This document summarizes key components of hemostasis including primary and secondary hemostasis. It describes platelet adhesion, activation, aggregation and secretion. Tests for evaluating hemostasis are outlined including bleeding time, platelet function analyzer, and assays for factors, fibrinogen, D-dimer and FDP. Causes and interpretation of abnormal results are provided for tests such as PT, APTT, TT and specific assays of platelet function and coagulation factors.
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This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
Rh typing and its technique , BLOOD TYPING , Rhesus (Rh) typing , procedures of rh typing, process of Rh typing, Test limitations, Sources of Error in Rh Antigen Typing, False positive reactions' reason, False negative reactions' reasons
how to select a healthy donor & care of donor .A healthy donor is one of the most vital part of transfusion medicine for safe transfusion of blood & blood product
An immature red blood cell without a nucleus, having a granular or reticulated appearance when suitably stained.
Reticulocytes are the immature RBC that contain nucleus.
They are originally seen at the site of their formation i.e. bone marrow. They take 2-3 (lays for maturation only about 1-2% of circulating RBCs are Reticulocytes.
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For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
Rh typing and its technique , BLOOD TYPING , Rhesus (Rh) typing , procedures of rh typing, process of Rh typing, Test limitations, Sources of Error in Rh Antigen Typing, False positive reactions' reason, False negative reactions' reasons
how to select a healthy donor & care of donor .A healthy donor is one of the most vital part of transfusion medicine for safe transfusion of blood & blood product
An immature red blood cell without a nucleus, having a granular or reticulated appearance when suitably stained.
Reticulocytes are the immature RBC that contain nucleus.
They are originally seen at the site of their formation i.e. bone marrow. They take 2-3 (lays for maturation only about 1-2% of circulating RBCs are Reticulocytes.
DEFINITION
FACTORS INVOLVED IN BLOOD CLOTTING
SEQUENCE OF CLOTTING MECHANISM
BLOOD CLOT
ANTICLOTTING MECHANISM IN THE BODY
ANTICOAGULANTS
PHYSICAL METHODS TO PREVENT BLOOD CLOTTING
PROCOAGULANTS
TESTS FOR BLOOD CLOTTING
APPLIED PHYSIOLOGY
The presentation deals with the basics of hemorrhage i.e. classification, etiology. It also covers the mechanism of hemostasis and the various methods to achieve hemostasis.
Hope you like it! Suggestions and feedback will always be well appreciated. :)
Brief overview of Haematostasis & its players. Haemostasis is divided into 4 different stages. The first 2 stages are called Primary Haemostasis & Secondary Haemostasis, and the third stage is the natural anticoagulants at its work to stop the propagation of thrombosis and final stage is Fibrinolysis.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
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A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
4. ADHESION : Attachment of platelets to something
besides other platelets.
Injury to endothelium
Exposes the subendothelial collagen fibers
Platelet attach to the collagen fibers
They require gpIb/IX receptor & vwf for this
attachment
Thus vwf acts as a bridge between platelets and
collagen fibers
5. Adhesion defect occurs in
- Bernard Soulier Disease
- Von Willibrand Disease
PLATELET ACTIVATION :
Once platelet attaches to collagen
A number of MORPHOLOGIC & FUNCTIONAL changes
occur
Platelet activation
It includes changes in :
1. Metabolic biochemistry
2. Shape
3. Surface receptor
4. Membrane phospholipid orientation
6. Platelet aggregation
It is attachment of platelet to one another.
2 phases:
(i) PRIMARY
(ii) SECONDARY
PRIMARY AGGREGATION
Injury
Damaged tissues and endothelial cells
Release agonists like ADP
Stimulate primary aggregation
If stimulus is weak,
Primary aggregation is reversible
7. SECONDARY AGGREGATION
Activated platelets
Release their own ADP & TXA2
Continue the stimulation process
Platelet aggregation is strong
Fibrinogen and Ca2+ are needed for aggregation to occur.
Both are plasma constituents
Fibrinogen acts as a bridge between platelets
8. SECRETION / RELEASE :
Secretion and secondary aggregation go side
by side.
Platelet cytoplasm has 3 types of granules
1. Dense bodies
2. α-granules
3. Lysosomal granules
Dense bodies :
ADP
ATP Mediators of
Ca2+ platelet function
Serotonin
9. α-granules : 2 major groups of protein
Group I Hemostatic proteins
eg: - Fibrinogen
- VWF
Group II Non-hemostatic proteins
eg: - PF4
- PDGF
Lysosomal granules : hydrolytic enzymes
All these leads to formation of primary hemostatic
plug.
10. Primary
haemostasis
Secondary
haemostasis
i) Platelet mediated
ii) Occurs within
seconds of injury
iii) Important in
preventing blood
loss from
capillaries, small
arterioles and
venules
iv) Forms platelet
plug
i) Coagulation factors
mediated.
ii) Takes several minutes
for completion
iii) Important role in
larger vessels.
iv) Forms a stable fibrin
plug.
11. SPECIFIC TEST FOR HEMOSTASIS
• PLATELET AGGREGATION TEST.
• COAGULATION FACTOR ASSAY TEST.
• ESTIMATION FOR FIBRINOGEN.
• TEST FOR FIBRINOGEN/FIBRIN DEGRADATION PRODUCTS.
• TEST FOR D-DIMER.
• PLATELET GLYCOPROTEIN ANALYSIS.
16. BLEEDING TIME(BT):
Time needed for the formation of primary haemostatic plug.
Significance
Assess Primary Hemostatic defect(vessel wall or platelet).
Dependent on adequate functioning of plt. & Bl.Vs.
Methods
I. Ivy’s
II. Duke’s-not recommended(as it can cause a large local
hematoma)
III. Template
Range
Ivy’s method: 2 to 7 mins.
Template method: 2.5 to 9.5 mins.
17. DUKE’S METHOD:
Site Ear lobe
Procedure Clean the site
Dry
Puncture with lancet
Start the stop watch
After every 30 seconds collect the drop of blood at one corner of
filter paper
DO NOT TOUCH the skin with paper
When bleeding ceases stop the watch
Record the time
Normal time 2- 7 mins
18.
19. IVY’S METHOD :
Site Volar aspect of forearm
Procedure Blood pressure cuff (40 mmHg)
Clean the area, dry
With a lancet 2 skin punctures are made about 5 cms apart
Start stop watch
Blot the blood from each site on separate piece of filter paper
Record the time(average of both the
time is taken)
Avoid a site with superficial veins
Disadvantages : depth of incision is
still NOT standardized
(approx 2-2.5mm)
Advantage : 2-3 pricks, thus more
standardized than Duke’s method
20. TEMPLATE METHOD :
Same as Ivy’s method except that instead of a
lancet a disposable device is used that
contains either a spring loaded blade which
descends vertically into the epidermis or a
blade which cuts the epidermis as it makes a
rotary arc
Thus the cut is standardized(6-9mm long and
1mm deep)
Causes of prolonged BT
I. THROMBOCYTOPENIA.
II. VWD.
III. PLATLET FUNCTION DISORDER(GLANZMANN
THROMBASTHENIA AND BERNARD SOULIER SYNDROME.
IV. DISORDERS
21. PLATELET FUNCTION ANALYZER(PFA)100:
In vitro system for measuring plt- vwf fuction.
Assesses both plt adhesion & aggregation
More sensitive than BT to asses Primary hemostasis.
The membrane is coated with collagen & epinephrine or collagen
& ADP.
It reproduces platelet vwf function under high shear rate.
Time req. for closure of full aperture is closure time
Normal closure time: 1 to 3 mins.
22.
23.
24. Platelet count :
I. Manual Method
Rees Ecker Method
Ammonium Oxalate Method
Microscopic Method
II. Automated Platelet count
Semiautomated
Fully Automated
III. Indirect Method
25. Rees Ecker Method:
SAMPLE VENOUS/ CAPILLARY BLOOD
VENOUS BLOOD IS PREFERRED
ANTICOAGULANT EDTA
DILUTING FLUID
Sodium citrate 3.8 g
Formaldehyde (40%)0.2 ml
Brilliant cresyl blue 0.1 ml
Distilled water 100 ml
26. Mix the sample properly
Using a red cell pipet, draw blood to 0.5 mark and the diluting
fluid to 101 mark
Gently mix the pipet for 3-5 minutes
Discard the 1st 3 or 4 drops from the pipet
Charge the Neubauer’s chamber
Allow it to stand for 15 minutes
Count the platelets in the corner 4 large squares of Neubauer’s
chamber
Platelets are visible as small highly refractive particles
Total platelet count
n x dilution factor x depth factor
area counted
n x 200 x 10=n x 500 plts/mm3
4
27. AMMONIUM OXALATE METHOD/ BRECKER
CRONKITE METHOD:
Here ammonium oxalate is used as a diluting fluid
Ammonium oxalate 1 gm
D/W 100 ml
stored at 40C
Advantage : It causes lysis of RBCs which can be sometimes
confused with platelets.
Normal Range : 1.5 – 4.5 lakhs/mm3
280± 130 x 109/L
Platelet count per ul=
No. of platelet counted x dilution factor(100)
Area in mm2 (1)x depth of chamber (0.1)
=no. of platelet counted x 1000
28. Microscopic Method :
Wright stained peripheral smear
Count the number of platelets seen per oil immersion field
8-25 platelets/oil immersion field is normal
The previous 2 methods should always be accompanied with
microscopic method
Thus we have a double check on platelet count
On PS we also get an idea about
- Platelet morphology Normal size is 1-3 µm
Giant platelets > 5 µ Platelet satellism
29. PROTHROMBIN TIME: (PT)
Significance
Reflects overall activity of the Extrinsic Pathway.
Most sensitive to changes in Factor V,VII,X.
Lesser to Factor I & II.
PT is used for controlling anti coagulant therapy.
Principle
Platelet poor plasml(0.1ML)+Tissue Thromboplastin reagent(0.1ml)+
after 1 min add Calcium chloride(0.1ml)
In Presence of F VII Extrinsic pathway is activated & clot
Formed
Normal Range
11 to 16 seconds(with rabbit thromboplastin)
10-12 seconds(with human thromboplastin)
30. Causes of prolonged PT:-
1. Deficiency of Factor VII,X,V,II,I
2. Vit K deficiency
3. Liver disease esp.Obstructive Jaundice
4. Oral anticoagulants
5. DIC
31. ACTIVATED PARTIAL THROMBOPLASTIN TIME
(APTT):-
Significance
Reflects efficiency of Intrinsic Pathway.
Sensitive to changes in Factor VIII,IX,XI,XII.
Also sensitive to heparin & circulating anticoagulants.
Principle
The test measures the clotting time of plasma(0.1ml) after the
activation of contact Factors(0.1m) (Kaolin/Silica/Ellagic acid) and
after 10mins the addition of phospholipid(0.2ml) and CaCl2, but
without added tissue thromboplastin.
So it indicates the overall efficiency of the Intrinsic pathway.
Normal range
26 to 40 seconds.
32.
33. Causes of prolonged APTT:-
1. Deficiency of Factor VIII(Hemophilia A).
2. Deficiency of Factor IX(Hemophilia B).
3. DIC.
4. Heparin therapy.
5. Circulating anticoagulants.
6. Liver disease.
7. Massive transfusion of plasma depleted stored
blood.
34.
35.
36. THROMBIN TIME(TT):
Significance:
Asses the final step of coagulation i.e.
conversion of
fibrinogen to fibrin in presence
of thrombin.
Bypasses Extrinsic & Intrinsic pathway.
Principle
Thrombin is added to plasma and the clotting time is
measured.TT is affected by the concentration and reaction
of fibrinogen and by the presence of inhibitory substances
including fibrinogen/fibrin degradation products(FDPs) and heparin.
Normal range
A patient’s TT should be within 2 s of the control
(i.e. 15–19 sec). Times of 20 s and longer are definitely abnormal
37. Causes of prolonged TT:-
1. Disorders of fibrinogen-
Afibrinogenaemia.
Hypofibrinogenaemia.
Dysfibrinogenaemia.
2. Presence of FDP- DIC or Liver disease.
3. Unfractioned heparin therapy.
4. Hypoalbuminaemia.
5. Paraproteinaemia
38.
39.
40. Divided into 6 main groups:-
1) Adhesion test
2) Aggregation test
3) Assessment of granular content
4) Assessment of release reaction
5) Investigation of Prostaglandin pathways
6) Test of platelet coagulant activity
Specific Platelet function tests :
41. Adhesion test : The adhesiveness of blood
platelets is measured in vitro by their
ability to adhere to the glass surfaces.
SALZMAN METHOD/ RETENTION IN A GLASS
BEAD COLUMN:-
42. Sample: Whole blood in 1 vaccutainer
according to routine procedure
Whole blood into 2nd vaccutainer via the glass
bead collecting system.
Platelet count is performed on both the
samples.
% of platelet
adhesiveness
=
Plt count without
Glass beads
Plt count with
Glass beads
- X 100
Plt count without
Glass beads
Normal value – 26-60% of platelet adhesiveness
Decreased adhesiveness – vW disease
Bernard Soulier Disease
Increased adhesiveness - venous thrombosis
Diabetes mellitus
Following splenectomy
43. Aggregation tests :
Invitro tests done to check the ability of
platelets to aggregate with certain agonists.
Indications : When a patient has increased
BT in presence of normal platelet count.
Sample : platelet rich plasma (PRF)
44. ADP AND EPINEPHRINE INDUCE A BIPHASIC CURVE,WHEREAS COLLAGEN,ARACHIDONIC ACID
AND RISTOCETIN INDUCE A SINGLE WAVE OF AGGREGATION.
45.
46. CLOT SOLUBILITY TEST(F XIII
QUALITATIVE ASSAY):-
PRINCIPLE—
Fibrin clot in presence of factor XIII & thrombin is
stable as a result of cross- linking.
But in absence of factor XIII clot dissolves rapidly
.
Interpretation—
CLOT NOT DISSOLVED IN 24HRS
F XIII PRESENT
CLOT DISSOLVES –
F XIII ABSENT
47. Fibrinogen Assay:-
Usually done by CLAUSS TECHNIQUE.
Principle
Diluted plasma is clotted with a strong thrombin solution.
The plasma must be diluted to give a low level of any inhibitors(e.g.
FDPs and heparin).
48. Normal range
1.8 to 3.6 g/l
Interpretation
Sensitive to inherited
Dysfibrinogenaemia.
Insensitive to Heparin unless the level is
very high(>0.8μ/μl).
High level of FDP(>190μg/ml)may also
interfare with the result.
49. FDP ASSAY:-
Plasminogen
Plasmin
Fibrinogen/ FDP X,Y,D,E
Fibrin
Principle
A Suspension of latex particles sensitized with specific Ab to
FDP fragments D & E.
Suspension mixed on a glass slide with a dilution of test
serum.
Agglutination indicates presence of FDPs.
50.
51. Agglutination with 1 in 5 dilution:-
FDP >10μg/ml
Agglutination with 1 in 20 dilution:-FDP>40μg/ml
Normal range- <10 μg/ml
10-40 μg/ml- Acute myocardial Infarction.
Acute venous thromboembolism.
Acute pneumonia.
>40 μg/ml- DIC.
Thrombolytic therapy with
Streptokinase .
D-DIMER ASSAY:-
Identical to FDP except latex particles are coated with a
Monoclonal Antibody specifically directed against
Fibrin D-dimer in human.
Normal range <200mg/l.