Notes about blood hemoglobin estimation, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Notes about blood hemoglobin estimation, lecture notes to Medical Laboratory Students at Medical Laboratory Technology, Middle Technical University, Baqubah, Iraq
Fetal hemoglobin and rh incompatibilityrohini sane
A comprehensive presentation on fetal hemoglobin & Rh incompatibility for undergraduate medical, dental, biotechnology & pharmacology students for self-learning .Presentation has physical & chemical properties of fetal hemoglobin along with its function. Binding affinity for O₂ of HbF and oxygen dissociation curve for HbF elucidated with suitable diagrams. Molecular constitution of Embryonic Hb ( Grover I &Grover II )with electrophoretic patterns are presented here . Importance of Kleihauer staining for detection of fetal cells is described briefly.
Diagrammatic representation of Rh- incompatibility is done for complete understanding of the concept. Signs & symptoms Kernicterus are presented diagrammatically.
Direct and indirect Coomb’s Test for Rh- incompatibility for diagnosis of Erythroblastosis Fetalis is illustrated. Biochemical aspects of Hemolytic Disease of Newborn (HDN) and Physiological /Neonatal Jaundice are presented. Comparison of Causes & biochemical findings for Hemolytic Jaundice along hepatic and obstructive jaundice is done in this presentation.
Molecular mechanism involved in biosynthesis of Hb Bart and Hb H along with their electrophoretic patterns for their detection are illustrated.
Hereditary persistent fetal Hb( HPFH ) & Point mutations causing HPFH are described in lucid manner. Google images are used for intense impact of the subject.
Fetal hemoglobin and rh incompatibilityrohini sane
A comprehensive presentation on fetal hemoglobin & Rh incompatibility for undergraduate medical, dental, biotechnology & pharmacology students for self-learning .Presentation has physical & chemical properties of fetal hemoglobin along with its function. Binding affinity for O₂ of HbF and oxygen dissociation curve for HbF elucidated with suitable diagrams. Molecular constitution of Embryonic Hb ( Grover I &Grover II )with electrophoretic patterns are presented here . Importance of Kleihauer staining for detection of fetal cells is described briefly.
Diagrammatic representation of Rh- incompatibility is done for complete understanding of the concept. Signs & symptoms Kernicterus are presented diagrammatically.
Direct and indirect Coomb’s Test for Rh- incompatibility for diagnosis of Erythroblastosis Fetalis is illustrated. Biochemical aspects of Hemolytic Disease of Newborn (HDN) and Physiological /Neonatal Jaundice are presented. Comparison of Causes & biochemical findings for Hemolytic Jaundice along hepatic and obstructive jaundice is done in this presentation.
Molecular mechanism involved in biosynthesis of Hb Bart and Hb H along with their electrophoretic patterns for their detection are illustrated.
Hereditary persistent fetal Hb( HPFH ) & Point mutations causing HPFH are described in lucid manner. Google images are used for intense impact of the subject.
Red blood cells (RBCs), also called erythrocytes, are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen (O2) to the body tissues—via blood flow through the circulatory system.
Techniques related to blood and related diseases. And tests for underlying disease detection. Blood dyscrasia and clotting disorders can be detected by Bleeding time and clotting time tests.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Learning Objectives
• By the end of this class, you should know
about
• Basic Structure of Hemoglobin.
• Function of Hemoglobin.
• Various laboratory methods for estimation of
Hemoglobin.
• Enumerate the advantages and disadvantages
of each method.
3. Introduction
• Hemoglobin is the major constituent of the
red cell cytoplasm, accounting for
approximately 90% of the dry weight of the
mature cell.
• It is comprised of heme and globin.
4. Structure of Hemoglobin
• Hemoglobin molecule is a tetramer
consisting of two pairs of similar
polypeptide chains called globin
chains.
• To each of the four chains is attached
heme which is a complex of iron in
ferrous form and protoporphyrin.
• The major (96%) type of
hemoglobin present in adults is
called HbA and it has
2 alpha globin chains and
2 beta globin chains (α2β2).
5. Structure of Hemoglobin
• The gene that codes for
• the formation of α globin
chains is located on
chromosome 16.
• The gene that codes for the
formation of β globin chains is
on chromosome 11.
• In adults, a minor amount of
HbA2 (α2β2) is also present
and constitutes less than
3.5%.
6. During embryonic and fetal life, other different types of hemoglobins predominate.
• Gower I, Gower II and Hb Portland present in early embyronic life.
• After the 8th week of development, embryonic hemoglobins are replaced by Fetal hemoglobin HbF
(α2β2)
– This remains the predominant hemoglobin until after birth and constitutes 50-90% of the total hemoglobin.
– After birth, it’s concentration decreases to less than 2% by 30 weeks of age.
• HbA is then the predominant hemoglobin.
• HbA2
• Abnormal - HbS,HbC,HbD,HbE
Haemoglobin variants
7. Function of Hemoglobin
• Heme has the ability to
bind oxygen reversibly and
carry it to tissues.
• It also facilitates the
exchange of carbon dioxide
between the lungs and
tissues.
Thus, hemoglobin functions
as the primary medium of
exchange of oxygen and
carbon dioxide.
10. Blood can be collected from 3 different
sources:
Capillary blood.
Venous blood.
Arterial blood.
11.
12. • Determine presence and severity of anemia
• Screening for polycythemia
• Response to specific therapy in anemia
• Estimation of red cell indices
• Selection of blood donors
Indications for Hb estimation
13. • Colour comparison between standard and test sample by
Visual methods
– Sahlis acid hematin,
– Tallqvist hemoglobin chart,
– WHO hemoglobin Color scale,
– Oxyhemoglobin Method
– Specific gravity method
Photoelectric methods
Cyanhemoglobin method
Oxyhemoglobin Method
Alkaline Hematin Method
Colorimetric methods
14. Gasometric Method
Oxygen carrying capacity
measured by Van Slyke apparatus
Based on formula,1 gm of Hb
carries 1.34 ml of oxygen
It does not measure
carboxyhemoglobin
sulfhemoglobin
methemoglobin.
Time-consuming and expensive.
Result is 2 percent less than other
methods.
15. • Iron content of hemoglobin is first estimated.
• Indirectly Hb is derived - 100 grams of
hemoglobin contain 374 grams of iron.
• Time-consuming method.
• This method is used to calibrate all other
methods of Hb estimation.
Chemical method
16. • Rough estimate is made from specific gravity
of blood
• Copper sulfate technique.
• Used in mass screening like selection of
donors.
Specific Gravity method
17. • Rapid and simple
• Commonly used in blood donor selection
• A drop of blood is allowed to fall in copper
sulphate solution of specific gravity of 1.053 from
a height of 1 cm
• Specific gravity is equivalent to 12.5 grams/dl
• Drop gets covered with copper proteinate
• If drop sinks,specific gravity is higher than copper
sulfate
Specific Gravity Method
18. Principle -
• Blood is mixed with an acid solution so that
Hb is converted to brown colored acid
hematin
• Diluted with water till brown colour matches
that of brown glass standard
• Hb value is read directly from the scale
Sahli’s Acid Hematin Method
21. Sahli’s Acid Hematin Method
• Place N/10 HCl into Hb tube upto 2
grams.
• Blood sample in Sahli’s Hb pipette
upto 20 micro litre.
• Add blood sample to acid solution.
• Mix with a stirrer.
• Allow to stand for 10 minutes.
• Add distilled water drop by drop till
the colour of the solution matches
to brown glass standard.
• Take the reading of the lower
meniscus from the graduated tube in
grams.
22. Sahli’s Acid Hematin Method
Advantages
• Easy to perform
• Quick
• Inexpensive
• Can be used as a bedside procedure
• Does not require technical expertise
23. Disadvantages
• For maximum colour, longer time is required
• Perfect matching with brown glass standard is not
possible
• Carboxyhemoglobin,methemoglobin and
sulfhemoglobin are not converted to acid hematin
• Developed of colour is slow and acid hematin is not
stable
• Source of light will influence the comparison of colours
Sahli’s Acid Hematin Method
24. • Most accurate method for estimation of Hb.
• Recommended by International Committee
for Standardisation in hematology because : -
All forms of Hb are converted to cyanmethemoglobin
(except sulfhemoglobin)
Stable and reliable standard is available.
Cyanmethemoglobin Method
25. Principle
• Blood is mixed with Drabkins solution.
Drabkins solution –pH 7.0 -7.4
Potassium ferricyanide
Potassium cyanide
Potassium dihydrogen phosphate
Non-ionic detergent
Distilled water
• Erythrocytes are lysed producing an evenly distributed Hb solution.
• Potassium ferricyanide converts Hb to methemoglobin.
• Methemoglobin combines with potassium cyanide to form cyanmethemoglobin.
• All Hbs present in blood are converted to this form.
• Absorbance is measured in spectrophotometer at 540 nm
• To obtain amount of unknown Hb sample,its absorbance is compared with the standard
cyanmethemoglobin solution
Cyanmethemoglobin Method
26. Cyanmethemoglobin Method - Equipment
• Photoelectric
colorimeter or
spectrophotometer
• Sahlis pipette at 20
micro litre
• Pipette 5 ml
27. • Take 5 ml of Drabkins solution and to it add 20
microlitres of blood
• Stopper the tube,mix by inverting serveral times
• Allow to stand for 5 minutes
• Transfer the sample to cuvette
• Read the absorbance in the spectrophotometer
at 540 nm
• Also take the absorbance of the standard solution
Cyanmethemoglobin Method
28. • Hemoglobin is derived from the formula
below
Cyanmethemoglobin Method
29. • A graph can be plotted when a large number of
samples are processed
• Hb concentration on horizontal axis and
absorbance on vertical axis
Note
• Hypertriglyceremia,leucocytosis,plasma cell
dyscrasias cause erroneous results
• Cyanmethemoglobin solution is stable
• Any delay will not affect the result
Cyanmethemoglobin Method
30. Cyanmethemoglobin Method
Advantages
• All forms of Hb except sulphemoglobin are converted to
hemiglobincyanide/cyanmethemoglobin (HiCN).
• Visual error is not there as no color matching is required.
• Cyanmethemoglobin solution is stable and it’s color does not fade with
time so readings may not be taken immediately.
• Absorbance may be measured soon after dilution.
• A reliable and stable reference standard is available from World Health
Organisation for direct comparison
31. Cyanmethemoglobin Method
Disadvantages
• Diluted blood has to stand for a period of time to ensure complete
• conversion of Hb.
• Potassium cyanide is a poisonous substance and that is why Drabkin’s
• solution must never be pipetted by mouth.
• The rate of conversion of blood containing carboxyhemoglobin is slowed
• considerably. Prolonging the reaction time to 30min can overcome this
• problem.
• Abnormal plasma proteins cause turbidity when blood is diluted with
• Drabkin’s solution.
• A high leucocyte count also causes turbidity on dilution of blood.
Centrifuging the diluted blood can help overcome the turbidity.
32. • Modification of cyanehaemoglobin method
• Other chemicals-sodium lauryl
sulphate,imidazole,sodium dodecyl sulphate
• Measurements are made at various
wavelengths depending on final stable
product
Automated Blood Count Method
33. • MCV,MCHC,RDW,hematocrit and platelet
parameters
• Two chambers-
– Hb/WBC chamber
– RBC/platelets chamber
3 part Differential Analyzers
34. 5 part Differential Analyzers
• Classify cells as
neutrophils,eosinophils,
basophils,lymphocytes
and monocytes
• These provide accurate
platelet count,red cell
parameters including
various reticulocyte
parameters,immature
platelets
35. • Series of lithographed colors said to correspond
to Hb values ranging from 10 to 100 percent
• Blood obtained from finger puncture
• Placed on a piece of absorbent paper
• Colour is matched against the colour on the chart
• Corresponding reading taken
• Cheap and simple
• Error-20 to 50 percent
Tallqvist Hemoglobin Chart
36.
37. • Devised by Scott and Lewis
• Principle is similar to Tallqvist method
• Rapid,simple,inexpensive,reliable
• 1 gram/dl for diagnosis of anemia
• Printed set of colors corresponding to Hb values
from 4-14 grams/dl
• Efficiency-greater than 90 percent in detecting
anemia
• 86 percent-in classifying its grade
WHO Hemoglobin Colour Scale
38. • Useful for screening blood donors
• Screening women and children in health
programmes
• Iron-therapy
WHO Hemoglobin Colour Scale
39.
40. • Blood mixed with weak ammonia solution
• Absorbance compared with the standard
• Rapid and simple
• No stable solution is available
Oxyhemoglobin Method
41. • Adult males- 150 ± 20 g/l.
• Adult females(non pregnant )- 135 ± 15 g/l.
• Various methods of Hb are-
– Sahli’s acid hematin.
– Cyanhemoglobin Method.
– Gasometric Methods.
– Tallqvist Hemoglobin Chart.
– WHO Hemoglobin Color Scale.
– Oxyhemoglobin Method.
– Oxyhemoglobin Method.
• Most commonly practiced is Sahlis acid hematin method.
• Principle - Hb converted to hematin on mixture with acid solution.
• Most accurate method for estimation of Hb is Cyanhemoglobin Method.
Summary