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Abstract
Pathology is the study off diagnosis of disease or injury. It involves wide interlinked spectrum of biosciences. There are two major divisions in pathology and several sub divisions. The two divisions are
- Anatomical pathology: it involves study of tissues, organs and even the whole body. It involves chemical, microscopic and macroscopic evaluation of tissues, organs and even the whole body to identify and treat the disease. It is further divided into several sub division. The major one being
- Cytology: study of cells to diagnose a disease. Usually helps in diagnosis of cancer.
- Surgical pathology: it is the analysis of tissues or organs removed surgically from a patient it is used to diagnose disease such as cancer, lipoma, cysts, infection of microbes and etc.
- Forensic pathology: it is the analysis of a cadaver to estimate the precise time and cause of death. It is used to check if the person was under the influence of any drugs or even if the cause of death as overdosing of drugs.
- Clinical pathology is a field of study through which we diagnose and analyze disease and disorders using tissues of our body and fluids produced by human body. It requires knowledge in many fields like biochemistry, microbiology, hematology and etc. It is a very crucial in the medical field as it is most often the primary step in treating a patient. As it gives information an identification of the disease the patient is suffering from and take the necessary protocols to treat him efficiently. The tests done are performed in a lab or a medical center. The tests usually require a wide array of equipment and chemicals. The tests are carried out by trained professionals who can use the equipment correctly to produce accurate test results. There are many divisions of clinical pathology some of are
- Chemical pathology
- Immunopathology
- Clinical microbiology
- Hematopathology
History of pathology
Earliest known recollection of studies of disease was in the Islamic golden age in the Middle East and Italian Renaissance in Western Europe. The person who thought of studying pathology oh human spine was Greek physician Hippocrates. Pathology may seem obvious today, but there is little to no concrete proof of where it exactly generated. During the time of Avicenna (980–1037) science behind infectious disease was being studied which was described in The Canon of Medicine (c. 1020), the skin disease known as scabies was caused by a parasite this information was discovered by the Arabian physician Avenzoar (1091–1161) he was the first physician to do postmortem dissections Antonio Benivieni (1443-1502) regularly performed dissections to determine the reason for death. Many physicians and other medical practioners started following their suit. But it was not until the development of different equipment and discovery of certain tests after that pathology was being recognized as a valued field of study.
Modern experimental pathology
Due to advancements in all fields of biomedical sciences the field of pathology is rapidly advancing. Development of more advanced techniques in the field of microscopy, immunochemistry, microbiology, molecular biology has inevitably led a great path in pathological research. Since pathology includes broad spectrum of biosciences working together its own development is development of other field of studies too.
Clinical pathology branches
1. Chemical pathology
It is the analysis of chemical properties of body fluids to identify any abnormalities with respect to normal or expected result and using this data for identifying the disease patient is suffering
differentiate between a malignant or benign tumor. Physical examination alone cannot correctly diagnose disease with similar signs and symptoms.
- Not only the disease a person is suffering from but also the potential medical conditions that could be faced by a person can also be known.
- It can help us in knowing the onset of the disease and help us preventing the disease from developing any further.
- Some diseases such as AIDS and cancer can only be confirmed by using different pathological techniques.
- It is also helpful in developing antibiotics and generating awareness about super pathogens which are resistant to antibiotics and find new antibiotics which interact differently so its resistance won’t help the pathogen much.
- Diagnostic of genetic disorders using molecular pathological techniques.
- Cancer is detected by multiple and complex chromosomal abnormalities like deletion, amplification, inversion, and etc.
- Helpful in isolation carcinogens.
- Helpful in identifying allergies a person is suffering from.
- Detection of narcotics and illegal drug usage or abuse can be achieved by forensic pathological techniques.
- Can be used to detect abnormalities in endocrine system which creates an imbalance of hormones.
- It is used to detect infertility in both male and female.
- Some tests are required to be done frequently like blood sugar test so a diabetic person can inject insulin accordingly. So machines that can estimate blood sugar level was invented using pathological techniques.
- Pregnancy tests are also a result of pathological knowledge gained and what changes occur in the urine of women who is pregnant and using this knowledge to device a simple kit that can be used by anyone to perform the test.
- Before blood transfusion the donor’s blood goes through various tests to check compatibility so the recipient’s body does not reject the blood or worse the donor has some infectious disease he/she is unaware about.
- It is also used to keep in check the concentration and effect of many therapeutic drugs.
- Tests like ultrasound, MRI, x-ray is critical to confirm an injury and know the extent of it. All imaging and screening tests are important before any surgical procedure.
Some Techniques and equipment used in clinical pathology
Immunoassay Analyzer
It is a device that runs biochemical tests to identify different chemicals and their concentrations.it can perform variety of test all of which are mostly automated.
Flow cytometers
They are used to analyze or quantize the cells in given sample through analyzing the optical properties of the cell. It can analyze thousand particles per second. it is useful in test like complete blood count , which is counting the total number of different cells in the blood sample.it shares similarities to a microscope but it produces automated accurate quantification of optical parameters instead of an image.
Cryostat
It is a device to maintain low cryogenic environment. Low temperatures are maintained using many refrigerating and cryopreserving techniques. That’s the reason behind its similar construction to vacuum flask. It is used to preserve tissue sample or an entire organ.
hemocytometer
The hemocytometer is made of a thick glass slide with a recant angular segment carved into the middle. The segment has perpendicular lines etched by laser. This device is constructed carefully as depth of the segment is also known. The concentration of cells is evaluated through analyzing a specific section of known depth so it contains known volume of sample.
Microscopy
Khetarpal Nursing Home, a multi-specialty to fame nursing home, is set up in year 1986 by Dr. Vinod Khetarpal who is a famous doctor in West Delhi. Khetarpal Nursing Home gives quality restorative consideration at reasonable costs to the patients from both inside and outside Delhi. The center has 15 beds and outfitted with cutting edge hardware and experienced and minding labor to give basic consideration benefits in the divisions of Cardiology, Nephrology, Urology, Gynecology, Paediatrics,Neonatology, Orthopedics, Gastroentology, and Plastic Surgeries. Khetarpal Nursing Home is an eminent Hospital situated at GN-5, Shivaji Enclave, New Delhi 110018. It gives capable medicinal treatment to the patients, best case scenario costs.
Facilities
Indoor Admission Wards Semi-Private/ Private Rooms X-Ray 500 and 100 mAReal Time 3D/4D High Resolution Ultrasound Echocardiography and Tread Mill Test (TMT)Peripheral and Vascular Colour Doppler Operation TheatreGynae and Maternity Wing with CTG Laparoscopic Surgery FOR Gall Stones Hernia Appendix LAVHAccident and Trauma Services and Orthopaedic Surgeries under C-Arm Guidance URO-Surgeries like TURP for Prostate Key Hole operation for Kidney Stones Advance Physiotherapy Neuro SurgeriesE.C.G. Fully Computerized Laboratory and Diagnostic Centre
Instruments
The Clinitek 500 Urinalysis analyzer is a semi-robotized, seat top analyzer. It is intended to peruse Bayer Reagent Strips, for example, Multistix 10 SG or Multistix PRO Reagent Strips. The analyzer is a reflectance spectrophotometer that investigates the shading and force of the light reflected from the reagent territory and reports the outcomes. The analyzer can decide and report the shade of the pee. The person using can enter the clarity for every sample. Alignment is performed naturally each time a reagent strip is run. The analyzer has a touch screen show, printer, push bar and fixed stage which comprise of strip stacking station, hatching/read station and waste canister. During testing a reagent strip is physically dunked into a pee test at that point put on the strip stacking station. The push bar moves the strip to the brooding/read station, where it is tried. When testing is finished, the strip is
dropped into the waste container and the outcomes are printed. It can test for Urinary Glucose, Blood, Creatinine, Bilirubin, Ketones, Leukocyte, Nitrite, pH, Protein, Explicit Gravity and Urobilinogen.
Tests performed
CHEMICAL EXAMINATION:
- Glucose.
- Proteins
SUGAR (GLUCOSE) TEST ("BENEDICT’S QUALITATIVE TEST”)
Principle : Benedict’s test is a commonly used test to detect presence of reducing sugars. A reducing sugar is a carbohydrate possessing either a free aldehyde or free ketone functional for example monosaccharides (eg. glucose, fructose, galactose) and many disaccharides, including lactose and maltose. It is used in laboratories to detect the presence of sugar in urine. Presence of glucose in urine is a sign of Diabetes mellitus.
Procedure of glucose
- Take 5ml of Benedict’s reagent in the test tube.
- Add 8 drops of urine.
- Boil for 2 minute and allow cooling under tap water.
Observation & Result :
Blue clear - Negative Green, no ppt - Trace
- Place a drop of normal saline on a glass slide
- Take a little fecal material by using a stick and mix with a drop of normal Saline.
- Place a cover slip. Result:
- Cells: Pus Cells, Epithelial cells, Erythrocytes
- Parasites
- Crystals
- Vegetables matter
- Undigested ingredients.
- Other findings (Bacteria and yeast)
CHEMICAL EXAMINATION OF STOOL
BENZIDINE TEST
- Microscopic slides
- Applicator stick
- Glacial acetic acid
- 30% H202 solution
- Benzedrine powder Specimen : Stool PROCEDURE :
- Take small amount of Benzedrine powder.
- Add acetic acid to make it acidify it.
- Add about 1.0 ml of H202 and mix well.
- Place a small quantity of stool specimen on a clean and dry slide.
- Place one or two drops of the Benzidine, glacial acetic acid, hydrogen peroxide mixture on the stool specimen on the glass slide.
- Observe change in color. RESULT :
- Change in color is negative - occult blood is not present
- If a change in color from green to blue - occult blood present.
CHEMICAL EXAMINATION OF BLOOD
GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD):
This is a quantative test for G6PD an enzyme in the body. It is mainly used to detect this
enzymes deficiency. It is also used to detect any infections.
PRINCIPLE:
Glucose -6-Phosphate Dehygenase present in hemolysate acts on substrate, Glucose -
– Phosphate (G6O4) and NADP which in presence of PMS decolorizes blue colored
indophenol dye(DCPIP) leaving behind color only due to hemolysate. Enzyme activity
determines the rate of reaction time for discoloration is inversely proportional to
enzyme concentration.
KIT REAGENT
1. Lyse agent
2. Buffer
3. Inert oil
PROCEDURE:
1. Take 20ml blood in a vial.
2. Put 1ml of lysing agent in it.
3. Keep it in refrigerator for 10 mints.
4. Add 5ml of buffer to the powdered detergent.
5. Add 1ml of inert oil in it
6. Mix well and incubate it for 1 hr.
7. Observe the color change.
OBSEVATION :
a) Normal subjects: 30 -60 mints.
b) G-6PD deficient subject (Heterozygous male, homozygous female):140 mints to 24
hrs.
c) G-6PD carriers (Heterozygous female): Some give result which overlap with normal
males, other decolorizes between 90 mints and several hours
