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Biochemistry and diagnostic


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Biochemistry and diagnostic

  2. 2. Is the study of chemical proces ses in living organisms, governs all living organisms and living processes.
  3. 3. Much of biochemistry deals with the structures and functions of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules. Today the main focus of pure biochemistry is in understanding how biological molecules give rise to the processes that occur within living cells which in turn relates greatly to the study and understanding of whole organisms.
  4. 4. As an experimental science of biochemistry requires numerous instrumental techniques that enable the development and expansion, some of them are used daily in any laboratory and others are very exclusive. . •Subcellular fractionation, including multiple techniques •Centrifugation •Chromatography •Electrophoresis •radioisotope techniques •PCR •Flow cytometry •Immunoprecipitation •ELISA •Electron Microscope •X-ray Crystallography •Nuclear magnetic resonance •Mass Spectrometry
  5. 5. The most known is the use of radioiodine (Iodine-131) in the treatment of hyperthyroidism and differentiated thyroid cancer. Is a technique that uses specific antibodies to a protein to remove these proteins from the solution. Examples include protein A, protein G, Zysorbin, or adding a second antibody to the solution.
  6. 6. In medicine, diagnosis or clinical propaedeutic is the procedure by which a disease is identified or any condition of health-disease. The medical diagnosis is based symptoms, signs and findings of additional tests to determine what disease a person suffers.
  7. 7. Symptoms Signs Physical Examination Supplementary Examinations
  8. 8. Example: physical experiences are reported by the patient . Not be observed painFatigue
  9. 9. The sings are findings in the patient and are detected by the doctor. Can be seen Example: Fever Edema
  10. 10. It consists of various maneuvers performed by the doctor in the patient Inspection percusion Auscultation Palpation
  11. 11. INSPECTION • is the method of physical examination is done by sight. PALPATION • is the process of examining the body using the sense of touch. Provides information on shape, size, texture, surface moisture, tenderness and mobility. PERCUSION • is a method that is tapped certain body parts during a physical examination with fingers, hands or small instruments to assess the size, consistency, borders and presence or absence of fluid in the body's organs. AUSCULTATION is to listen, either directly or through instruments like the stethoscope, normal or pathological sounds produced by the human body.
  12. 12. They are a setof studies that providevaluableinformatio n tomedical analysis,and either to confirmor givemore c ertaintyto the diagnosis of a disease. Biopsy UltrasoundRadiograph
  13. 13. Biopsy: procedure in which tissue samples under a microscope to observe. Radiograph: noninvasive procedure, which shows soft and solid structures of the body. Ultrasound: uses sound waves to create images of internal oraganos.
  14. 14. Diagnosis and Treatment of Tuberculous Pleural Effusion in 2006
  15. 15. Tuberculous (TB) pleural effusion occurs in approximately 5% of patients with Mycobacterium tuberculosis infection. The HIV pandemic has been associated with a doubling of the incidence of extrapulmonary TB . The definitive diagnosis of TB pleural effusions depends on the demonstration of: The diagnosis can be established in a majori ty of patients from the clinical features pleural fluid examination including cytology Biochemistry Bacteriology pleural biopsy acid-fast bacilli in the sputum pleural fluid pleural biopsy specimens.
  16. 16. A total of nine million new cases and approximately two million deaths from TB were reported in 2004 Although the African region has the highest estimated incidence (356 per 100,000 pop ulation per year) the majority of patients with TB live in the most populous countries of the Asian subc ontinent
  17. 17. TB pleural effusions can manifest as primary or reacti vated disease. is considered the initial event in the pathogenesis of primary TB pleural effusions. •predominantly from: increased capillary permeability and •secondarily from: impairment of lymphatic clearance of p roteins and fluid from the pleural space. because of occlusion of pleural stomata
  18. 18. The definitive diagnosis of TB pleural effusions depends: demonstration of M tuberculosis in:  sputum pleural fluid pleural biopsy specimens. others: demonstration of classical TB granulomas in the pleura and elevated adenosine deaminase (ADA) IFN-_ levels in pleural fluid.
  19. 19. patients with pleur al TB without conc omitant pulmonary disease. Are: sputum negative a nd Therefore: no contagious. Positive: evidence in the diagnosis of TB pleural effusions in areas of low prevalence. Negative: could result from the following: anergy secondary to immunosuppression  recent infection; sequestration of purified protein derivative-reactive T-lymphocyte in pleural space.
  20. 20. • A TB pleural effusion is typically clear and straw colored • it can be turbid or serosanguinous • Pleural fluid pH is usually between 7.30 - 7.40 Pleural Fluid Examination • in patients with HIV coinfection, the yield of pleural fluid microscopy is 20% • Culture requires a minimum of 10 to 100 viable bacilli Pleural Fluid Smear and Culture
  21. 21. • catalyzes the conversion of adenosine and deoxyadenosine to i nosine and deoxyinosine with the release of ammonia. • several studies have explored the usefulness of estimation of AD A activity in the diagnosis of TB pleural effusions pleural fluid ADA level 70 IU/L is highly suggesti ve of TB, while a level 40 IU/L virtually excludes t he diagnosis.
  22. 22. Produced by T-lymphocytes, Several studies have found elevated co ncentrations of INF in TB pleural effusions, which is related to increa sed production at the disease site by effector T cells.
  23. 23. Polymerase chain reaction (PCR) is based on amplification of mycobacterial DNA fragments. Advantages of PCR include rapid diagnosis, improved specificity and sensitivity, a nd no requirement of intact immunity.
  24. 24. The utilization of immunodiagnostics is hindered by its low sensitivity. The Table lists the details regarding various studies using immunologic markers in the diagnosis of TB pleural effusions. Further studies are required to address the clinical utility of these markers.
  25. 25. The patients with extensive or bilateral pleural effusions and sputum positivity are given treatment under category I (treated during intensive phase with four drugs: isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months followed by continuation phase of 4 months with isoniazid and rifampin).
  26. 26. Corticosteroids through their antiinflammatory action may hasten fluid resorption and prevent pleural adhesions during healing. Three randomized trials have inves tigated the possible role of adjunctive oral corticosteroids in TB pleural effusion. A dose of 0.75 to 1 mg/kg/d was used for a period ranging from 4 to 12 weeks .
  27. 27. for yOur attentiOn!!!