Is group of tests that are used to diagnose diabetes or its complications , it includes:
Blood glucose
4 types: FBS, PPBS, RBS, OGGT
Microalbuminurea
Ketones
HbA1C
Insulin
ICA (islent cell antibody) for type I
C-peptide
Glycosylated Hemoglobin, also called Glycated Hemoglobin, Hemoglobin A1c, or HbA1c, refers to hemoglobin which is bound to glucose. Glycosylated Hemoglobin Test is performed to measure the percentage of glycosylated hemoglobin in blood which reflects the average blood glucose over a period of past two to three months (8 - 12 weeks).
For more information, visit
https://www.1mg.com/labs/test/glycosylated-hemoglobin-1611
This document provides information about lipid profiles and their normal ranges. It discusses how to collect and process blood specimens for lipid profiles. It then defines the components of a lipid profile including total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and VLDL cholesterol. For each component, it provides the normal ranges and clinical significance of abnormal levels. It also briefly discusses apolipoprotein B, phospholipids, chylomicrons, and factors that can increase or decrease their levels.
The document discusses the anatomy, functions, and tests related to evaluating the liver. It notes that the liver is the largest organ located in the upper right abdomen and contains hepatocytes as its main cells. The liver has important metabolic, excretory, hematological, storage, protective, and detoxification functions. Common tests to evaluate liver function include assessing serum enzymes like AST, ALT, ALP, GGT, and bilirubin levels. Tests can also examine the liver's metabolic capacity through galactose tolerance or its synthetic function using prothrombin time.
Lipids are fatty substances that play an important role in a number of body functions. Apart from being structural components of the cells, Lipids also act as a source and mode of storage of energy for the body. The Lipid Profile Test measures the levels of specific types of lipids in the blood.
For more details, visit:
https://www.1mg.com/labs/test/lipid-profile-1909
Glycosylated hemoglobin (HbA1c) represents the average plasma glucose over the previous 2-3 months and is measured to monitor long-term glycemic control in patients with diabetes. The document discusses the relationship between HbA1c levels and diabetes complications, factors that affect HbA1c, and recommendations for using HbA1c to diagnose diabetes. International expert committees now recommend using HbA1c ≥6.5% to diagnose diabetes due to standardization of assays and its correlation with complications.
This document discusses methods for estimating proteins, albumin, and globulin in urine and serum. It provides details on reagents and procedures for urine protein tests using acetic acid and sulphosalicylic acid. Methods are described for estimating total serum protein using the biuret reaction and serum albumin using bromocresol green dye. Normal ranges are provided for serum albumin, globulin, and total protein.
The document discusses liver function tests (LFTs). It begins by providing an overview of liver anatomy and functions. Key points include that the liver is the largest organ and performs many metabolic and excretory roles. LFTs evaluate the liver's functioning in these roles. The document then examines specific LFTs in detail, grouping them into those related to pigment metabolism, carbohydrate metabolism, plasma proteins, lipids, detoxification, excretion, blood clotting factors, blood ammonia, and serum enzymes. Elevations in different enzymes and analytes provide clues to conditions like hepatitis, cirrhosis, or obstruction. The tests discussed provide insights into liver health and disease.
Glucose tolerance tests are also used to diagnose diabetes. The OGTT is used to screen for or diagnose diabetes in people with a fasting blood glucose level that is high, but is not high enough (above 125 mg/dL or 7 mmol/L) to meet the diagnosis for diabetes.
Glycosylated Hemoglobin, also called Glycated Hemoglobin, Hemoglobin A1c, or HbA1c, refers to hemoglobin which is bound to glucose. Glycosylated Hemoglobin Test is performed to measure the percentage of glycosylated hemoglobin in blood which reflects the average blood glucose over a period of past two to three months (8 - 12 weeks).
For more information, visit
https://www.1mg.com/labs/test/glycosylated-hemoglobin-1611
This document provides information about lipid profiles and their normal ranges. It discusses how to collect and process blood specimens for lipid profiles. It then defines the components of a lipid profile including total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and VLDL cholesterol. For each component, it provides the normal ranges and clinical significance of abnormal levels. It also briefly discusses apolipoprotein B, phospholipids, chylomicrons, and factors that can increase or decrease their levels.
The document discusses the anatomy, functions, and tests related to evaluating the liver. It notes that the liver is the largest organ located in the upper right abdomen and contains hepatocytes as its main cells. The liver has important metabolic, excretory, hematological, storage, protective, and detoxification functions. Common tests to evaluate liver function include assessing serum enzymes like AST, ALT, ALP, GGT, and bilirubin levels. Tests can also examine the liver's metabolic capacity through galactose tolerance or its synthetic function using prothrombin time.
Lipids are fatty substances that play an important role in a number of body functions. Apart from being structural components of the cells, Lipids also act as a source and mode of storage of energy for the body. The Lipid Profile Test measures the levels of specific types of lipids in the blood.
For more details, visit:
https://www.1mg.com/labs/test/lipid-profile-1909
Glycosylated hemoglobin (HbA1c) represents the average plasma glucose over the previous 2-3 months and is measured to monitor long-term glycemic control in patients with diabetes. The document discusses the relationship between HbA1c levels and diabetes complications, factors that affect HbA1c, and recommendations for using HbA1c to diagnose diabetes. International expert committees now recommend using HbA1c ≥6.5% to diagnose diabetes due to standardization of assays and its correlation with complications.
This document discusses methods for estimating proteins, albumin, and globulin in urine and serum. It provides details on reagents and procedures for urine protein tests using acetic acid and sulphosalicylic acid. Methods are described for estimating total serum protein using the biuret reaction and serum albumin using bromocresol green dye. Normal ranges are provided for serum albumin, globulin, and total protein.
The document discusses liver function tests (LFTs). It begins by providing an overview of liver anatomy and functions. Key points include that the liver is the largest organ and performs many metabolic and excretory roles. LFTs evaluate the liver's functioning in these roles. The document then examines specific LFTs in detail, grouping them into those related to pigment metabolism, carbohydrate metabolism, plasma proteins, lipids, detoxification, excretion, blood clotting factors, blood ammonia, and serum enzymes. Elevations in different enzymes and analytes provide clues to conditions like hepatitis, cirrhosis, or obstruction. The tests discussed provide insights into liver health and disease.
Glucose tolerance tests are also used to diagnose diabetes. The OGTT is used to screen for or diagnose diabetes in people with a fasting blood glucose level that is high, but is not high enough (above 125 mg/dL or 7 mmol/L) to meet the diagnosis for diabetes.
This document summarizes serum total protein estimation. It explains that proteins are polymers of amino acids and serve many important functions in the body. Abnormal total protein levels can indicate nutritional status, kidney disease, or liver disease. Hypoproteinemia is a low total protein level caused by excessive protein loss or decreased intake/synthesis. Hyperproteinemia is an increased level caused by dehydration. The biuret method is used to quantify total proteins by developing a color change proportional to protein concentration.
This document discusses urea and creatinine, which are waste products excreted by the kidneys. It describes how urea is formed from ammonia in the liver and how defects in the urea cycle can cause metabolic disorders. It outlines methods for measuring blood urea and urine urea. Creatinine is formed from creatine in muscle and increased levels can indicate muscle or kidney issues. Methods for measuring serum and urine creatinine are provided. The document concludes by noting creatinine clearance is a sensitive indicator of kidney function.
these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
Analytical Methods of Determining Diabetes Mellitus outlines several methods for testing and monitoring diabetes, including blood tests, urine tests, and glycated hemoglobin (HbA1c) levels. Key blood tests discussed are fasting blood glucose, oral glucose tolerance tests, and HbA1c levels. Urine tests that can indicate diabetes include those for glucose, ketones, microalbumin, and protein levels. Laboratory methods for analyzing glucose, glycated hemoglobins, and other markers are also reviewed. Regular monitoring of blood lipids, kidney function, and liver enzymes is also recommended to prevent diabetes complications.
The lipid profile is a group of blood tests that measure cholesterol and triglyceride levels to determine risk for heart disease. It includes measurements of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. High LDL ("bad") cholesterol increases risk of plaque buildup in arteries while high HDL ("good") cholesterol helps remove cholesterol from arteries. An abnormal lipid profile can indicate risk for conditions like atherosclerosis and help diagnose underlying issues like hyperlipidemia.
The document discusses liver function tests (LFTs) and their use in evaluating liver diseases. It provides details on 3 key LFTs:
1. Bilirubin tests which are used to diagnose prehepatic (hemolytic), hepatic, and obstructive jaundice. Elevated conjugated bilirubin indicates obstructive jaundice while elevated unconjugated bilirubin indicates hepatic or hemolytic jaundice.
2. Liver enzymes like ALT, AST, ALP, and GGT which provide information on liver health and injury. Elevated ALT and AST indicate liver parenchymal damage while elevated ALP and GGT can indicate obstructive jaundice.
3
Quality control in clinical biochemistryAshok Katta
This document discusses quality control in clinical biochemistry laboratories. It explains that laboratory tests play an important role in clinical diagnosis and treatment decisions. Therefore, test results must be reliable and accurate. Quality control involves measures to ensure test accuracy, including internal quality control procedures done daily in the lab and external quality assessment involving evaluation by an outside agency. Proper quality control is essential to producing test results that healthcare providers can trust in making decisions for patients.
The document summarizes plasma proteins and their functions. It discusses that normal plasma proteins are 6-8 g/dl and consist of albumin, globulins, and fibrinogen. The main fractions of plasma proteins - albumin, alpha, beta, and gamma globulins - are described. Key plasma proteins like albumin, ceruloplasmin, haptoglobin, and C-reactive protein are explained in terms of their structure, function, and clinical significance. Acute phase proteins that increase or decrease during inflammation are also outlined.
The document discusses lipid profile tests, which measure triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol levels. High levels of these lipids can increase the risk of coronary heart disease. The document provides details on normal reference values, testing procedures, clinical implications, and lifestyle factors that affect lipid levels.
This document summarizes blood glucose regulation and diabetes. It explains that insulin decreases blood glucose by stimulating glucose uptake and glycogenesis, while glucagon and epinephrine increase it by stimulating glycogenolysis and gluconeogenesis. The oral glucose tolerance test (OGTT) measures blood glucose levels after consuming glucose to diagnose diabetes, where abnormally high post-meal levels indicate the condition. Fasting plasma glucose levels between 100-125 mg/dL signal impaired fasting glucose, and over 126 mg/dL indicate diabetes.
Serum protein electrophoresis & their clinical importanceDr.M.Prasad Naidu
This document discusses serum proteins and electrophoresis techniques used to analyze them. It provides details on the major serum proteins - albumin and globulins - and their functions. Electrophoresis separates proteins based on their charge and size. Several electrophoresis methods are described, including agarose gel, SDS-PAGE, and capillary electrophoresis. Factors influencing electrophoresis results and common stains used are also outlined. The document concludes with descriptions of normal and abnormal serum protein electrophoresis patterns and their clinical significance.
The document discusses various methods for estimating blood glucose levels, including the glucose oxidase, alkaline copper reduction (Folin-Wu), and oxidase-peroxidase methods. It provides details on the chemical reactions involved in each method and notes that the glucose oxidase-peroxidase method is preferred for measuring glucose in plasma due to its accuracy. Normal fasting blood glucose values are 70-100 mg/dL while post-meal values should be less than 140 mg/dL. Increased glucose can indicate conditions like diabetes while decreased levels may signal hypoglycemia or infections.
The document discusses kidney functions and urine formation. The kidney removes waste, regulates electrolytes and water, and maintains acid-base balance. Urine is formed in nephrons through glomerular filtration, tubular reabsorption, and tubular secretion. Tests like creatinine clearance and inulin clearance are used to measure glomerular filtration rate (GFR) as an indicator of kidney function. Proper collection and preservation of urine samples is important for accuracy in clearance and other renal function tests.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Liver function tests (LFTs) evaluate liver health and detect liver damage. LFTs measure enzymes released from damaged liver cells (ALT, AST), synthetic function (albumin, clotting factors), and signs of obstruction (bilirubin, ALP, GGT). Elevations in ALT and AST indicate hepatocyte injury while increased bilirubin, ALP, and GGT suggest cholestasis or blockage of bile flow. LFTs help diagnose liver diseases, determine severity, monitor treatment effectiveness, and assess operative risk or need for transplantation.
This document discusses lipid profile testing and the determination of various lipids in the blood, including total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and others. It provides information on the clinical significance and normal ranges of each lipid, as well as methods for estimating and measuring the different lipids. Key points covered include the importance of cholesterol for various body functions but that too much can lead to health issues; sources of cholesterol from the body and diet; and the relationships between HDL, LDL, and risk for coronary artery disease.
Laboratory diagnosis of Diabetes mellitus Monika Nema
This document summarizes Dr. Monika Nema's presentation on laboratory diagnosis and monitoring of diabetes mellitus. It discusses various laboratory tests used for diagnosis of diabetes including estimation of blood glucose, oral glucose tolerance test, and glycated hemoglobin (HbA1c). It also describes tests used to assess glycemic control such as periodic HbA1c measurement and self-monitoring of blood glucose. Laboratory tests for screening and diagnosis of gestational diabetes are also summarized.
Glucose tolerance test- Indications, contraindications, preparation of a patient, precautions, types of GTT, normal curve, diabetic curve, renal glycosuria, lag curve, Criteria for diagnosis of DM
The document discusses renal function tests (RFTs). It provides information on:
- The functions of the kidney including homeostasis, excretion, and hormonal functions.
- Common RFTs including urine analysis, serum creatinine, BUN, eGFR, and cystatin C. These tests are used to evaluate glomerular filtration rate and detect kidney problems.
- Additional details are given on clearance tests using inulin, creatinine and urea to estimate GFR. Urine analysis and tests of tubular function are also summarized.
Early screening of Diabetes Mellitus can prevent the unwanted complications of Diabetes Mellitus like diabetic nephropathy, diabetic retinopathy, diabetic foot, etc.
This document summarizes serum total protein estimation. It explains that proteins are polymers of amino acids and serve many important functions in the body. Abnormal total protein levels can indicate nutritional status, kidney disease, or liver disease. Hypoproteinemia is a low total protein level caused by excessive protein loss or decreased intake/synthesis. Hyperproteinemia is an increased level caused by dehydration. The biuret method is used to quantify total proteins by developing a color change proportional to protein concentration.
This document discusses urea and creatinine, which are waste products excreted by the kidneys. It describes how urea is formed from ammonia in the liver and how defects in the urea cycle can cause metabolic disorders. It outlines methods for measuring blood urea and urine urea. Creatinine is formed from creatine in muscle and increased levels can indicate muscle or kidney issues. Methods for measuring serum and urine creatinine are provided. The document concludes by noting creatinine clearance is a sensitive indicator of kidney function.
these clearance test plays an very important role in determining the functioning capacity and working status of kidney.
and we estimate how amount of compund is excreted in the urine and absorption too.
and i also attached the mathematical caluculation to identify the metabolic valuve of urea, creatinine, inulin clearance by kidney.
Analytical Methods of Determining Diabetes Mellitus outlines several methods for testing and monitoring diabetes, including blood tests, urine tests, and glycated hemoglobin (HbA1c) levels. Key blood tests discussed are fasting blood glucose, oral glucose tolerance tests, and HbA1c levels. Urine tests that can indicate diabetes include those for glucose, ketones, microalbumin, and protein levels. Laboratory methods for analyzing glucose, glycated hemoglobins, and other markers are also reviewed. Regular monitoring of blood lipids, kidney function, and liver enzymes is also recommended to prevent diabetes complications.
The lipid profile is a group of blood tests that measure cholesterol and triglyceride levels to determine risk for heart disease. It includes measurements of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. High LDL ("bad") cholesterol increases risk of plaque buildup in arteries while high HDL ("good") cholesterol helps remove cholesterol from arteries. An abnormal lipid profile can indicate risk for conditions like atherosclerosis and help diagnose underlying issues like hyperlipidemia.
The document discusses liver function tests (LFTs) and their use in evaluating liver diseases. It provides details on 3 key LFTs:
1. Bilirubin tests which are used to diagnose prehepatic (hemolytic), hepatic, and obstructive jaundice. Elevated conjugated bilirubin indicates obstructive jaundice while elevated unconjugated bilirubin indicates hepatic or hemolytic jaundice.
2. Liver enzymes like ALT, AST, ALP, and GGT which provide information on liver health and injury. Elevated ALT and AST indicate liver parenchymal damage while elevated ALP and GGT can indicate obstructive jaundice.
3
Quality control in clinical biochemistryAshok Katta
This document discusses quality control in clinical biochemistry laboratories. It explains that laboratory tests play an important role in clinical diagnosis and treatment decisions. Therefore, test results must be reliable and accurate. Quality control involves measures to ensure test accuracy, including internal quality control procedures done daily in the lab and external quality assessment involving evaluation by an outside agency. Proper quality control is essential to producing test results that healthcare providers can trust in making decisions for patients.
The document summarizes plasma proteins and their functions. It discusses that normal plasma proteins are 6-8 g/dl and consist of albumin, globulins, and fibrinogen. The main fractions of plasma proteins - albumin, alpha, beta, and gamma globulins - are described. Key plasma proteins like albumin, ceruloplasmin, haptoglobin, and C-reactive protein are explained in terms of their structure, function, and clinical significance. Acute phase proteins that increase or decrease during inflammation are also outlined.
The document discusses lipid profile tests, which measure triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol levels. High levels of these lipids can increase the risk of coronary heart disease. The document provides details on normal reference values, testing procedures, clinical implications, and lifestyle factors that affect lipid levels.
This document summarizes blood glucose regulation and diabetes. It explains that insulin decreases blood glucose by stimulating glucose uptake and glycogenesis, while glucagon and epinephrine increase it by stimulating glycogenolysis and gluconeogenesis. The oral glucose tolerance test (OGTT) measures blood glucose levels after consuming glucose to diagnose diabetes, where abnormally high post-meal levels indicate the condition. Fasting plasma glucose levels between 100-125 mg/dL signal impaired fasting glucose, and over 126 mg/dL indicate diabetes.
Serum protein electrophoresis & their clinical importanceDr.M.Prasad Naidu
This document discusses serum proteins and electrophoresis techniques used to analyze them. It provides details on the major serum proteins - albumin and globulins - and their functions. Electrophoresis separates proteins based on their charge and size. Several electrophoresis methods are described, including agarose gel, SDS-PAGE, and capillary electrophoresis. Factors influencing electrophoresis results and common stains used are also outlined. The document concludes with descriptions of normal and abnormal serum protein electrophoresis patterns and their clinical significance.
The document discusses various methods for estimating blood glucose levels, including the glucose oxidase, alkaline copper reduction (Folin-Wu), and oxidase-peroxidase methods. It provides details on the chemical reactions involved in each method and notes that the glucose oxidase-peroxidase method is preferred for measuring glucose in plasma due to its accuracy. Normal fasting blood glucose values are 70-100 mg/dL while post-meal values should be less than 140 mg/dL. Increased glucose can indicate conditions like diabetes while decreased levels may signal hypoglycemia or infections.
The document discusses kidney functions and urine formation. The kidney removes waste, regulates electrolytes and water, and maintains acid-base balance. Urine is formed in nephrons through glomerular filtration, tubular reabsorption, and tubular secretion. Tests like creatinine clearance and inulin clearance are used to measure glomerular filtration rate (GFR) as an indicator of kidney function. Proper collection and preservation of urine samples is important for accuracy in clearance and other renal function tests.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Liver function tests (LFTs) evaluate liver health and detect liver damage. LFTs measure enzymes released from damaged liver cells (ALT, AST), synthetic function (albumin, clotting factors), and signs of obstruction (bilirubin, ALP, GGT). Elevations in ALT and AST indicate hepatocyte injury while increased bilirubin, ALP, and GGT suggest cholestasis or blockage of bile flow. LFTs help diagnose liver diseases, determine severity, monitor treatment effectiveness, and assess operative risk or need for transplantation.
This document discusses lipid profile testing and the determination of various lipids in the blood, including total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and others. It provides information on the clinical significance and normal ranges of each lipid, as well as methods for estimating and measuring the different lipids. Key points covered include the importance of cholesterol for various body functions but that too much can lead to health issues; sources of cholesterol from the body and diet; and the relationships between HDL, LDL, and risk for coronary artery disease.
Laboratory diagnosis of Diabetes mellitus Monika Nema
This document summarizes Dr. Monika Nema's presentation on laboratory diagnosis and monitoring of diabetes mellitus. It discusses various laboratory tests used for diagnosis of diabetes including estimation of blood glucose, oral glucose tolerance test, and glycated hemoglobin (HbA1c). It also describes tests used to assess glycemic control such as periodic HbA1c measurement and self-monitoring of blood glucose. Laboratory tests for screening and diagnosis of gestational diabetes are also summarized.
Glucose tolerance test- Indications, contraindications, preparation of a patient, precautions, types of GTT, normal curve, diabetic curve, renal glycosuria, lag curve, Criteria for diagnosis of DM
The document discusses renal function tests (RFTs). It provides information on:
- The functions of the kidney including homeostasis, excretion, and hormonal functions.
- Common RFTs including urine analysis, serum creatinine, BUN, eGFR, and cystatin C. These tests are used to evaluate glomerular filtration rate and detect kidney problems.
- Additional details are given on clearance tests using inulin, creatinine and urea to estimate GFR. Urine analysis and tests of tubular function are also summarized.
Early screening of Diabetes Mellitus can prevent the unwanted complications of Diabetes Mellitus like diabetic nephropathy, diabetic retinopathy, diabetic foot, etc.
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes that occurs when there is not enough insulin in the body. It is caused by a lack of insulin and high levels of stress hormones. This leads to high blood sugar, the building up of ketones in the blood, and metabolic acidosis. Symptoms include nausea, vomiting, and fruity-smelling breath. It is diagnosed based on high blood sugar, ketones in the urine or blood, and metabolic acidosis. Treatment involves fluid replacement, electrolyte replacement, insulin administration, and monitoring to correct the condition safely.
This document summarizes blood glucose homeostasis. It defines normal fasting and post-prandial blood glucose levels. It describes the main sources of blood glucose and the factors that regulate blood glucose levels, including gastrointestinal, hepatic, renal, and hormonal factors. Specifically, it outlines the roles of insulin and glucagon in maintaining blood glucose within a narrow range.
PPG is a global company founded in 1883 that manufactures paints, coatings, and other products. It has over 40,000 employees working in more than 140 manufacturing sites across 60 countries. PPG provides coatings for the automotive industry, protecting over 30 million vehicles per year with its electrocoat products. The company is moving towards more waterborne and powder coating technologies to respond to market demands.
This document discusses the diagnosis and management of diabetic ketoacidosis (DKA). It outlines the signs and symptoms that suggest DKA including altered mental status, nausea/vomiting, and fruity breath odor. Key lab findings include hyperglycemia, hyperketonemia, and metabolic acidosis. Treatment involves monitoring glucose, electrolytes, and acid-base status while providing insulin and fluid resuscitation. Differential diagnoses that can mimic DKA's presentation are also reviewed.
The document discusses postprandial hyperglycemia (high blood sugar after eating) as an independent risk factor for cardiovascular disease. It provides details on the management of postprandial hyperglycemia, including non-pharmacological interventions like diet and exercise as well as pharmacological agents that target post-meal blood sugar spikes. These include meglitinides, alpha-glucosidase inhibitors, prandial insulin, GLP-1 analogues, and DPP-4 inhibitors. The document emphasizes that controlling post-meal hyperglycemia is important for achieving optimal overall blood sugar control and reducing complications.
Blood functions to transport nutrients, gases, hormones, and waste throughout the body. It also helps regulate pH and temperature. Blood is composed of plasma and formed elements, including red blood cells, white blood cells, and platelets. Plasma is 55% of blood volume and contains water, proteins, electrolytes, nutrients, and waste products. The major proteins are albumin, globulins, and fibrinogen, which help regulate pressure, viscosity, coagulation, immunity, and transport of substances.
Prediabetes refers to blood glucose levels that are higher than normal but not high enough to be diagnosed as diabetes. People with prediabetes often do not experience symptoms. There are three main tests - A1C, fasting plasma glucose, and oral glucose tolerance test - that can be used to detect prediabetes. Lifestyle changes like modest weight loss through diet and exercise can significantly lower one's risk of developing type 2 diabetes.
This document describes a case of a 41-year-old female patient with type 1 diabetes mellitus who presented with loss of consciousness. She has a history of recurrent urinary tract infections. On examination, she was found to have diabetic ketoacidosis, as evidenced by ketones and high blood glucose levels on urinalysis and blood gas analysis. Diabetic ketoacidosis occurs when a lack of insulin causes fat breakdown and ketone production, resulting in metabolic acidosis. The document outlines the mechanisms, management, and importance of prevention of diabetic ketoacidosis through patient education and insulin therapy.
Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia. DM prevalence in Saudi Arabia is high at 23.7%. DM is diagnosed based on classic symptoms and elevated blood glucose levels. Prediabetes conditions like impaired fasting glucose and impaired glucose tolerance are risk factors for future diabetes and cardiovascular disease. Glycemic goals aim for an A1C below 7% and treatment involves medical nutrition therapy, oral medications, insulin, and preventing complications. Management of DM focuses on controlling blood glucose, blood pressure, lipids, and screening for and treating common complications.
Skin Manifestations of Scleroderma, by Dr. Lorinda Chung MD maushard
Keynote presentation by Dr. Lorinda Chung MD at March 9, 2013 Cheri Woo Scleroderma Education Seminar in Tualatin, OR hosted by Oregon Chapter of the Scleroderma Foundation.
LAB DIAGNOSIS N INVESTIGATION OF DIABETES MELLITUS.madhursejwal
The document outlines the diagnostic criteria for diabetes mellitus, including having a fasting plasma glucose level of 126 mg/dL or higher, symptoms of hyperglycemia with a casual plasma glucose of 200 mg/dL or higher, or a 2 hour plasma glucose of 200 mg/dL or higher during an oral glucose tolerance test. It also lists the WHO criteria for diagnosing metabolic syndrome which includes having any two of the following: diabetes, high blood pressure, high triglycerides or low HDL cholesterol, central obesity, or insulin resistance. The document notes that microalbuminuria, lipid profiles, electrolytes, lactate, C-peptide levels, and evaluating complications are also important for diagnosis.
Scleroderma is a multisystem collagen vascular disease characterized by fibrosis of the skin and involvement of internal organs. It can be classified as diffuse or localized systemic sclerosis. Common manifestations include pulmonary fibrosis, esophageal dysmotility causing reflux, delayed gastric emptying, and small bowel involvement seen as "hidebound sign". Skeletal involvement causes acro-osteolysis, joint space narrowing, and flexion deformities of the hands.
Glycated hemoglobin (HbA1c) is a form of hemoglobin used primarily to identify a person's average blood glucose level over the past 3 months. HbA1c is formed through a non-enzymatic process as glucose binds to the hemoglobin in red blood cells. The HbA1c test measures the amount of glycated hemoglobin and provides an indication of a person's blood glucose control over the past 120 days (3 months), which corresponds to the average lifespan of red blood cells. Several methods can be used to measure HbA1c levels including HPLC, immunoassay, and boronate affinity chromatography.
This document summarizes information about systemic sclerosis (SSc), including its definition, classification, epidemiology, etiology, pathophysiology, clinical manifestations, diagnostic criteria, management, and treatment. SSc is a chronic autoimmune disease characterized by fibrosis of the skin and internal organs. It can be classified as limited or diffuse cutaneous SSc depending on the extent of skin involvement. Common clinical features include Raynaud's phenomenon, skin thickening, joint/muscle involvement, and interstitial lung disease. Treatment focuses on managing symptoms, preventing complications, suppressing the immune system, and detecting/treating organ involvement early. New treatments targeting the fibrotic process are showing promise.
Systemic sclerosis, or scleroderma, is a multisystem disorder characterized by vascular abnormalities, skin and organ fibrosis, and immune system activation. It can be classified as either diffuse or limited cutaneous systemic sclerosis based on the extent and pattern of skin involvement. Common clinical features include Raynaud's phenomenon, skin thickening, gastrointestinal issues, lung fibrosis, and renal crisis. Treatment involves managing symptoms, with immunosuppressants sometimes used to modify disease progression. Prognosis depends on subtype, with limited scleroderma carrying a better long-term survival rate than diffuse disease.
The document discusses different types of blood samples and liver function tests. It explains that plasma contains clotting factors while serum does not. Several liver function tests are described including ALT, AST, ALP, GGT, total protein, albumin, and bilirubin. The roles and clinical significance of these enzymes and proteins are summarized. Kidney function tests and lipid and blood glucose tests are also briefly mentioned.
Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. A1C testing should be performed routinely in all patients with diabetes. The frequency of A1C testing should be dependent on the clinical situation, the treatment regimen used, and the clinician’s judgment. Some patients with stable glycemia well within target may do well with testing only twice per year. Unstable or highly intensively managed patients (e.g., pregnant type 1 diabetic women) may require testing more frequently than every 3 months.
The document discusses laboratory investigations for diabetes mellitus, including urine analysis to check for glucose, ketones, and microalbuminuria; blood tests like fasting blood glucose, oral glucose tolerance test, HbA1c, and lipid profile; and immunological assays. Urine tests check for glucose and ketones to detect hyperglycemia and assess kidney damage, while blood tests diagnose and monitor diabetes and assess control and complications. Microalbuminuria detects early kidney damage from diabetes.
Determination of Blood Glucose Using Glusose Oxidase-Peroxidase MethodZoldylck
This document discusses blood glucose determination using the oxidase-peroxidase method. It begins by introducing diabetes and its prevalence worldwide. It then describes the materials and methodology used, which involves collecting a blood sample, separating the plasma, and adding an O-toluidine reagent before measuring absorbance. The results showed the patient's glucose level was within the normal range. It further discusses hyperglycemia and hypoglycemia, the different types of diabetes, diagnostic criteria, and gestational diabetes.
The document discusses regulation of blood glucose levels and metabolic derangements in diabetes. It describes how hormones like insulin and glucagon tightly regulate blood glucose levels by controlling glucose uptake and release. In diabetes, there is either insufficient insulin production or insulin resistance, leading to hyperglycemia. This causes symptoms like excessive thirst and urination as the body tries to eliminate excess glucose through urine. Without treatment, high blood glucose in diabetes can cause serious complications like diabetic ketoacidosis or hyperosmolar coma.
This document provides information on type 2 diabetes mellitus. It begins with an introduction defining diabetes and describing the pathogenesis of type 2 diabetes. It then discusses the pathophysiology in detail, explaining how insulin resistance and relative insulin deficiency lead to hyperglycemia. The etiology, symptoms, acute and chronic complications, diagnosis and management of type 2 diabetes are also summarized. Management includes dietary recommendations focusing on macronutrient distribution using strategies like glycemic index, glycemic load and carbohydrate counting to improve glycemic control.
This document provides information on diabetes mellitus (DM), including:
1. DM results from either insufficient insulin production (type 1) or insulin resistance (type 2), leading to high blood glucose.
2. Symptoms include excessive thirst (polydipsia), hunger (polyphagia), and urination (polyuria) as the body tries to eliminate excess glucose via urine.
3. Diagnosis involves blood tests of glucose and HbA1c levels; management requires lifestyle changes and may include oral drugs or insulin depending on the type of DM.
Analytical Methods of Determining Diabetes Mellitus outlines several methods for testing and monitoring diabetes, including blood tests, urine tests, and glycated hemoglobin (HbA1c) levels. Key blood tests discussed are fasting blood glucose, oral glucose tolerance tests, and HbA1c. Urine tests examined include those for glucose, ketones, microalbumin, and protein. The document also reviews methods for measuring glucose and glycated hemoglobins, as well as guidelines for regularly testing lipids, kidney function, and liver enzymes in people with diabetes.
The pancreas secretes enzymes to help digest food and hormones like insulin and glucagon to regulate blood sugar levels. Diabetes occurs when the pancreas does not produce enough insulin or the body does not respond properly to insulin, resulting in high blood sugar. There are three main types of diabetes: type 1 is characterized by lack of insulin production; type 2 is caused by insulin resistance; and gestational diabetes develops during pregnancy. Long-term complications of high blood sugar include damage to organs and blood vessels. Diagnosis involves testing blood sugar levels through fasting plasma glucose tests or oral glucose tolerance tests.
Medical technology encompasses healthcare products that diagnose, monitor, or treat diseases. Medical technologists perform complex scientific tests on blood and body fluids to analyze results. Carbohydrate metabolism provides energy for the body and is tested through various methods by medical technologists, including tests for glycogen storage diseases, galactosemia, hypoglycemia, diabetic ketoacidosis, and diabetic hyperosmolar syndrome. These conditions are diagnosed through blood and other tests to determine levels of sugars, electrolytes, ketones, and other substances affected by carbohydrate metabolism. Treatment depends on rehydration and controlling blood glucose and ketone levels.
SIGNIFICANCE
OVERVIEW
WHAT IS DIABETES?
DEFINITION
MECHANISM
PREVELANCE
EPIDEMIOLOGY
CLASSIFICATION
GESTATIONAL DIABETES
RISK FACTORS
DIAGNOSIS
COMPLICATIONS
MEDICAL TEST
MEDICAL NUTRITIONAL THERAPY
HERBS FOR DIABETES
MYTHS AND FACTS
REFERENCES
The document discusses diabetes mellitus (DM), specifically:
1) DM occurs when the body does not properly regulate blood glucose levels due to insufficient insulin production or impaired insulin function, leading to hyperglycemia.
2) There are several types of DM including type 1 caused by autoimmune destruction of beta cells, type 2 related to lifestyle and genetics, and gestational DM occurring during pregnancy.
3) Insulin resistance and impaired beta cell function contribute to the development and progression of type 2 DM.
Diabetes mellitus is a group of metabolic disorders where there are high blood glucose levels due to issues with insulin secretion or insulin resistance. There are two main types: type 1 diabetes where the body does not produce insulin, and type 2 diabetes where the body does not properly use or produce enough insulin. Chronic complications can affect many organs and tissues over time through mechanisms like increased sorbitol pathway flux, formation of advanced glycation end products, and accelerated atherosclerosis, leading to conditions like retinopathy, neuropathy, nephropathy, and cardiovascular disease. Diagnosis involves evaluating symptoms and testing blood glucose levels via fasting plasma glucose, oral glucose tolerance tests, or A1C levels.
Ketoacidotic coma, also known as diabetic ketoacidosis (DKA), is a serious complication that occurs in people with diabetes when the body produces high levels of blood acids called ketones. It develops when the body cannot produce enough insulin to allow blood sugar to enter cells, causing the body to break down fat for energy and produce a buildup of ketones. Symptoms include thirst, frequent urination, nausea, vomiting, and confusion. Treatment involves fluid replacement, electrolyte replacement, and insulin therapy to lower blood sugar and acid levels. DKA requires emergency treatment in a hospital to prevent complications like low blood sugar, low potassium, and swelling of the brain.
Ketosis occurs when the body needs to break down body fat for energy due to low glucose levels. This produces ketones as byproducts. Ketosis takes place when there is insufficient glucose available, such as during low-carb diets, lack of insulin, or excessive alcohol use. Very high ketone levels can make the blood acidic and cause the dangerous ketoacidosis condition. Ketosis is treated by replacing fluids, electrolytes, and administering insulin therapy to reverse the processes that caused it.
Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel.
Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body produces high levels of acids called ketones due to insufficient insulin. Signs include excessive thirst, frequent urination, nausea, abdominal pain, weakness, shortness of breath, and fruity breath. Treatment involves fluid and electrolyte replacement through IVs as well as insulin therapy to lower blood sugar and reverse the condition. Preventing DKA requires carefully managing diabetes through medication, monitoring blood sugar, adjusting insulin as needed, and seeking help when ill.
This document discusses diabetes mellitus and its various types. It defines diabetes as a metabolic disorder characterized by hyperglycemia due to lack of insulin or cellular resistance to insulin. There are four main types of diabetes: type 1 usually diagnosed in childhood and requiring daily insulin injections; type 2 which is most common and often associated with obesity; gestational diabetes occurring during pregnancy; and pre-diabetes involving above average blood glucose. Symptoms, diagnostic tests, treatment options involving medications and insulin, and management are described for the different types of diabetes.
This document discusses diabetes mellitus and its various types. It defines diabetes as a metabolic disorder characterized by hyperglycemia due to lack of insulin or cellular resistance to insulin. The four main types of diabetes are described as type 1, type 2, gestational diabetes, and pre-diabetes. Type 1 diabetes is usually diagnosed in childhood and requires daily insulin injections. Type 2 diabetes is the most common type and is often associated with obesity. Gestational diabetes occurs during pregnancy and increases risk of future diabetes. Pre-diabetes involves above normal blood sugar levels that can lead to long-term health damage if not addressed.
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) and diabetic ketoacidosis (DKA) are complications of diabetes that can occur when insulin levels are inadequate. HHNS typically occurs in non-insulin dependent diabetics and is characterized by severe hyperglycemia and hyperosmolality without acidosis. DKA usually occurs in insulin-dependent diabetics and results in hyperglycemia, dehydration, and metabolic acidosis. Treatment of DKA involves fluid resuscitation, electrolyte replacement, and administration of insulin to resolve the acidosis.
Bio Whepon and COVID 19 - Is Corona Virus a Bio Weapon?Ravi Kumudesh
Is Corona Virus a Bio Weapon?
The Internet was brimming with conspiracies about the coronavirus, and, perhaps, one of the most prominent ones was that the virus could be a bioweapon.
According to an ET Prime report, a group of Chinese scientists in Canada were accused of spying and were stripped of their access to Canada’s National Microbiology Lab (NML) which is known to work on some of the most deadly pathogens.The alleged ‘policy breach’, highlighted the bioweapon program of other countries including China. Dr Francis Boyle, the creator of Bio Weapons Act, also claims that ‘the coronavirus is an offensive biological warfare weapon with DNA-genetic engineering’.Again, the claims about coronavirus being a biological weapon are unsubstantiated.
Novel Coronavirus thought to have transferred to Human from the seafood market in Wuhan, China become a one of the most dangerous viruses in the subfamily Orthocoronavirinae. According to the literature, the genome size of RNA of this viruses are greater than 20 kilobases.
Genetic engineers has committed to change the genes of some organisms to create new features of them, and this can be applied for the Coronavirus as well.
A real-time polymerase chain reaction (real-time PCR), also known as quantitative polymerase chain reaction (qPCR), is a laboratory technique of molecular biology based on the polymerase chain reaction (PCR). It monitors the amplification of a targeted DNA molecule during the PCR (i.e., in real time), not at its end, as in conventional PCR.
The reverse transcription - polymerase chain reaction (RT-PCR) is a sensitive technique for the quantification of steady-state mRNA levels, particularly in samples with limited quantities of extracted RNA, or for analysis of low level transcripts. The procedure amplifies defined mRNA transcripts by taking advantage of retroviral enzymes with reverse transcriptase (RT) activity, coupled to PCR.
Escape the trap Teaching Hospital Anuradhapura 2019Ravi Kumudesh
The document discusses implementing quality management systems and a laboratory information management system (LIMS) in a medical laboratory. It provides an overview of total quality management (TQM) principles and components of an effective LIMS. The document outlines initial steps for assessing the needs and relevance of a TQM program and LIMS for the laboratory, which include evaluating personnel qualifications, training requirements, and customizing the systems to meet the laboratory's specific needs. Key elements that must be addressed include effective communication, data protection, and standardized request forms.
Laboratory quality towards patient centered careRavi Kumudesh
1) The document discusses approaches to improving quality in medical laboratories through total quality management and patient-centered care. It focuses on reducing errors, improving processes, and meeting customer expectations through accreditation.
2) A key aspect is defining customers as both external patients and internal departments, and measuring service quality according to reliability, assurance, tangibles, empathy, and responsiveness. The goal is consistently high quality at a lower cost through patient-centered approaches.
3) Patient-centered care in medical laboratories means respecting patient values and preferences, sharing complete information, encouraging participation in care, and collaborating with patients on policies and programs. This helps improve outcomes and experiences for patients.
Total quality management for medical labs ravi kumudeshRavi Kumudesh
Ensuring establishment of QMS
Implementation and Maintain QMS
Maintain Quality policy
Assist to documentation of Quality Objective
Assist to establishment of Quality Objective
Crate awareness of users in the lab
Assist preparation, administration, dissemination and regular review of quality Manual
Assist to maintaining document Control System,
Maintain Technical Records
Assist to control clinical material
Participate to Management Review
Total Quality Management for Medical Labs - Ravi KumudeshRavi Kumudesh
Duties of Qualty Manager
Ensuring establishment of QMS
Implementation and Maintain QMS
Maintain Quality policy
Assist to documentation of Quality Objective
Assist to establishment of Quality Objective
Crate awareness of users in the lab
Assist preparation, administration, dissemination and regular review of quality Manual
Assist to maintaining document Control System,
Maintain Technical Records
Assist to control clinical material
Participate to Management Review
Accuracy of Laboratory Parameters in Management of CKD.Ravi Kumudesh
This document discusses laboratory parameters for managing chronic kidney disease (CKD). It covers direct and indirect methods of nutritional assessment, modifiable and non-modifiable risk factors for CKD, types of assays including static and functional, targets for assay accuracy and precision, categories and specific tests of renal function including glomerular filtration rate (GFR) tests. It addresses factors that can interfere with creatinine levels, patient preparation, reference ranges, and interpretation of creatinine concentrations. Stages of CKD and roles in patient safety are outlined. Alternative ways to identify early CKD and approaches for the future are proposed.
Accuracy of Laboratory Parameters in Management of CKD and NCDRavi Kumudesh
New model for Health care delivery is suggesting to replace traditional health care organisational structure in Sri Lanka. This type of innovation is essential for "Non Patient" type healthcare receivers, such as "Healthy healthcare receivers" and "Risk Groups".
This topic is inspired by Secretary, CMLS.SL at the Annual Academic Sessions of DiASL on April 22, 2017.
CMLS.SL - College of Medical Laboratory Science, Sri Lanka
DiASL - Dietetic Association of Sri Lanka
The document discusses the importance of Earth's atmosphere and its composition and structure. It is composed primarily of nitrogen and oxygen and helps protect the planet from radiation. The atmosphere is divided into five layers - the troposphere, stratosphere, mesosphere, thermosphere and exosphere - with properties like temperature and pressure changing with altitude. Each layer plays an important role in regulating the planet's climate and shielding its surface.
This seems to fit in with a campaign explicitly aimed at linking trade unionists with terrorist insurgents. Key trade union activists who participated in the Fort Railway Station protest on 6 February are now being publicly accused of being covert terrorist operatives. Since 8 February, posters depicting trade union leaders as traitors and terrorists have begun to appear in many parts of the country, calling for their arrest. Anton Marcus of the Free Trade Zone and General Services Employees' Union (FTZGSEU), which is affiliated to the International Textile, Garment and Leather Workers' Federation (ITGLWF), Sman Ratnapriya and Ravi Kumudesh of the Health Sector Trade Union Alliance (HSTUA), Sampath Rajitha and Raja Kannangara of the Joint Railway Trade Union Alliance (JRTUA), and Joseph Stalin of the Ceylon Teachers' Union (CTU) are among the targeted trade unionists.
Administration Regulations - Management Hierarchy for Ministry of HealthRavi Kumudesh
Administration Regulations - Management Hierarchy for Ministry of Health
The three levels of management typically found in an organization are low-level management, middle-level management, and top-level management. Top-level managers are responsible for controlling and overseeing the entire organization.
Administration Regulations Chapter xxxii - Political RightsRavi Kumudesh
Administration Regulations Chapter xxxii - Political Rights
Civil and political rights are a class of rights that protect individuals' freedom from infringement by governments, social organizations, and private individuals. They ensure one's ability to participate in the civil and political life of the society and state without discrimination or repression.
Administration Regulations Chapter xxiv - Loans
A loan is a debt provided by an entity (organization or individual) to another entity at an interest rate, and evidenced by a promissory note which specifies, among other things, the principal amount of money borrowed, the interest rate the lender is charging, and date of repayment.
Administration Regulations Chapter xlviii - Disciplinary Action
Staff Employee Disciplinary Action: When and How to Take It. Disciplining employees is a difficult part of supervision and management. It is important that you address performance issues as they arise and pursue a progressive approach to discipline.
This document discusses various topics related to health care management and patient satisfaction. It addresses how to delight patients, provide quality service, and handle complaints effectively. It emphasizes treating the patient as the most important person and focusing on their experience. Specific tips are provided for dealing with angry patients and common patient complaints. The importance of seeing things from the patient's perspective is highlighted. Overall, the document stresses prioritizing excellent patient care, communication and satisfaction.
Guide to Professional Success by Ravi KumudeshRavi Kumudesh
"Guide to Professional Success"
Management training for Allied Health Science internship
Lecture By, Ravi Kumudesh
President - Sri Lanka Society for Medical Laboratory Science
December 2, 2016 (1st Group)
December 9, 2016 (2nd group)
National Institute of Health Science (NIHS)
Kaluthara, Sri Lanka
This document provides tips and advice for laboratory managers. It discusses that while laboratory managers want to focus on research, their roles often involve more administrative tasks like ordering supplies, managing people and meetings. It emphasizes that leadership and management skills are important for all science careers. The document outlines that effective laboratory management involves planning with a long-term strategy, organizing people and resources, providing leadership, and controlling projects. It provides suggestions for setting clear standards, empowering lab members, celebrating successes, and finding time for fun alongside work.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
1. Sri Lanka Society for Medical Laboratory Science
slsmls.org / kumudeshr@gmail.com
Diabetic Profile
Ravi Kumudesh
MSc/BSc/Dip(MLT)
2. Diabetes Mellitus
• It is a chronic disease due to
disorder of carbohydrate
metabolism, due to insulin
deficiency results in
hyperglycemia (increased
blood glucose level) &
glucourea (presence of
glucose in urine).
• Associated with several
changes in metabolism; such
as metabolism of proteins &
fats.
slsmls.org / kumudeshr@gmail.com
3. • Glucosuria.
• Large volume of urine
• increase urination frequency
(Polyuria)
• Polyphagia (eats more frequently)
• Several metabolic changes
slsmls.org / kumudeshr@gmail.com
4. Metabolic changes in diabetes
Include increase in:
Fat catabolisim leads to increase in FFAs in blood & liver.
Acetyl.coA leads to increase formation of cholesterol &
risk of atherosclerosis.
ketone bodies generation in blood and urine leads to
acidosis.
catabolism of tissue protein due to energy requirement
(because glucose can't uptake by cells) lead to weight
loss and increase in level of amino acids in blood & more
formation of urea by deamination of amino acid.
slsmls.org / kumudeshr@gmail.com
5. Types of diabetes
• Type I diabetes mellitus (TIDM)
• Type 2 diabetes mellitus (TIIDM)
• Gestational diabetes mellitus (GDM)
• Other "due to drugs or chemicals"
slsmls.org / kumudeshr@gmail.com
6. Is group of tests that are used to diagnose diabetes
or its complications , it includes:
Blood glucose
4 types: FBS, PPBS, RBS, OGGT
Urine Analysis
Urine Sugar / Urine Protein /Urine Microalbumin / Ketones
HbA1C
Insulin
ICA (islent cell antibody) for type I
C-peptide
slsmls.org / kumudeshr@gmail.com
9. Glucosuria
o First-line screening test for diabetes
mellitus
o Normally glucose does not appear in urine
until the plasma glucose rises above 160-
180 mg/dl.
o In certain individuals due to low renal
threshold glucose may be present despite
normal blood glucose levels.
o Conversely renal threshold increases with
age so many diabetics may not have
Glycosuria despite high blood sugar levels.
Positive
Benedict’s test
10. o A specific and convenient method to
detect glucosuria is the paper strip
impregnated with glucose oxidase and
a chromogen system (Clinistix,
Diastix), which is sensitive to as little
as 0.1% glucose in urine.
o Diastix can be directly applied to the
urinary stream, and differing color
responses of the indicator strip reflect
glucose concentration.
o Benedict’s and Fehling’s test can
also detect glucosuria.
Diastix-
Reagent strips
12. o The importance of micro-
albuminuria in the diabetic
patient is that it is a signal
of early reversible renal
damage.
o Performing an albumin-to-
creatinine ratio is probably
easiest.
o Microalbuminuria is a
common finding (even at
diagnosis) in type 2
diabetes mellitus and is a
risk factor for macro
vascular (especially
coronary heart) disease.
Gradation of turbidity is linked to
protein concentration
slsmls.org / kumudeshr@gmail.com
Microalbuminuria
13. Microalbuminuria
o May be defined as an albumin
excretion rate intermediate
between normality (2.5-25 mg/day)
and macroalbuminuria
(250mg/day).
o The small increase in urinary
albumin excretion is not detected
by simple albumin stick tests and
requires confirmation by careful
quantization in a 24 hr urine
specimen.
15. Specimen Collection for Microalbimin
• Collect freshly voided urine in a clean, dry
container
• Preservatives should be avoided
• Samples which cannot be tested within 3 days of
collection should be refrigerated
• Samples should not be frozen
• The test should be free from significant
interference from glucosuria, pH, ketonuria or
bacterial contamination
slsmls.org / kumudeshr@gmail.com
16. MICRAL Strips
Micral strip screening tests offer a cost-
effective method of screening
Dip sticks show acceptable sensitivity (95%)
and specificity (93%)
All positive tests should be confirmed by
more specific methods
slsmls.org / kumudeshr@gmail.com
19. What Are Ketones?
Acids that result when the body does not have
enough insulin and uses fats for energy
May occur when insulin is not given, during
illness or extreme bodily stress, or with
dehydration
Can cause abdominal pain, nausea, and vomiting
Without sufficient insulin ketones continue to
build up in the blood and result in diabetic
ketoacidosis (DKA)
slsmls.org / kumudeshr@gmail.com
20. Why Test for Ketones?
DKA is a critical emergency state
Early detection and treatment of ketones
prevents diabetic ketoacidosis (DKA) and
hospitalizations due to DKA
Untreated, progression to DKA may lead to
severe dehydration, coma, permanent brain
damage, or death
DKA is the number one reason for hospitalizing
children with diabetes
slsmls.org / kumudeshr@gmail.com
21. When Should Ketones Be Checked?
The DMMP should specify, generally:
When blood glucose remains elevated
During acute illness, infection or fever
Whenever symptoms of DKA are present
Nausea
Vomiting or diarrhea
Abdominal Pain
Fruity breath odor
Rapid breathing
Thirst and frequent urination
Fatigue or lethargy
Common symptoms including fruity odor to breath,
nausea, vomiting, drowsiness, abdominal pain
−
slsmls.org / kumudeshr@gmail.com
22. How Quickly Does DKA Progress?
An isolated high blood glucose reading, in the absence
of other symptoms is not cause for alarm
DKA usually develops over hours, or even days
DKA can progress much more quickly for students who
use insulin pumps, or those who have an illness or
infection
Most at risk when symptoms of DKA are mistaken for
flu and high blood glucose is unchecked and untreated
slsmls.org / kumudeshr@gmail.com
23. Checking for Ketones
Urine testing
Most widely used method
Blood testing
Requires a special meter and strip
Procedure similar to blood glucose checks
slsmls.org / kumudeshr@gmail.com
24. 1. Gather supplies
2. Student urinates in clean cup
3. Put on gloves, if performed by someone
other
than student
4. Dip the ketone test strip in the cup
containing urine. Shake off excess urine
5. Wait 15 - 60 seconds
6. Read results at designated time
7. Record results, take action per DMMP
How to Test Urine Ketones
slsmls.org / kumudeshr@gmail.com
25. Test Results: Color Code
no ketones
trace
small
moderate
large ketones present
slsmls.org / kumudeshr@gmail.com
26. Considerations
Colors on strips and timing vary according
to brand
If using a scale with “urine glucose” and
“urine ketones,” be sure to read the correct
scale when testing for ketones
Follow package instructions regarding
expiration dates, time since opening,
correct handling, etc., as incorrect results
may occur
slsmls.org / kumudeshr@gmail.com
27. How To Test for Blood Ketones
1. Prepare lancing device
2. Wash hands using warm soapy
water and dry them completely
3. Remove the test strip from its foil
packet
4. Insert the three black lines at the
end of the test strip into the strip
port
5. Push the test strip in until it stops
slsmls.org / kumudeshr@gmail.com
28. How To Test for Blood Ketones
6. Touch the blood drop to the purple
area on the top of the test strip. The
blood is drawn into the test strip
7. Continue to touch the blood drop to
the purple area on the top of the test
strip until the monitor begins the test
8. The blood ß-Ketone result shows on
the display window with the word
KETONE
slsmls.org / kumudeshr@gmail.com
29. Ketonuria
o Qualitative detection of
ketone bodies can be
accomplished by nitroprusside
tests (Acetest or Ketostix),
Rothera’s test etc.
o These tests do not detect
Beta-hydroxy butyric acid,
which lacks a ketone group
o Ketone bodies may be
present in a normal subject as
a result of simple prolonged
fasting.
Positive
Rothera’s
test
Ketostix-
Reagent
strips
31. 1. Fasting blood sugar (FBS)
• Measures blood glucose after fasting for at least 8-12 hrs
• It often is the first test done to check for diabetes.
• patient with mild or borderline diabetes may present
with normal FBG values.
• If diabetes is suspected, GTT can confirm the diagnosis.
Normal levels:
70-110mg/dl
slsmls.org / kumudeshr@gmail.com
32. 2. Post-Prandial Blood Sugar (2-hour PPBS)
• After the patient fasts for 12 hours, a meal is
given which contains starch and sugar
(approx. 100 gm).
• Then after 2 hours blood is collected to
measure glucose level.
• home blood sugar test is the most common
way to check 2-hour postprandial blood sugar
levels.
slsmls.org / kumudeshr@gmail.com
33. 3. Random blood sugar (RBS)
measures blood glucose randomly at any time
throughout the day without patient fasting.
it is useful because glucose levels in healthy
people don’t vary widely throughout the day.
blood glucose levels that vary widely may
indicate a problem.
slsmls.org / kumudeshr@gmail.com
34. 4. Oral glucose tolerance test (OGTT)
• Glucose Tolerance is defined as the capacity of the body
to tolerate an extra load of glucose or it measures the
body's ability to use glucose.
• It is series of blood glucose measurements taken after
drink glucose liquid
• It is considered as definitive diagnostic test for DM.
• It is ordered to:
Confirm the diagnosis, in pre-diabetic
Diagnose gestational diabetes (most commonly)
• Recommended if 100-126 mg/dL (5.5 mmol/L-7.0 mmol/L)
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35. Arrive FBS: After an overnight fasting
(10-12 hrs)
Drink: 75-100g dissolved in 250-300ml of
water and given orally.
After drink: blood samples and urine are
collected every 30min for 3hrs
(1 hr, 1.5 hr , 2hr, 2.5hr, 3hr )
A curve between time and blood glucose
concentration, is plotted.
Procedure
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36. • Extended GTT :
Glucose measured for 4-5 hrs after giving glucose to see how the
curve behaves below the normal fasting glucose limits. Done in
some conditions causing hypoglycaemia.
• Cortisone Stressed GTT :
Can be used for detecting latent DM.
• Intravenous GTT :
Is done if oral glucose is not tolerated or oral GTT curve is
flat.
In these cases 20% glucose as 0.5g glucose/Kg body weight.
Usually peak occurs within 30 min after infusion and returns
to normal after 90 min.
Other types of OGTT
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37. Interpretation
Normal Response :
FBS is normal. After 1 hr it will rise, returns to normal fasting
level within 2 hours.
Diabetic curve :
FBS: 140mg/dl or 7.8 mmol/L. After 2 hr: 200mg/dl (11
mmol/L) or more. Glucosuria is usually seen
Impaired GTT:
with 2hrs glucose level between 140mg/dl - 200mg/dl
It is not abnormal but must be followed up for DM.
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38. Hypoglycemia :
• When blood glucose falls below 60 mg/dl.
Causes
1. Most commonly seen in overdose of insulin in
treatment of DM.
2. Hypothroidism.
3. Insulin secreting tumours of pancrease – rare.
4. Hypoadrenahsm (Addison's disease)
5. Hypopitruitism.
6. Severe exercise.
7. Starvation.
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39. Principle:
Glucose + H2O + O2 Gluconic acid + H2O2
2H2O2 + 4 aminoantipyrine + PHBS Quinoneimine dye + H2O
Red color
POD
GOD
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46. Hb A1C
HbA1C: is glucose bound to hemoglobin
Measures blood glucose conc. over a longer period of time
It indicates how well diabetes has been controlled in the 2-3
months before the test.
The A1C level is directly related to complications from diabetes
Type of sample: whole blood in EDTA tube
Normal Values
Glycohemoglobin A1c:4.5%-5.7%
Total glycohemoglobin:5.3%-7.5%
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47. Key Messages
1. Glycated hemoglobin (A1C) measure every
3 months (6 months if stable at target)
2. Self monitoring Blood Glucose (SMBG) is an aid
to assess interventions and hypoglycemia
3. Individualize the frequency of SMBG
4. SMBG and continuous glucose monitoring (CGM)
needs to be linked with structured educational
program to facilitate behavior change
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48. Glycated Hemoglobin: A1C
• Reliable measure of mean plasma glucose
over 3-4 months
• Valuable indicator of treatment effectiveness
• Measure every 3 months when glycemic
targets are not being met or treatments
adjusted
• Measure every 6 months if stable at glycemic
targets
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49. Conditions that can Affect Value
Factors affecting A1C Increased A1C Decreased A1C Variable Change
in A1C
Erythropoiesis B12/Fe deficiency Decreased
erythropoiesis
Use of EPO, Fe, or B12
Reticulocytosis
Chronic liver Dx
Altered hemoglobin Fetal hemoglobin
Hemoglobinopathi
es Methemoglobin
Altered glycation Chronic renal failure
↓↓erythrocyte pH
ASA, vitamin C/E
Hemoglobinopathies
↑ erythrocyte pH
Erythrocyte destruction Splenectomy Hemoglobinopathies
Chronic renal failure
Splenomegaly
Rheumatoid arthritis
HAART meds,
Assays Hyperbilirubinemia
Carbamylated Hb
ETOH
Chronic opiates
Hypertriglyceridemia
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51. Insulin is the primary hormone responsible for controlling glucose
metabolism, and its secretion is governed by plasma glucose
concentration.
The insulin molecule is synthesized in the pancreas
The principal function of insulin is to control the uptake and
utilization of glucose in the peripheral tissues.
Insulin concentrations are severely reduced in insulindependent
diabetes mellitus (IDDM) Other conditions, non-insulin-dependent
diabetes mellitus (NIDDM), obesity, and some endocrine
dysfunctions.
Insulin Test - Clinical Relevance
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52. The Insulin ELISA is a two-site enzyme immunoassay utilizing the direct
sandwich technique with two monoclonal antibodies directed against separate
antigenic determinants of the insulin molecule.
Specimen, control, or standard is pipetted into the sample well, then followed
by the addition of peroxidase-conjugated anti-insulin antibodies.
Insulin present in the sample will bind to anti-insulin antibodies bound to the
sample well, while the peroxidase-conjugated anti-insulin antibodies will also
bind to the insulin at the same time.
After washing to remove unbound enzyme-labelled antibodies, TMB-labelled
substrate is added and binds to the conjugated antibodies.
Acid is added to the sample well to stop the reaction, and the colorimetric
endpoint is read on a microplate spectrophotometer set to the appropriate
light wavelength.
Insulin - Test Principle
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54. Using the indirect fluorescent antibody method enables serologic
assessment or possible detection of pancreatic disease.
The presence of a (histologically defined) circulating antibody to one or
more of the islet cell antigens can aid in patient diagnosis and prognosis.
The substrate utilized in this kit is sections of monkey pancreas. Islet Cell
antibodies have been associated with a group of "autoimmune" endocrine
disorders, more specifically with insulin dependent diabetes.
Organ-specific autoimmunity is characterized by the presence of
antibodies in patients that can be detected years before the onset of the
clinical symptoms.
Patients with autoimmune thyroiditis, adrenalitis or gastritis have an
increased risk of developing insulin dependent diabetes at any age.
Demonstration of Islet Cell Antibody (ICA)
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55. The indirect fluorescent antibody test is used for the detection of human
IgG antibody to the antigens of monkey pancreas islet cells.
Tissue is placed in the wells of specially prepared microscope slides.
Dilutions of patient sera are placed on the wells where antibody, if present,
binds to the antigen.
The reaction is visualized through the use of a conjugate.
The conjugate is fluorescein isothiocyanate (FITC) labeled, anti-human IgG
Excitation of the FITC by ultraviolet (UV) light causes this dye to emit
longer, visible, wavelengths of light in the yellow-green portion of the color
spectrum.
The conjugate will bind with human IgG antibodies attached to the
antigens causing fluorescence when viewed through a microscope
equipped with a UV light source
Test Principle and Procedure
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57. C-peptide testing can be used for a few different
purposes
C-peptide is a substance produced by the beta cells in
the pancreas when pro insulin splits apart and forms
one molecule of C-peptide and one molecule of insulin
Insulin is the hormone that is vital for the body to use
its main energy source, glucose
Since C-peptide and insulin are produced at the same
rate, C-peptide is a useful marker of insulin production
C-peptide Test
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58. Sweating
Palpitations
Hunger
Confusion
Blurred vision
Fainting
In severe cases, seizures
loss of consciousness
When is it ordered?
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59. What does the test result mean?
A high level of C-peptide generally indicates a high level
of endogenous insulin production. This may be in response to a high blood
glucose caused by glucose intake and/or insulin resistance.
A high level of C-peptide is also seen with insulinomas and may be seen
with low blood potassium, Cushing syndrome, and renal failure
When used for monitoring, decreasing levels of C-peptide in someone with
an insulinoma indicate a response to treatment; levels that are increasing
may indicate a tumor recurrence
A low level of C-peptide is associated with a low level of insulin production.
This can occur when insufficient insulin is being produced by the beta cells,
with diabetes for example, or when production is suppressed by treatment
with exogenousinsulin
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