Arham Anwar

13/08/2024

Continuing what we started
Today we will talk about
Manual counting of blood images

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Above are pictures I downloaded from Google of the shape of the counting slide
🌺Hemocytometer
🌺The shape of white blood cells
🌺The shape of a complete blood film

Here we start and say
What is a complete blood picture
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🌺White count
🌺Red count
🌺Platelet count

And all of them after them with the lens 10

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First

💖Red blood count
.. We take 2 ml of the red counting solution

+
10 microns of blood

And wait 5 minutes

And then we add 20 microns to the counting slide

🧐🧐..It is necessary After placing the solution on the slide, we wait a minute before starting the count, taking care not to form air bubbles.

🌺🌺🌺So, how do we count?

We count in 16 small squares in each of the five squares in the middle of the slide

And the result of the count combined we multiply by
10 thousand
Meaning
👇
If the squares were counted, it was
90
83
87
95
85
If their sum is 440
Then the number of red blood cells =
=440×10000=4440000

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Secondly
🌺White count

In it, we take
190 microns of the white counting solution

+10 microns of blood
We wait 5 minutes and then we count in the counting slide in the large squares
And we multiply the result by 50

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Note
When counting blood cells in the squares, we must go through the rows of squares in the form of Zigzag so we don't forget and repeat the count in a row of rows

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For example

The number of squares was as follows

20
25
35
25
If their sum = 105
If the number of white blood cells
105×50=5250

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Third

🌺Counting platelets

190 microns of platelet solution

+
10 microns of blood and wait 5 minutes

After that, we add 20 microns to the counting slide

And we bring a petri dish and put the counting slide in it with a cotton ball soaked in water next to the slide and close the dish and leave it for 20 minutes

Until the platelets settle on the counting slide

And when placing it on the microscope B
We try not to move the slide

So that the platelets do not shake from their place

And when counting 👈 There are red counting squares, but this method is not suitable if the platelet count is less than 50 thousand.

After counting, we multiply the result by 1000.

For example,

If the count is in the five squares

30
50
35
40
30
Then their total is 185.

Then the number of platelets =
185 x 1000 = 185,000

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Well, a piece of information on the fly
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If I make a blood film.. I draw a blood sample on my hand.. We spread 10 microns on the slide.. We leave it for a few minutes until it dries.. We add Leishman stain and leave it for two or three minutes.. We wash the slide with distilled water.. And leave it until it dries.. We put The slide on the microscope

And let's watch the movie 😁😁😁😁

And the illustrative pictures above

If this work is acceptable, then God's blessing

And if there is a mistake, it is from me and I hope to correct it

I am a lab technician and I am proud 🫡

May you always be well
🌺🌺🌺🌺

13/08/2024

_ about hepatitis C tests
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⭕What is the most accurate way to diagnose the virus?
⭕How do we interpret the analysis results?
⭕What is the difference between each method?
⭕When can we say that the patient is infected with the virus?
⭕What is the analysis that we can do?

⭕Follow up on the patient, is there a response to treatment?

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Medical diagnosis of hepatitis C virus is only made after conducting the necessary laboratory tests.

Note: One of the important notes in the C virus is the (fluctuating pattern) of liver enzymes, meaning that they are high for a period and normal or slightly high for another period, and this pattern continues with the chronic patient until the final stages (if without treatment).
The first laboratory test for hepatitis C virus is based primarily on detecting the presence of antibodies against the virus in the body.
There are two laboratory methods for conducting this test.

The first method: Immune-chromatographic test (rapid) or cards
Of course, this is a weak technology, has many errors, and suffers from cross reactivity.
My advice is not to use it, and if it is necessary, you should repeat the ELISA immediately if there is any doubt about the result.
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The second method: Enzyme Linked Immunosorbent Assay (ELISA)
It is the best and most accurate technology, although it also suffers from cross reactivity, but to a lesser extent than the cards.

Note: There is a widespread mistake that a person infected with schistosomiasis in the past would give a false positive result with a hepatitis C test. This is unscientific talk that I did not find in any book or reference.

Note: In the past, there was a good technique used to detect antibodies called (Recombinant ImmunoBlot Assay (RIBA)) which was used as a confirmatory test for positive cases in the first test from cards or ELISA, but currently the spread of PCR has made the use of this technique very rare.
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Question: Beginners in the field often ask why when we diagnose hepatitis C, we detect the presence of antibodies, while when we diagnose hepatitis B, we detect the antigen (HBsAg)?
The answer is first that the number of C viruses in the blood is very small (compared to B, as we explained), and therefore it is difficult to detect it easily.
But recently, there is a technique called (two-step chemiluminescent microparticle immunoassay) through which you can detect the hepatitis C virus itself as an antigen and not its antibodies. It is available in Egypt in the laboratory, but of course it is an expensive technique and practically does not have much benefit.

Ok, now let's see the possibilities I have for the C test result.
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⭕The first possibility: The result of the antibodies in the ELISA is negative.
Most likely the patient is not infected and there is no need to conduct any other tests.
Special case: ----- A person who was infected from a syringe stab wound and does the test and it comes out negative... Here it is most likely to repeat the test after two to three months to make sure because in this case the result could be (false-negative) because the test was done before the antibodies appear in the blood (which takes about 4 months to appear after infection) or to do a PCR if there is a strong suspicion of infection.

⭕The second possibility: The result of the antibodies in the ELISA is equivocal.
This means that you cannot determine whether it is positive or negative (the level of antibodies may be lower than to give a clear reading).
Here, it is correct that the analysis be repeated after a month to clarify the result (or do a PCR).

⭕The third possibility: The result of the antibodies in the ELISA is positive.
Here I have three possibilities for this result.
*** First: The patient must actually be infected with the virus.
*** Second: The result is (False positive) as a result of (cross reactivity).
*** Third: The antibodies are actually present, but the body got rid of the virus some time ago (auto-recovery).

That's why in cases of positive antibodies, you must write this comment.
To confirm HCV diagnosis HCV-PCR is recommended
This means that the presence of antibodies does not necessarily mean the presence of the virus, and it must be confirmed by detecting the virus itself using PCR technology.

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PCR analysis measures the viral load or number of viruses in each milliliter of blood. This is very important, firstly to confirm or rule out actual infection, and secondly to determine the patient's baseline viral load before starting treatment.
The result is in IU/ml or Copies/ml.
1 IU/ml Corresponds to approx. 5 copies/ml.

Back to the story of possibilities
🏮What does it mean for the PCR to be positive and the antibodies to be positive?

09/04/2023

Surat No 90 : سورة البلد - Ayat No 19

وَ الَّذِیۡنَ کَفَرُوۡا بِاٰیٰتِنَا ہُمۡ اَصۡحٰبُ الۡمَشۡئَمَۃِ ﴿ؕ۱۹﴾

اور جن لوگوں نے ہماری آیتوں کے ساتھ کفر کیا یہ کم بختی والے ہیں ۔

15/02/2022