fia a ~Vh frac14Bandfrac12 da ordfky fjk eas vkrh gS rkd jx dh d iV V s s

ifjkke dkjkRed gSaA llllddddkkkkjjjjkkkkRRRReeeedddd frac14frac14frac14frac14Positivefrac12frac12frac12frac12ampampampamp nks fia a ~Vhka frac14Bandsfrac12vkrh gSaAd jx dh iVd daVks Sj d VLV fjk es rks ifjkke ldkjkRed gSAordf y fjk vk s a bbbb oooosss s a a sUM iV~Vh frac14Bandfrac12 VsLV fjk ea vkrh gS vkSjffffyMyMyMyM frac14frac14frac14frac14 nvalidfrac12frac12frac12frac12ampampampamp fid jx dh d c sda ordfky fjk ea dks Z iV~Vh frac14Bandfrac12 gh vkrh gS rks VLV ifjkke b os SAV s s b s fyM g

83

ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

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ffffppppdddd xxxxfqffqf kkkk VsVsVsVsLLLLVVVV (Rapid Test for Chikunguniya)qq

vvvvkkkkoooodddd llllkkkkeeeexxxxzzzzhhhhampampampamp

1111 VVVVLsLLsLVVVV ffffddddVVVVamp 1 Vss sLV fMokbl 2 cQj lkYql 3 xks a qxVsYM dkt4 Mordfkij

ffffofofofofkkkkamp 1 lHkh fjtsa a Lifrsquokes s dejs ds rkiek ij j[kaV o s dk sA 2 nks cawn cQj lkYql VsLV fMokbl ^^Tesa MkyasA 3 rRirsquopkr~ nks cwan lhjeIykTek feykA 4 pkj cawnas cQj lkYql dh MkysaA 5 vc nks cwns xks atqxs sAa a YM dk V dh Mkya6 rRirsquopkr~ pkj cawns cQj lkYql dh Mkyas vkSj ifjkke ilt+Asa7 ifjkke tYnh ilt+s 5 fe V ls igysA

iiiiffffjjjjkkkkkkkkeeee frac14Resultfrac12amp

1111 ffff xxxxfsffsfVVVVoampoampoampoamp fn dss s aa a ordfky fjt ^^Cea vkrk gS rkoy d yky jx dk LikV frac14kCckfrac12 dV s s s Vs s SALV dk fjtYV f xfVo g

WWWW ooo s yky jx ds LikV frac14kCcfrac12 d dVks Sj d Vs2222 iiiikkkkffffttttffffVVVVoampfn nk a s a ordf y ^^C vk LV ^^T fjt es vkrs gS rks fjts WftfVo gSAa UV ik

3333 bbbb oooosss s a s sLV ^^T fjt eas vkrk gS rks fjtYVffffyyyyMMMMampampampampfn yky jx dk LikV doy Vb os SAfyM g

84

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85

Page 86: Pathology Tests - Madhya Pradesh · MMMMkkkkW0000 cccchhhh----,,,,llll---vvvvkkkksggg jjjjhhhh ¼,¼,¼,¼,eeee---MMMMhhhh½½½½ llllppaa p kkkyyyydddd ¼Vª¼Vª¼Vªffffs ½suauauauaxxxx½½½

llllhhhh----ffffjjjjsss s zkzzkzkksss s VVVVsss sffffDDDDVoVoVoVo iiii VhVhVhVh LLLLVVVV (Rapid C- Reative Protein Test)

flje esa lh-fjfDVo is zkVh dh lks na zrk 06 fe-yh xzke izfryhVj k mlls vfkd gk s s ij ysVsDl ikfVZdYl tks fd UVh gw fDVo is zkVh ls dkVs M gks s s gS ese lh-fj s r a Xyw s Z ns SAfV rsquok fn[kkb rk g

EEEEiiiiyyyyampampampamplhjellllsss s

ffffofofofofkkkkamp frac14ifrac12 lHkh fjts Sj lhje dks dejs ds rkiek ij j[ksaUV vk A frac14iifrac12 f E fyf[kr rjhds ls fjts Sj lhje dks fpfUgr xks s es MkysUV vk y a A

frac14afrac12 d cawn ikftfVo dUVordfksy + d cawn ysVsDl Vht afrac14bfrac12 d cwn f xs ordfky + d cwn ysVDl aVht a fVo dUV s a sfrac14cfrac12 50 e-y lhje + d cwan ysVs aVht Dl

tcy LVhd lfrac14iiifrac12 fMLiks s s vPNh rjg feykasA frac14ivfrac12 dkMZ dks 100 rpm ij 2 fe V ds fy kqeks vkSj fjtYV ns[kasA

Interpretation ndash ikftfVo dUVordfksy amp XywfV rsquok sf xs ordfks amp yqfV rsquok gh VLV os SAfVo dUV y s s fyM gVs s amp Xyw rsquok frac14ikftfVofrac12 CRP= 6mgdlLV lEiy fV s

amp Xyw s sfV rsquok gh frac14f xfVofrac12 CRP= 6mgdl

85


LLLL IIII AAAA NNNN CCCC LL OOOO UUU PPP IIII CC · a s 0 9 3 - 7 9 4 6 s.e.c. registration number a llll llll iiii aaaa nnnn cccc eeee gggg lll oooo bbbb aaaa lll gggg rrrr oooo

LLLL IIII AAAA NNNN CCCC LL OOOO UUU PPP IIII CC · a s 0 9 3 - 7 9 4 6 s.e.c. registration number a llll llll iiii aaaa nnnn cccc eeee gggg lll oooo bbbb aaaa lll gggg rrrr oooo

p t t i 1. means “twins” in Italian - chefgeoff.comS_KIDS_MENU... · pppp llll eeee cccc eeee rrr ... uuuu iii i oooo uuuu aaaa aaaa zzzz qqqq eeee eee e yyyy uuuu ddd d kkk k

p t t i 1. means “twins” in Italian - chefgeoff.comS_KIDS_MENU... · pppp llll eeee cccc eeee rrr ... uuuu iii i oooo uuuu aaaa aaaa zzzz qqqq eeee eee e yyyy uuuu ddd d kkk k

MMMMM IIII CCCCCC HHHH AAA EEEE LLLL HHHH OOO …michaelhope.net/hallnotes.pdf · MMMMM IIII CCCCCC HHHH AAA EEEE LLLL HHHH OOO PPPP EEEE HallelujahHallelujah ... "I love that music

MMMMM IIII CCCCCC HHHH AAA EEEE LLLL HHHH OOO …michaelhope.net/hallnotes.pdf · MMMMM IIII CCCCCC HHHH AAA EEEE LLLL HHHH OOO PPPP EEEE HallelujahHallelujah ... "I love that music

Mysterious Bog People from the past WWWW hhhh oooo a a a a rrrr eeee B B B B oooo gggg P P P P eeee oooo pppp llll eeee ???? PPPP rrrr eeee ssss eeee rrrr.

Mysterious Bog People from the past WWWW hhhh oooo a a a a rrrr eeee B B B B oooo gggg P P P P eeee oooo pppp llll eeee ???? PPPP rrrr eeee ssss eeee rrrr.

LLLL OOOO 2015 - ospreyiii.co.uk · The official newsletter of the The official newsletter of the Fareham Sailing & Motor Boat Club 2015 CCCC LLLL OOOO SSS S EEEE QQQQ UUUU

LLLL OOOO 2015 - ospreyiii.co.uk · The official newsletter of the The official newsletter of the Fareham Sailing & Motor Boat Club 2015 CCCC LLLL OOOO SSS S EEEE QQQQ UUUU

PPPP - Staffordshiremoderngov.staffordshire.gov.uk/documents/s7700/Microsoft PowerPoint... · 1 PPPP uuuu bbbb llll iiii c cc c HHHH eeee aaaa llll tttt h hh h Produced by SSPCT Public

PPPP - Staffordshiremoderngov.staffordshire.gov.uk/documents/s7700/Microsoft PowerPoint... · 1 PPPP uuuu bbbb llll iiii c cc c HHHH eeee aaaa llll tttt h hh h Produced by SSPCT Public

Placido Rizzotto CCCC oooo rrrr llll eeee oooo nnnn eeee, 2 2 2 2 2 g g g g eeee nnnn nnnn aaaa iiii oooo 1 1 1 1 1 9999 1111 4444 – C C C C C oooo rrrr.

Placido Rizzotto CCCC oooo rrrr llll eeee oooo nnnn eeee, 2 2 2 2 2 g g g g eeee nnnn nnnn aaaa iiii oooo 1 1 1 1 1 9999 1111 4444 – C C C C C oooo rrrr.

207.20 Internal Affairs - REV2 09JUN15 - NJ TRANSIT · 2020. 3. 27. · NNNN JJJJ TTTT RRRR AAAA NNNN SSSS IIII TTTT PPPP OOOO LLLL IIII CCCC EEEE DDDD EEEE PPPP AAAA RRRR TTTT MMMM

207.20 Internal Affairs - REV2 09JUN15 - NJ TRANSIT · 2020. 3. 27. · NNNN JJJJ TTTT RRRR AAAA NNNN SSSS IIII TTTT PPPP OOOO LLLL IIII CCCC EEEE DDDD EEEE PPPP AAAA RRRR TTTT MMMM

MATHEMATICS Grade 5 - Edl Shirts Color Red 32 Blue 35 Green 24 Orange 18 Purple 38 Tally Frequency llll llll llll llll llll llll llll lll llll llll llll lll llll llll llll llll llll

MATHEMATICS Grade 5 - Edl Shirts Color Red 32 Blue 35 Green 24 Orange 18 Purple 38 Tally Frequency llll llll llll llll llll llll llll lll llll llll llll lll llll llll llll llll llll

Grandad the Greengrocer Recap - phunkyfoods.co.uk · ffff rrrr oooo kkkk gggg ffff llll rrrr nnnn llll rrrr iiii yyyy kkkk cccc bbbb rrrr oooo tttt eeee uuuu ssss wwww pppp uuuu rrrr

Grandad the Greengrocer Recap - phunkyfoods.co.uk · ffff rrrr oooo kkkk gggg ffff llll rrrr nnnn llll rrrr iiii yyyy kkkk cccc bbbb rrrr oooo tttt eeee uuuu ssss wwww pppp uuuu rrrr

1 IIII mmmm pppp eeee rrrr ffff eeee cccc tttt iiii oooo nnnn ssss IIII nnnn S S S S oooo llll iiii dddd ssss Chapter 5.

1 IIII mmmm pppp eeee rrrr ffff eeee cccc tttt iiii oooo nnnn ssss IIII nnnn S S S S oooo llll iiii dddd ssss Chapter 5.

Versatile Pump Control System - unicous.com · llll llll llll lll llll llll l Data Collection/Reporting llll llll Time-stamped user-definable data sampler llll llll llll llll Head-end

Versatile Pump Control System - unicous.com · llll llll llll lll llll llll l Data Collection/Reporting llll llll Time-stamped user-definable data sampler llll llll llll llll Head-end

P PP RRRR EEEE SSSS RRRR EEEE LLLL EEEE AAAA SSSS … · PPP RRRR EEEE SSSS SSSS RRRR EEEE LLLL EEEE AAAA SSSS EEEE AsiaAsia----Europe looks ahead Europe looks ahead Europe looks

P PP RRRR EEEE SSSS RRRR EEEE LLLL EEEE AAAA SSSS … · PPP RRRR EEEE SSSS SSSS RRRR EEEE LLLL EEEE AAAA SSSS EEEE AsiaAsia----Europe looks ahead Europe looks ahead Europe looks

WWWW eeee llll cccc oooo mmmm eeee T T T T eeee aaaa cccc hhhh eeee rrrr ssss T T T T oooo OOOO uuuu rrrr C C C C llll aaaa ssss ssss.

WWWW eeee llll cccc oooo mmmm eeee T T T T eeee aaaa cccc hhhh eeee rrrr ssss T T T T oooo OOOO uuuu rrrr C C C C llll aaaa ssss ssss.

-UNDERGRADUATE UUUU NNNN SSSS EEEE LLLL I N GGGG D …CCC OOO UUUU NNNN SSSS EEEE LLLL III NNN GGGG COUNSELING AND HUMAN SERVICES DEPARTMENTAL NEWSLETTER V O L U M E 1 , I S S U E

-UNDERGRADUATE UUUU NNNN SSSS EEEE LLLL I N GGGG D …CCC OOO UUUU NNNN SSSS EEEE LLLL III NNN GGGG COUNSELING AND HUMAN SERVICES DEPARTMENTAL NEWSLETTER V O L U M E 1 , I S S U E

1.P P oooo uuuu rrrr qqqq uuuu oooo iiii t t t t rrrr aaaa vvvv aaaa iiii llll llll eeee rrrr s s s s uuuu rrrr l l l l éééé vvvv aaaa llll uuuu aaaa.

1.P P oooo uuuu rrrr qqqq uuuu oooo iiii t t t t rrrr aaaa vvvv aaaa iiii llll llll eeee rrrr s s s s uuuu rrrr l l l l éééé vvvv aaaa llll uuuu aaaa.

EKOSISTEM EKOSISTEM HHHH OOOO MMMM EEEE SSSS TTTT UUUU DDDD YYYY O O O O BBBB JJJJ EEEE CCCC TTTT IIII VVVV EEEE LLLL EEEE SSSS SSSS OOOO NNNN C C C C.

EKOSISTEM EKOSISTEM HHHH OOOO MMMM EEEE SSSS TTTT UUUU DDDD YYYY O O O O BBBB JJJJ EEEE CCCC TTTT IIII VVVV EEEE LLLL EEEE SSSS SSSS OOOO NNNN C C C C.

TTTT hhhh eeee T T T T aaaa llll eeee o o o o ffff M M M M rrrr.... G G G G rrrr iiii mmmm mmmm CCCC llll iiii cccc kkkk h h h h eeee rrrr eeee t t t.

TTTT hhhh eeee T T T T aaaa llll eeee o o o o ffff M M M M rrrr.... G G G G rrrr iiii mmmm mmmm CCCC llll iiii cccc kkkk h h h h eeee rrrr eeee t t t.

I have four sides and two sets of parallel sides. What shape am I? Circle RRRR eeee cccc tttt aaaa nnnn gggg llll eeee Triangle Trapezoid.

I have four sides and two sets of parallel sides. What shape am I? Circle RRRR eeee cccc tttt aaaa nnnn gggg llll eeee Triangle Trapezoid.

Risk Management Course - UKFSC Mgment Material/Risk Course Feb 2008.pdf · Risk Management Course Stockholm 5 – 6 February 2008 . ... PPPP CCCC LLLL IIII NNNN EEEE RRRR EEEE PPPP

Risk Management Course - UKFSC Mgment Material/Risk Course Feb 2008.pdf · Risk Management Course Stockholm 5 – 6 February 2008 . ... PPPP CCCC LLLL IIII NNNN EEEE RRRR EEEE PPPP