Ramnik Sood MD
Formerly Sr Pathologist Maulana Azad Medical College New Delhi
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Textbook of Medical Laboratory Technology
© 2006, Ramnik Sood
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition : 2006
9788180615917
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., Noida.
to
My Father and my friend
Deepak G Tripathi
5Preface
The current medical laboratory practice has significantly changed from what it was say a decade ago. Now most of the inputs that come for lab technicians are ready-made. They do not have to prepare anything at all, dipsticks estimate simple things like urine albumin and sugar and for complicated procedures like estimation of tumour markers—ready to use kits are available. To run these kits, automated instruments are also available. I was lucky to have a partner in Tulip Diagnostics Pvt. Ltd—a pioneering company related to medical laboratory diagnostic technology. They have very kindly permitted me to use their products and their associated technical literatures for use in this textbook as technology demonstrator. Fortunately, Tulip Diagnostics makes products from A to Z of medical laboratory technology, one of their sister concerns—Lilac Medicare—provides imported high end technological products to the Indian consumers. My very special thanks are due to my very special friend and director of the Tulip Group Mr Deepak G Tripathi who very kindly offered me the products and papers from his repertoire. The completeness of the book is due to the presence of in-use products as on date from the range of Tulip Diagnostics. Gone are the days when we used to import important products, we now export to the very same countries from where we used to source finished products earlier. Gradually the diagnosis making is shifting to the bedside. With the availability of RDTs a confirmed diagnosis can now be established at the bedside or even at the primary health center level without the use of expensive instruments. Diagnosis of malaria, leptospirosis, dengue fever or acute myocardial infarction at the patient's residence, etc. is possible these days.
While methodologies are important, more important is their interpretation. One must also understand the problems that can creep while working and should be in a position to troubleshooting them. The book discusses the relevance of tests, gives various methods available, talks about interpretation of the reports generated and tells ways of troubleshooting the accompanying problems.
Wish to start a laboratory, you shall know everything as to what hardware, consumables and other materials are needed from within the covers of this book. The book also tells as to what to source from where. Medico-legal aspects are also considered.
Normal reference ranges have been provided considering the latest acceptable values. They are given according to the age and sex of individuals for all parameters as applicable. SI units are mentioned, as are the conversion factors. Wherever important panic level values are given.
Laboratory technologists, medical undergraduates, postgraduates and practitioners alike shall find the book useful. Few may want the methods while others may want to go through the interpretations. All routine and most sophisticated investigations have been covered under relevant chapters. The monotony of reading through a single colour has been avoided by presenting the entire book in two colours. Parasitology segment provides indepth understanding by way of pictorial representation of their lifecycles and the pathologies caused. AIDS/HIV has been dealt with in ample detail—the disease, diagnosis and precautionary measures have been discussed in detail. Clinical chemistry goes as far as trace elements. Endocrinology delves deep till thyroid antibodies and C-peptide. Sero-immunology aptly details third generation tests for HIV/AIDS. Diagnostic immunology mentions all about turbidimetry. Need one ask for more!6
While going to press, the author and the publisher have made all efforts to weed out all typographic and other textual errors, however, in a volume of this size, inadvertently an error may creep in. The same should kindly be overlooked. The author and the publisher disclaim any or all responsibility for the same. It would be ideal for the end-user to judge the quality of various products mentioned personally.
Enjoy the most up-to-date and comprehensive book the Textbook of Medical Laboratory Technology.
Ramnik Sood