This document provides an overview of the Clinical Biochemistry course PLC 402. The course covers proper blood sampling techniques, components of the human body, and the study of electrolytes, hormones, liver and kidney function, and disorders. It involves analyzing blood under healthy and abnormal conditions to diagnose diseases, screen for risk factors, and monitor treatments. The document outlines different laboratory tests, procedures for safe blood collection and handling, quality control measures, and factors that can influence test results.
Collecting blood samples and other biological specimens is crucial to the understanding, prevention, and treatment of disease. However, from the patient’s perspective, it can also be painful, unnerving, frightening, and inconvenient.
2021 laboratory diagnosis of infectious diseases dr.ihsan alsaimarydr.Ihsan alsaimary
2021 laboratory diagnosis of infectious diseases
dr. ihsan alsaimary
university of basrah - college of medicine- DEPARTMENT OF MICROBIOLOGY
POBOX 696 ASHAR
BASRAH 42001
IRAQ
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Collecting blood samples and other biological specimens is crucial to the understanding, prevention, and treatment of disease. However, from the patient’s perspective, it can also be painful, unnerving, frightening, and inconvenient.
2021 laboratory diagnosis of infectious diseases dr.ihsan alsaimarydr.Ihsan alsaimary
2021 laboratory diagnosis of infectious diseases
dr. ihsan alsaimary
university of basrah - college of medicine- DEPARTMENT OF MICROBIOLOGY
POBOX 696 ASHAR
BASRAH 42001
IRAQ
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
This pdf is about the Schizophrenia.
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This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
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.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
2. ➢Prof. Hend Hussein
➢ Ass. Dr. Samer Zahran
Course Assistant:
Ass. Lect. Sara El-Hadey
3. Clinical Biochemistry course provide an advanced
knowledge of human body chemistry levels under
healthy and abnormal conditions. Also, it evaluates
the suitability of clinical specimens and the
laboratory test outcomes, and explain the relation
between the diseases and the abnormality in blood
chemistry.
4. Clinical Biochemistry (PLC 402) involves the
study of the proper sampling techniques, study of
chemical components of the human body, plasma
proteins, kidney, liver function, as well as the
study of body electrolytes, acid-base balance,
hormones and disorders in thyroid function.
5. 1. Introduction
2. Blood Sampling
3. Acid-Base balance
4. Electrolytes
5. Kidney Function
6. Acute Phase Protein
7. Hormones 1
8. Hormones 2
9. Thyroid function
10. Diabetes Mellitus
11. Liver Function
12. Cardiac Function
13. Tumor Markers 1
14. Tumor Markers 2
6.
7.
8. ➢ To diagnose diseases
➢ To screen for risk factors
➢ To monitor the effects of treatments &
medications.
9. In blood tests, blood sample is usually obtained
from the patient's vein. Other specialized blood
tests, such as the blood gases, require blood
extracted from an artery.
➢ Blood gas analysis is used to monitor CO2,
O2, blood pH and bicarbonate levels related
to pulmonary function or certain metabolic
conditions.
14. Universal precautions should be used to increase the
safety of blood collection.
These precautions are important to reduce the risk of
exposure skin and/or mucus membranes to infectious
materials. It includes the use of a variety of protective
barriers, such as gloves, masks, gowns (or white coat),
and eyewear.
Precautions
15. Universal precautions were designed to prevent the
transmission of HCV, HBV, HIV, and other blood
pathogens.
Universal precautions are applied in blood, semen,
vaginal secretions, pleural fluids, cerebrospinal,
synovial, peritoneal, pericardial, amniotic fluids
and tissues.
universal precautions
16. You must avoid blood drawing from:
➢ arm affected by a stroke or neurological injury
➢ arm of a mastectomy
➢ areas with extensive scar tissues, shunt, varicose
veins, and the palm
➢ arm of a patients that receive intravenous fluids.
➢ site that is swollen or affected by certain skin condition such
as eczema or other infection
17. Before the blood drawing, you should ask the
patient about some factors that may affect test
results: medications, pregnancy and age.
Make sure the patient has followed special
instructions such as fasting or taking a
medication.
18. The patient should be instructed about what blood
tests have been ordered and why.
Ask the patient if anytime has had trouble during the
blood drawing. This question may be an alert to
potential problems in finding an appropriate vein.
Also ask the patients what position would be most
comfortable for them when drawing the specimen.
Venipuncture makes many patients nervous, and
having them lie down.
20. ➢ Needles: vacutainer needles, syringes, butterfly needles
➢ Antiseptic. 70% alcohol wipes or disinfection swabs
➢ Tubes
➢ Vacutainer holder
➢Tourniquet (is used to find a vein)
➢Adhesive dressing
➢ Rubber gloves
➢ Pillow or other support
➢ Sharps disposal container
➢ Disposal box
21.
22. The vacuum tubes are designed to draw a determined volume of
blood. This system consists of vacuumed specimen tubes, a
needle, and a plastic holder. When the tube is placed into the
holder and pressed against the needle, negative pressure results,
and blood is pulled into the tube
23.
24. ➢ Transfer and storage tubes
➢Pipettes
➢ Centrifuge
➢ Racks for tubes
➢ Special boxes for tube transfer and storage
➢ Freezer (for storage)
25. 1. Venipuncture is useful to obtain cells and
extracellular fluids (plasma or serum) from the body
for analysis.
2. Fingerstick : If only a few drops of blood are needed
(make a small prick in the tip of the finger and then
squeeze the blood out). Ex: blood group
26. 3. Heel-stick is the preferred method of blood
collection on a newborn baby or infant
27. During blood collection, the arm should rest on a
pillow or other supportive prop. The patient open
and close the fist. The phlebotomist sets the
tourniquet around the upper arm, searches the
proper vein by inspecting and palpating and then
sterilizes the injection site. The use of a tourniquet
should be minimized (to avoid changes in blood
hemoconcentration).
28. After that, the needle beveled upward, should be
pushed smoothly and quickly into the vein, to
minimize the possibility of hemolysis as a result of
vascular damage. Immediately after the insertion,
the tourniquet should be released (to minimize the
effect of hemoconcentration).
29.
30. The needle will be attached either to a low pressure
blood test bottle (Vacutainer), or to a syringe where
the plunger is pulled back to create low pressure.
When the necessary amount of blood has been
extracted, the needle is removed and a little ball of
cotton wool is held over the wound for 1 minute.
31. The artery blood it is usually extracted from the
wrist where the artery is very close to the skin.
After taking blood from an artery, a ball of
cotton wool is held over the wound about 5
minutes to stop any bleeding.
32. Blood collection tubes come with a variety of colored
stopper caps, and may contain additives. The colored
stopper is important to avoid the cross-
contamination of additives between tubes
33. 1. Serum separator tube (SST). This tube contains
a polymer gel for blood chemistry (Glucose, urea,
cholesterol, Na, K, Mg Zn, …..
2. Heparin tubes (green top tubes) are used for lithium
and ammonia levels.
34. 3. EDTA tubes ( with lavender top). For complete
blood counts.
4. Sodium citrate tubes (light blue top) are used for
prothrombin time (PT) and partial prothrombin
time (PTT) analysis.
35. 5. Sodium fluoride (anti glycolytic agents) that
preserve glucose for up to five days. The tube is used
primarily to obtain glucose levels.
6. Free anticoagulants or additives (can be used for
blood typing and cross- matching).
37. During working in the laboratory:
Not allowed to eat in laboratories.
Tables should be kept clean and wiped by
sterilizing agents.
Wash hands in running water before and after
blood collection .
Gloves should be used in blood drawing and
handling.
Needle is disposed in sharp container
38. Needle stick injuries
Don't panic.
Clean the infected area.
Rinse with of water.
Wash with antibacterial soap
Squeeze wounded area
Place 70% alcohol on the wound for two minutes.
Contact the local health professional responsible for
infectious diseases.
39. 1. Internal quality control
Each laboratory system should has quality
control materials.
In which, secondary calibrators should be applied
according to an internationally recognized
reference method. Each standard (calibrator)
should be run at least in duplicate
40. 2. External quality control
External quality control is arranged by internationally
recognized reference laboratories that distribute batches of
samples of various concentrations for each assay.
In external quality control, The participating laboratory is
blinded to the concentration of the analyte. Standard
deviations of the results of the participating laboratory serve
as a measure of performance.
41. 1. Individual analytical variation
2. Laboratory analytical variation
1. Individual analytical variation
a. Inter- individual variation
Age – Sex – Race – Genetics
b. Intra- individual variation
Diet – Drugs - Sleep pattern - Situation or Position
42. 2. Laboratory analytical variation
a. Pre-analytical variation
Transport - Exposure to UV light
Standing time before separation of cells
Centrifugation time
Storage conditions
b. Analytical variation
Random errors
Systematic errors
c. Post-analytical variation
Transcriptions errors
Result reports to wrong patient
43. Hemolysis
Hemolysis ( Rupture of red blood cells) can cause significant
change in some analytics as potassium, magnesium, sodium,
……….
Red color of plasma or serum due to the hemolysis can affect the
results that are measured by colorimetric
Lipemia (lots of fats ) & proteinemia (lots of proteins)
Cause serum or plasma to be become turbid. This can affect
colorimetric and turbidimetric based tests ( give false results)